Overview of the UCSF Public Pyschiatry Fellowship at ZSFG

 OVERVIEW OF THE UCSF PUBLIC PSYCHIATRY FELLOWSHIP AT ZSFG

 

Schedule

Public Psychiatry didactics start at 10am in ZSFG Room 7E12.  Schedule is on google sheets.  

  • 10-11:30am           Seminar (lecture 10-11, discussion 11-11:30)
  • 11:30-11:45am      Reflections with Fellowship Directors
  • 11:45am-12pm      Break
  • 12-1pm                  Group Supervision (except 3rd Wednesday of the month from 9-10am)
  • 1-4pm                    Research Supervision

Field Placement

Fellows will be placed at community mental health sites across the Bay Area (see Fellowship Clinic Site Overview for more details).

PGY-5 Fellows will attend their clinics on Mondays, Tuesdays, Thursdays and Fridays from ~8:30-5pm.  PGY-4 fast-track Fellows have a modified schedule.  We encourage fellows to talk to their site supervisor about going on field/home visits to enhance their clinical experience.  

Fellowship Supervision

We have several different types of supervision to enhance your fellowship experience:

  1. Group Supervision:  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 together.
  2. Individual Supervision:  Individual supervision is held on the 1st week of the month either before (9-10am) or after class (12-1p).  To make the most out of the individual supervision time, fellows are encouraged to provide an agenda at the beginning of supervision. Often, fellows discuss how things are going at their site, research project status, and jobs. 
  3. Site Director Supervision:  All fellows should meet with their site supervisor at least 1 hour a week for supervision.  Since clinical productivity is a major concern and critical for the on-going financial support of the fellowship, fellows should discuss their productivity at least monthly with their supervisors
  4. Research Supervision: Melanie Thomas will meet with the fellows on Wednesday afternoons for research supervision 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 the research projects.

Wednesday Didactics

The didactics are organized in a module format.  Before each module, we 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 8 modules: 1) Structure of Public Psychiatry; 2) Integration of Care; 3) Recovery, Psychosocial Rehabilitation, and Advocacy; 4) Homelessness and Housing Policy; 5) Management—Funding; 6) The Role of the Psychiatrist in Publicly-Funded Community Services; 7) Forensic Issues; 8) Management—Leadership.  After each didactic, we will have time to reflect together, so feel free to bring in a recent article and/or assigned reading to discuss.

Fellow Presentations

Fellows are expected to give the several 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 30-35 minutes.  We will NOT have supervision this day to accommodate time for four presentations.
  2. Case Presentations:  Fellows are expected to deliver presentations throughout the year that are grounded in a case, but dive deeply into one of the five topics provided for that module.  Fellows and are encouraged to look on CLE and/or PubMed/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 and use a case example to ground the topic.  Unless they are “on the fly,” cases will be distributed the week before.  These presentations will be 10 minutes (reviewing 1pg summary) with 5 minutes of discussion.  The topics include:
    1. Integration of Care (AIMS model, SAMHSA PCBHI, HIV Psychiatry, The Domestic Violence Initiative, Stepped Care)
    2. Recovery [President’s New Commission on Mental Health (could be coupled with SAMHSA),  Peer Support, Trauma-informed care, SBIRT, PORT Health Promotion]
    3. Homelessness (Wet housing, Safe injection sites, Housing First, Supported Housing, Phasic Model of Homelessness)
    4. Forensic Cases (Violence and Mental Illness; Assisted Outpatient Treatment; Registered Sex Offenders, Mandatory Reporting, Commitment Laws)
    5. Management/Supervision (on the fly—no preparation needed)
  3. Grant Writing/Responding to an RFP (Request for Proposals):  This section is designed to provide fellows an experience in responding to an RFP.  With guidance from faculty, fellows will together review a Request for Proposal together as a group and talk through the requirements and strategies for completing a proposal.  Conducted over two sessions, at the end of the first session, fellows will be given a truncated budget template and asked to create a “response” to the RFP as an exercise that will ask the fellow to think through a proposed program, writing a brief description of the proposed program and a short justification for funding to support the staffing needed. Fellows will then give a brief presentation of their program, along with the budget to support the program. This presentation should be 30 minutes.
  4. 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 your 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.
  5. Final Quality Improvement / Program Evaluation Research Project Presentation:  The Quality Improvement / Program Evaluation Project Description will be described in detail by Dr. Thomas.  This is more of a reflective and informal discussion in which lessons learned from each of the Fellow Products (APA poster, grand rounds, executive summary presentation at medical directors’ meeting, clinic presentation) should be discussed.  This presentation should be 10 minutes.

Enhancing Classroom Learning

San Francisco Health Network-Behavioral Health (SFHN-BH) Medical Directors’ meetings:  These meetings occur on the 4th Wednesday of the month from 8:30-9:30am, 1380 Howard Street, Room 515.  There, you can learn about administrative issues faced by medical directors in public mental health settings.

Field Trips:  All fellows will participate in the following field trips

  1. Public Psychiatry Fellowship San Francisco-based Clinics
  2. Project Homeless Connect
  3. SRO “Hotel Rounds,” Supported Housing (The Richardson); Homeless Shelter (MSC-Shelter)
  4. Behavioral Health Court, Citywide Forensic, and SFPD Ride Along
  5. San Quentin Correctional Facility
  6. Department of Public Health

American Psychiatric Association’s Annual Meeting (Beginning of May in various major US cities).  We encourage attendance at national academic conferences.  We will NOT have PPF didactics the week of APA, so you will only use up 2 education days.  Note: you can count your travel day as an extra education day.

The UCSF PPF will provide each fellow with funding to cover all costs (registration, travel, hotel, and meals) for attending the APA and potentially other academic meetings (if receive approval from Director).  Each fellow is allowed a maximum of $2,500.  There are restrictions on coverage (e.g., alcohol, triangulated trips). Please refer to the CLE “Reimbursement 101” document and submit your itemized receipts within one week of travel. 

Future Employment

We are dedicated to helping fellows obtain rewarding positions in the public mental health system after graduation.  Ideally, these should include leadership opportunities.  To attain this goal, we encourage:

  • Monthly discussions with individual and field supervisor about job searches
  • Specific group supervision in August and April about jobs
  • Meet SFHN-BH Medical Director Irene Sung
  • Attend the annual NCPS Job Fair (Usually in January, www.ncps.org). 

Collaborative Learning Environment (CLE)

The schedule for the fellowship is maintained on Google sheets (which you will all be given access to) and UCSF’s CLE.  This website also includes assigned readings, website links of interest, program contact information and blog space.

Evaluations

We are very interested in improving the fellowship.  Therefore, after each module, fellows are asked to complete periodic evaluations in group supervision.  These will include evaluation of each lecture and the overall impact of each module.  Fellows will also be asked to give more broad feedback about the fellowship twice a year.

Vacation & Sick Leave

Fellows have ample vacation over the course of the year (20 days), in addition to education leave (5 days) and sick leave (12 days) if necessary.  Please do not take vacation in the first or last months of the fellowship (July or June).  If possible, please let Dr. Mangurian and your site director know about vacation at least a month or two in advance.  Please refer to the leave policy document for more details.  

Moonlighting

All fellows (with SFGH Privileges) can moonlight in PES.  During orientation, fellows will meet with staff in PES.  They can discuss legal status, outpatient referrals (including ADUs, Westside Crisis, Dore, Substance abuse, major clinics), PES policies (CIWA, opiate, agitation, S&R, antipsychotic), and staffing.