Primary Care Behavioral Health Fellowship

The Department of Family Medicine and Community Health at the University of Minnesota Medical School is actively recruiting a postdoctoral fellow in primary care behavioral health.

This two-year fellowship provides training on the integration of behavioral health in primary care, as well as medical education to family medicine residents. Fellow activities include:

Providing evidence-based psychological services in the primary care setting, with special attention to refugee and immigrant populations.
Developing and implementing behavioral health programs that target population health and other clinic quality improvement initiatives.
Working effectively in an inter-professional team (faculty physicians, resident physicians, clinical pharmacists, care coordinators, legal partners and many others).
Educating family medicine residents on topics such as patient-centered communication, behavior change counseling, and mental health diagnosis and treatment.
Participation in a variety of teaching activities as part of the overall behavioral medicine curriculum for family medicine residents (e.g., video review, shadowing residents in clinic and hospital).
Completing a scholarly activity that advances the field of integrated behavioral health.

Brief History

We offer two fellowship opportunities within the department. One opportunity was established in 2007 and involves a longstanding partnership between two of our family medicine residency programs at Bethesda and Smiley's family medicine clinics.

In 2017, our fellowship expanded with the addition of another training opportunity, which is at Broadway Family Medicine Clinic and North Memorial Medical Center.

The fellowship is a member of the Association of Psychology Postdoctoral and Internship Centers (APPIC).

Apply

We offer two fellowship opportunities. One is located at Bethesda and Smiley's family medicine clinics. The second one is at Broadway Family Medicine Clinic and North Memorial Medical Center.

We are currently accepting applications to fill two Primary Care Behavioral Health Fellowship positions (Job ID 337784). The positions are open until Friday, January 15, 2021. Apply today!

For internal (current UMN employees) applicants, view the job description by logging in with your X500: https://hr.myu.umn.edu/jobs/int/337784

Eligibility Criteria

Applicants must have a PhD or PsyD degree in clinical or counseling psychology from an APA/CPA accredited program and completed an internship that meets APA, APPIC, or CAPPIC requirements.
Preference is given to applicants that have experience in primary care, health psychology, or behavioral medicine, as well as an interest in psychotherapy.
Must be eligible for Minnesota licensure.

Offers will be made in accordance with the Association of Psychology Postdoctoral and Internship Centers (APPIC) match guidelines.

Two Fellowship Tracks

We offer two fellowship opportunities. One opportunity is at Bethesda and Smiley's family medicine clinics in the Twin Cities. The other opportunity is at Broadway Family Medicine Clinic in North Minneapolis. All three clinics are certified health care homes.

Bethesda/Smiley's Track

The Department of Family Medicine and Community Health at the University of Minnesota Medical School is actively recruiting one postdoctoral fellow in primary care behavioral health for the Bethesda and Smiley's family medicine clinics position. This two-year fellowship provides training on the integration of behavioral health in primary care. The fellow's time is split equally between two clinics, one in St. Paul (Bethesda -St. Joseph's Family Medicine Residency) and one in Minneapolis (Smiley's - UMN Medical Center Family Medicine Residency).

The purpose of this dynamic fellowship is to equip psychologists with the knowledge, flexibility, and skills needed to meet the behavioral health needs of diverse patient communities, lead interdisciplinary teams and advocate for the health of patients, families, and broader communities. Fellows train alongside family medicine and pharmacy residents, which allows for learning in the areas of population health, team communication, complex care management, and supporting wellness in occupational settings. The opportunity to provide care within two clinic settings offers unique opportunities to fellows interested in how the integrated care model may be adapted to best fit the unique needs of various populations and communities based on the resources available in those settings.

The fellowship, as well as both clinics, are deeply devoted to identifying and dismantling racism as it affects our patients, colleagues, and communities. We strive to create a supportive environment that prioritizes and maintains the well-being of residents, fellows, faculty, and staff.

Our Clinics:
Bethesda Family Medicine Clinic is a certified health care home located in the St. Paul neighborhood of Frogtown, just blocks from the state Capitol. The Bethesda team includes family physicians, social workers, psychiatry, care coordinators, nurses, and pharmacists. The clinic has a medical-legal partnership with a local free/low-cost legal service team, which provides patients with help for health-harming legal needs. Bethesda serves a diverse patient community which includes many marginalized, ethnically diverse populations including Karen, Burmese, and Hmong refugees, among others. A hallmark of the culture of care at Bethesda is caring for the whole patient within their unique socio-cultural context.

