Hospital-based training (80% time)

The training-based experience involves the provision of psychological services to a range of medical services across this tertiary care center and its clinics. Within the service, the bulk of a fellow’s time will be devoted to bedside assessment and intervention.  Referrals are made with the expectation that we will provide timely recommendations and treat as appropriate. Further, a wide range of patient diagnoses and referral questions are presented, including medical adherence, coping with injury/illness, pain and anxiety management, grief, acute stress reaction, adjustment to disability and pre-transplant evaluation. Fellows develop appreciation for working in a fast-paced environment, in which the role of psychology is integral to patient care. Fellows provide psychological consultation to a variety of medical teams and learn to work collaboratively and efficiently with different medical and allied health staff (physicians, nurses, rehabilitation therapists, nutritionists, pharmacists, case managers, child life and pastoral care providers).

Additional specialized focus areas within the hospital-based service  

Adult Fellow training

• Palliative Care Service
  The Health Psychology service provides consultation to the multidisciplinary palliative care treatment team, who works directly with inpatients at end-of-life or with symptom management needs. This includes providing consultation for ethical dilemmas and clinical decision-making that occurs when working with patients at end of life. Intervention with dying patients and their families is also a part of this experience. The training experience also includes didactics in palliative care.    

• Acute Care for Elders (ACE) Service
  Fellows can choose to provide consultation to this multidisciplinary treatment team focused on comprehensive treatment planning for geriatric patients. Consultation questions include decisional capacity assessment, safety evaluation and dementia/delirium/depression work-up. Fellows attend morning rounds, work with patients and families and provide consultation to treatment teams.    

• Neurology and Neurosurgery Service
  Fellows can choose to attend Neurology/Neurosurgery rounds and take a psychology lead on this multidisciplinary treatment team. Patients seen include those who have suffered stroke, undergone resection of brain tumors, or are being treated for seizure disorder. Patients diagnosed with Functional Neurological Disorder (FND) can also be seen while a member of this treatment team.     

• Vascular Surgery
  Fellows can choose to attend Vascular Surgery rounds on a weekly basis and tend to work with the patients who are undergoing planned amputation as a result of vascular disease. Fellows engage in walking rounds and also attend weekly case conferences on this service.    

• Trauma Surgery
  There is great opportunity for fellows to assist patients who have sustained physical injuries as the result of a trauma, such as a fall, farming-related accident, assault-related incident or a motor vehicle, bicycle or ATV accident. As a Level I Trauma Center, University Hospital is frequently the local hospital of choice for individuals who have suffered more severe injuries that require more advanced and comprehensive care. Our fellows play an important role in providing support and education to these patients, and also can participate in weekly rounds.

• Burn Service
  UW Burn Service houses an inpatient acute care unit for adult and pediatric burn patients.  Specific skills developed include trauma screening, pain management and helping with adaptation to loss and body image change.

• Other experiences
  The general hospital setting is very receptive to any fellow who expresses interest in a certain area of training or population. Health Psychology services are also frequently requested by Cardiology, Colorectal Surgery, Critical Care, Gynecological Oncology, Medical Transplant, Orthopedic Surgery, Thoracic Surgery, Otolaryngology and Urology Services.

Pediatric Fellow training

• Hematology/Oncology Psychosocial Rounds
  Fellows may attend rounds for pediatric Hematology/Oncology patients who are often hospitalized for long periods of time. They also see patients and their families to assist with symptom management and ongoing support during hospitalization.  

• Neonatal Intensive Care Unit (NICU)
  Fellows can be actively involved in working with families of infants in the NICU. Fellows also provide consultation to nursing staff as appropriate and may attend weekly NICU rounds.   

• Rehabilitation Service
  Fellows see patients and families on the rehabilitation service to assist adjustment to disability. They work closely with rehabilitation therapists and the physiatrists on the Rehabilitation team. They assist with pain management, adjustment to cognitive deficits, body image and coping with ongoing rehabilitation efforts. They can attend weekly rounds with the Pediatric Rehabilitation Service.

Specialty elective rotation (20% time)   

• Each fellow will spend eight hours per week in one specialty elective rotation throughout the year. This rotation will be determined by several factors, including fellow level of interest, availability of site and recommendation of the Training Director. Options may include Inpatient Rehabilitation, Outpatient Cancer Psychology, Outpatient Adult Health Psychology, Transplant Psychology, Digestive Health Psychology and Outpatient Pediatric Health Psychology.

Multidisciplinary treatment team and rounds

Fellows are expected to attend multidisciplinary treatment team meetings and/or rounds on a regular basis. Fellows attend 1– to 2-hour rounds/team meetings on a weekly basis with any of the following services:

• Burn
• Palliative Care
• Vascular Surgery
• Trauma Surgery
• Neurology/Neurosurgery
• Acute Care for Elders (ACE)
• Hematology
• NICU (pediatric track)
• Pediatric Rehabilitation (pediatric track)
• Pediatric Hematology/Oncology (pediatric track)

Fellows can be involved in one of the above services for the full year or can split the experience into two six-month options. 

Supervision 

• Each fellow is supervised by at least two licensed psychologists throughout the year.
• The Director of Postdoctoral Training oversees all training and supervision. Fellows receive a minimum of two hours of formal supervision per week.
• Ongoing, informal supervision is available throughout every day, as there are always training faculty on site.
• Fellows are formally evaluated on a quarterly basis using the Psychology Trainee Competency Assessment Form (PTCAF). The fellowship program is overseen by the Director of Postdoctoral Training at UW Hospitals and Clinics, a licensed staff psychologist whose responsibility it is to ensure that training needs are being met.
• The Director of Postdoctoral Training is responsible for the recruitment and selection of fellows, and provides direction to and oversees the training faculty with regard to their involvement in the fellowship program.
• Fellows are required to maintain records of their clinical activities, and these records might be reviewed by the Director of Training to ensure a breadth of experience during the fellowship year. These records include the number of patient contact hours, the settings in which clinical services are provided, the type of psychological assessments and interventions provided and the fellows’ exposure to diversity in patient cultures.
• Fellows are asked to provide feedback and to evaluate their supervisors, training experiences and the overall fellowship program throughout the year. An exit interview is performed by the Director of Postdoctoral Training and the Health Psychology administrator with each fellow at the end of the year.
• Fellows might also have the opportunity to provide peer mentoring to practicum students and interns who rotate through University Hospital and American Family Children’s Hospital when available. There is also the opportunity to provide training to medical residents and other allied health staff on an as requested basis.