Psychiatry Residency Program. University of Connecticut Health Center, School of Medicine.

The University of Connecticut Health Center and Affiliated Institutions

The University of Connecticut Department of Psychiatry, Correctional Managed Health Care, and affiliated community clinics, are part of an integrated program in psychiatric education. This consortium incorporates the strengths of various clinical settings and assembles a diverse and enthusiastic faculty working together to provide a residency training program that utilizes the best from a vast pool of resources. The consortium is flexible, creative, forward looking, and supportive of education.

The University of Connecticut Health Center is the primary site for the residency program. Residents are active in each aspect of psychiatric clinical services at the Health Center and they also serve a valuable role in other medical settings within the hospital where psychiatric issues are prevalent. The other major home-based site is the Talcott Notch Road Outpatient Clinic, where each resident is allocated their own office and they establish a clinic that continues for two consecutive years. In addition to those two UConn-run sites, the program has contracted with several outside agencies, as detailed below. There are many advantages to training in a structure such as this. The diversity of the academic resources (private and public), the richness of our clinical populations, and a dynamic faculty representing various scientific orientations, offers a wealth of educational opportunities. This training model prioritizes the vitality and quality of education over other competing interests. The collaborations within the community are mutually beneficial, providing a stimulating educational experience while residents and faculty strive to provide first-rate care for these community populations.

UCONN-Based Clinical Sites:
The University of Connecticut Health Center
Talcott Notch Road Outpatient Clinic

Major Area Hospitals:
Hartford Hospital
Institute of Living
Saint Francis Hospital

Affiliated Sites, Community Clinics, and Specialty Services at UCONN:
Manson Youth Institution (MYI)
Hartford Behavioral Health
Community Health Services
VA Health Center
UHP Child Clinic
Hartford Methadone Clinic
Community Health Resources Clinic
Huntington’s Disease Clinic
UConn Health Center – Student Health Service at Talcott Clinic
UConn Health Center – ECT Department
UConn Health Center – General Medicine/Psychiatry CLINIC
UConn Health Center – Cancer, Depression, and Fatigue Clinic

UConn-Based Sites:

The University of Connecticut Health Center, John Dempsey Hospital, 263 Farmington Ave. Farmington, CT - website

The University of Connecticut Health Center is a modern health-sciences complex, structured as a continuous curvilinear building where teaching, research, and clinical services are elegantly integrated within one site. This trio of priorities is reflected within the Department of Psychiatry's core mission. Since the 1975 opening of the Health Center in Farmington, the Department of Psychiatry has gained a national reputation for its educational and research programs. The full range of psychiatric services includes a general adult inpatient unit, an inpatient unit specializing in psychiatry-medicine and geropsychiatry, a consultation liaison service providing psychiatric consultation to all different non-psychiatric units within John Dempsey Hospital, intensive outpatient and partial hospital programs for the treatment of patients with chronic mental illnesses and addictions, and psychiatry emergency/crisis services.

Talcott Notch Road Outpatient Clinic, 10 Talcott Notch Rd. Farmington, CT - website

This clinic, fondly referred to as, "10 Talcott", is the hub of outpatient psychiatry at UCHC and serves as a home to senior psychiatry residents. The clinic structure allows growth of PGYIII residents towards independent and responsible clinicians at the conclusion of their outpatient rotations. With outstanding attending supervisors and multidisciplinary team of therapists, APRNs, social work, and case management, residents learn comprehensive and evidence-driven management of psychiatric illnesses. The patient population is diverse including patients with serious and chronic mental illness, patients with medical and substance use comorbidities, as well as specialized patient populations such as patients with intellectual disabilities.

Major Area Hospitals:

Hartford Hospital, Hartford, CT - website

With 819 beds, Hartford Hospital is the largest general hospital in the State of Connecticut. It serves as a major affiliated training site for house officers in psychiatry, medicine, and has a reputation for the excellence of its patient care and teaching programs. Hartford Hospital is one of two sites where UCONN psychiatry residents rotate on the internal medicine service. It is the only site for the neurology rotation during the first year. It also serves as the location of HIV clinic as a fourth year elective.

Institute of Living, Hartford, CT - website

Founded in 1822, The Institute of Living was one of the first mental health centers in the United States, and the first hospital of any kind in Connecticut. Today, as part of Hartford Hospital, it is one of America's leading not-for-profit centers for comprehensive patient care, research, and education in the fields of behavioral, psychiatric, and addiction disorders. This center serves as the location for second year inpatient rotations in child and adolescent psychiatry.

