Longitudinal Ambulatory Clinical Experience – Behavioral Sciences and Mental Health Pathway (lace-mhp): a novel Clinical Experience Ali Asghar-Ali, md and Christopher Martin, md michael E



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Longitudinal Ambulatory Clinical Experience – Behavioral Sciences and Mental Health Pathway (LACE-MHP): A Novel Clinical Experience Ali Asghar-Ali, MD and Christopher Martin, MD Michael E. DeBakey VA Medical Center Menninger Department of Psychiatry, Baylor College of Medicine

  • “In participating in this LACE experience, I was reminded of what I have felt for a long time – that children are very powerful people.  That …is the very reason why I went into teaching middle school and why I have been interested in child psych as a medical specialty.”
  • CONCLUSIONS:
  • LACE-MHP provides exposure to longitudinal ambulatory psychiatry
  • AND
  • Broadens students' appreciation for community based interventions
  • The LACE-MHP supplements traditional psychiatry rotations with a longitudinal ambulatory psychiatry rotation and innovative community and classroom experiences
  • BACKGROUND:
  • Medical schools have extensive didactic instruction and clinical rotations that emphasize biological and hospital-based
  • psychiatric treatments.
  • Experiences in outpatient psychiatry, influences of psychiatry,
  • and psychosocial treatments are greatly lacking in medical
  • school curricula.
  • PROGRAM STRUCTURE:
  • The LACE-MHP is a specialized pathway in the Longitudinal
  • Ambulatory Care Experience (LACE) students for third year
  • medical students.
  • Students are selected into the pathway based on an essay
  • reflecting their interest in mental health.
  • For the entire third year, Thursday afternoon is reserved for
  • LACE activities
  • The first half of the year (August-December) involves weekly
  • visits with a board certified psychiatry preceptor in an
  • ambulatory, community setting.
  • The latter half of the year exposes the students to a variety of
  • community sites and innovative seminars.
  • WORKSHOPS & DISCUSSION GROUPS (SAMPLE):
  • Intersection of spirituality and the practice of psychiatry
  • Electroconvulsive therapy
  • Movie club facilitated by Dr. Glen Gabbard
  • Cross-cultural communication in psychiatry
  • Book club (book selected by students)
  • PRECEPTOR COMPONENT:
  • Supervised one-on-one by preceptor
  • Opportunities to sharpen psychiatry knowledge and skills
  • Build a mentoring relationship
  • Discuss career opportunities in psychiatry
  • Challenges of practicing medicine
  • Ethical dilemmas that arise during clinical care
  • Six seminar series titled, Therapy 101: Introduction to
  • Psychotherapy
  • Students learn the basics of the practice of psychotherapy
  • No such curriculum identified in our search of the
  • literature
  • COMMUNITY SITES (SAMPLE):
  • AA meeting
  • Community residential facility for persons with mental retardation
  • Tour of shelter and transitional living facilities
  • Center for children who have been victims of abuse
  • Forensic unit at prison
  • PATHWAY COMPONENTS
  • The LACE-MHP is a third year medical student course that promotes physician competency in managing the psychiatric, social, spiritual, and cultural needs of patients.
  • The LACE-MHP underscores the interface of psychiatry with culture and the role of psychosocial interventions.
  • “My patient, who I’ll call Mr. L, came in very angry about his life and his pain…  I took the time to discuss many life issues with him…  I realize that his journey through addressing his mental health issues will be a long one.  I feel honored to have helped him embark along that path.  Just taking the time to sit and listen to him – non-judgmentally – certainly meant a lot to both of us.  Yes, I will remember to always listen to my patients.”
  • Community site - Midtown Terrace, Houston, TX


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