Introduction:

Psychosomatic Medicine (PM) (consultation Liaison Psychiatry) is the medical discipline which encompasses the study and practice of psychiatric disorders in patients with medical, surgical, obstetrical, and neurological conditions; particularly for patients with complex and/or chronic conditions. In general, psychiatric disorders are common and serious yet treatable illnesses. Its prevalence in general population’s lifetime is 33%, and 42% for patients with chronic medical conditions. Meanwhile, psychiatric conditions have 30-60% prevalence on patients with short-term medical or surgical conditions.

Patients with serious mental illnesses like schizoprenia and bipolar disorder may die fifteen (15) years younger than the general population because of its higher medical co-morbidity.  Its medical cost is doubled for depressive patients, and frequently, cost for emergency services requires seven time more.

The Adult Psychosomatic Medicine Unit is comprised of specialized Mental Health Teams who provide comprehensive mental health assessments, feedbacks and brief interventions for adult in-patients in medical, surgical and obstetric units in general hospitals.

The Psychosomatic Team assists the Medical Treating Staff in providing diagnostic, management and referral advice to patients who are suffering from mental disorders or psychological distress.  Moreover, they also provide collaborative and integrative mental health care to primary and secondary medical and surgical outpatient populations (e.g. psycho-oncology, psycho-nephrology, cardiac psychiatry, perinatal psychiatry, neuropsychiatry, transplant & bariatric surgery psychiatry, GI psychiatry and shared care family medicine.

The rapid and impressive progress in the field of psychosomatic medicine in the recent decades, and the expected advances in the future, require a special practice in a milieu where teaching and research are actively conducted.

Hence, the mission of the Psychosomatic Medicine Fellowship Program at King Saud University (KSU) is to train psychiatrists to become highly-qualified consultants in psychosomatic medicine. The program requires participants to complete their training to be eligible for the Certification in Psychosomatic Medicine. This fellowship program lasts for two (2) years where trainees are expected to gain more excellent clinical skills, a deeper knowledge of the discipline and a higher standard of professional ethics.

 

Program Objectives:

Fellows completing the psychosomatic medicine fellowship are expected to:

1. Medical Expert

• Demonstrate knowledge in conceptual theory and scientific literature required for patient care, particularly relevant knowledge about psychosomatic medicine conditions and its respective treatments.
• Demonstrate an open­minded, analytical approach in acquiring new knowledge.

1. Clinical Skills

• Demonstrate competence in immediate care for patients with Psychopathology Symptoms in a general medical setting.
• Demonstrate knowledge and competence in gathering accurate and essential information from all sources - including medical interviews, physical examinations, medical records and diagnostic/therapeutic procedures.
• Has the ability to make informed recommendations about preventive, diagnostic and therapeutic options, and interventions that are based on clinical judgment, scientific evidence, and patient preference.
• Has the ability to develop, negotiate and implement effective patient management plans and integration of patient care.
• Able to competently perform diagnostic and therapeutic procedures that are considered to be essential to the practice of psychosomatic medicine.

1. Communicator

• Establish rapport with a culturally-diverse population of medically ill patients and their families.
• Interact with consultants in a respectful and appropriate manner.
• Provide effective and professional consultation to other physicians and health care professionals, and sustain therapeutic and ethically-sound professional relationships with patients, their families, and colleagues.
• Use effective listening, nonverbal communication, questioning, and narrative skills to send accurate messages to patients and their families.

1. Collaborator

• Consults effectively with other health care team members, including non-psychiatric physicians, nurses, social workers, psychologists and spiritual care staff, recognizing their roles and responsibilities.
• Can participate effectively and respectfully in a “Collaborative Care Model” with other health care providers in the management of patients with psychiatric or behavioral problems/issues.
• Contribute effectively to the interdisciplinary management of the medical/surgical patients.
• Is able and willing to teach and learn from colleagues/students and/or other health care professionals, within the context of a clinical care team.
• Is able to address interpersonal conflict in patient care and utilize negotiation skills to arrive at a workable endpoint.

1. Leader

• Utilize resources effectively to balance patient care, learning needs and outside activities.
• Set realistic priorities and use time effectively in order to optimize professional performance.
• Appropriate and efficient use of health care resources.
• Understand and make use of information technology to optimize patient care and life-long learning.
• Coordinate the efforts of the treatment team through effective delegation of tasks

1. Health Advocate

• Identifies and addresses stigma affecting the medical/surgical patient with psychiatric illness.
• Advocates for the patient within the context of the treatment setting and with respect to access to services.
• Identifies and understands the determinants of physical and mental health affecting medical/surgical patients individually or as a group, and recognizes and responds to issues where advocacy is appropriate for the patient or their community.

1. Scholar

• Demonstrates an ongoing effort to maintain and expand his knowledge and skills to optimize the evaluation and treatment of psychiatric disorders in medically-ill patients.
• Demonstrates skills for obtaining up-to date-reliable information from the literature to optimize the care of patients.
• Maintains newness in literature specific to Psychosomatic Medicine (e.g PM Journals, Textbooks & other media).

