Consultation/Liaison Psychiatry Fellowship

The Department of Psychiatry & Human Behavior is pleased to offer an ACGME-accredited fellowship in Consultation/Liaison Psychiatry at Thomas Jefferson University Hospital. Our fellowship has recruited applicants since its inception in 2008, and has been participating in the NRMP Match program since 2014. 

As the intersection of psychiatry and general medicine is ever increasing, fellows who graduate from our program are well-prepared to succeed in a number of different careers, including both in-hospital and outpatient psychiatry settings. Our graduates have obtained careers in a wide variety of administrative, academic, and clinical environments, including several ACGME-accredited programs and clinical service directorships.

We accept both the Common Application and ERAS Applications. Given the tailored nature and clinical variety of our fellowship training program, we encourage trainees interested in non-CL careers to apply to our program. 

Program Overview

This one-year fellowship program offers a diverse, multidisciplinary, highly collaborative training environment. The CL Psychiatry Service at Thomas Jefferson University Hospital utilizes an interventionalist philosophy and an evidence-based approach in their provision of comprehensive psychiatric consultation in order to effect maximal outcomes for patients and consulting teams. This includes a proactive CL subservice managed by our psychiatric nurse practitioner, a robust Heart/Lung/Liver/Kidney Transplant psychiatry service, and a state-of-the-art addiction medicine service providing the nation's only protocolized treatment of xylazine and medetomidine withdrawal, endemic to Philadelphia.

Program Faculty

Every member of our faculty are fellowship-trained and board-certified in CL Psychiatrists. The diversity of our faculty reflects not only the multidisciplinary nature of consultation/liaison psychiatry, it also reflects the wide breadth of care available at Thomas Jefferson University Hospitals. This gives the fellows who match with our program the opportunity to participate in tailoring their training experience to best fit their interests. Each incoming fellow works with the program to select and finalize their chosen rotations, electives, as well as any future conferences and research in which they will participate.

Clinical Training

Fellows spend one half of the year on the General CL service, managing the most complex cases in the hospital, and not only "bread-and-butter" conditions such as delirium. Our fellows see a significant number of rare conditions, including:

• Catatonia due to medical conditions (accounts for approximately 5% of all Jefferson consults)
• Posterior reversible encephalopathy syndrome
• Anti-NMDA-receptor encephalitis
• Psychiatric manifestations of cerebellar disease
• Post-stroke/TBV neurosurgical syndrome
• Nutritional deficiencies with psychiatric complications.         

Fellows spend the other half of the year divided between other inpatient specialty rotations (Transplant Psychiatry; Addiction Medicine Service; Palliative Care), in addition to their other outpatient clinical experiences (Sleep and Headache Medicine Services; Oncology).   

On Transplant Psychiatry, CL fellows become experts in evaluating patients for:

• suitability for transplant or living donation
• managing immunosuppresant-induced neuropsychiatric syndrome

On Addiction Medicine, fellows learn how to:

• manage alcohol withdrawal by utilizing a benzodiazepine-sparing protocol
• manage patients abusing high-potency opioids and alpha-agonists, including use of:
  • intravenous methadone
  • dexmedetomidine
  • low-dose and high-dose buprenorphine inductions

Outpatient experiences are scheduled as half-days, and are a mixture of core rotations and "selectives",

Elective Experiences

We pride ourselves not only in the range of experiences that we can offer, but also in the flexibility such a rich training environment can provide, affording us the opportunity to construct well­-supervised elective experiences in nearly any medical subspecialty. Each fellow designs an elective experience that aligns specifically with their personal academic interests. A few examples of electives constructed by past fellows include:

• Dermatology
• Sports Medicine
• Sickle Cell Clinic
• Bariatrics
• Pain Medicine
• ECT
• Psychodynamic Therapy for medically complex patients 

Educational Program

A fully formed didactics curriculum is taught from both within the department and visiting professors, in addition to a separately scheduled journal club, along with weekly supervision and Psychiatry Grand Rounds sessions to round out our fellowship program experience. Our fellows are also actively involved in teaching and research, and are provided with protected administrative time for these activities.

Clinical Environment

As a 908-bed academic medical center, Thomas Jefferson University Hospital is an ideal location for CL fellowship training. Home to the NCI-designated Sidney Kimmel Comprehensive Cancer Center, TJUH also offers a Level I Trauma and Burn Center with Air Transport services, as well as the Marcus Institute of Integrative Health, that provides research and clinical services within the field of integrative medicine.

Futhermore, Jefferson Health houses several internationally-renowned medical institutes and centers, including:

• The Farber Institute for Neuroscience
• Jefferson Hospital for Neuroscience
• Wills Eye Hospital
• Rothman Orthopedics Institute

As a proud graduate of Thomas Jefferson University Hospital's Consultation/Liaison Fellowship myself, I can speak confidently that, as a graduate of our fellowship, you will be well­-prepared for any career at the interface of general medicine and psychiatry.

I invite you to learn more about our fellowship. If you have any questions about the program or our available experiences, please do not hesitate to contact me directly.

Lex Denysenko, MD, FACLP, UCNS-H