Smiley's Family Medicine Clinic is a certified healthcare home and certified behavioral health home located in South Minneapolis. The Smiley's team includes family physicians, psychiatry (both adult and child), social work, pharmacists, nurses, and care coordinators. The Smiley's team cares for a racially, ethnically, and socioeconomically diverse patient population including Somali, Ethiopian, and Oromo immigrants. Smiley's is also well-known in the community as a safe place offering gender-affirming primary care.

At the time of this posting, we are offering most of our behavioral health services via telemedicine (video or phone, depending on patient preference and access). However, we are currently seeing some patients for brief consults in person during our integrated care clinic shifts. PPE is provided by the clinic. When the Fellow starts in September 2021, we anticipate that we will be offering a combination of both telemedicine and in-person services.

Fellow Activities:

Traditional Psychological Services:
Individual Psychotherapy: Fellows provide diagnostic evaluation and evidence-based care to adults with a wide range of behavioral health concerns. Length of treatment varies but within the fellowship, there are opportunities for both short-term, problem-focused psychotherapy as well as long-term care. Patients are referred by our primary care providers and have a wide range of presenting problems including depression, bipolar, anxiety, trauma/PTSD, and substance misuse, etc. Our program has recently received formalized training in Written Exposure Therapy (WET: Sloan & Marx, 2019) for trauma, and we are offering this new, evidence-based treatment to our patients.

Health psychology opportunities: Opportunities at both clinics exist for chronic pain management care planning and lifestyle consultations (e.g., weight management, chronic disease management, and tobacco cessation) across the lifespan.

Integrated Care:
Fellows work alongside the rest of our team in an integrated care model for 3-4 sessions/week. During the COVID-19 pandemic, we have been innovative in continuing to provide our clinic teams with behavioral health consultation and education by employing both face to face and virtual modes of communication. Activities during this time include:

Consultation on patients with behavioral health concerns
Psychosocial interventions for children at annual wellness visits that focus on improving sleep, nutrition, physical activity, and screen use.
Evaluation of patients starting suboxone
Preliminary assessment for N648 (citizenship exam waiver form) concerns
Care coordination
Crisis management (e.g., suicidal patients, new diagnosis)
Co-visits for patients in need of more comprehensive support
Resident shadowing of visits to coach on communication skills.

Resident Education:

Behavioral health is very involved in resident education at both clinics, and fellows participate in:
Interdisciplinary team meeting discussions of complex patients
Precepting family medicine residents on topics such as patient-centered communication, behavior change counseling, and mental health diagnosis and treatment
Provision of learning experiences for residents on their behavioral health rotation
Behavioral health didactics
Video review (teaching communication skills to residents)
In-clinic shadowing of residents to support patient-centered care
Shadowing residents in the hospital (this is on hold at this time due to COVID, but we hope to resume in the future)

Quality Improvement Projects and Research:

Fellows complete a scholarly project that advances the field of integrated behavioral health. They may also collaborate with others on quality improvement initiatives that target population health. Examples of past/current projects include:

Caring Contacts: Culturally Relevant Suicide Prevention for the Karen Community
Patient survey of interest in/format of pain management groups
Naloxone teaching and electronic medical record tools to assist providers
Implementation of a healthy lifestyle program for child well checks

Continuing Education:
Fellows participate in a variety of training opportunities including a week-long program about substance use treatment at Hazelden, an annual University of Minnesota Psychiatry Update, Community Health workshop, and Sexual Health workshop.

Supervision
Fellows receive weekly clinical supervision as follows, which is sufficient for meeting the supervision requirements for the MN Board of Psychology for licensure:

Two hours of scheduled individual supervision per week, one each from licensed psychologists at respective clinics (Dr. Danner at Bethesda and Dr. Brandenburg at Smiley's)
One hour of group supervision with other University of Minnesota family medicine Behavioral Health fellows facilitated by various behavioral health faculty within the Department of Family Medicine
Informal consultation is always available as needed as well

Evaluation
Evaluation is an ongoing process in which supervisors continuously highlight and celebrate strengths and provide constructive feedback to support further development. Formal written evaluations are conducted at 6, 12, 18 months, and 24 months and are reviewed in a face-to-face meeting with primary supervisors.

Broadway Track

The purpose of this unique fellowship is to train the next generation of psychologists to become leaders who possess critical and systemic skills to support the empowerment of vulnerable populations in integrated primary care settings. Fellows co-train alongside family medicine residents and receive specific interdisciplinary training on leadership, team skills, population health, and complex care management.

