Program Curriculum

Program Overview

The UNC Consultation-Liaison Psychiatry Fellowship Program is an ACGME accredited one-year training program in which Fellows become proficient in the management of all major psychiatric symptoms and disorders in the medically ill. Fellows learn to identify and manage neuropsychiatric conditions, conduct comprehensive clinical assessments and treatments, collaborate with diverse clinical teams, navigate complex systems, and address legal and ethical challenges across various care settings. Through direct patient care, resident supervision, and structured learning experiences in specialty inpatient and outpatient clinical opportunities, Fellows explore new areas of study, develop areas of expertise, and gain the skills needed to excel as clinician-educators, researchers, and leaders.

Clinical Settings

Our program offers comprehensive training at UNC Hospitals, encompassing both UNC Medical Center, a large, academic tertiary care safety net hospital with over 1000 medical and surgical beds, and UNC Hillsborough, a 123-bed community-based hospital where fellows provide virtual consultation-liaison services.

Key inpatient clinical settings include:

With strong partnerships with a diverse range of medical and surgical subspecialty services, fellows gain exposure to and can develop expertise in various fields including oncology, burn / intensive care, women’s health, transplant, and virtual care.

In line with the evolving field of CL psychiatry, fellows gain experience in a variety of outpatient specialty clinics that feature different care models including virtual, integrative, and collaborative care. We currently offer over 10 specialty outpatient experiences, complemented by a prominent, longitudinal experience in the Lineberger Cancer Center’s Psycho-Oncology Clinic. This balance of dedicated patient care in a multi-disciplinary cancer clinic and exposure to a range of specialty clinics allows you to hone your skills and explore your interests.

Current Subspecialty Clinics

Direct: Women’s Mood Disorders (General, Perinatal, and Perimenopausal), HIV, Pain Anesthesia, Neuro-Oncology, Cystic Fibrosis, Aging Brain (Geropsychiatry imbedded in Neurology Clinic)

Resident Supervision: Transplant Clinic, Women’s Mood Disorders (General, Perinatal, and Perimenopausal)

Collaborative: Internal Medicine Primary Care, Cystic Fibrosis, Family Medicine

Consultative: TBI (Multi-Disciplinary Veterans Service), Sickle Cell Disease, Epilepsy Pre-Surgical Evaluation, Cystic Fibrosis, Psychiatry Consultative Clinic (Limited consultative evaluations for primary care patients.)

Structure

The fellowship’s academic year is designed to provide a balanced mix of inpatient and outpatient experiences. Instead of a traditional block schedule, we utilize a novel “2+1” schedule where fellows alternate between two weeks of inpatient duties followed by one week of dedicated outpatient clinic and administrative time. Fellows have more flexibility to allocate time toward their interests, research, QIPS endeavors, and self-care.

Inpatient Experience

• Direct Patient Care (6 weeks): The year begins with direct consultative care to familiarize fellows with the service and prepare them for their future role as supervisors. Fellows also get exposure providing direct consultative care over the course of the year on Wednesday afternoons.
• Junior Attending Role (26 weeks): Fellows transition to supervising residents on our two specialty teaching services, spending the remainder of the year receiving graded supervision by experts in the field while managing a busy academic CL service. Fellows divide their time between our Hillsborough (Virtual) / Oncology / General (HOG) and Burn / Solid Organ Transplant / General (BTG) services, preparing them for the diverse challenges of being an attending CL psychiatrist.
• Palliative Medicine (2 weeks)

Outpatient Experience

• Psycho-Oncology Clinic: Fellows participate in a weekly, longitudinal half-day Psycho-Oncology clinic, including dedicated didactics and multi-disciplinary case discussions with the Comprehensive Cancer Support Program (CCSP).
• Specialty Clinics: Every third week, fellows gain exposure to at least two ½ day specialty clinics per semester, immersing themselves in co-localized, integrated care in medically complex clinics. See Current Specialty Outpatient Clinics above for a comprehensive list.

