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Consultation-Liaison Fellowship

Overview

Consultation-liaison (C/L) psychiatrists are specialty trained physicians with expertise caring for patients with comorbid psychiatric and medical conditions. Consultation-liaison psychiatry is the newest subspecialty in psychiatry with its first certifying exam in 2005. The growth of the field (the major organization for the specialty has grown 55 perceent in the past eight years) is related to the growing value health care systems are placing on effectively managing the behavioral health problems of large populations of patients seen in primary and specialty medical settings. 

There is good evidence that patients with any mental health or substance use disorder have two to three times higher health care costs than those without any such disorder.  We also know that most behavioral health services, if given at all, are provided by primary care providers, namely family and internal medicine physicians.  There is a growing need for psychiatrists who can work on and help lead multidisciplinary teams caring for patients in primary and specialty medical settings.  That is a major training goal of the University of Iowa Consultation-Liaison Psychiatry Fellowship.

The primary training sites for our C-L Fellowship are:

  • University of Iowa Hospitals and Clinics: UI Hospitals and Clinics is an 811-bed hospital that annually admits about 37,000 patients for inpatient hospital care. In fiscal year 2018, UI Hospitals and Clinics had 58,000 emergency department visits and the system has more than 200 outpatient clinics and care areas and accommodated more than 1 million clinic visits at the main campus and community outreach clinics. UIHC offers services by physicians board certified in more than 200 specialties and in 2018 performed 665 organ and tissue transplants. 
  • The Iowa City VA Health Care System: ICVAHCS is composed of an 83-bed hospital, including 43 medicine/neurology beds, 25 surgery, and 10 intensive care beds, and 15 psychiatry beds. The Iowa City VA Medical Center operates seven community-based outpatient clinics in Bettendorf, Waterloo, Dubuque, Cedar Rapids, Ottumwa and Decorah, Iowa; and Galesburg, Quincy and Sterling, Illinois. The Medical Center also operates a satellite outpatient clinic in Coralville, Iowa.  The Iowa City VA makes services available to 184,000 veterans living in 50 counties in Eastern Iowa, Western Illinois and Northern Missouri.

The clinical, educational, and research opportunities for residents and fellows in the University of Iowa Department of Psychiatry rival that of any major academic medical center in the country:

  • Inpatient C-L psychiatry services at UI Hospitals and Clinics and the Iowa City VA Hospital
  • Inpatient psychiatry services (UI Hospitals and Clinics: 44 adult inpatient beds, 14 child beds, 15 geriatric beds, 15 Med/Psych beds; VA: 15 adult inpatient beds)
  • Assertive Community Treatment services
  • Addiction services offering inpatient consults, partial hospitalization, intensive outpatient, outpatient, and medically assisted therapy services
  • Inpatient and outpatient ECT
  • Transcranial Magnetic Stimulation
  • Developing ketamine services
  • Women’s wellness psychiatry/psychology services
  • Psych-oncology services
  • Specialty inpatient and outpatient services for those with intellectual disabilities
  • Neuropsychology and expert clinical psychologist services
  • Clinical and research partnerships with the Iowa Neuroscience Institute, Iowa Neuroimaging Consortium, and Huntington’s Disease Center of Excellence.

Other University of Iowa highlights:

  • UI Hospitals and Clinics has one of the few medical-psychiatry units in the US, caring for those with active medical and psychiatric disorders. Doing C-L psychiatry in a center that has a med-psych unit (staffed by either a double-boarded medical-psychiatry attending or an internist and psychiatrist) dramatically improves the care provided to medically ill patients and helps make the management of psychiatrically complicated medical and surgical inpatients much more effective.
  • UI Hospitals and Clinics, as the major academic and quaternary care center in the state, has every type of specialty medical clinic available.

The University of Iowa and Iowa City VA Healthcare System have a long tradition of fostering integrated psychiatric and medical care at many levels:

  • Family medicine/psychiatry training program
  • Internal medicine/psychiatry training program
  • Evidence-based collaborative care programs in the family medicine primary care setting and the VA primary care setting

For all these reasons, consider doing your C-L Psychiatry fellowship at the University of Iowa. Our program will provide an in-depth, balanced clinical experience with didactics, research, and supervision provided by experts in consultation-liaison psychiatry, internal medicine, and family medicine – all coupled with a high quality of life living in a vibrant, diverse, Midwest academic community. We will help prepare you for a successful career in academic or community consultation-liaison psychiatry!

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