Our Clinic:
Broadway Family Medicine Clinic is located in North Minneapolis (in a brand-new building as of January 2021), and has 24 family medicine residents and 16 faculty members. It is a healthcare home and has been serving the North Minneapolis community for more than 40 years. We care for a culturally, ethnically, and racially diverse population, including approximately 70% Black and 10% Hmong patients. Broadway truly embraces an inter-professional team approach to patient care and resident education, including physician faculty and residents (MDs and DOs), nurses, psychologists, pharmacists, a dietitian, community health worker, and care coordinators. To learn more about our residency program, check out this website: https://med.umn.edu/familymedicine/education-training/residency/north-memorial

Promoting social justice and empowerment among patients, families and the North Minneapolis community at large is central to our mission. Our commitment to diversity, equity, and inclusion is demonstrated in how our clinic and program function. Fellows are encouraged to participate in a variety of community-based advocacy activities. For example, we host a monthly mentorship program for youth from underprivileged areas who are interested in careers in healthcare (The Ladder: https://theladdermn.org/). We provide services in a local shelter and teen runaway clinic. We have monthly workshops for community members focused on the social determinants of health (CHAT: https://chatmpls.wordpress.com/chat/).

Our clinic also has a strong Addiction Medicine service, including offering Buprenorphine and naloxone (Suboxone) for patients living with Opioid Use Disorder. Fellows have opportunities to get involved in providing behavioral health services to these patients as well as collaborate on research projects rooted in this service. We also have specialized patient care and training in Sports Medicine, with faculty who play key roles with Minnesota professional sports teams.

The current syndemic (COVID-19, social injustice, and economic instability) has invited us to significantly modify how we provide behavioral health services in our clinic. At the time of this posting, we are offering all of our behavioral services via telemedicine (video or phone, depending on patient preference and access), which offers strong training experiences for the fellow. Furthermore, we have noted a considerable increase in patient show-rates and have observed that some patients who would never have come into the clinic are now getting our services. When the fellow starts in September 2020, we anticipate that we will be offering a variety of telemedicine and in-person services.

Fellow Activities:
Traditional Psychological Services:

Short-term Psychotherapy: Following a practitioner-scholar model, fellows provide evidence-based care to adults, including both individuals and couples. Fellows generally provide short-term, problem-focused outpatient psychotherapy to our diverse population. Over 95% of our psychotherapy patients speak English; interpreters (both in-person and via the phone) are available for our non-English-speaking patients. Patients are referred by our primary care providers and have a wide range of presenting problems including depression, anxiety, trauma/PTSD, desire for health behavior change, chronic pain, somatization, substance abuse, etc. Our program has recently received formalized training in Written Exposure Therapy (WET: Sloan & Marx, 2019) for trauma, and we are offering this new, evidence-based treatment to our patients.

Hmong Support Group: Fellows co-facilitate (with our Hmong care coordinator) a support group for Hmong women, many of whom live with mood disorders and chronic pain. This group meets twice per month, and getting to work with these resilient women is often a highlight of the fellow's experience.

Chronic Pain Care Plans: Fellows participate in the interdisciplinary Chronic Pain committee and co-create with the patient's care plan that includes recommendations to maximize the quality of life and pursuit of meaningful activities while living with chronic pain.

Couples Therapy: Training and experience in couples therapy are also available if the fellows are interested in this mode of treatment.

Health Behavior Change: Former Broadway Family Medicine fellow, Stephanie Hooker, PhD, LP, MPH, (now at HealthPartners Institute), Dr. Sherman, and numerous Broadway faculty and residents created a 10-module curriculum titled Change that Matters: Promoting Healthy Behaviors (https://changethatmatters.umn.edu/). Modules address topical areas commonly raised in primary care (e.g., chronic pain, physical activity, smoking cessation, depression). Each module includes an interactive patient handout, EHR templates, and a PowerPoint lecture. Fellows can utilize these resources in their patient care and teaching.

