PGY-1

General Adult Inpatient Unit 14 Thompson is a 16 bed secure psychiatric acute care unit dedicated to the treatment of severe mental illness. Inpatients treated on 14 Thompson suffer from a wide range of major psychiatric illnesses, including schizophrenia spectrum or affective psychoses, major depressive disorders, substance use disorders, adjustment disorders, and personality disorders. The patient mix is drawn from both the inner city and suburban populations of the Tristate area. Residents have firstline1 responsibility for managing a caseload of inpatients. Residents participate in interdisciplinary treatment teams including nurses, social workers and activities therapists. The unit provides the most secure setting for treatment of ill patients regardless of their degree of psychiatric pathology. The unit often admits patients seen through the Trauma Program, especially where injuries have been self-inflicted, following an initial period of medical stabilization. 14 Thompson regularly accepts patients from the medical and surgical services, who develop psychotic reactions or major affective disorders and require psychiatric care. Additionally, we are a citywide referral service for medically ill or pregnant patients in need of acute inpatient psychiatric care.

Division of Geriatric Psychiatry The Geriatric Psychiatry Program treats elderly patients primarily and a small number of younger patients with neuropsychiatric disorders. Most of the elderly patients suffer from chronic age-related psychiatric, medical, and neurological conditions such as depression, dementia, Parkinson’s disease, stroke, and accompanying medical disorders.  The unit is composed of 18 inpatient beds in a specially designed environment for an elderly disable population. Somatic therapies include psychopharmacology, electroconvulsive therapy, and management of concurrent medical and neurological comorbidities. The treatment program is multidisciplinary and includes psychiatry, neurology, family medicine, nursing, social work, and occupational and creative art therapies. Each discipline contributes its own specific expertise to create a comprehensive treatment program. Residents have first line responsibility for managing a caseload of geriatric inpatients. Active training and research establish the academic program.

Jefferson Emergency Psychiatric Service The service provides psychiatric consultation to the Thomas Jefferson University Hospital Emergency Department for patients who present with acute psychiatric conditions. We see a diverse patient population drawn from both urban and suburban areas throughout the Tristate. Faculty and residents provide consultative services for the evaluation, diagnosis, triage to appropriate service or secure, structured environment, and initial stabilization of acute agitation via medication management and supportive psychotherapy. In addition, residents may be called to consult on sexual assault victims who may have a mental disorder.

The Albert Einstein Medical Center The Albert Einstein Medical Center (AEMC) is a medical facility with 506 beds serving the Philadelphia area, and one of the principal clinical components of the Jefferson Health System. It is located in Philadelphia approximately 6 miles from the Jefferson Campus. The Crisis Response Center serves over 5,000 adults and over 1,000 children yearly who present with acute psychiatric symptoms. At the AEMC Crisis Response Center, residents are trained to manage the following: 1) assessment and triage of agitated patients while maintaining patient and staff safety; 2) assessment and management of delirium, emergency substance abuse disorders, and involuntary commitments; 3) identification and assessment of risk factors for suicide; and 4) assessment of medical conditions presenting as psychiatric emergencies.

PGY-2

General Adult Inpatient Unit 14 Thompson is a 16 bed secure psychiatric acute care unit dedicated to the treatment of severe mental illness. Inpatients treated on 14 Thompson suffer from a wide range of major psychiatric illnesses, including schizophreniaspectrum or affective psychoses, major depressive disorders, substance use disorders, adjustment disorders, and personality disorders. The patient mix is drawn from both the inner city and suburban populations of the Tristate area. Residents have firstline responsibility for managing a caseload of inpatients. Residents participate in interdisciplinary treatment teams including nurses, social workers and activities therapists.

The unit provides the most secure setting for treatment of ill patients regardless of their degree of psychiatric pathology. The unit often admits patients seen through the Trauma Program, especially where injuries have been self inflicted, following an initial period of medical stabilization. 14 Thompson regularly accepts patients from the medical and surgical services, who develop psychotic reactions or major affective disorders and require psychiatric care. Additionally, we are a citywide referral service for medically ill or pregnant patients in need of acute inpatient psychiatric care.

