Postdoctoral Fellowship Rotations

CHCW offers a variety of experiences for fellows related to behavioral health integration. Below is an overview of the fellowship experiences. Note that 1 clinic = ½ day for a total of 10 clinics per week

Experiences

  • PCBH service delivery (Locations: CWFM, YP, HLD; 5-6 clinics per week: CL, HLD, YP): Fellows will provide brief (i.e., 15-30 minutes) behavioral consultation services to patients in our outpatient family medicine residency clinic (CWFM), our outpatient pediatric clinic (Yakima Pediatrics [YP]), and our rural clinic (Highland [HLD]). Fellows will be available for immediate, same day referrals (i.e., warm-handoffs) from primary care providers. They will also consult with the primary care team regarding behavioral health concerns.  By the end of the year, fellows are expected to function as independent BHCs and see on average 4-5 patients per clinic and 1.5 patients per hour.  
  • Shadowing and providing feedback to family medicine residents (Location: CWFM/Ellensburg, 1 clinic per week: RES)

Fellows will shadow residents in their clinics and provide patient centered communication and psychosocial medicine feedback. This experience will help prepare them for employment as Behavioral Scientists in family medicine residencies.

  • Group (1 – 2 clinics per month: GRP): Fellows will assist in multiple groups offered at our clinics (e.g. chronic pain, teen health, and wellness group). They may also have the opportunity to identify unmet needs within the clinics and implement new group curriculums that address these needs.
  • Pairing with a medical provider (2-3 clinics per month: PAIR) In order to provide fellows the experience of a primary care provider, Fellows will pair with an advance practice clinician (APC; physician assistant, nurse practitioner), resident or attending in their respective clinics. The experience will evolve over the year from solely shadowing the provider to providing population based health/pathway initiatives (e.g., completing co-visits).
  • Experiential Learning and Group Supervision (1 clinic per week: EL): One afternoon per week (except the week of consortium didactics) will be used to provide fellows with an in-depth, interactive learning experience in which they will practice skills and discuss topics relevant to PCBH and the practice of psychology. This time will also be used for group supervision in the form of case presentations and consultation. This will take place at CWFM.
  • Projects and Paperwork Time (.5-1.5 clinics per week: PPW): Fellows will have protected time each week to complete paperwork and work on projects. This time will be used for self-directed journal review, the Quality Improvement project (described below), among other activities. A minimum of 2hrs, with most weeks having 4-6 hours, will be allotted for this. Provided that paperwork is completed and adequate progress is being made on projects,  or other scholarly activities of the fellows choosing.
  • Quality Improvement Project: Fellows will design and implement a quality improvement project at a CHCW clinic. Quality improvement consists of systematic and continuous actions that lead to measurable improvement in healthcare settings and the health status of targeted patient groups. Fellows will have the flexibility in the topic and are encouraged to focus on a quality improvement area that interests them. The project will culminate in a presentation, forum TBA. Projects will not be penalized based on whether or not improvements are made but rather the thought, planning, and critical analysis that is put into the project.

 Projects will be evaluated based on:

  • Addressing an identified need
  • Sustainability
  • Consideration of all members of the team
  • Research methodology
  • Use of the Plan, Do, Study, Act model
  • Presentation

Fellow Schedule and Time Allocation

 Fellows are expected to complete 2000 hours over a 12-month period. 

 Fellows’ schedule will be 40 – 50 hours per week on a Monday through Friday schedule to be arranged between the intern and the clinic of placement.  Our clinics are open late (until 8:00pm) five evenings per week and Fellows may be expected to work one late shift per week.

 

Required Assignments

Time Commitment

Patient contact

10-20 hrs./week

Individual supervision

2 hrs./week

Experiential Learning and Group Supervision

4hrs./week

Self-Directed Journal Review

2 hrs./week

Scholarly Project

NPTC Didactics/Professional Development

1/year

8-10 hrs./month

 

Example schedule for Fellows

  Monday Tuesday Wednesday Thursday Friday
AM HLD or CL YP PPW PSY HLD
PM HLD or CL YP PSY YP (Until 7 PM) RES

 CL = CWFM clinic, YP = YP clinic, HLD = Highland clinic; PPW = Projects/Self-directed Journal Review/Paperwork, SUP = Individual Supervision, GRP = Group, PAIR = Paring with medical provider; EL = Experiential Learning/Group Supervision; RES = Shadowing residents