UH-JABSOM Psychiatry Student Interest Group (JPSIG) 2007-2008
Goal: To increase medical student exposure to psychiatry, so as to enhance recruitment into psychiatry as well as the value of psychiatry for all specialties.
Objectives:
1.
Increase medical student awareness of psychiatry and its subspecialties (addiction, child and adolescent, forensic, geriatric, psychosomatic)
2.
Develop opportunities for medical students to access academic and community mentors
3.
Promote collaboration between medical schools and national and regional organizations in recruiting medical students into the specialty
4.
Promote a greater appreciation among all medical students of the importance of psychiatry and its subspecialties as an integral part of patient care.
Benefits and opportunities for student participants:

Socialization with other students, residents, and faculty throughout the country

Mentorship from psychiatrists

Journal clubs, presentations, seminars

Community service activities (e.g., Brain Awareness Week for grade school children)

AACAP and APA annual meetings as a SIGN representative

Leadership skills

Scholarships (summer research, annual meeting)
AACAP ( http://www.aacap.org
) and APA ( http://www.psych.org
) membership:

Online use of the AACAP Journal

AACAP newsletter

Free annual meeting registration

Access to practice guidelines

Members-only website access

Award opportunities
Coordinators:
(Faculty): Dan Alicata, M.D. ( dalicata@pol.net
) and Tony Guerrero, M.D.
( GuerreroA@dop.hawaii.edu
)
(Students): Christine Palermo MS4 ( palermo@hawaii.edu
) and Alana Sasaki MS2
( aksasaki@hawaii.edu
)
(Staff): Dana Iida ( IidaD@dop.hawaii.edu
)
National Contacts: ( http://www.psychsign.org
)
Dr. Steven Cuffe, AACAP Student Interest Group Network (SIGN) spc45@scdmh.org
Dr. Michael Houston, AACAP Student Interest Group Network (SIGN) mh@jmhmd.com
1

JPSIG yearly activities (for the whole group):
July
Format: Display table and social at the new student orientation
Topic 1: The Value of Psychiatry in Medicine
Audience: All interested students, particularly MS1’s
September
Format: Late afternoon session, Internet slides
Topic 2: Psychiatric Careers, including Misconceptions
Audience: All interested students
December
Format: Social activity
Christmas Caroling at the children’s hospital
Audience: All interested students
April
Format: Late afternoon discussion, Internet slides
Topic 3: Behavioral Science in Perspective
Audience: All interested students, particularly MS2’s
Whole Year
Internet discussions (need a continuously updated list-serve)
Specialty-specific opportunities:
Geriatric Psychiatry Journal Clubs (3 rd
Thursdays of the month, QMC UT room 413,
430pm)
Addiction Psychiatry Journal Clubs (2 nd Thursdays of the month, QMC UT)
2

Internet Discussion Topic: Award Opportunities
Previous JABSOM winners:
APA Minority Medical Student Elective in HIV Psychiatry

Vi Nguyen, Class of 2005
APA Program for Minority Research Training in Psychiatry (PMRTP)

Chia Granda, Class of 2005
Association of Women Psychiatrists (AWP) the Leah J. Dickstein, M.D. Award

Christine Palermo, Class of 2008
The CMHS Jeanne Spurlock Minority Medical Student Clinical Fellowship in Child and
Adolescent Psychiatry

Vi Nguyen, Class of 2005
Karasu Psychotherapy Award, Albert Einstein College of Medicine

Ethan Pien, Class of 2002

Kanani Texeira, Class of 2004
Additional information: http://www.psych.org/career_corner/careers_psych/training/summer_oppmed.cfm
WHERE WHAT CONTACT
American
Association
Psychiatric APA/SAMHSA Annual Meeting Travel
Scholarship for minority medical students supports travel and related costs for approximately 10 medical students to attend the APA Annual Meeting, (which is one of the largest and most highly respected medical meetings in the world), to be held May 1-6,
2004 in New York, NY. This program is a part of the minority fellowships and is supported by the Substance Abuse and Mental Health
Services Administration. This program is open to currently enrolled U.S. minority medical students. Selected students who are not APA
Marilyn King
Mking@psych.org
703-907-8653
3

