DEPARTMENT OF FAMILY MEDICINE AND COMMUNITY HEALTH
POST DOCTORAL FELLOWSHIP
IN PRIMARY CARE PSYCHOLOGY
The Department of Family Medicine and Community Health of the University of Massachusetts Medical School announces its Fellowship in Primary Care Psychology. This is a two-year, full time, training and service experience designed to prepare clinical and counseling psychologists to work in the clinical service, research, and training settings associated with primary medical care. The fellowship training is affiliated with the Family Medicine Residency Programs of the Department. We have recently finished recruiting candidates for the Fellowship for 2009 and will be recruiting for 2010 in November.
The Setting:
The first
residency in Family Medicine at
There
are presently Fellows based at the Hahnemann and
Purpose:
The purposes of the Department for instituting a post-doctoral training program for psychologists are: to provide significantly more teaching in behavioral science to family medicine residents, to teach family medicine residents to work collaboratively with behavioral health providers in providing primary care services, to increase the capability of the department to conduct research on primary care questions, to develop a group of providers for the primary care practices that are part of the U.Mass/Memorial system, and to increase the visibility and status of the department nationally as a center for innovation in primary care service and training.
The purposes of the fellows for choosing our program are: to finish requirements for licensure, to work in a medical setting, to have an opportunity to mix practice and research, to have a teaching role while still in training, and to prepare for a position as a health provider in primary care and/or as a faculty member in Family Medicine or other medical education setting.
Every effort is made identify fellows as part
of a resident class. Having behavioral
health providers as peers in their training helps residents develop the
personal relationships on which collaboration is based. Having family medicine residents as peers in
their training helps the fellows develop familiarity with the primary care
setting in an environment of support where help with the vagaries of “medical
culture” is easily available.
The goals of the program for the training of
the Fellows are:
1) Fellows will be capable of assuming roles in medical
education upon graduation. The most immediate type of positions that we expect
graduates to obtain are positions as a leader and developer of programs
providing behavioral health providers in primary care and/or as a faculty
member in Family Medicine or other medical education setting.
2) Fellows will develop expertise in developing programs,
service lines, and inter-professional teams within health care settings.
3) Fellows will be capable of making meaningful scholarly
contributions within health care settings and be active in relevant
professional organizations.
4) Fellows will provide excellent clinical care in health settings, particularly in primary care.
Faculty:
Ronald Adler, MD, is the primary medical preceptor in the
Team Precepting experience. Dr. Adler is
Medical Director at
Nicholas Apostoleris, Ph.D., is the Director of Behavioral
Science in the
Alexander Blount, Ed.D., is the Director and primary clinical supervisor of the
Fellowship. Dr. Blount is the Director
of Behavioral Science for the Department of Family Medicine and Community
Health. He was previously Director of the
Kathleen Braden, MD, is a Developmental Behavioral Pediatrician with extensive experience in child behavior problems, autism spectrum disorders and child psychopharmacology. She is one of the faculty in the Program for School Aged Children clinic in which fellows learn brief child and family assessment and therapy.
William Ferrarone, PhD, is a member of the faculty at the
Craig Wiener, EdD, is the on-site clinical supervisor at Family Health Center of Worcester. He has extensive experience in residency training and a special interest in child behavioral issues.
The Program:
Fellows receive focused training in family systems therapy and behavioral medicine techniques. They provide behavioral health treatment in the health centers and possibly in other family medicine practices in the U.Mass/Memorial system. They provide behavioral science precepting (one on one observation and teaching) for residents in Family Medicine and join them in collaborative patient care. They teach selected behavioral science subjects in the health centers. Finally, they participate in research on the processes of primary care, either by proposing their own research studies or by working in ongoing faculty research projects.
Supervision: All Fellows will be given at least one hour
of clinical supervision by both the psychologist faculty member in their
assigned health center and by either the Director or Associate Director of
Behavioral Science. In all cases, Fellows
will have two different psychologists providing clinical supervision. In addition, they average one to two
additional hours of supervision per week in live supervision and case
discussions. During all their clinical work,
there is a medical faculty preceptor available on site for back up with
decisions, adding a second layer of guidance and support. Fellows are expected in addition to their
clinical supervision to have a designated Advisor whose role is to provide help
in navigating the Fellowship and the subsequent world of employment
successfully. Fellows may choose one of
their clinical supervisors for this role, though we suggest that they ask a
different psychologist faculty member to provide it.
Evaluation: Each Fellow will participate in an
evaluation process using the Performance Evaluation Form twice per year. Fellows are asked to fill out the form
concerning their own work in advance of the meeting with their supervisors and
the Director of the Program. Less
structured input is also solicited through the “360 Evaluation” process of each
health center so that the Fellow’s final evaluation reflects input from medical
faculty, Family Medicine residents, nursing and staff.
Fellows are giving a
written summary at the end of each evaluation process. If the fellow agrees with the evaluation,
they are asked to sign it. If they want
to add comments as addenda, they are permitted to do so. In addition, fellows are asked to comment on
the effectiveness of each of the teaching activities and their progress toward
reaching the goals of the program as part of the exchange that the evaluation
conversation embodies. An evaluation
form of the Fellowship filled out by the fellow provides a structure for this
part of the conversation.
