Residency Program

Behavioral Medicine PGY 3 Curriculum

All PGY-3 family medicine residents complete a 4-week rotation in Biopsychosocial Medicine. This rotation emphasizes the importance of family dynamics and family counseling as it relates to medical issues, such as the effect of one's family members' illness on other family members, substance abuse and its effect on family dynamics and economics, physical violence, mental illness, dysfunctional family relationships,etc. The rotation allows for sequentially organized and focused teaching opportunities that are not possible in our current longitudinal behavioral medicine curriculum. During their rotation , residents participate in didactic curriculum and have clinical responsibilities. Residents participate on clinical teams as observers and co-facilitators. This experience is expected to familiarize residents with the issues that are of importance to both the referring physician and the professional(s) who provide(s) collaborative family health services. Following these experiences of providing linkages from primary care providers to family-oriented health services, the resident will have a more in-depth understanding of collaborative consultation as a family physician.

Developmental Curriculum

Goals:

1. To expand the resident's skills, knowledge and attitudes regarding biopsychosocial assessment of patients and their families in the busy clinical setting.
2. To provide an opportunity for direct feedback of behavioral medicine skills.
3. To improve the residents' confidence in their ability to assess the most common psychosocial issues encountered in primary care practice.

Knowledge Objectives

At the end of the third year of residency the resident will have covered and be familiar with the following topics:

• Patient centered relationship
• Behavior Change Model
• Most common Mental Health Diagnoses
• Family Systems Theory
• Biopsychosocial Assessment of the Family Health Care of the family in transition
• Family-Oriented approach to Specific Medical Problems
• Implementing Family Oriented Primary Care
• Principles of cognitive behavioral therapy

Skills Objectives

At the end of the third year of residency the resident will demonstrate proficiency in:

• Primary care counseling
• Relaxation Techniques
• Leadership of family conferences
• Collaboration with mental health providers

ATTITUDE OBJECTIVES

At the end of the third year of residency the resident will demonstrate increased awareness of the increased awareness of:

• Ways families affect health and ways health affect families
• Being part of larger treatment system
• Increased confidence in abilities to work with families

Educational Strategies

• Behavioral Medicine Attending requirement
   
  Purpose: To be available for psychosocial consultations and to do direct observation of the resident's behavioral medicine skills.
   
  Objectives: At the end of the academic year the resident must have completed 5 hours of behavioral medicine consultations.
   
  The following skills must have been observed and successfully completed at least once during the academic year:
  • Pt. education on relaxation techniques
  • Biopsychosocial assessment of the family
  • Screening for depression
  • Assessment of suicidality / homicidality
  • Screening for anxiety
  • Differential diagnosis of anxiety disorders
  • Assessment of readiness to change behavior
  • Screening for substance abuse
  • Screening for family violence
  • BATHE technique
  • Psychopharmacology Discussion
  • Grief counseling
  • Delivering bad news
  • Dealing with the angry patient
   
  
• Behavioral Medicine block rotation
• Logitudinal conferences
• Cards (Family life cycle, CBT)

Evaluation

Completion of 5 hours of Behavioral Medicine consultations
Bimonthly report of the accumulated hours and the skills successfully completed.
Pre-post rotation tests