members will automatically receive membership. APA membership is free for medical students. The deadline is January 23,
2004.
American
Association
Psychiatric The Program for Minority Research Training in
Psychiatry (PMRTP) is seeking applications from medical students interested in participating in a summer research experience.
Funded by the National Institute of Mental
Health and administered by the American
Psychiatric Association (APA), the PMRTP is designed to increase the number of underrepresented minority men and women in the field of psychiatric research. The PMRTP provides funding for training opportunities at the medical school level. Support is available for training opportunities during an elective period
(three- to six- month rotation) or as a summer experience.
Training takes place at research-intensive departments of psychiatry in major U.S. medical schools and at other appropriate sites.
A research mentor at the site is responsible for overseeing the applicant's research training experience.
Ernesto Guerra
Eguerra@psych.org
703-907-8622
American Association for
Child and Adolescent
Psychiatry (AACAP)
The American Academy of Child & Adolescent
Psychiatry announces the Jeanne Spurlock
Minority Medical Student Clinical Fellowship in
Child and Adolescent Psychiatry.
The Award provides five $2,500 fellowships for work during the summer with a child and adolescent psychiatrist mentor plus five days at the AACAP Annual Meeting in the fall.
Applications are accepted from African
Marilyn Benoit, M.D.
(202) 966-7300
4

American, Asian American, Native American,
Alaskan Native, Mexican American, Hispanic, and Pacific Islander students in accredited U.S.
Medical Schools. For more information, http://www.aacap.org/research/spurlck2.htm
Association of Women
Psychiatrists (AWP)
The Leah J. Dickstein, M.D. Award , which recognizes a female medical student who best exemplifies the spirit of creativity, energy, and leadership that Dr. Dickstein herself epitomizes and seeks to foster in others.
Frances Roton at womenpsych@aol.com
American Academy of
Addiction Psychiatry
The American Academy of Addiction Psychiatry is pleased to announce the 2001 Medical
Student Award. This award provides a travel stipend for a medical student who is interested in the diagnosis, root causes and treatment of addictive disorders. The recipient of the award will be invited to attend the AAAP Annual
Meeting and Symposium to receive their award.
Registration fees will be waived, and airfare and hotel costs will be paid for the Medical
Student Award winner (up to $1,000).
The applicant must have been a medical student within the 12 months preceding submission. For more information, http://www.aaap.org/membership/student.html
American Academy of
Addiction Psychiatry
7301 Mission Road,
Suite 252
Prairie Village KS 66208
Fax: 913-262-4311
American Academy of
Addiction Psychiatry
The American Academy of Addiction Psychiatry offers the opportunity for medical students who are interested in learning about the etiology, diagnosis and treatment of substance use disorders to attend their Annual Meeting. Three travel stipends are available for medical students in years 1-4. Travel and lodging costs
(up to $1,000) will be provided, and the meeting registration fee will be waived. For more information,
American Academy of
Addiction Psychiatry
7301 Mission Road,
Suite 252
Prairie Village KS 66208
Fax: 913-262-4311
5

American
Association http://www.aaap.org/membership/student.html
Medical AMA Foundation Leadership Award
If you are interested in developing your leadership skills through organized medicine, the AMA-MSS encourages you to apply for the 2002 AMA Foundation Leadership Award. The award recognizes 25 medical students and 25 residents or fellows who have demonstrated strong non-clinical leadership skills in medicine or community affairs. Award winners will receive funding to attend the 2002 AMA National Leadership
Conference in Los Angeles, CA in March. Applications are DUE
DECEMBER 21.
AMA Department of
Medical
Services
Student
1-800-262-3211, x4746 or e-mail mss@amaassn.org
. http://www.ama-assn.org/ama/pub/category/7631.html
Rock Sleyster, MD Memorial Scholarship
Submission Deadline
–
Postponed to 2005
The American Medical Association Foundation is pleased to request nominations for the 2004 Rock
Sleyster, MD Memorial Scholarships. These scholarships of $2,500 each are funded by a bequest from the estate of Clara Sarah Sleyster that established a Memorial Fund to honor her husband, Rock
Sleyster, MD, AMA President (1939 –1940).
Annually this fund awards approximately 20 scholarships to assist US citizens enrolled as students in US or Canadian medical schools, who aspire to specialize in psychiatry. In accordance with the terms of the bequest, the awards are based on demonstrated interest in psychiatry, scholarship, and financial need.
1
2
Each medical school in the United States and Canada is invited to submit nominees, in accordance with the size of the third – year class. All nominees must be rising seniors.
Number of nominations Third – year class size
3
1 – 150
151 – 250
251 – up
1. Applicant information form (available upon request).
2. Three letters supporting the nomination: o
Letter from the Office of the Dean, outlining the basis of the nomination. o Letter from the student, outlining his/her career goals in the field of psychiatry. o Letter of support from a member of the medical school’s Department of Psychiatry.
3. AMA Foundation Student Financial Statement completed by the medical school’s Financial Aid
Office (available on request).
4. Medical school transcript.
6