Saint Francis Hospital, Hartford, CT - website

Established in 1978, the Saint Francis Foundation is the fundraising and resource development organization for Saint Francis Hospital and Medical Center. The Saint Francis Hospital and Medical Center Foundation operate exclusively to advance the charitable, scientific, and educational purposes of the Hospital through relationship building, community visibility, and fund raising. At Saint Francis, a full range of medical and surgical treatments, as well as specialized, acute and rehabilitative services are offered throughout a 617- bed multi-facility center. Saint Francis has a long established partnership with the University of Connecticut Schools of Medicine and Dentistry, and provides participant training and clinical rotations in Internal Medicine, as well as integrated and supplemental residency programs. First year psychiatry residents rotate alongside internal medicine residents at this facility for two of their required four months of internal medicine.

Saint Francis Mount Sinai Campus, Hartford, CT - website

Behavioral Health Services include a full range of mental health and substance abuse treatment programs for all ages. This is a facility where one month of addiction psychiatry is completed in the second year of psychiatry residency.

Affiliated Sites, Community Clinics, and Specialty Services at UConn:

Macdougall-Walker Correctional Facility, Suffield, CT - website

One of the largest high security prisons in Connecticut, this facility serves as a site for third year rotations. The rotation takes place on the mood disorders unit, a subacute care unit (as opposed to inpatient level care). This is not a hospital unit but is a residential unit for prisoners with specific disorders. A wide variety of psychopathology is seen including dual diagnoses, personality pathology, mood pathology, and pathology related to medical/drug related conditions. Malingering is commonly seen. Biopsychosocial management is stressed with emphasis on relevance to prescribing. Case management and therapy are available to the clients; this provides substantial support to the prescribing clinician. There is no insurance paperwork or disability paperwork on this rotation. Coverage of patients is limited to hours in clinic. Other issues that might arise between clinics are handled by on site staff. Discharge planning is handled by social work. This rotation offers a unique experience with the correctional system and with inmates with substantial psychiatric disorders.

Manson Youth Institution (MYI), Cheshire, CT - website

Manson is Connecticut's correctional facility for incarcerated 14-21 year-old males. Because research increasingly identifies youths in corrections as having high rates of undiagnosed and untreated psychiatric disorders, the division runs a once-weekly child psychiatry clinic within the prison. Psychiatry residents and child psychiatry fellows work directly with a child psychiatrist in the clinic to evaluate and treat incarcerated adolescents. This rotation is very consistent with the department's emphasis on training child psychiatrists for work in the public sector. Residents and fellows are encouraged to provide individual and group therapy using evidence-based models of psychotherapies along with psychopharmacology. Mini-specialty clinics promote in-depth evaluation and treatment of some disorders such as PTSD, impulse-control disorders, sleep disorders and obesity. Evaluation of early-onset substance use as well as severe conduct disorder, antisocial behavior, ADHD, and deficiencies in moral development related to the development of psychopathic personality traits are some of other teaching goals at this clinic.

Hartford Behavioral Health, 1 Main Street Hartford, CT - website

This is a non-profit, federally qualified community adult clinic in the only minority-run behavioral health clinic in the State of Connecticut. It serves as a site for third year rotations. The patient population is a very different one from that seen in Talcott Clinic. This is a chance to do what can best be described as “Primary Care Psychiatry” for the indigent. Patients seen most often have depression, PTSD, psychosis, substance abuse/dependence.

Community Health Services, New Britain, CT - website

This is a Primary Care Clinic with integration of medicine and psychiatry in one setting and provides a unique experience with multidisciplinary management of patients in a primary care clinic setting. With an efficient electronic database, on site support from primary care clinicians, therapists, and substance use counselors, and an outcomes driven system, this FQHC is considered top-notch in the state of Connecticut. It serves a diverse patient population with different levels of psychopathology, including some with anxiety or depression, some with significant comorbid substance use and some with serious treatment refractory mental illness. The patient population has interesting and diverse demographics with a large number of Spanish speaking, Polish speaking, and bilingual patients. This clinic also provides an excellent experience in Ambulatory C/L.

