Overview of the UCSF Public Pyschiatry Fellowship at ZSFG

Schedule

On Wednesday, Fellows will have didactics starting at 10am at ZSFG.

  • 10-11:30am:             Seminar (lecture 10-11, discussion 11-11:30)
  • 11:30-11:45am:         Discussion with Fellowship Directors
  • 11:45am-12pm:         Break
  • 12-1pm:                    Supervision*

 

*Note: Individual supervision is normally held on the 4th week of the month from 12-1.  Since Christina supervises two fellows, one meets from 1-2pm.  Research Supervision is normally held on the 2nd Wednesday of the month from 1-4 with Melanie Thomas.

 

Field Placement

Fellows will be placed at the following sites:

  • Chinatown-North Beach Clinic (Field Mentor: Thao Tran)
  • South of Market Mental Health Service (Field Mentor: Steven Wozniak)
  • Westside Clinic (Field Mentor: Rich Oliva)

 

All fellows should meet with their field supervisor (medical director) at least 1 hour a week for supervision.  We encourage fellows to talk to their field supervisor about going on field/home visits to enhance their clinical experience.  They should also attend the CBHS Medical Directors’ meetings (4th Wednesday of the month from 8:30-9:30am) to learn about administrative issues faced by medical directors in public mental health settings.

 

Wednesday Didactics

The didactics are organized in a module format.  Before each module, Christina will send out an “Overview of the module” with learning objectives and chapter readings via e-mail.  We encourage active learning during our didactics, so please feel free to ask questions during the talks.  We have the following seven modules:

 

  1. Structure of Public Psychiatry
  2. The Role of the Psychiatrist in Publicly-Funded Community Services
  3. Recovery & Psychosocial Rehabilitation
  4. Homelessness and Housing Policy
  5. Management - Part I: Funding & Part II: Leadership Skills
  6. Integration of Care
  7. Forensic Issues

 For a more detailed look at the modules, please click here: 2013-2014 Academic Schedule

 

Fellowship Supervision

Fellows will receive supervision by UCSF PPF faculty every week.  We typically have group supervision, where fellows should come in prepared with agenda items that are most pressing to them at that time.  These items might be related to their clinical demands, research project, or job searches.   We will spend the first 5 minutes of group supervision setting the agenda. At the end of each module, we will spend some time during supervision discussing the learning objectives and readings.  

 

On the fourth Wednesday of the month, we will have individual supervision.  One fellow will meet with Jim Dilley from 12-1, and two fellows will meet with Christina Mangurian from 12-2 (they will decide the order). To make the most out of the individual supervision time, fellows are encouraged to provide an agenda at the beginning of supervision.  During that individual supervision, fellows should discuss the following:

  • How they are doing at their site
  • Status of research project (including timeline and status of deadlines)
  • Status of next fellowship presentation
  • Job search progress
  • Feedback (both for the fellow and supervisor) about the fellowship as a whole and the clinical site

 

 

In general, Melanie Thomas will meet with the fellows the 2nd Wednesday of the month from 1-4pm.  Melanie will work with the fellows to decide whether individual or group meetings are more effective.  Please see schedule for precise dates and let Melanie know ahead of time if you will be absent. These meetings are critical for completing your research project in a timely fashion.  Melanie is also available to meet with fellows more often individually throughout the fellowship to discuss their research project.

 

Enhancing Classroom Learning

Field Trips:  All fellows will participate in 5 local field trips:

  1. Citywide Focus, including hotel rounds
  2. Housing Facility (Richardson)
  3. SFPD Ride Along
  4. Project Homeless Connect
  5. Homeless Shelters (MSC-Shelter and a Women’s Place)

 

UCSF Department of Psychiatry Quality Improvement Didactics:  These new classes are being held two afternoons in August.  Fellows are only expected to attend these first two sessions, but are NOT expected to join a group and complete a project outside of the one they are doing for the fellowship.  This is a potential opportunity for the fellow to have their site chosen as for a QI project by a group of UCSF psychiatry residents.

 

UCSF Health and Society Pathway:  We will be utilizing this existing UCSF learning opportunity. Fellows are expected to go to your clinics every day in the afternoon, and will NOT have PPF didactics on that Wednesday so this will only use up 1 education day.

 

Academic Conferences: We encourage attendance at national academic conferences.  

  • The Institute of Psychiatric Services Annual Conference
  • American Psychiatric Association’s Annual Meeting

 

The UCSF PPF will provide each fellow with some funding (approximately $2,500 per fellow) to cover all costs (registration, travel, hotel, and meals) for attending these academic meetings.

 

Fellow Presentations

Fellows are expected to give four individual presentations throughout the year (examples on CLE):

  1. Logic Model of Field Placement Agency:  Each Fellow presents her/his field placement organization, using the logic model. These presentations use the logic model as both a descriptive and analytic tool.  The Congruence model will be used as a framework to help gather the information needed for the logic model.  The focus is on understanding the problems with the clinic and developing a quality improvement initiative that could be implemented during the course of the year.  This presentation should be 45 minutes.  We will NOT have supervision this day to accommodate time for three presentations.
  2. EBM Prescribing Practices:  Each Fellow will submit a 1-page executive summary on a classic pragmatic clinical trial (STAR-D, STEP-BD, or CATIE).  They should use this as a guide for what they could present during a medical staff meeting.  In class, the fellow will make a brief 5 minute presentation highlighting key components of this summary and also discuss their thoughts about how he/she might go about implementing EBM prescribing practice changes in a clinic.  This presentation should be BRIEF—15 minutes max.
  3. Budget Presentation: Each Fellow presents information about his/her agency's or program's budget, both in terms of revenues as well as expenditures.  Half of the presentation should be on the process of getting this fiscal information from their clinic.  Examples of budgets will be provided to help the fellows learn what questions to ask in order to get this information from site medical directors (specifically, number of FTEs at their site, indirect costs, benefit costs, revenue, OTPS, etc.).  This presentation should be 30 minutes.
  4. Final Quality Improvement / Program Evaluation Research Project Presentation:  See Quality Improvement / Program Evaluation Project Description below.  This presentation is very informal and should outline each of the Fellow Products and ways in which their presentations could be improved in the future.  This presentation should be 30 minutes.

 

Fellow Case Presentations

Fellows are expected to give four case presentations throughout the year.  Fellows can work together on these presentations and are encouraged to look at PubMed and/or Google Scholar to find evidence supporting their positions/work for certain presentations.  These cases typically involve the fellow to put him/herself in the position of a community mental health clinic medical director. Dr. Mangurian will be distributing the cases the week before.  The topics broadly include:

 

  1. General Management Issues (on the fly)
  2. Grant Writing
  3. Forensic Issues
  4. Supervision Issues (on the fly)

 

Journal Club

To enhance fellows’ learning experience, we expect that once during the year each fellow will bring in a recent journal article (ideally from Psychiatric Services) for discussion.  This should be an informal discussion and ideally related to the current module.  Please send the article to the Dr. Mangurian at least one week before the fellow would like to share it with the group during group supervision.