The following materials must be submitted:
The scholarship recipients will be announced by September 1, 2004. Recipients of the award will be designated as "Rock Sleyster Scholars" for a 1
– year period.
Please send all application materials and direct inquiries to:
Frank A. Simon, MD, Director
Division of Undergraduate Medical Education
American Medical Association
515 North State Street
Chicago, Illinois 60610
Phone: (312) 464-4567
E-mail: jacqueline_edwards@ama-assn.org
From: Deborah Hales [mailto:DHales@PSYCH.ORG]
Sent: Friday, July 15, 2005 3:51 AM
To: AAP@LISTS.HSC.WVU.EDU
Subject: Medical Student Interest Groups: we need 7 students to brainstorm about how the APA can support them
PLEASE PASS ON TO INTERESTED MEDICAL STUDENTS!
Does your medical school have an interest group in psychiatry? Are you interested in being actively involved on a national level?
The American Psychiatric Association (APA) is creating a national network of psychiatry interest groups and will sponsor 7 medical students to form the leadership for this network. The students will meet in San Diego, CA for a 1-day meeting on October 8, 2005. One student will be selected to represent each area of the APA. They are as follows:
Area 1 (Connecticut, Maine, Massachusetts, New Hampshire, Ontario, Quebec, Rhode Island and Vermont)
Area 2 (New York)
Area 3 (Delaware, Maryland, New Jersey, Pennsylvania and Washington, DC)
Area 4 (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota,
Ohio, South Dakota and Wisconsin)
Area 5 (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, No Carolina,
Oklahoma, Puerto Rico, So Carolina, Tennessee, Texas, Virginia, West Virginia and Uniformed
Services)
Area 6 (California)
Area 7 (Alaska, Arizona, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah,
Washington, Wyoming, and Western Canada)
The APA pay for your hotel room and meals associated with this meeting. Students will cover their own airfare, through their Psychiatry Department or other school funds. We are modeling this on AMSA meeting funding.
If you are interested, send me and email and I will send you an application form.
7

Along with the completed application form, you also need write a short essay on why you should be selected, write about your interest in psychiatry and what you can contribute to create a national network of psychiatry interest groups. If you have any questions, contact Nancy Delanoche at ndelanoche@psych.org
or by telephone at 703-907-8635.
Nancy Delanoche, MS
Associate Director, Office of Graduate and Undergraduate Education
American Psychiatric Association
1000 Wilson Boulevard, Suite 1825
Arlington VA, 22209-3901
Tel: 703-907-8635, Fax: 703-907-7849
Deborah J. Hales, MD
Director- Division of Education
American Psychiatric Association
1000 Wilson Boulevard Suite 1825
Arlington, VA 22209
(703) 907-8633
Fax (703) 907-7849
Internet Discussion Topic: Summer Research and Preceptorship Opportunities
(information to be made available)
8

