Join Dr. Sanya Virani and her guests, Paul B. Hill, M.D., and Dr. Hugh Caldwell to discuss the invaluable new title The Psychiatry Resident Handbook which aims to provide support, experience and mentorship to new residents, a book that trainees across the country will benefit from having on their bookshelves. In this episode, our guests -both contributors to the section on physician Impairment, share their experiences and perspectives around the subjects of physician burnout and substance abuse among colleagues and professionals, and what treatments and tools are available for best outcomes.

In this episode:
Introduction (0:11)
Recent experiences and observations (02:20)
Helpful programs, PHPs and resources (05:10)
The Well toolkit (14:40)
Peers in other specialties (17:50)
Confidentiality (21:10)
The Blueprint project (27:10)
Closing thoughts (29:08)

Dr. Paul B. Hill is a psychiatrist specializing in the treatment of geriatric and medically ill patients in Memphis, Tennessee. Dr. Hill is on the faculty of the University of Tennessee Health Science Center (UTHSC) College of Medicine.

Dr. Hugh Caldwell is an Assistant Professor, also at the University of Tennessee.

The Well toolkit

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Join Dr. Sanya Virani and her guests, Dr. Iverson Bell and Dr. Allison Ford to discuss the invaluable new title The Psychiatry Resident Handbook which aims to provide support, experience and mentorship to new residents, a book that trainees across the country will benefit from having on their bookshelves. In this episode, our guests -both contributors to the section on physician Impairment- share their experiences and perspectives around the subjects of physician burnout, compassion fatigue and substance abuse among colleagues and professionals, the signs to look out for, the consequences, and strategies for intervention.

In this episode:
Introduction (0:11)
Dr. Bell’s experience of physician impairment (2:45)
Dr. Ford’s experience of physician impairment (06:05)
The scope of the problem (10:00)
Defining “impairment” (16:30)
Personal experience of encountering stress in physicians (18:35)
Where to draw the line (24:25)
Confronting your colleagues (26:55)
Sobering statistics (30:35)
Closing thoughts (32:20)

Dr. Iverson Bell, Jr., MD, son of the AAVMC icon for diversity, earned the MD degree in 1977 from Vanderbilt University School of Medicine. Dr. Bell specializes in psychiatry and lives with his wife and children in Atlanta, GA.

Dr. Allison Ford is an Assistant Professor of Child and Adolescent Psychiatry at The University of Tennessee Health Science Center.

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Join Dr. Sanya Virani and her guests, Alka Mathur, M.D., and Neal Amin, M.D., Ph.D. to discuss the invaluable new title The Psychiatry Resident Handbook which aims to provide support, experience and mentorship to new residents, a book that trainees across the country will benefit from having on their bookshelves. In this episode, our guests -both contributors to the chapter on telepsychiatry- share their experiences and perspectives around the pros and cons of moving to a remote, digital workspace, how Covid-19 has accelerated our societal transition to reliance on video-screens, and the challenges posed by new technology.

In this episode:
Introduction (0:09)
This episode’s guests (1:14)
Post-pandemic changes in the role of telepsychiatry (6:20)
The experience of a trainee during Covid-19 (8:59)
Experiences with different platforms (12:12)
Advantages of telepsychiatry (13:53)
Whither telepsychiatry? (18:37)
Interstate regulation (24:00)
Malpractice (25:39)
Consent and documentation (29:00)
Emergencies (34:00)
Platforms and the role of AI (37:01)
The age spectrum, and privacy concerns (39:14)
Conclusion (42:20)

Alka Mathur M.D. is a Stanford trained Psychiatrist where she is a Clinical Assistant Professor on the Affiliate Faculty Line. She previously served as the Medical Director of Virtual Behavioral Health Services for the VA Palo Alto Healthcare System, overseeing Telehealth services for all Mental Health Programming. Dr. Mathur has a strong interest in health innovation and digital applications to increase access to care.

Neal Amin M.D., Ph.D. is a Clinical Assistant Professor in the Department of Psychiatry at Stanford University. He completed the Research Track Psychiatry Residency Program at Stanford University. He earned his MD and PhD degrees from the University of California, San Diego where he conducted his graduate studies at the Salk Institute for Biological Studies.

