Fourth Year Psychiatry Electives

This elective includes intensive work with inpatients who suffer from major psychiatric disorders with or without substance abuse. Emphasis is on assessment, acute treatment, and arrangement of continuing care in the community. The subintern functions as an integral member of a multidisciplinary treatment team. Clinical research participation is encouraged. Opportunities are available to explore special areas of interest (e.g., forensics, psychopharmacology, administration) with CMHC faculty.

Prerequisite: required Psychiatry clerkship.

Open to fourth-year students only. One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

This elective affords opportunities for third- and fourth-year students to observe and participate in “competency to stand trial” evaluations with a clinical team that makes these assessments at the New Haven Correctional Center. In addition, they may attend Law School classes with students who represent psychiatric patients, observe civil commitment procedures, and attend probate court hearings as well as the criminal proceedings in local New Haven Superior Courts. Students attend work seminars where case evaluations and write-ups are discussed and prepared, and read appropriate legal cases and psychiatric literature. Students may be able to participate in parts of evaluations of insanity defense, custody determination, and other forensic issues. They attend the Law and Psychiatry seminar during their rotation.

Prerequisite: required Psychiatry clerkship.

One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

An elective clinical training experience in addiction psychiatry for third- and fourth-year students. The primary training site is the Detoxification and Addiction Stabilization Service at the VA Connecticut Healthcare System in West Haven. Students learn about performing detailed initial evaluations; treating alcohol, opioid, and benzodiazepine withdrawal; initiating medication-assisted treatment; providing opioid overdose education and naloxone distribution, providing smoking cessation treatment, utilizing psychosocial interventions and mutual help, as well as the principles of harm reduction; and addressing psychiatric and medical comorbidities. The rotation includes a discussion of several readings in addiction psychiatry.

Prerequisite: required Psychiatry clerkship.

One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

This elective includes intensive work with patients who suffer from major psychiatric disorders and range in age from college students to middle age. Emphasis is on assessment, acute treatment, and arrangement of post-discharge follow-up care in the community. The student is an advanced clerk functioning as a member of the multidisciplinary treatment team, taking on primary clinician and psychiatric/medical responsibilities for patients under the supervision of senior clinicians. The elective is given on the inpatient service at the Yale New Haven Psychiatric Hospital; clinical research and outpatient involvement may be options.

Prerequisite: required Psychiatry clerkship.

Open to fourth-year students only. One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

The elective is focused on the provision of outpatient mental health services for Spanish-speaking Latino communities in the United States and will cover three main themes:

1. Clinical assessment and conceptualization: Culturally-specific and linguistically appropriate clinical skills including interviewing, diagnosis, and formulation of a recovery-oriented treatment plan that includes psychopharmacology and psychotherapy.
2. Systems-based practice: Understanding the impact of community-academic partnerships and the characteristics of a culturally responsive behavioral health system of care for Hispanics.
3. Recovery-oriented care: Culturally sensitive approaches to recovery from mental illness.

This elective offers senior medical students the opportunity to work closely with a variety of patients who are hospitalized during their participation and treatment in research protocols. The Clinical Neuroscience Research Unit (CNRU) is a thirteen-bed inpatient ward with associated outpatient clinics and basic science laboratories on the third floor of the Connecticut Mental Health Center (CMHC). Supervised implementation of novel psychopharmacology, exposure to multiple aspects of clinical and basic science research, and in-depth experience with individual and group psychotherapies are educational aspects of this elective. Patients’ diagnostic categories include depression, obsessive-compulsive disorder, schizophrenia, cocaine abuse, substance abuse, and psychiatric genetics.

Prerequisite: required Psychiatry clerkship.

Open to fourth-year students only. One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

This elective offers senior medical students the opportunity to learn about neuromodulation techniques in the treatment of mood disorders, more specifically, by using electroconvulsive therapy (ECT) and repetitive transcranial stimulation (TMS). Students learn the theoretical basis for the use of ECT and TMS, among other neuromodulation techniques, in the treatment of mood disorders. They learn indications and contraindications to treatment, the process of evaluation of patients prior to and during treatment (including use of standardized depression rating scales), how to monitor for complications and side effects to treatment, and the latest research in the field. Students work closely with psychiatry attending physicians and residents at the VA in the evaluation of patients referred for ECT and TMS, and have the opportunity for supervised participation in the performance of these treatments. Patient population includes veterans of all ages with a variety of psychiatric conditions, including mood disorders with comorbid anxiety and substance use disorders.

Prerequisite: required Psychiatry clerkship.