Topic 1: The Value of Psychiatry in Medicine
Psychiatry is the medical specialty involving the diagnosis and treatment of mental illnesses.
Psychiatrists care for medical conditions that affect those things that make us human – for example, how we think, how we feel, how we behave, and how we relate with others. For this reason, many believe that psychiatry is a particularly “stressful” specialty – because it seems to
“hit so close to home” as our own emotions are engaged. However, an important part of training in psychiatry is learning how to appropriately handle such emotions and, in fact, to skillfully use them for the therapeutic benefit of not just “psychiatric” patients but also patients with general medical conditions. Through increasing our skill in recognizing and managing these emotions
(which otherwise might catch us “off guard”), such training, properly applied, can actually help prevent the emotional “burnout” which could arise from caring for patients in any medical specialty. Most of us chose medicine as a career because we want to help people by relieving their suffering. Those of us who chose psychiatry have found a richly rewarding career that enables us to truly address all aspects of a patient’s well being.
“The stereotype of the `bearded analyst’ sitting by the couch is obsolete. While psychoanalysis is still practiced, most psychiatrists today are not analysts. Rather, today’s psychiatrist provides a wide range of biological, psychotherapeutic, and psychosocial treatments that are tailored to the specific needs of the patient. The psychiatrist also serves as the medical expert for the mind/brain/body interface.” (American Psychiatric Association “Careers in Psychiatry”)
So why study psychiatry?

Mental health conditions are common. o An estimated 22.1% of Americans age 18 and older (44.3 million people) suffer from a diagnosable mental disorder in a given year (NIMH, 2002) o According to the Surgeon General’s report, 20% of children and adolescents have a mental health condition resulting in impairment (reviewed, AACAP, 2000).

Mental health conditions are a significant cause of morbidity. o Leading cause of morbidity worldwide, surpassing other general medical disorders (WHO) o Depression, anxiety and somatoform disorders are associated with significant impairments in health-related quality of life – even relative to other “medical” conditions such as diabetes, arthritis, and cardiac disease (Spitzer et al, 1995).

Mental health conditions are a significant cause of mortality. o Top leading causes of death among adolescents and young adults: accidents, homicide, and suicide; among children and adolescents ages 1-19 years, these three are the 1 st , 2 nd , and 3 rd leading causes of death (MacDorman et al, 2002). o Improving access to mental health care is an important priority for violence prevention in youth (Commission for the Prevention of Youth Violence, 2001) o 3-5 times increase in mortality in patients who have recently had a myocardial infarction who have comorbid depression (Frasure-Smith and Penninx, 2001)

Psychiatry is useful for all medical specialties. o Many patients with psychiatric symptoms on medical and surgical services can have life-threatening conditions: e.g., alcohol withdrawal, subdural hematomas, hemorrhages near the brainstem. o Psychiatric disorders predict length of hospital stay and medical readmission
(Levitan and Kornfeld, 1981).

Psychiatry is a much-needed specialty, based on workforce demands.
9

o For example, the current supply of 6300 child psychiatrists is anywhere from
4000 to 24000 short of what’s actually needed (reviewed, AACAP, 2000). o Federal designations for mental health shortage areas (just like primary care shortage areas).
 There’s a lot of scientific evidence (e.g., randomized, controlled, double-blinded studies) that psychiatric treatment is indeed effective. “Evidence-based psychiatry” has come of age. o Anti-depressants and specific psychotherapies for major depression, panic disorder, obsessive-compulsive disorder; specific treatment for almost any other mental health condition. o Rates of success (substantial symptom reduction or remission) for psychiatric illnesses surpass those of some common medical procedures (e.g., 60%, 60-65%, and 80% for schizophrenia, depression, and panic disorder, respectively, versus
40% and 50% for angioplasty and atherectomy, respectively) (National Mental
Health Advisory Council, 1993).

Solid interviewing skills can help you: regardless of whether you go into psychiatry or not, and regardless of what type of setting you end up practicing in.
“The Interview Pyramid”
Tony Guerrero, 2000
TREATMENT:
Address all the relevant issues from formulation.
FORMULATION: Synthesize all of your information from multiple perspectives (bio, psycho, social) in a way that sensibly guides treatment, patient education, and education of others involved.
CLINICAL DATA: Elicit the appropriate history and mental status findings to rule-in and rule-out
DSM-4 DIAGNOSES and to best understand the patient’s condition.
SAFETY: Make sure you identify conditions which could pose an emergent risk (to the patient, to you, and/or to others)– suicidality, homicidality, abuse/being victimized, psychosis, general medical conditions, substance abuse.
RAPPORT: Establish and maintain rapport. Have unconditional positive regard and be attentive to patient’s comfort. Adequately prepare patient for the interview. Identify barriers to effective rapport (“problems”), generate “hypotheses,” gather “additional information,” and adjust appropriately. Develop skill in choosing in the spectrum of open-ended versus closed-ended questions. Be responsive to the content of what the patient says as well as the associated emotions.

