2017-2018 M3/M4 Course Syllabi
Psychiatry
COURSE NUMBER:
20 01 63
TITLE:
INTRO TO ADDICTION PSYCHIATRY/MEDICINE
This elective will focus on addiction-related disorders and associated psychiatric and medical conditions. It includes assessment, diagnosis, detoxification, as well as some aspects of rehabilitation, pharmacotherapy and medical management of related conditions.
PREREQUISITES:

Successful completion of Psychiatry Core Clerkship. 

Please contact Eddie Leonard at Eddie.LeonardJR@va.gov   for any questions on this elective.

 

expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
YES
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: YES
COURSE LENGTH:
4 wks
DIRECTOR:
Shannon Miller, MD
shannon.miller@va.gov
861-3100 ext. 4870
VA Medical Center, B724
ADMINISTRATIVE SUPPORT PERSON:
Christina Meyer
meyer3ci@ucmail.uc.edu
558-4866
Stetson, 3280A
INSTRUCTOR:
MichaelKrueger, MSN, APRN,
SITE(S):
UC Psychiatry at Ridgeway
UCMC - University of Cincinnati Medical Center
VAMC
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 07/03/2017 - 07/28/2017 1
2 07/31/2017 - 08/25/2017 1
3 08/28/2017 - 09/22/2017 1
4 09/25/2017 - 10/20/2017 1
5 10/23/2017 - 11/17/2017 1
6 11/27/2017 - 12/22/2017 1
7 01/02/2018 - 01/26/2018 1
8 01/29/2018 - 02/23/2018 1
9 02/26/2018 - 03/23/2018 1
10 03/26/2018 - 04/20/2018 1
11 04/23/2018 - 05/18/2018 1
12 05/21/2018 - 06/22/2018 0

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00 am - 5:00 pm Monday-Friday
REPORT 1ST DAY:
VAMC 3200 Vine St B712 8:00 am

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • active participation in team meetings, attend Journal Club
  • Patient Presentation--Learner
  • Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
ORIENTATION:
Dr. Shannon Miller, Elective Director and Instructor
TEACHING:
50% Attending Physician
25% Senior Resident
25% Other Faculty
FEEDBACK:
Faculty
ASSESSMENT:
FINAL GRADE:
60% Clinical work performance evaluations
15% Attitude, e.g., professionalism, motivation etc
25% review of literature; use of supervision
GRADE ASSIGNED BY: Principle instructor

OBJECTIVES

Attitudes :

1.   Display professionalism, promptness

2.   Display optimal therapeutic alliance, boundaries, non-stigmatizing approach to patient care

3.   Demonstrate active listening, active learning

4.   Consistently incorporate new knowledge, skills into ongoing patient care

5.   Read regularly, apply knowledge to team discussions of patient care

Curricular Resources :
PCYI booklet of teaching articles (see Ms. Milner for a copy) Reis R. Fiellin D. Miller S. Saitz R (editors), Principles of Addiction Medicine, American Society of Addiction Medicine/Lippincott, Williams and Wilkins, Baltimore, Maryland: 2009 April. (available at http: //www.asam.org)
Knowledge/Skills:

1.  View substance use disorders as chronic medical disorders, akin to diabetes, asthma, and hypertension

2.   Recognize general issues in evaluation and management of Substance Use Disorders

3.   Understand and implement Stages of Change theory, Motivational Interviewing in everyday clinical practice

4.   Understand the process of evaluation and management Withdrawal States of the most common substances (i.e., alcohol, opiates, and sedatives)

5.   Understand the process of evaluation and management of Nicotine Dependence

6.   Understand the process of evaluation and management of Opioid Dependence and the Co-morbid states

7.   Understand the process of evaluation and management of Psychiatric co-morbidities

Main Course Topics :

1. Interviewing skills

2. Attitudes, transference, counter-transference, empathy, and ethics

3. Diagnosis and management of the most common substances of abuse

4. Case presentation skills

5. Understanding and applying Motivational Enhancement Therapy

6. Understanding the significance of treatment planning

7. Detoxification strategies for the most common substances of abuse

8. Understanding and applying Literature review and computer services 9. Understanding and applying pharmacotherapies for withdrawal states of the most common substances of abuse 10. Understanding and applying pharmacotherapies for relapse prevention (i.e., naltrexone, acamprosate, disulfiram, varenicline, bulproprion, buprenorphine, methadone, nicotine replacement, etc.)
Objectives:

Other Resources - Audiovisuals:
n/a
Other Resources - Computer resources:

Internet access to all VA computers (including PubMed, Ovid, free access to textbooks, etc.)