Any deficiencies in
the fellow’s progress or performance noted in the evaluation will be followed
by remediation steps spelled out as part of the summary. Should a fellow be at risk of termination for
lack of progress, a warning will be explicit in relation to the necessity of
successful completion and successful outcome of the remediation. Fellows will indicate their understanding of
the warning by their signatures on the document.
The first year is spent refining skills that are necessary for the practice of psychology in primary care, becoming familiar with the routines, language, and issues of primary care medical treatment and developing a role as a caregiver in primary care medical practice. First year experiences include:
Clinical practice and consultation in primary care - Six half-days per week
The fellow spends the majority of his or her time as a member of primary care treatment team in one of the family practice residency clinics. This involves observing resident physicians in their practice, seeing patients jointly with physicians, and carrying a caseload referred by physicians in the practice. In the beginning of the year, the fellow’s time is fairly unstructured. They learn what the residents are doing by observing them as they see their patients. This leads quickly to dual interviews in which residents and fellows work together to treat patients. In their clinical work in this setting, fellows are most likely to see patients who are anxious, depressed, coping with illness, child behavior problems, having relationship or family problems, or are abusing substances.
This is a family therapy oriented brief assessment and treatment clinic. Faculty members are Dr. Blount and Dr. Braden. It serves children aged 5-12 and their families. It is a training clinic for residents in Family Medicine and Pediatrics. Fellows do clinical work in front of the one-way mirror under the supervision or provide teaching for residents.
Working in practice with Dr. Blount at
Fellows spend one half-day rounding in the hospital with teams of residents. The fellow is an integral part of the team, helping highlight psychosocial issues and offering a psychologist’s perspective on the patients each team sees. In addition, fellows are currently developing a Quality Improvement program on the Family Medicine Inpatient Service by screening patients who have been admitted to rule out a heart attack for anxiety and depression.
Team Precepting – One half-day
“Team precepting” is a process in which a
medical faculty member and a behavioral science faculty member work together
with a resident who sees a regular half-day of patients in front of the one-way
glass. The usual preceptors are Ronald
Adler, MD and Dr. Blount. Being with the
team allows the fellows to observe primary care services and hear the feedback
of faculty about what they are seeing.
Fellows can observe or participate in the process as they gain
confidence and experience[u1][u1].
Seminar in Primary Care Psychology
Fellows take and often help teach the
Certificate Program in Primary Care Behavioral Health. The program consists of six all day workshops
given one Friday a month for six months which are designed to provide the
skills and tools needed by mental health professionals who want to work
successfully as a behavioral health clinicians in primary care. The course
is given twice a year. A description of
the program can be found at
http://www.integratedprimarycare.com/Certificate%20Program%20spring%2008.htm.
In addition . . .
In addition, fellows give occasional lectures on mental
health topics of interest to residents at both
The second year is spent developing skills in some of the special kinds of care offered by primary care psychologists, in formal precepting with residents, and in some sort of research in primary care. Whereas in the first year, the Fellows are functioning more as peers and collaborators with residents, in the second year they take on more faculty-like responsibilities. Second year experiences include:
Clinical practice and consultation in primary care - Six half-days per week
As in the first year, the fellow spends the majority of his or her time as a member of primary care treatment team in a family practice residency clinic. There is special emphasis on consultation to help residents care for patients that they would have referred before. There is also an experience of developing population-based clinical care. The fellow identifies a particular group of patients who need a behavioral aspect to their care and researches, develops, proposes and helps implement one “critical pathway” of care to be offered to every patient in the practice with the identified illness.
During this day the fellow is flexibly available for patient consultation and for precepting at a health center where the fellow does not have a practice. Fellows can respond to any resident, discussing patients or interviewing patients alone for a report back to the resident (usually with the patient present) later in the day.
Fellows pursue their own research project, usually in relation to the “critical pathway” of treatment that they develop.
Evaluation:
Fellows are given an evaluation with the Director of the Fellowship and the psychologist supervisor at their health center each year with midyear feedback discussions. Feedback on Fellows' work is ongoing. Because Fellows view their supervisor's clinical work and are observed in their work, the process of exchange for mutual growth is ongoing, making formal evaluations usually enjoyable, but somewhat redundant in feel. A Due Process plan has been adopted for trainees. It is available on request.
Qualifications:
Admission requirements include completion of all professional doctoral degree requirements from a regionally accredited institution of higher education or an APA/CPA-accredited program and pre-doctoral internship meeting APPIC standards. We will give preference to candidates with demonstrated training and experience in family therapy and/or behavioral medicine. Bilingual (English/Spanish) candidates are especially sought after. Minority and disabled candidates are urged to apply.
Information for Applicants:
The
salary is $38,000 ($40,000 the second year). Fellows are employees of the
University of Massachusetts Medical School and receive
the same benefits package as medical residents. This includes four weeks
vacation, low cost individual or family health plan, disability and life
insurance. Applications will be
accepted until the position is filled or February 15, whichever comes first.
Early submission improves a candidate’s chances. Start date is
To Apply:
A letter stating interest, a CV and three letters of
recommendation constitute an application. We prefer to receive these by
e-mail to Alexander Blount, Ed.D. The email address
is Amy.Green@umassmed.edu .
Applications can be mailed to Any Green, Department
of Family Medicine and Community Health,
IntegratedPrimaryCare home Training Programs in Integrated Primary Care
[u1]This may need to be changed! Team Precepting is now on Mondays and not Thursdays.