Consultation-Liaison Psychiatry The Consultation-Liaison Psychiatry division is a nationally recognized academic division that is active in educational, clinical, and research activities. The consultation service sees about 1000 patients per year who have medical, surgical, and obstetrical diagnoses, complicated by psychiatric symptoms. The faculty teaches residents about competency evaluations; the use of psychotropic medications in the medically ill; identification and management of delirium tremens and/or withdrawal/intoxication states; and a variety of other psychiatric conditions. The consultation liaison psychiatry faculty has specific expertise in cancer, complementary medicine, stress management, AIDS, women’s health, pain, and medically ill children.

Division of Substance Abuse Programs

Narcotic Addict Rehabilitation Program (NARP) This is an outpatient methadone maintenance treatment program serving about 360 opiate dependent patients. Residents serve as treatment team leaders and consultants to the treatment team. In these roles, residents are involved in admitting patients to the program and performing psychiatric evaluations and follow up visits. Residents spend about two thirds of their time at this program.

Intensive Outpatient Program (IOP) Patients enrolled in IOP attend the program three half days per week for about three hours each day. The predominant approach is group therapy. Residents act as co-leaders/observers in an ongoing group. In addition to following a group of patients over the six-week period, they also conduct psychiatric evaluations and follow up visits. Residents spend about one quarter of their time at this program.

Family Center Program (FCP) FCP is a program for addicted pregnant and parenting women. Within FCP, there are three programs including an outpatient component, a methadone maintenance treatment program and a residential program. Residents rotate here one half day per week and serve as psychiatric consultants to the staff-seeing patients for their initial evaluations and follow up visits. Residents spend about one eighth of their time at this program.

Belmont Center for Comprehensive Treatment

Adolescent Inpatient Unit The Adolescent Unit is a 28 bed secure psychiatric acute care unit dedicated to the treatment of mental illness in adolescents. The patients' ages range from 13 to 18 years. Residents are involved in all stages of inpatient care, including, admissions evaluations, individual/group/family psychotherapy, medication management, and disposition planning. Resident educational objectives include: 1) interviewing techniques as applied to adolescents; 2) diagnosis of psychiatric disorders and emotional difficulties in adolescents; 3) and use of psychiatric medications for inpatient children and adolescents.

Belmont Center for Comprehensive Treatment

Adult Inpatient Psychiatry The services at Belmont include 3 general adult units with 68 beds, an affective disorders unit of 16 beds, and an eating disorders unit of 10 beds. Residents at Belmont will divide their time among the eating disorders unit and one or more of the other adult units. Residents at Belmont will continue to attend Wednesday afternoon didactics at Jefferson, but will attend Friday Grand Rounds at Albert Einstein Medical Center.  Each resident is expected to undertake the care of a representative mix of patients and learn to use various treatment modalities. A climate of therapeutic devotion and academic dedication is fostered on the service.

PGY-3

Community Mental Health/Mental Retardation (COMHAR) COMHAR, Inc. is a private, nonprofit, full service Community Health Center that primarily serves the Kensington, Port Richmond, Fishtown, Juniata Park, and Northeast Philadelphia areas. COMHAR’s Mental Health Division provides variety of services including outpatient, partial hospitalization, targeted case management, residential, clubhouse and outreach programs to a diverse population of adults and children. It is the only Community Mental Health Center in the City of Philadelphia that has dedicated mental health services for individuals with HIV/AIDS. COMHAR also specializes in services to the Latino population. Residents perform intake evaluations and manage medications in collaboration with nonmedical staff. Residents also rotate through the partial hospital or HIV service.

PGY-4

Adult Outpatient Clinic The adult outpatient clinic is staffed by two fulltime faculty psychiatrists and psychiatric residents in their third and fourth year of training. The clinic treats adult patients between the ages of 18 and 65 with diverse clinical psychiatric diagnoses. In a typical year, the clinic records upwards of 4,000 patients visits. A majority of these patients have affective disorders, which may often be accompanied by an Axis II diagnosis. In addition, the clinic treats patients with psychotic disorders. Each new case is discussed in detail during an intake meeting with faculty, where a sophisticated approach to diagnostic formulation and differential therapeutics prevail. Some patients are deemed suitable for intensive psychotherapy, others for a combination of medication and psychotherapy, and still others for group interventions. An attempt is made to tailor the treatment to the patients’ needs. Each resident is expected to undertake the care of a representative mix of patients and learn to use various treatment modalities. A climate of therapeutic devotion and academic dedication is fostered on the service.