VA Health Center, Newington, CT (including Nicotine dependence and PTSD clinics) - website

The Substance Abuse Treatment Program at the Newington VA offers a range of clinical services including assessment, outpatient detoxification, an intensive 15 day substance abuse day program, and general substance abuse outpatient treatment. Patients served in this treatment program present with a range of substance abuse and dependence diagnoses, including alcohol, cocaine, opiates, benzodiazepines, etc. Approximately 75% carry co-morbid psychiatric diagnoses, while nearly half of the patients are homeless. Residents will have an opportunity to gain exposure to in-depth substance abuse assessment, treatment disposition and planning, and opiate and alcohol detoxification. They will conduct complete substance abuse-psychiatric evaluations to develop biopsychosocial case formulations that will drive treatment planning. They will work with addiction psychiatrists to learn pharmacological management of substance abuse, including Buprenorphine, Acamprosate, Naltrexone, Antabuse, etc, and to manage psychiatric co-morbid diagnoses. They will work with clinical psychologists with expertise in addictions to gain exposure to cognitive-behavioral therapy, motivational enhancement, 12-step facilitation, and community reinforcement models. Furthermore, working within a multi-disciplinary team, they will become familiar with a multi-disciplinary rehabilitation approach, and will hone skills of team leadership and team direction. Residents will work within the Smoking Cessation Treatment Program to learn evidence based pharmacological and behavioral treatments of nicotine dependence and tobacco use disorder.

An attending psychiatrist directly supervises residents’ clinical care of Veterans with a diverse group of diagnoses with an emphasis on combat PTSD. In the Mental Health Clinic (MHC), residents will follow their own caseload of newly diagnosed veterans just back from the current wars in Iraq and Afghanistan, as well as older veterans of the Vietnam, Korean, and WWII eras. An effort is made to match up individual residents with particular types of patients that interest them. In addition, the residents follow patients in the Primary Mental Health Care Clinic (PMHCC), a walk-in psychiatric clinic that works in a modified Collaborative Care Model with Primary Care. Emphasis in this part of the rotation is on integrating the medical and psychiatric care of the patient and communicating with multi-disciplinary staff. The rotation is supplemented with evidence-based literature on the diagnosis and treatment of PTSD with medication, psychotherapy, and social treatments. Residents are also introduced to concepts of Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy, and other treatment options. An opportunity for an independent literature review and presentation of this review to an interdisciplinary audience is encouraged if the resident is interested.

UHP Child Clinic, Kane Street, West Hartford, CT (including Child Depression Clinic, ADHD Child Clinic, Child Trauma/Psychotherapy Clinic)

This is an outpatient child and adolescent psychopharmacology clinic serving children 6 to 17 years old and their families. The clinic emphasizes a team approach to early-onset mental health disorders. A team meeting occurs with clinic staff every Thursday from 12 noon to 1:30 pm. Residents who participate in the clinic are asked to attend these meetings once monthly. The clinic is a rich experience in the evaluation and treatment of early-onset ADHD, depression, bipolar, substance abuse, and trauma disorders. Specific learning objectives include understanding the evaluation and treatment of child and adolescent mood disorders, the evaluation and containment of suicidality in the young, and the intergenerational transmission of affective disorders and its link to depression and bipolar disorder in adults. Residents will learn the use of common rating scales to assess symptom severity and how to recognize and treat comorbid psychiatric conditions in depressed children and adolescents.

ADHD clinic provides an excellent learning experience in the assessment and treatment of Attention Deficit Hyperactivity Disorder. Learning objectives include: assessment of ADHD and management of rating scales in children, adolescents, and families, evaluation of co-occurring psychiatric conditions such as opposition defiant disorder, conduct disorder and learning difficulties, as well as anxiety disorders. Another goal for the residents is to feel comfortable in the proper psychopharmacological treatment of ADHD. This experience will enhance ultimately the history taking and diagnostic skills in child and adolescent psychiatry, by allowing the rotating residents to be in the place of a child and adolescent professional and experience calling parents, teachers, and dealing adequately and effectively with the systems. It is a rewarding experience to see how comprehensive treatment improves response to medication. Room for research is always available and the volume of patients is constantly growing, due to the dire need for these services. Team approach is encouraged and in fact due to the high prevalence of comorbid disorders there is a Parenting Group that residents can eventually participate in. A team meeting occurs with clinic staff every Thursday from 12 noon to 1:30 PM. Residents who participate in the clinic are asked to attend once monthly.