Integrated Care:
Fellows work alongside physicians, pharmacists, and our dietitian in an integrated care model for 4-5 sessions/week. Activities during this time include:

Consultation on patients with behavioral health concerns
Warm hand-offs
Crisis management (e.g., suicidal patients, new diagnosis)
Post-hospitalization team visits
Paired visits (with resident)
Follow-up resident shadowing of in-person visits to coach on communication skills

Resident Education:
Behavioral health is very involved in resident education at Broadway, and Fellows participate in:

Interdisciplinary team meeting discussions of complex patients
Precepting family medicine residents on topics such as patient-centered communication, behavior change counseling, and mental health diagnosis and treatment
Behavioral health didactics
Video review (teaching communication skills to residents)
In-clinic shadowing of residents
Shadowing residents in the hospital
Participation in table rounds at the hospital

Of note, we have a strong commitment to resilience among our residents, faculty, and staff. Fellows have the opportunity to help develop and participate in wellness activities for our clinic.

Quality Improvement Projects and Research:
Fellows complete a scholarly activity that advances the field of integrated behavioral health. They may also collaborate with others on quality improvement initiatives that target population health. In addition, fellows who are interested may choose to participate in other research projects underway at Broadway, either developing projects of the fellow's interest or collaborating with others on existing projects.

Experience in the North Memorial Medical Center:
In the 2nd year of fellowship, the fellow spends one half-day per week at the North Memorial Medical Center, working with the faculty and resident physicians. The fellow shadows the residents while seeing patients and offers recommendations on communication skills, relationship skills with patients and staff, and managing challenging patient presentations. The fellow also participates in the daily table rounds where the entire team discusses all active patients on service.

Supervision

Fellows receive clinical supervision as follows:

Two hours of scheduled individual supervision per week from the Director of Behavioral Health at Broadway Family Medicine
One hour of peer supervision with other University of Minnesota family medicine Behavioral Health fellows
Ongoing consultation as needed

Formal Didactics and Continuing Education:

Fellows select didactic and continuing education opportunities that appeal to their interests. Many activities occur regularly, such as:

Weekly half-day didactics for all Broadway trainees
Grand rounds at North Memorial Medical Center
Monthly department grand rounds
Primary Care in Psychiatry: Management and Medications course
Integrated Behavioral Healthcare Conference
Program for Human Sexuality didactics
University of Minnesota's psychology internship didactics (as appropriate)
Society of Teachers of Family Medicine conference

Evaluation
Evaluation is an ongoing process in which supervisors continuously highlight and celebrate strengths and provide constructive feedback to aid in further development. Formal written evaluations are conducted at 6, 12, and 18 months, and are conducted in a face-to-face meeting.

Michelle D. Sherman, Ph.D. LP ABPP
Professor
612-802-3200
Sherman@umn.edu
Graduate School: University of Missouri-Columbia
Internship / Fellowship: Oklahoma City VA Medical Center
Expertise: Health behavior change, resilience, supporting families affected by mental illness and PTSD, couples therapy
Full bio: https://med.umn.edu/bio/familymed/michelle-sherman

Additional Information

Benefits

Behavioral health fellows are provided the following benefits:

Learn more by viewing the following:

Continuing Medical Education Credit

Receive $1,000 of continuing medical education credit per year that can be used for educational expenses such as conferences or courses. These funds roll over from year to year, and any unused funds would be forfeit upon the end of the two year fellowship.

Contact

For more information regarding payroll, vacation, assistance planning leave, or sick leave:

Angela Kamau
612-624-2622
koon0008@umn.edu

For more information regarding other benefits:

UMN Office of Human Resources
612-624-8647 or 800-756-2363
benefits@umn.edu

Fellows

Senior fellows

Eli Martinez, PhD

Graduate school: University of Wisconsin-Madison
Internship: Rutgers University Behavioral HealthCare in central New Jersey
Medical interests: Chronic illness and pain management, diabetes treatment and care, and treatment of trauma and its effects on the body
Personal interests: Spending time with her cat and family, reading, and trying different restaurants and foods across Minnesota

Adam Sattler, PhD

Graduate school: University of Mississippi

Internship: William S. Middleton Memorial Veterans Hospital in Madison, WI

Medical interests: Health behavior change, chronic pain, dissemination and implementation of evidence-based mental health practices, and mindfulness-based interventions for mental health issues

Personal interests: Biking, running, meditation, and playing and listening to music

First-year fellow

Ehren Emter, PsyD

Graduate school: Doctor of Psychology in Counseling Psychology, Chatham University, Pittsburgh, PA
Internship: Clinical Health Psychology, Dayton Veteran's Affairs Medical Center, Dayton, OH
Medical interests: Integration of physical and mental health, sleep disorders/insomnia, chronic pain, chronic disease management, substance use, adherence to physical health treatment, and gender and sexual minority health
Personal interests: Reading, city bicycling, running, and watching Chinese costume dramas