You may like it – and find a career that you’ll be happy with for the rest of your life.
 You’ll meet a lot of potentially good mentors – who can help you even beyond the clerkship.
10

Related Topic (more immediate): the Value of Psychiatry in the Pre-clerkship PBL
Curriculum:
A few myths about Behavioral Science…
MYTH #1: Behavioral science is not really important.
REALITIES:
•
One of the major 7 USMLE topics (along with anatomy, physiology, biochemistry, microbiology, pathology, and pharmacology)
• Includes several “hot topics,” even from LCME perspective – e.g., violence and abuse, culture, ethics, etc.
•
Important causes of morbidity and mortality.
• “High-yield” according to many review books.
MYTH #2: The “psychosocial” is just a unique quirk of the JABSOM PBL system. It’s basically “fluff.”
REALITY:

Required in medical school curricula (LCME, 2003); medical schools have formal courses in behavioral science. Excerpts (LCME, 2003):
•
ED-10. Behavioral and socioeconomic subjects
•
ED-19. Communication skills
•
ED-20. Medical consequences of common societal problems – e.g., violence and abuse.
•
ED-21. Cultural competence
•
ED-22. Gender/cultural sensitivity
•
ED-23. Ethics and human values
MYTH #3: We do so much psychosocial stuff as part of PBL, and it’s all common sense anyway.
REALITY:
•
Several specific topics that merit review are almost guaranteed board material that you could get guaranteed correct if you studied them.
MYTH #4: Shouldn’t we be able to “ace” behavioral science because of PBL?
REALITIES:
•
Clearly some advantages to the PBL approach in general.
•
We seem to do about average.
MYTH #5: There aren’t any good resources for behavioral science
REALITIES:

Faculty in the Department of Psychiatry are more than happy to help you! Check out our website at: http://www.hawaiiresidency.org/psychiatry/index.html
or call us at
586-2900.
11

Some examples of useful textbooks:
 Behavioral Science: basic overview
High-Yield Behavioral Science

General psychiatry (more as a reference textbook)
Kaplan and Sadock's Comprehensive
Textbook of Psychiatry
Benjamin J. Sadock (Editor), Virginia A. Sadock (Editor)
12

 Medical (or “Consultation-Liaison”) Psychiatry: psychiatric and psychosocial aspects of general medical illnesses you may encounter in tutorial cases (more as a reference textbook)
American Psychiatric Publishing Textbook of Psychosomatic Medicine
James L. Levenson
So here’s what behavioral science includes:
•
Human development
•
Human behavior
•
Psychopathology, substance abuse, behavioral neuroscience
•
Suicide, Violence, and Abuse
•
Culture
•
Sexuality
•
The physician-patient relationship and ethics
•
Health care 101
•
Epidemiology and biostatistics
Good luck, and we’re always happy to help!
Dan Alicata, M.D.
Psychiatry Clerkship Director
Pager 691-1001; Office 586-2900 (Queen’s) dalicata@pol.net
Tony Guerrero, M.D.
Director of Medical Student Education in Psychiatry
Pager 272-1185; Office 586-2900 (Queen’s)
GuerreroA@dop.hawaii.edu
13

Topic 2: Psychiatric Careers, including Misconceptions
Selected video clips (psychiatry as depicted in the media)
According to the APA (“Careers in Psychiatry”):
“The average psychiatrist spends more than 48 hours each week at work. During this time, professional activities include administration, teaching, consultation, and research. Most spend over 60% of their time with patients. Two-thirds of these patients are seen as outpatients, with the rest being seen in a hospital setting or, increasingly, in partial hospital or day programs and community residential programs…
“Psychiatrists work in group or solo private practice much the same as other physicians. They also practice in the public sector, such as Veterans Administration and state hospitals and community mental health centers that are unique to psychiatry. Medical schools, HMOs, and general hospitals, as well as specialized psychiatric hospitals are settings for psychiatric practice.”
Note the people who won the Nobel Prize in Physiology/Medicine for 2000 (Drs. Carlsson,
Greengard, and Kandel).
You should consider psychiatry if you are:

Fascinated by the science of the brain and willing to rigorously understand the biological and psychosocial components of illness.

