Navigating Burden of C-L Training in Residency: Sponsored by ACLP's Residency Education Subcommittee

Abstract: A positive C-L experience during residency forms an important foundation for an interest in C-L psychiatry and for recruitment to the field. Further, C-L psychiatry is a core rotation for residents and stressful experiences during this required rotation can impact morale and retention of residents. There have been several recent developments driving rapid change in C-L trainees’ experiences. COVID-19 has impacted the volume and complexity of patient presentations and has impacted resident safety. Expansion of hospital systems has led to an increase in resident call responsibilities. Patient mistreatment of trainees has increased as well. These new complexities are in addition to historical challenges such as balancing C-L work with outpatient commitments, integrating and applying knowledge from different rotations, and managing conflict. The collective and rapidly evolving burden of these experiences make it more critical than ever for faculty to attend to resident experiences and develop and disseminate strategies to manage burden and maximize C-L education.

Mallika Lavakumar will introduce the topic, the speakers, and provide grounding in relevance of the topic (5 minutes)

Amanda Mihalik-Wenger will provide a resident’s perspective of challenges in the learning environment that are compounded by the COVID-19 pandemic and can contribute to the emotional burden of a C-L rotation. She will identify processes that facilitated resident growth such as faculty acknowledgment of the resident experience, adoption of a solutions-focused approach, and inclusion in opportunities such as quality improvement (QI) projects (20 minutes).

Ann Schwartz will highlight how scholarly endeavors provide trainees opportunities to be creative and feel a sense of control and accomplishment. She will teach about how to produce scholarship on the C-L service including generating clinical case material such as posters, oral presentations, case conferences, case reports, and QI projects (20 minutes).

Thomas Soproeno will describe a novel curriculum to train residents in curbside consultation to address increase in call responsibilities. This modality of psychiatric support can preserve the health and well-being of our trainees during high-risk times, like during recent waves of the COVID-19 pandemic. This strategy naturally incorporates an educational framework that is conducive to independent and asynchronous learning (20 minutes).

Anita Chang will discuss the impact of microaggressions and other forms of discrimination towards trainees during clinical care and tactics for addressing them. She will instruct on ways to deal with discrimination that are helpful and empowering for trainees (20 minutes).

Mallika Lavakumar will make closing remarks (5 minutes).

This workshop/symposium will be relevant for all psychiatry residents and C-L educators of residents.


References:

Sales PMG, Arshed A, Cosmo C, Li P, Garrett M, Cohen MA. Burnout and Moral Injury Among Consultation-Liaison Psychiatry Trainees. Psychodyn Psychiatry. 2021 Winter;49(4):543-561. doi: 10.1521/pdps.2021.49.4.543. PMID: 34870461.