Combined family medicine/psychiatry curriculum
The combined family medicine/psychiatry curriculum at UC Davis ensures that combined residents finish residency with the competency not only to practice as an excellent family physician and psychiatrist but also to fill an important but unmet need in medicine by providing excellent medical care for our chronically mental ill population. In our unique combined curriculum these goals are achieved through rotations and didactics that fulfill the rotational requirements of categorical family medicine and psychiatry residency.
The combined curriculum at UC Davis consists of experiences that are shared with the internal medicine/psychiatry program and experiences unique to the family and community medicine/psychiatry program. The shared experiences enrich and broaden the general medical educational experiences of both programs while the unique experiences highlight the specific training for the family physician.
Family Medicine Continuity Clinic
Residents work with family medicine and combined faculty to manage the complete primary care needs for families and individuals on their panel. The patient population is diverse and includes patients with Medi-Cal, Medicare and private insurance. During this five year longitudinal continuity clinic residents are encouraged to evaluate and manage presenting comorbid psychiatric conditions as appropriate. This experience encourages residents to see the "whole" patient and integrate the treatment of the psychiatric and medical issues.
Integrated Medicine and Psychiatry Consultation Team (IMPaCT) Clinic
In the fourth and fifth year, residents work one-half day per week with combined faculty in a "med-psych" clinic at the Family Medicine Continuity Clinic. These internal referrals expose residents to the role of a consultant in a family medicine setting for such common conditions as postpartum depression, childhood and adult attention deficit disorder and somatoform disorders.
IMPaCT Noon Case Conference
Held on the fourth Thursday of the month, this informal case conference consists of case discussions and didactics that emphasize the recognition and practical management of psychiatric illness in the family and community medicine setting. Led by combined faculty and open to categorical residents, combined residents are expected to periodically teach and discuss cases.
Longitudinal Academic Elective
Beginning in the third year and extending to the end of residency, combined residents have the option of working with Dr. Kay Nelsen, the family medicine curriculum director, to develop a research and/or clinical experience. Two afternoons per month are set aside for this longitudinal experience intended to allow combined residents an opportunity to explore their niche in psychiatry/primary care.
The neurology experience for combined residents includes an inpatient experience in the first year and outpatient experience in the fifth year. It consists of specialty clinics in Alzheimer's dementia, movement disorders, neuropathy and epilepsy among others in addition to general neurology. Many of these conditions have significant psychiatric implications and thus provide a particularly valuable experience for the combined resident. Supervision is provided by the Department of Neurology at the UC Davis Medical Center.
Sacramento County Mental Health Treatment Center
Inpatient Psychiatry: Training largely takes place in a busy 25-bed special population unit of this 100-bed psychiatric health facility. Patients on this unit often have complicated comorbid medical conditions as well as acute psychiatric illness. Residents are encouraged to manage all aspects of medical and psychiatric care with supervision provided by psychiatry and combined faculty.
Emergency Psychiatry: Residents manage a psychiatry emergency service where they will learn to efficiently evaluate common psychiatric conditions in an emergency setting as well as triage patients with common comorbid medical issues such as diabetes and hypertension. Supervision is provided by psychiatry and combined faculty.
Psychosomatic Medicine Service
The 528-bed UC Davis Medical Center, a Level 1 trauma center and the major tertiary care medical center for inland northern California, provides the setting for the psychosomatic medicine service. Residents work with medical students, fellow combined and categorical residents and psychosomatic medicine fellows to provide consultative evaluations for medical/surgical services. Cases are extremely diverse and truly complement the outpatient combined curriculum at the Sacramento County Primary Care Clinic and IMPaCT clinic.
Sacramento County Primary Care Clinic (PCC)
After the one year of continuous outpatient psychiatry experience at the UC Davis Psychiatry Outpatient Clinic in the third year, residents may choose to continue their half-day per week outpatient psychiatry continuity clinic at the PCC. This county primary care clinic with a significant indigent population has a high psychiatric comorbidity and affords the combined resident the opportunity to practice outpatient psychiatry in a setting that emphasizes integration of primary care with psychiatry. Residents will also serve as medical/psychiatric consultants for the primary care physicians at the clinic, a role in which they will find themselves often in their career. Supervision is provided by combined faculty.
MAP (Medicine and Psychiatry) and PCP (Primary Care Psychiatry) Case Conference
All family and community medicine/psychiatry residents are required to attend these alternating bimonthly case conferences held in conjunction with the internal medicine/psychiatry program. The MAP case conference is a lecture series designed to improve diagnostic skills and treatment strategies relating to commonly encountered conditions like somatoform disorders, cognitive disorders, depression/anxiety, epilepsy, psychotic disorders, sleep disorders, eating disorders, etc. The PCP case conference is open to all primary care providers and is a lecture series designed to help primary care providers manage psychiatric illnesses in the primary care setting. Beginning in the third year of training, all family medicine medicine/psychiatry residents are required to give at least one presentation per year at each case conference.
MAP (Medicine And Psychiatry) Advisory Group
This optional evening gathering is part social and part business. All UC Davis faculty and residents are welcome to attend these monthly meetings. The focus for this group is threefold:
Continually improve the internal medicine/psychiatry and family and community medicine/psychiatry combined educational experience for residents and students.
Increase awareness of combined training and practice.
Discuss research opportunities in the areas of education and patient care.
Psychiatry/Family Medicine electives (various sites)
In addition to the longitudinal elective experience afforded by the Longitudinal Academic Elective there are three 4-week blocks available for electives in the fourth and fifth year. Potential offerings can be combined during the rotation and may include:
Telepsychiatry consulting for the many rural communities in Northern California
Primary care provider for the 100-bed Sacramento County Mental Health Treatement Center (supervision provided by the facility's board certified family physician)
Med/Psych consultant at the PCC (supervised by combined faculty)
Psychosomatic medicine service senior resident
Research - there are many ongoing research projects through family medicine, psychiatry and MAP that residents may participate in during this elective time.