Electives
Up to 4 weeks can be spent on rotations supplementing the fellowship experience. Fellows are encouraged to explore areas of interest. Examples of past electives include:

• • Addiction Medicine
  • Interventional Psychiatry (ECT, TMS, Brexanolone, esketamine)
  • Specialty Inpatient Psychiatry Units (ex. Perinatal and Eating Disorder Units)
  • Pediatric CL Psychiatry
  • Palliative Medicine / Hospice
  • Physician Advisor (Care Management / Utilization)
  • Emergency Psychiatry
  • Additional Direct CL on our Non-Teaching Service

Other

• • Orientation
  • Administrative Time: Fellows are allotted dedicated time every third week to pursue individual interests, including research, quality improvement, patient safety, and diversity, equity, and inclusion initiatives. This time can also be used for board preparation, exploring post-graduate opportunities, and personal well-being.
  • ACLP: Fellows receive financial support to attend our annual conference.

  Didactics

  Fellows participate in a robust educational program that includes required conferences and other additional education opportunities. All seminars are protected time for trainees.

  • Weekly CL Fellows’ Seminar
    • Didactics: Primarily expert opinion and/or text-based
    • Focus: Balances CL board preparation and clinically relevant topics.
    • Collaboration: Includes a Joint Lecture series with Indiana University.
  • Weekly CL Division Meeting featuring:
    • Administrative: Includes projects and meetings that model the running of a large academic CL service where fellow participation is encouraged.
    • Clinical: Features real-time quality improvement initiatives, patient safety measures, scholarly and research project development, journal discussion, and case discussion.
    • Collaborative: Includes integrated literature reviews with various faculty.
  • Weekly CL Case Conference
    • Evidence-Based: Integrates relevant text and literature.
    • Multidisciplinary: Attended by medical students, psychiatry residents, psychiatry faculty (CL and non-CL), alumni, and providers from various medical and administrative disciplines.
  • Monthly Self-Assessment Meeting
    • Structured: Includes directed self-assessment and group supervision with senior CL leadership.
  • Weekly Comprehensive Cancer Support Program (CCSP) Grand Rounds
    • Optional: Multi-disciplinary conference at the intersection of Psychiatry, Oncology, and Palliative Medicine.
  • Weekly Department of Psychiatry Grand Rounds
    • Optional: Includes Grand Rounds on topics in general psychiatry, QIPS, and DEI.

  Administrative Projects: Research, QIPS, and DEI

  Participation in ongoing research protocols is encouraged and completion of a scholarly project such as authorship of a literature review article, abstract, poster or presentation is supported as an aspect of the curriculum. Quality improvement and safety projects are also a critical part of fellow training. Fellows receive dedicated mentorship and guidance to explore opportunities in these academic areas.

  Mentorship

  Our fellowship program offers comprehensive mentorship to support your growth. The fellowship year goes by quickly and we believe strong mentorship is crucial for making the most out of your experience. Receive regular formal and informal feedback and guidance on your clinical, administrative, teaching, QIPS, DEI, and research development. Our structured mentorship program will provide the support and guidance you need to succeed in your fellowship and beyond.

  Program Director Mentorship: Monthly meetings with the PD to discuss well-being, clinical progress, administrative tasks, and topics including board prep, job search, contract negotiation, and transition to post-graduate life.
  Scholarly Mentorship: Regular meetings with suggested mentors who share your academic interests to discuss research, explore academic goals, and receive support for scholarly work.

  Teaching

  Fellows play a major role in teaching. They become responsible as ‘Junior Attendings’ for supervising psychiatry residents and third- and fourth-year medical students who rotate through the Consultation-Liaison Service as part of their training. Fellows have an opportunity to participate in the formal general residency didactics. There are also opportunities to develop, implement and participate in formal instruction of other disciplines, physician assistant students, and medical students.