Committed to treating medical conditions that affect emotions and behavior (in a sense, helping people to feel human again).
Psychiatry has been a very rewarding career for many, with high job satisfaction. There’s big demand for psychiatric services (e.g., Surgeon General’s statement on child and adolescent mental health needs).
What are the psychiatric subspecialties, and how long is training? (some examples):
Years 1
General Psychiatry
General Pediatrics
(“Triple-board Program”)
2
General Psychiatry
(first year could be in primary care)
3
General Psychiatry
4
Fellowship:
Geriatric
Addiction
Forensic
C/L
Fellowship:
Child and Adolescent
Child and Adolescent
Psychiatry
5
14

Other combinations:
Internal Medicine/Psychiatry (5 years)
Family Practice/Psychiatry (5 years)
Psychiatry/Neurology
What do each of the subspecialties entail, and how many programs are there in the country? (source:
ACGME website):
Addiction psychiatry – focuses upon the prevention, evaluation, and treatment of substance abuse and dependence, with related educational and research efforts.
Child and adolescent psychiatry – focuses upon the skilled and comprehensive medical care of children and adolescents suffering from psychiatric disorders.
Forensic psychiatry – focuses upon the interrelationships between psychiatry and the law (civil, criminal, administrative), including the evaluation and treatment of people in the legal system, and related educational and research efforts.
Geriatric psychiatry – focuses upon the prevention, diagnosis, evaluation, and treatment of mental disorders and disturbances in older adults.
Psychosomatic medicine (“consultation-liaison psychiatry”) – focuses upon the study and treatment of psychiatric disorders in patients with medical, surgical, obstetrical, and neurological conditions, particularly patients with complex and/or chronic conditions.
What are the needs and job opportunities for the future?
ENORMOUS – for all of these subspecialties. To give a graphic example: the current supply of
6300 child and adolescent psychiatrists is about 24,000 short of what’s actually needed, based on a reliable estimate of need. The U.S. Surgeon General has declared child and adolescent mental health a significant area of public health concern. Likewise, the needs in the other specialties – e.g., with the aging population, with the rise in substance abuse (including the methamphetamine use epidemic in Hawai‘i), and with the increasing prominence of the interface between psychiatry and the law – are also awesome.
Which of the above programs are available in Hawai‘i?
Addiction psychiatry, child and adolescent psychiatry, general psychiatry, geriatric psychiatry, and the “triple-board” program. There is interest in starting a psychosomatic medicine fellowship in the near future.
Whom can I contact for more information?
Addiction Psychiatry:
Dr. William Haning, Program Director (586-2900; HaningW@dop.hawaii.edu)
Child and Adolescent Psychiatry and Triple-Board Program:
Dr. Cathy Bell, Program Director (586-2900; BellC@dop.hawaii.edu)
General Psychiatry:
Dr. Courtenay Matsu, Program Director (586-2900; MatsuC@dop.hawaii.edu)
Geriatric Psychiatry and Psychosomatic Medicine:
15

Dr. Junji Takeshita, Program Director (586-2900; TakeshitaJ@dop.hawaii.edu)
… and of course you can always contact us:
Dr. Tony Guerrero, Director of Medical Student Education in Psychiatry (586-2900;
GuerreroA@dop.hawaii.edu)
Dr. Dan Alicata, Psychiatry Clerkship Director (596-2900; dalicata@pol.net)
Appendix 1: Psychiatry Recruitment at UH-JABSOM (note – national average is only 3-
4%):
Psychiatry Recruitment at UH-JABSOM (1991-2007)
14
12
10
8
6
4
2
0
19
91
19
93
19
95
19
97
19
99
Year
20
01
20
03
20
05
20
07
Percentage of MS4 students matching into psychiatry
(categorical and combined)
Percentage of MS4 students matching into UH psychiatry programs (categorical and tripleboard)
Appendix 2: Slides for Psychosocial Aspects of Pediatrics (will be made available via internet)
Topic 3: Behavioral Science in Perspective
(Slides will be made available)
16