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Join Dr. Sanya Virani and her guests, Dr. Sallie De Golia, Dr. Raziya Wang, and Dr. Csilla Lippert to discuss the invaluable new title The Psychiatry Resident Handbook which aims to provide support, experience and mentorship to new residents, a book that trainees across the country will benefit from having on their bookshelves. Editors De Golia and Wang are joined by an early career psychiatrist, Dr. Csilla Lippert, who contextualizes the book in terms of the differing experiences common in training and residency.

In this episode:
Introduction (0:10)
What led to the creation of this book? (2:59)
Why now? (6:23)
How is Psychiatry different from other residencies? (9:05)
The best ways to use this book (13:47)
The professional development journey of residency training (19:15)
Diversity in training (25:30)
Differing experiences of supervision (28:03)
Deliberate practice (39:00)
Seeking a mentor (44:30)

Sallie G. De Golia, M.D., M.P.H., is a Clinical Professor, Associate Chair of Clinician Educator Professional Development, and Co-Residency Director in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine in Stanford, California.

Raziya S. Wang, M.D., is the former Designated Institutional Official and Program Director of Psychiatry Residency Training Program at San Mateo County in San Mateo, California. She is currently a Clinical Assistant Professor, in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine in Stanford, California.

Dr. Csilla Lippert earned her undergraduate degree from the California Institute of Technology followed by a combined MD and PhD in Biomedical Sciences from University of California, San Diego. She completed her psychiatry residency training at Stanford University, where she had additional specialized training in psychotherapy and teaching other physicians. Since 2021, Dr. Lippert has been working with veterans as a telehealth staff psychiatrist for the Veterans Affairs Palo Alto Health Care System.

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Dr. Virani focuses on the impact of Climate Change, and associated emergent anxieties, on our underlying mental health. Climate Change is affecting our livelihoods, our environments and our perceptions of the future; with implications on how we act and how we perceive our day-to-day lives. Virani (and guests) consider examples of patients presenting with climate-change specific conditions, discuss case-histories, and look for evidence that organizations are acting to address the causes and effects of Climate Change.

Discussed in the episode:

• Current data on Climate Change anxiety as a factor impacting mental health (3:00)
• Case study: “Jim” (5:15)
• Transformational Resilience (7:00)
• Don’t Look Up (11:45)
• Examples of improvement in climate change response at APA (13:15)
• Mental-health factors affecting “Jim” (15:15)
• Case-study: “Hannah” (18:30)
• Mental-health factors affecting “Hannah” (21:52)
• APA conference carbon footprint study (24:45)

Guests:

• Elizabeth Haase is Medical Director of Psychiatry for Carson Tahoe Regional Medical Center and an Associate Professor of Clinical Psychiatry at the University of Nevada at Reno School of Medicine. She chairs the Committees on Climate Change and Mental Health for the American Psychiatric Association and the Group for the Advancement of Psychiatry and is a founding member of the Climate Psychiatry Alliance.
• Joshua Wortzel is a chief resident in psychiatry at the University of Rochester, and he will be starting his child and adolescent psychiatry fellowship at Brown University in June. During residency, he is pursuing a Master’s in Health Professions Education at the University of Rochester. He is a member of the APA Committee on Climate and Mental Health, a steering committee member of the non-profit Climate Psychiatry Alliance, and a participant of the Group for the Advancement of Psychiatry – Climate Committee. He also serves as the chair of the APA/APAF Leadership Fellowship.

Links:

Visit the CPA website here.

The effects of Climate Change on Mental Health film

Carbon Footprint JAMA article

Don’t Look Up (Adam McKay, 2021) is available on Netflix.

Climate Psychiatry: What Every Psychiatrist Should Know APA course

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Dr. Virani focuses on exposure to war, violence, shootings, and the impact of migration.   These migrants are forced to flee from their homes due to threats of violence and death due to cultural or religious beliefs.    Just as traumatic for these individuals is the ability to adapt and be accepted in their new homes. 