American Psychiatric Association Practice guidelines

http://psych.org/psych_pract/treatg/pg/prac_guide.cfm

http://psych.org/psych_pract/treatg/pg/prac_guide.cfm

Literature searches - Search Databases: MD Consult, Medline, etc.

Other Resources - Other :
Study Guide to Substance Abuse Treatment (review questions with answers and explanations -- available from Ms. Milner)

Procedures:
n/a

SAMPLE WEEK

Monday:
7:30AM 8:30AM Pre-Round on 5 North
8:30AM 12:00PM Inpatient Detox 5 North or Ambulatory Detox
1:00PM 4:00PM Addiction Sciences Outpatient Services
Tuesday:
7:00AM 11:00AM Methadone Maintenance Clinic
11:00AM 12:00PM PGY-1 Didactics (when held)
1:30PM 4:00PM OSS/BTC Treatment Team Meetings
Wednesday:
7:00AM 12:00PM Methadone Maintenance Clinic
1:00PM 4:30PM Addictions Fellowship Didactocs/Ambulatory Detox Services/Addiction Education Group
Thursday:
7:30AM 8:30AM Pre-Round on 5 North
8:30AM 12:00PM Inpatient Detox 5 North or Ambulatory Detox
1:00PM 2:00PM Tobacco Treatment Group
2:00PM 4:00PM Ambulatory Detox Service
Friday:
7:30AM 8:30AM Pre-Round on 5 North
8:30AM 12:00PM Inpatient Detox 5 North or Ambulatory Detox
1:30PM 4:30PM Smoking Cessation Clinic/Addiction Sciences Outpatient Services
SCHEDULE NOTE:

Medical Student Schedule of Responsibilities

Mon

Tue

Wed

Thu

Fri

7:30am to 8:30 am

Pre-Round on 5 North Detox (VAMC)

 

8:30 – Noon

Inpatient Detox – 5 North

(VAMC)

                      OR   

Ambulatory Detox Service

(VAMC)

(Please page the attending at

the beginning of the shift –

OSDEC schedule attached)

 

Check with Dr. Lin for which service is primary for the day

7am to 11 am

Methadone Maintenance Clinic

(3131 Harvey Ave)

 

11am to Noon

Didactics with Dr. Bebo

7am to Noon

Methadone Maintenance Clinic

(3131 Harvey Ave)

7:30am to 8:30 am

Pre-Round on 5 North Detox (VAMC)

 

8:30 – Noon

Inpatient Detox – 5 North

(VAMC)

                      OR   

Ambulatory Detox Service

(VAMC)

(Please page the attending at

the beginning of the shift –

OSDEC schedule attached)

 

Check with Dr. Lin for which service is primary for the day

7:30am to 8:30 am

Pre-Round on 5 North Detox (VAMC)

 

8:30 – Noon

Inpatient Detox – 5 North

(VAMC)

                      OR   

Ambulatory Detox Service

(VAMC)

(Please page the attending at

the beginning of the shift –

OSDEC schedule attached)

 

Check with Dr. Lin for which service is primary for the day

Noon to 1pm – Lunch

 

Noon to 1pm – Lunch

Addiction Journal

Club/Addiction Research

Incubator

Noon to 1pm – Lunch

Psychiatry Grand Rounds

Noon to 1pm – Lunch

 

Noon to 1pm – Lunch

 

1pm to 4pm

Addiction Sciences Outpatient

Services (3131 Harvey Ave)

with Dr. Bebo

1:30pm to 4pm

OSS/BTC Treatment Team

Meetings (VAMC 7th floor Rm

B725)

1pm to 4:30pm

Addiction Fellowships Didactics

(VAMC)

                       OR

Ambulatory Detox Service

(VAMC per OSDEC schedule)

                       OR

If no patients, then Addiction Education Groups VAMC 8-

South Rm A811

1pm – 2pm

Tobacco Treatment Group

VAMC 8th floor – RM A820

 

2pm – 4pm

Ambulatory Detox Service (VAMC)

(Please page the attending at the beginning of the shift – OSDECD schedule attached)

1:30pm- 4:30pm

Smoking Cessation Clinic

with Mike Krueger, MSN,

FNP, BC, CTTS (VAMC 7th floor)

                         OR

Addiction Sciences

Outpatient Services

(3131) Harvey Ave)

with Dr. Bebo

a

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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