Curriculum

Mayo Clinic Psychosomatic Medicine Fellowship faculty members discussing a case

Our curriculum includes mandatory and elective clinical rotations, didactics, self-directed study, clinical and educational supervision, a mentored quality improvement project and opportunities for research.

Clinical training

You receive extensive clinical experience in psychiatric consultation-liaison and psychosomatic medicine practices — both inpatient and outpatient. You gain the skills and experience necessary to independently evaluate and treat patients with complex behavioral morbidity associated with medical and surgical illnesses and other complex psychological problems.

This program offers you a unique opportunity to participate in a multidisciplinary team approach to psychological problems. At Mayo Clinic, we have a distinctive practice environment that will immerse you in multidisciplinary clinical teams. We emphasize collaborative care models throughout our clinical practice. You are intimately involved in clinical decision-making with many opportunities to develop your diagnostic, therapeutic and team leadership skills.

Clinical venues

Inpatient psychiatric consultation-liaison service

Our consultation-liaison (C/L) service provides support for our medical and surgical colleagues taking care of inpatients at Mayo Clinic Hospital — Rochester. The hospital has two campuses about a mile apart from one another, with regular transportation between them:

  • Saint Marys campus. The campus has 1,265 inpatients beds, including our general medical and surgical units, medical and surgical intensive care units, specialty care units (neurology-neurosurgery intensive care, heart failure and respiratory care, for example), children's hospital, physical medicine rehabilitation unit, psychiatric inpatient units (for children, adults, geriatric, and medical-psychiatric patients) and emergency medical services.
  • Methodist campus. The campus has 794 beds, including dedicated units for obstetrics and gynecology and transplant surgery.

Our C/L service receives about 2,600 new consultations annually. The service is staffed Monday through Friday by two faculty members, two psychiatric nurse practitioners or physician assistants, rotating psychiatry and neurology residents, medical students and our Psychosomatic Medicine fellow (when assigned). Staffing on Saturday and Sunday is one faculty member and one psychiatry or neurology resident.

As a fellow, you have opportunities to work in two distinct roles on the C/L service:

  • In a traditional academic role, where you act as a hands-on teacher for residents and students, while receiving mentorship from faculty members on your clinical and teaching skills, allowing you to develop these professional abilities simultaneously
  • Where you serve as the supervising physician for our nurse practitioners and physician assistants, giving you the chance to gain valuable experience in a role that is becoming increasingly important in today's medical practice

Behavioral Medicine Program (BMP) and other tertiary collaborative care teams

Mayo Clinic's founders were surgeons who recognized that achieving the best patient outcomes required a health care team. Our psychosomatic medicine psychiatrists and clinical health psychologists work closely with colleagues in medical and surgical departments throughout the institution to evaluate and treat patients.

The BMP is your outpatient home as a fellow. There you join our team of psychiatrists, psychologists, nurses and masters' level therapists to offer collaborative care to patients with structural and functional neurological disorders with colleagues in neurology and physical medicine and rehabilitation (PM&R), functional GI disorders with staff from GI medicine and PM&R, and vestibular and balance disorders with clinicians in ENT, neurology and PM&R.

You collaborate with medical, surgical and radiation oncologists to provide individual and group therapy and medication management to patients with cancer distress. You also will work with colleagues in neurosurgery and neurology to evaluate patients who may benefit from implantable neuromodulating devices to treat Parkinson's disease, other movement disorders and intractable pain.

Evaluations and treatment interventions are fully integrated across medical, surgical and psychiatric disciplines at Mayo Clinic. Our psychiatrists and psychologists shape diagnostic impressions and treatment plans right from the start of care.

Outside of the BMP, you are able to choose from numerous electives that allow you to play an integral role in our Transplant Center, weight management and obesity program, Transgender and Intersex Specialty Care Clinic (TISCC), and comprehensive Pain Rehabilitation Center. These experiences will give you an appreciation for 21st century concepts of psychosomatic disorders and help you to acquire a range of skills to treat these conditions successfully. You are prepared to work in full partnership with medical and surgical colleagues to address these conditions.

Integrated Behavioral Health (IBH)

All of Mayo Clinic's primary care internal medicine and family medicine practices in Rochester receive psychiatric and psychological support though our IBH program. In primary care, patients receive regular screening for depression, anxiety and other mental health problems, which are then managed by their primary care clinicians with on-site support from care managers (usually experienced psychiatric nurses) and a dedicated group of psychiatrists and psychologists who belong to the IBH teams.

IBH psychiatrists review evaluations performed by primary care clinicians and care managers, interface with primary care colleagues, and examine patients personally when needed. IBH teams track the progress of patients throughout their treatment. This approach allows our psychiatrists to ensure that primary care patients receive high-quality mental health care.

Minnesota was the first state in the country where Medicaid and all major private insurers agreed to pay for the IBH model of care. Medicare now pays for this service nationwide, but Mayo Clinic has been using this approach for more than a decade. Throughout your fellowship, you spend one afternoon a week leading an IBH team under the mentorship of a seasoned IBH faculty member. This gives you future-oriented skills in team leadership and population health management.

