Michael J. Vergare, MD
Professor & Chair,
Department of Psychiatry
& Human Behavior
Consultation-Liaison General Service: Formal teaching rounds are led by Psychosomatic Medicine faculty and include walking rounds. The psychosomatic medicine fellow, PGY-2 adult psychiatry residents, and Jefferson medical students attend rounds. You will discuss treatment with the attending during case presentations on formal teaching rounds. You will be in charge of conducting follow-up teaching rounds on patients on the service and will supervise the PGY-2 residents as needed.
Thomas Jefferson University Hospital is a large academic teaching hospital located in the center of Philadelphia. It includes Jefferson Hospital for Neuroscience. The clinical population is made up of a diverse ethnic, socio-economic, and cultural mix. Physicians see patients of all cultures and ethnic backgrounds. We are consulted by all services, including internal medicine, family medicine, cardiology, oncology, pediatrics, obstetrics and gynecology, surgery, trauma, neurology, neurosurgery, rehabilitation, and others. Patients carry varied psychiatric diagnoses: delirium, dementia, schizophrenia, other psychoses, substance abuse, bipolar and unipolar depression, anxiety disorders, personality disorders, adjustment disorders, post-traumatic stress disorders, somatoform disorders, and disorders due to general medical conditions.
We are consulted for issues with management of acute and chronic pain. We see patients with catatonia, and neuroleptic malignant syndrome. Capacity evaluations are common. When the capacity evaluation leads to a court hearing you may have the opportunity to testify or witness court testimony. Treatments provided include psychopharmacology, psychotherapy, crisis management, and family/couples interventions.
Outpatient Mood Disorders Clinic: The Mood Disorders Program in the Department of Psychiatry at Thomas Jefferson University is an outpatient clinical, research, and research program. You will work directly with Dr. Mago for half a day each week all year long, evaluating and following up patients with mood disorders and/or significant medical comorbidities. Immediately after the patient visits, you will meet with Dr. Mago for one hour each week to discuss the cases, mainly from the viewpoint of psychosomatic medicine.
Sleep Medicine: For six months you will participate in the Sleep Disorders Center for a half day each week. The Center is a clinical, research, and education program. Its clinical focus is the evaluation and management of patients suffering from a wide variety of sleep-related disorders. Treatment modalities include continuous positive airway pressure (CPAP), pharmacological agents, oral applications, surgery (most commonly laser-assisted uvuloplasty and somnoplasty), biofeedback, hypnosis, stimulus control therapy, chronotherapy, sleep hygiene management, phototherapy, and sleep restriction, among others. Here you will assess patients with sleep disorders, and present them to one of the Sleep attendings. You will then generate and discuss differential diagnosis and treatment with the attending.
Pain Medicine: For six months you will participate in the outpatient pain medicine program for a half day each week. You will assess patients with chronic cancer and noncancer pain syndromes and will discuss them with Dr. Cohen in order to arrive at a differential diagnosis, treatment plan, and to manage follow-up care. We provide rich case material that introduces new clinical issues related to pain and psychiatric comorbidity. You will learn to perform a pain-focused physical examination. We will train you in the use of accepted pain assessment tools, case formulation, and treatment planning. We collaborate with psychiatry, anesthesia, neurology, rehabilitation, neurosurgery, physical therapy, and psychology practices throughout the tri-state region. You will learn the use of psychotropic medications, narcotics, and adjuvant analgesics in the pharmacologic management of chronic pain. You will gain familiarity with a variety of nonpharmacologic modalities (hypnosis, psychotherapy, acupuncture, acupressure, surgery, biofeedback, etc), their indications, and relative utility in pain management. You will provide treatments including medications, psychotherapy, relaxation, hypnosis and biofeedback.
Electives: Liaison assignments will include Geriatric Psychiatry on a medical-psychiatric inpatient unit, Geriatric Medicine and Palliative Care, Epilepsy, Neurosurgery, Obstetrics/Gynecology, Oncology, Sickle Cell/Hematology, and Transplantation. During each 6 month block, you will choose one liaison rotation. You will attend clinical, research, and educational activities in your chosen area of interest. You will be assigned supervisory or primary responsibility for all psychiatric consultations in your chosen area of interest on the general consultation service.
Michael J. Vergare, MD
Madeleine Becker, MD
Program Director, Psychosomatic Medicine Fellowship
1020 Sansom Street
Philadelphia, PA 19107
- Psychosocial benefits of a novel mindfulness intervention versus standard support in distressed women with breast cancer
- Erratum: Safety and tolerability of levomilnacipran ER in major depressive disorder: Results from an open-label, 48-Week extension study(Clin Drug Investig (2013):33:761-771 DOI 10.1007/s40261-013-0126-5)
- Safety and tolerability of levomilnacipran ER in major depressive disorder: Results from an open-label, 48-week extension study
- Catatonia and Glucose-6-Phosphate Dehydrogenase Deficiency: A Report of Two Cases and a Review
- Antidepressant-induced excessive sweating: Clinical features and treatment with terazosin