Methadone Clinic, Hartford, CT

Patients seen have dual diagnosis issues in addition to their maintenance on methadone. There is also a small Suboxone clinic. This clinic also provides onsite primary care services for the clients.

Community Health Resources Clinic (CHR), Manchester, CT

Community Health Resources is one of the state’s largest community mental health agencies with 650 staff serving 10,000 adults and children a year, with the largest geographic catchment area of any CT Community mental health clinic. Services include outpatient, partial hospital, case management, crisis services, residential, ACT team, and addiction services. The Manchester site is one of the main divisions of CHR and this rotation is in the Manchester Adult Outpatient Clinic. The clinic serves adults with, primarily, severe and persistent mental illness but the range of psychopathology and function is broad with many comorbidities (medical, addictions, and trauma). Emphasis is on providing a multidisciplinary team approach and on communication with providers, family, and supports – viewing the patient (and presenting symptoms) as integrated into a larger system. Part of the day is therefore spent in the team meeting. Although the core task is pharmacotherapy, this rotation provides a window into how our public mental health ‘safety net’ works. The supervisor is the Chief Medical Officer of CHR and offers unique instruction on mental health policy, systems, and leadership in public sector psychiatry.

Huntington’s Disease Clinic, Dowling Building, Farmington, CT - website

The mission of the University of Connecticut Huntington's Disease (HD) Program is to provide care, treatment and education to patients with HD and their families. Persons eligible for care include Connecticut residents who have or are at risk for HD and their family members. The program, which is supported by the State of Connecticut, provides services to over 150 families within the state. The HD Program is also charged with being an educational resource for the state of Connecticut. Residents from the Department of Psychiatry and the Department of Neurology at UConn have the opportunity to rotate through the clinic and gain valuable experience working with patients and their families.

UConn Health Center-- Student Health Service at Talcott Clinic

The Department of Psychiatry runs the behavioral health component of the Student Health Service at UConn Health Center, providing assessment, treatment, and follow-up to medical, dental, and graduate students. This would be an opportunity for PGY-4 residents to work with primarily dental and graduate students.

UConn Health Center – ECT Department

The ECT Service does inpatient and ambulatory ECT for patients with severe affective disorders, catatonia, and some patients with schizophrenia. This Selective will encompass a three month block, a half day a week, 1:00 – 5:00 PM on either Monday, Wednesday, or Friday. Residents will expand the knowledge and experience from the 2nd year rotation, not only doing many procedures, but being involved in the overall management of the service, including consultations with patient candidates, planning of treatment courses, integration of ECT into overall psychiatric treatment plan provided elsewhere, and discharges. Also covered will be current thinking regarding mechanism of action, potential risks, consent procedures and associated legal ramifications, management of adverse events, evaluation of therapeutic outcome and of cognitive side effects, what to do after ECT course completed, and documentation. The resident will assist with teaching medical students about ECT as well.

UConn Health Center- General Medicine/Psychiatry Clinic

This is a new clinic being developed by Dr. Kamath in collaboration with a UCHC internist, Dr. Andrews. Residents will see patients attending this general medical clinic who have been identified by their internist to need psychiatric evaluation/treatment. This clinic is an excellent experience for residents interested in psychosomatic aspects of mental illnesses and outpatient consultation-liaison psychiatry.

UConn Health Center- Cancer, Depression, and Fatigue Clinic

Patients with cancer struggle with depressive, anxiety and fatigue symptoms. In this Cancer Depression and Fatigue Clinic, we try to address these issues in a comprehensive manner with multidisciplinary interventions. We collaborate with oncologists and endocrinologists to first rule out any medically reversible conditions that can lead to depressive, anxiety, and fatigue symptoms. The focus of the clinic is on pharmacological interventions for depressive/anxiety and fatigue disorders. But, collaboration happens with the social workers, group therapists, and individual therapists to add interventions based on the need of individual patients. Acupuncture services (by a neurologist) and Alternative Medicine services (by a physician conducting energy medicine) will be added to this program in the next few months. Residents will also be able to attend monthly Breast Cancer Research group meetings, where innovative research proposals are discussed on a regular basis. This is an innovative program. Very few such coordinated programs exist in the United States. This clinic is an excellent experience for residents interested in psychosomatic aspects of mental illnesses.