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UCLA Mental Health Services for Physicians in Training. Paula W. Stoessel, Ph.D., Director Program Directors’ Conference May 14, 2010. UCLA Graduate Medical Education. UP, UP AND AWAY. ACKK!! KRYPTONITE!!! KRYPTONITE!!!. Bluebird of Happiness visits. How to Get Up And Get Dressed.

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ucla mental health services for physicians in training

UCLA Mental Health Servicesfor Physicians in Training

Paula W. Stoessel, Ph.D., Director

Program Directors’ Conference

May 14, 2010

slide4

UP, UP AND AWAY

ACKK!! KRYPTONITE!!!

KRYPTONITE!!!

slide7

How to Get Up

And Get Dressed

slide10

MARRIAGE

COUNSELOR

“The problem as I see it, is that you both are extremely adept at pushing each other’s buttons”

COUPLES PROBLEM ??

slide11

HELLO….. YES,

THIS IS DR SMITH…..

vignette 1
Vignette #1

You are concerned about the performance of one of your interns.

His evaluations remark that he is often late and his appearance is sometimes unprofessional.

Where he was meticulous in his patient care until recently, he has poor attention to details and often seems preoccupied.

You ask to speak to him.

slide13
When you ask the resident if there is anything going on with him to explain the change in his behavior and evaluations, he says, “I don’t want to be in medicine. I dread every day.” He will reveal nothing more, and he has poor eye contact and is clearly uncomfortable with you.
as a pd what would be the most appropriate next step
As a PD, what would be the most appropriate next step?
  • Given the resident’s performance, place him on probation with a follow up meeting in 1 month.
  • Refer the resident to his faculty advisor for counseling.
  • Suggest to the resident that he seek outside therapy.
  • Refer resident to the MHSPT.
please make your selection
Please make your selection...

10

  • Place resident on probation
  • Refer to faculty advisor
  • Suggest outside therapy
  • Refer to MHSPT
slide16
Dr. Stoessel interviews the resident and finds that …
  • He is overwhelmed with anxiety about performing on the wards and cannot turn it off at night
  • He suffers from Major Depression that recurs and has stopped his medication
  • He always wanted to continue his studies in music and play the oboe, but his family told him he would never make money that way
  • His father is dying at home and every day in the hospital reminds him of his father’s illness; he does not feel he is entitled to ask for time off to see his father
slide17
During the interview, Dr. Stoessel, found out that the resident’s poor eye contact and discomfort during your interview with him were due to:
  • Shame
  • Cultural issues
  • Feelings of helplessness
  • Deference to authority
slide18
The resident’s father is dying. He gives permission for Dr. Stoessel to speak to you, his Program Director.

Which is the most likely recommendation?

  • Time off
  • A second visit to Dr. Stoessel; follow-up psychotherapy
  • Medication evaluation
  • An external psychiatric evaluation when the resident is ready to return to work
possible recommendations
Possible recommendations ...
  • Time off
  • Follow up psychotherapy
  • Medication Evaluation
  • External psychiatric evaluation

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