• Discussed in the episode:
• Cultural Psychiatry
• Pre-migration stressors
• Post Migration stressors 
• Misdiagnosis of mental health issues in the migrant population
• Tips for diagnosing and working with refugees 
• The emergence of compulsive symptoms years after trauma 
• The importance to individualize each case.  
• Trust in leaders of the community
• Working with the religious communities to identify mental health issues

Today's guests 

Dr. G. Eric Jarvis is an Associate Professor of Psychiatry at McGill University and Director of the Cultural Consultation Service, the First Episode Psychosis Program, and the Culture and Psychosis Working Group at the Jewish General Hospital.

Dr. Victor Pereira-Sanchez is a child, adolescent, and adult psychiatrist based in New York. He obtained his medical degree (MD) in 2014 at Universidad de Navarra, in Spain, where he also completed a clinical residency program in psychiatry in 2019 and received his Ph.D. in 2021.

In this episode, Dr. Virani and her guests, Dr. Qayyum and Dr. Conrad, focus on the impact of Adverse Child Experience (ACE) and Adverse Early Life Experiences (AELEs) on mental health and provide some insights through case discussions about the downstream impact of these experiences.

Subjects discussed

Inability to trust and build safe relations by victims of early childhood experiences

The effect of trauma on the social determinants of mental health as an adult

Post-traumatic growth

Unpredictable behavior of parents

The power of close good relationships for a victim of ACE.

This episode is the second in a series covering the social determinants of mental health.

Dr. Zheala Qayyum is the Training Director for the Child and Adolescent Psychiatry Fellowship Program and the Medical Director of the Emergency Psychiatry Services at Boston Children’s Hospital/Harvard Medical School. She also serves as an officer in the United States Army reserves medical corps

Dr. Rachel Conrad is a Child and Adolescent Psychiatrist at Brigham and Women’s Hospital. She is now director of the Child Psychiatry Track in the BWH/ HMS Psychiatry Residency Program.

Listen to this podcast on your favorite podcast platform or here

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Social Determinants of Mental Health book

In Eleanor Rigby, the Beatles lament about loneliness and isolation and challenge us to “look at all the lonely people”. In this episode, Dr. Virani invites Dr. Dolores Malaspina and Dr. Luca Pauselli to explore social exclusion and insolation and its effects on mental health through case studies.  Join us on the first episode of a new season of Finding Our Voice covering the social determinants of mental health.  

In this episode

Jumbo, the elephant, and isolation of caged animals

DSM-5 code 62.4

Social isolation and exclusion during the pandemic

Loneliness and schizophrenia study published in Psychiatric Research

Loneliness and its effect on the body

Biological pathways and the social determinants of mental health.

Dr. Dolores Malaspina is the chair of the research and education workgroup of the current Presidential taskforce on Social Determinants of Mental Health chaired by Dr. Dilip Jeste.  Dr. Malaspina directs the Psychosis Program called Critical Connections at the Icahn SM Mount Sinai where she is a Professor of Psychiatry, Neuroscience, and Genetics & Genomics and the Vice-Chair for DEI. She was previously the Steckler Professor and Chairman of the NYU/Bellevue psychiatry departments, where she founded and directed a multidisciplinary program for research and training (Institute of Social and Psychiatric Initiatives- InSPIRES).

Dr. Luca Pauselli is a PGY3 in the Mount Sinai Morningside/West psychiatry residency program. Luca completed medical school and a residency in Italy.

This podcast is subject to the Terms of Use at www.psychiatry.org.  The views and opinions expressed in this podcast are those of the individual speakers only and do not necessarily represent the views of the American  Psychiatric Association, its officers, trustees, or members. The content of this podcast is provided for general informational purposes only and is not intended as, and shall not be understood or construed as, medical or any other type of professional advice nor does it represent any statement of the standard of care. We strongly recommend that any listener follow the advice of physicians directly involved in their care and contact their local emergency response number for any medical emergency. The information within this podcast is provided as-is and is not guaranteed to be correct, complete, or accurate.