Behavioral Medicine Program

The resident chooses his/her behavioral health topic in conjunction with his or her B-Med preceptor.

The resident has an opportunity to explore a topic that is of interest to him/her. This assignment affords the resident practice by giving a presentation on a B-Med topic and may provide the groundwork for other scholarly work in the future.

Example topics

• Diabetes and compliance
• ADHD identification and treatment
• Depression and pregnancy

Monograph assignments required on the B-Med rotation offer a meaningful learning opportunity by providing thorough reviews assessment of the following topics:

• Depression
• Childhood Behavioral Problems
• Family Violence
• Addiction in Family Medicine

Therapy patient encounter/case review/note writing

• Gain greater awareness of the psychological processes typically seen in standard medical patient encounters
• Practice diagnostic interviewing skills in assessing psychiatric issues
• Practice note writing for targeted psychosocial issues

Group attendance/delivery

• Cancer Support Group
• Expression Through Art group
• Smoking cessation
• AA/NA groups (refer to the Resources section for the  community resource manual)

Video/audio training

These are training videos targeted toward the training needs of a Primary Care Physician.

• Interviewing skills in primary care
  • Motivational Interviewing/Health behavior change
  • How to motivate your patients without running them off!
• Family Violence
  • How to conceptualize/evaluate/ intervene
• Disclosing adverse events
  • Who/what/when/where?

The knowledge of human behavior, mental health, and mental disorders is incorporated into the everyday practice of family physicians. Family medicine residents must develop and display sensitivity to, and knowledge of, the emotional aspects associated with organic illness. Furthermore, family medicine residents must be able to identify relationships that exist among their patients´ biological, psychological and social factors. Among these interrelationships, residents will also consider the ethical scope of patient care.

During the residents´ second year (PGY2), a four-week period of formal training will take place in an inpatient setting at Emory University Hospital Midtown. The psychiatric rotation experience will focus on assessment and diagnosis, psychopharmacology approaches to psychotherapy and collaboration with mental health providers such as psychiatrists, mental health therapists, psychologists, and allied health professionals ( Emory Family Medicine Residency Program Handbook).

The Emory Family Medicine Residency Program facilitates and enhances resident education through an all-inclusive didactics program which is conducted every Thursday from 8 am to 12 pm in the Emory Family Medicine Main Office. Didactic presentations focus not only on medicine but also on behavioral medicine and psychiatry and serve as an avenue for educating and evaluating the residents´ knowledge in the ACGME six core competency areas.

Previous behavioral medicine/psychiatry didactic presentations have focused on topics such as the following:

• Affective Mood Disorders
• Family Violence: Intimate Partner Violence (IPV)
• Anxiety and Its Presentation in Primary Care
• Bereavement
• Balint Group Orientation
• Mind-Body Medicine
• Pain Management
• Borderline Personality Disorder in Primary Care
• Cultural Issues: Focus on African American Patients
• Attention Deficit Hyperactivity Disorder-Specialty Referral Issues

Because videotaping is an essential component of residency education, residents are expected to avail themselves of this valuable tool. The primary goal of videotaping is to provide an effective method of learning, practicing and ensuring competence in patient interviewing techniques and communication skills.

In the videotaping review cycle, residents are assigned specific patient encounters and then required to meet with faculty and fellow residents to review them. At the end of each videotape review session, future videotape assignment requirements are determined by the resident´s demonstrated proficiency level as outlined on the Videotaping/Communication Skills Progress Report Form.

Quarterly, the Behavioral Medicine faculty conducts Balint Group with Family Medicine Residents in their second year. Balint Group is based on an experiential model in which residents meet once a month to discuss, process, and examine the physician-patient relationship. During this time, group members listen to the presenting physician's story while concentrating specifically on the doctor-patient relationship. The primary goal of Balint Group is to assist the physician in understanding the relationship between physicians and their patients, as opposed to advising the physician on options for treatment.

The Balint Group process is unique in that difficult situations can be processed in a non-threatening manner so that pertinent information about patients' feelings may be discerned. This group experience provides an opportunity for residents to become more comfortable with feelings of uncertainty and complexity without feeling pressured to arrive at a resolution. Furthermore, the Balint Group process encourages residents to be more self-aware and self-reflective about ways in which they interact with patients on occasions when it is important to examine these emotions*

For additional information about Balint Group and the ACGME Competencies, please feel free to visit the American Balint Society website.

Important Forms/Requirements

• Videotaping Requirements found in the Resident Handbook
• Videotaping Encounter form
• Psychosocial Case Study Format

*American Balint Society website, June 8, 2005; STFM Conference, September 2005