Rotation schedule

Your fellowship schedule includes a combination of 13 four-week blocks and weekly longitudinal rotations.

Block rotations are typically scheduled in the morning and include required hospital-based services and required and elective outpatient assignments. Longitudinal rotations are typically scheduled in the afternoon and include required and elective outpatient experiences, didactics, self-study time, supervision, and a required scholarly project. Research time may be scheduled in blocks or longitudinally, depending on the nature of the project.

Required rotations (4-week blocks) Length
Inpatient consultation-liaison service 4 blocks
Outpatient Behavioral Medicine Program 2 blocks
Transplant service 1 block
Medical Psychiatry Inpatient Unit 1 block
Outpatient behavioral neurology 1 block
Electives 4 blocks

Elective rotations

Choose four blocks (four weeks each) and one longitudinal experience:

Psychosomatic medicine and clinical health psychology

  • Pain Rehabilitation Center
  • Psycho-oncology — Cancer stress management program
  • Transgender and Intersex Specialty Care Clinic (TISCC)
  • Weight management and obesity — endocrinology, surgery and clinical health psychology clinics
  • Women's health
  • Additional time on the inpatient C/L service, Medical Psychiatry Inpatient Unit, or outpatient Behavioral Medicine Program may be selected by those who wish to concentrate in these areas.

Clinical neurosciences

  • Neuropsychological and psychological testing
  • Neuroradiology

Other psychiatric subspecialties

  • Addiction psychiatry
  • Child and adolescent psychiatry
  • Geriatric psychiatry
  • Mayo Clinic Depression Center
  • Neuromodulation (electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation)

Other medical services

  • Fibromyalgia and chronic fatigue program
  • Functional GI disorders — GI Clinics, motility laboratory and pelvic floor training program
  • Functional neurological spells — Epilepsy Clinic, EEG laboratory, Epilepsy Monitoring Unit
  • Functional movement disorders — Movement disorders clinic, Movement Disorder Laboratory and behavioral shaping therapy program
  • Functional vestibular disorders — neuro-otology clinics, Vestibular and Balance Testing Laboratory, vestibular rehabilitation
  • Palliative care and hospice service
  • Physiatry — inpatient rehabilitation unit (brain rehabilitation and general physical medicine services)

Related nonmedical services

These are two-week blocks:

  • Ethics consultation service (generally combined with palliative care)
  • Chaplain's consultation service

Research

You may use more than one elective for research:

  • Research education. We offer introductory and advances courses, such as statistics and project design.
  • Research experience. This could be a basic science, clinical or health sciences research project.

Individualized electives

These might include some other medical or surgical specialty or subspecialty setting approved by the training committee.

Typical schedule

This sample schedule shows the standard 13 rotation blocks and continuity experiences for the year. It also includes a sample weekly schedule, plus elective options.

Call frequency

Our program does not require any after-hours on-call duties.

Didactic training

Our educational program consists of daily rounds, didactic seminars, case conferences, journal club, mentoring in career development, and dedicated time for self-study and pursuit of a scholarly project.

Our goals are to foster clinical excellence, expert knowledge in the field, and compassion for patients and colleagues who struggle with the difficult dilemmas of medical-psychiatric problems. Daily interactions between our faculty and fellows foster close working relationships in a dynamic learning environment.

We individualize your didactics depending on your background, previous experience, and a self-assessment that you complete during the first month of your fellowship. That helps us to focus your educational experiences on areas where you need more help while enhancing your strengths.

Conferences

During the Psychosomatic Medicine Fellowship, you participate in the following:

  • Psychosomatic Medicine Core Seminar Series (weekly)
  • Psychosomatic Medicine Case Conference (monthly)
  • Psychosomatic Medicine Journal Club (monthly)
  • Psychiatry and Psychology Grand Rounds (weekly)
  • Psychosomatic Medicine Supervisory and Administrative Seminar (weekly)
  • A program of mentored, self-directed study (weekly)
  • A mentored scholarly project — quality improvement project, basic or clinical research (weekly)
  • Educational offerings of other departments when rotating there
Mayo Clinic Psychosomatic Medicine Fellowship director giving a presentation

Research training

We offer many research opportunities to advance your skills and experience in scholarly inquiry, from the required scholarly project to immersion in cutting-edge research. In all of these activities, you are guided by faculty mentors who are matched to your background, interests and educational needs.

In addition to this hands-on work, Mayo Clinic also offers numerous opportunities for formal training in research topics, including classroom and online courses in research design, statistics, ethics and scientific writing. We encourage you to generate at least one national presentation and one peer-reviewed publication by the end of your training.

If you have a particularly strong interest in a research career, you may be eligible to apply for entry into a postdoctoral certificate or degree-granting program in the Mayo Clinic graduate school. These are highly competitive positions that require additional training time and are dependent on available funding.

Learn more about research in the Department of Psychiatry and Psychology.

Teaching opportunities

Opportunities are available for you to teach rotating residents and medical students.

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Psychosomatic Medicine Fellowship. You are formally evaluated by supervising faculty members on a regular basis and meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.

Sept. 27, 2017