Curriculum

Our curriculum will familiarize you with all aspects of emergency psychiatry and prepare you for practice, research and teaching in the field. You will collaborate with attending psychiatrists and other professionals in the field to enhance your core clinical skills with specialization in emergency psychiatry.

Over the course of the program, you will:

• Evaluate patients in the emergency room setting, and determine appropriateness for inpatient hospitalization or discharge.
• Perform lethality and violence risk assessments.
• Manage patients’ symptoms using psychotherapeutic and pharmacologic techniques.
• Identify and treat patients with mood and psychotic disorders, including schizophrenia and bipolar disorder, personality disorders, somatic symptom disorders, PTSD & other anxiety disorders, developmental disorders and neurocognitive disorders.
• Evaluate and treat patients with comorbid substance abuse disorders.
• Provide consultation to Crisis Services of Erie County and the medical emergency department.
• Collaborate with a multidisciplinary treatment team and community-based partners.
• Teach and mentor junior trainees in the CPEP.
• Investigate research opportunities and develop scholarly work.
• Explore administrative dynamics with opportunities to shape systems of care.

Your training experience includes both core and elective rotations designed to develop and strengthen clinical skills in areas relevant to the practice of emergency psychiatry. 

During your core rotations, you will be scheduled in the Comprehensive Psychiatric Emergency Program (CPEP) at Erie County Medical Center: you'll gain experience on all shifts.

Our program incorporates an extended observation bed unit, mobile crisis outreach, crisis residential bed program and home-based crisis interim visits.

Your core training will include experience in:

• Hospital diversion programs that provide community-based, outpatient psychiatric interventions in a range of clinical settings for children, adolescents, and/or adults with a variety of clinical issues, potentially including those with developmental disabilities.
• Substance-use disorder/toxicology care focused on acute management of overdoses, withdrawal syndromes, adverse medication effects, and long term addictions issues, including those with co-morbid mental health treatment needs.
• Administrative collaboration with hospital and community based providers, including exposure to processes involving regulatory agencies, audits, and program improvement projects exploring ways to maximize care despite constraints related to staffing, facilities, and budgets.

In our program, you have many elective rotations to choose from to individualize your training experience.

You will participate in an on-going project relevant to the field of emergency psychiatry, or develop an individual investigative project under the supervision of a faculty mentor. 

You will identify an area of interest and research paucity, write a proposal based on a specific research question, collect and interpret data, analyze project results and submit an abstract for possible publication.

You will participate in bi-weekly scheduled supervision with the fellowship director, focusing on case discussion and topic review.

On alternate weeks, you will have journal club, off-ward supervision, and further topic review.

Topic review covers concepts especially relevant to emergency psychiatry. Topics may be coordinated with the timing of clinical encounters and include:

• Agitation
• Alcohol use disorders
• Anxiety disorders
• Children and families
• Community coordination and resources
• Crisis intervention
• Legal and forensic issues
• Medical triage and delirium
• Mood disorders
• Opioid use disorders
• Personality disorders
• Psychosis and catatonia
• Quality improvement
• Social determinants and homelessness
• Somatic symptom disorders
• Stimulant and other use disorders
• Suicide risk
• Team leadership
• Trauma-informed care
• Violence risk

Off-ward supervision allows for in-depth discussion of specific cases and integration of reviewed material.

This type of supervision can be adapted to address specific points of your interests, including mentorship in scholarly work, team leadership and trainee teaching.