One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

The purpose of this elective is to provide fourth-year medical students interested in child and adolescent psychiatry and/or adolescent medicine an experience in working with adolescents presenting with acute psychiatric illness. The elective is based on the adolescent inpatient unit at Yale New Haven Psychiatric Hospital, a short-term fifteen-bed unit serving patients aged 12–18. Students gain exposure to a diverse patient population with severe mood, psychotic, behavioral, and/or substance use disorders, as well as begin to understand the intricacies of working with families and systems providing care for adolescents with significant emotional and/or behavioral disturbances. Teaching activities include daily rounds and weekly case conferences.

Prerequisite: required Psychiatry clerkship.

One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

Intensive work with inpatients who suffer from major psychiatric disorders with or without substance abuse and who have significant social challenges often including lack of access to stable housing, work, and healthcare insurance. Emphasis is on assessment, acute treatment, and arrangement of continuing care in the community. The sub-intern functions as an integral member of a multidisciplinary treatment team and serves as the primary clinician for 4-5 patients.

The subinternship occurs on the inpatient service (4th floor) of the Connecticut Mental Health Center (CMHC).

Director: Brian Fuehrlein, MD, PhD

Intensive work with patients who suffer from major psychiatric disorders and range in age from college students to middle age. Most patients have access to healthcare insurance or have Medicare and/or Title XIX. Emphasis is on assessment, acute treatment, and arrangement of post-discharge follow-up care in the community. The sub-intern is an advanced clerk functioning as a member of the multidisciplinary treatment team, taking on primary clinician and psychiatric/medical responsibilities for patients under the supervision of senior clinicians.

The subinternship occurs on the general adult inpatient service at the Yale Psychiatric Hospital.

Director: Brian Fuehrlein, MD, PhD

This sub-I experience affords the student an opportunity to gain insight into what is it like to work in clinical psychiatry. Students will function as high level clinical care providers and will be an integral part of the treatment team. The Clinical Neuroscience Research Unit (CNRU) is a specialized service dedicated to the diagnosis, treatment and research of neuropsychiatric disorders. The unit consists of an inpatient service, as well as outpatient specialty clinics for addictive, depressive, obsessive-compulsive, psychotic, and women's behavioral health disorders. Most patients voluntarily participate in clinical research studies designed to determine the neurobiological mechanism underlying these disorders. We additionally supplement our census with patients admitted to compliment resident and student education and training. Pharmacotherapy, individual psychotherapy, group therapy, and behavior therapy are provided as clinically indicated. Clinical treatment is provided free of charge to patients.

The subinternship occurs on the Clinical Neuroscience Research Unit (CNRU) of the Connecticut Mental Health Center (CMHC).

The Sub-I is scheduled throughout the year during regular subinternship rotations for a minimum of four weeks.

Director: Brian Fuehrlein, MD, PhD

The aim of this elective is to provide the student with an intensive experience in infant, child, and adolescent psychiatry. The curriculum includes assessments of normal development and psychopathology in childhood, treatment methods, and research in major disorders of childhood. Students are active team members of the Children’s Psychiatric Inpatient Service (CPIS) and the consultation service to the pediatric wards of Yale New Haven Hospital and can take advantage of the wide range of ongoing seminars, conferences, and clinical services in place at the Child Study Center. Teaching methods include seminars, conferences, field observations, ward rounds, and practicals selected by the student following consultation with the director of medical studies and the Child Study Center.

One student every four weeks.

Director: Brian Fuehrlein, MD, PhD

This four-week elective provides students with exposure to caring for older adults with mental health concerns, including mood disorders, anxiety disorders, grief, and adjustment disorders, as well as neurocognitive disorders ranging from mild cognitive deficits to dementia with complex neuropsychiatric symptoms. The student will work closely with geriatric psychiatry fellows and attendings in the outpatient evaluation and treatment of such disorders, and participate in comprehensive psychiatric evaluations, cognitive and functional assessments, individual and family psychoeducation, and treatment. The student will participate in daily team huddles which include a multidisciplinary group of physicians, nurses, social workers, and peer specialists. The student will have an opportunity to participate in group therapy as well as weekly geriatric psychiatry didactics and psychiatry department Grand Rounds. It may also be possible to rotate a half day a week with neurology (movement disorders and neurocognitive clinic) or palliative care clinic experiences, if the students is interested.

During this rotation, it is necessary to be on site at the VA Annex in Orange, CT (200 Edison Road) where the outpatient geriatric psychiatry clinic is located.