1. Professionalism

• Demonstrates accountability, integrity, honesty, compassion, and respect for diversity within the context of PM practice.
• Interacts with colleagues and other health care professionals in an honest and respectful manner within the context of PM practice.
• Fulfills the medical, legal and professional obligations of a psychiatrist. Notably, completes consultations and reports in a timely manner.
• Demonstrates responsibility, dependability, self-direction, and punctuality.
• Accepts and constructively utilizes feedback.
• Adheres to ethical principles of autonomy (e.g., informed consent) and confidentiality.
• Demonstrates an understanding of and sensitivity to end-of-life care, withdrawal and withholding of care, and issues regarding the provision of compassionate care.

Program Curriculum: (BRIEF Summary)

Clinical Rotations: Fellows spend the majority of their time at the King Khalid University Hospital. Listed below are the learning objectives for each rotation in the training program. Each objective is referenced to the relevant Canmeds core competencies. (Medical Expert, Clinical Skills, Communicator, Collaborator, Leader, Health Care Advocate, Scholar, Professionalism).

 

 

In patient Psychosomatic Medicine Service

Description and Objectives:

• The psychosomatic medicine fellow will have the opportunity to provide comprehensive mental health specialist assessment, feedback and brief intervention to adult inpatients of medical, surgical & obstetric units in the general hospitals wards and ICUs.
• The Fellow will follow all consultations (new and old) and will be responsible in the day-to-day evaluation of patients, tracing results and writing progress notes.
• Responsibilities will be upgraded as the Fellow advances in his/her training program.
• It is of paramount importance that the Fellow should achieve the pertinent CANMEDS competencies of psychosomatic medicine as detailed above.

Psychosomatic Medicine Outpatient Clinic

The Fellow will be assigned in the Outpatient Clinics where he/she prepares the initial assessment of the patients, summarize history, physical/mental and laboratory findings and will discuss management of care with the Attending Consultants as needed.

 

 

Description and Objectives:

• The fellow will cover the general/ specialized psychosomatic clinics under supervision of the attending consultant.
• It is of paramount importance that the Fellow should achieve the pertinent CANMEDS competencies of psychosomatic medicine as detailed above.

 

Training Program Outline

The program allows the fellows to engage in a number of required and elective clinical and research rotations, and educational activities where they can serve both as a learner and educator. The program also allows each Psychosomatic Medicine Fellow to develop his or her own unique strengths and interests.

Besides the required Psychosomatic Medicine Inpatient and Outpatient rotations, the Fellowship offers a variety of elective rotations, including Neuro-Critical Care, Research, Psycho-Oncology, Palliative Care, Ethics, Neuropsychiatry, Transplant Psychiatry, Pain, Bariatric Surgery, and Psychiatry among others.

 

Psychosomatic Medicine Fellowship Rotation

A fellow must cover the following requirements:

• 22 months in Inpatient Psychiatric Consultation and General Psychosomatic Medicine Clinic.
• 6 to 12 months in Specialty Psychosomatic Medicine Clinic as an Elective.
• 2 weeks in Neuro Critical Care Service and Palliative Care Service.
• 6 months dedicated for research and electives.

Program Director: - (Brief SUMMARY RESUME)

 

His contact No.: 467-1226

His email address: falosaimi@ksu.edu.sa

His secretary Number: 469-2609

 

 

Dr. FAHAD DAKHEEL ALOSAIMI is an Associate Professor at King Saud University, the Head of its Adult Psychosomatic Medicine Unit at Psychiatry Department, and a member of the Academic Counselling Committee of the College of Medicine.

Aside from KSU, he also worked in different educational institutions like Almareefa College in Riyadh, Imam Mohammed Bin Saud University and The Virtual Medical Academy. He was also a visiting professor at the Psychosomatic Medicine Department of Stanford University in USA on 2015.

Apart from his teaching experiences, he also had a fair share of different lectures about a broad range of topics from the very medical and scientific discussions on Psychiatric Disorders, Neuropsychiatry, Psycho-oncology, Nephrology, Family Medicine, Geriatric Psychiatry and the like, down to lighter yet substantial talks on Communication Skills of Medical Practitioners, Time and Stress Management, and Professionalism.

He had travelled different countries for conferences, trainings and symposia which usually focus on psychiatry and psychosomatic medicine. Some of which places were Egypt, Austria, USA, Hungary, Czech Republic, France, Portugal, Romania and Jordan.

He had won merit awards for his Outstanding Performance in the General and Specialized Consultation Liaison Psychiatry Fellowship for Saudi Arabian Cultural Bureau in Canada during the years 2009 and 2010 respectively. He also got the Best Research Award on his paper on the Relation of Infertility and Psychosocial Condition. Also, he won King Abdullah bin Abdulaziz International Award for Translation.

He had a number of different research publications and articles in various scientific journals focusing on Psychiatry, psychosomatic medicine, medical ethics and medical education. Some of his titles in psychosomatic medicine area were related to psychosocial issues in gastroenterology, nephrology, neurology, oncology, OB/GYN, endocrinology and cardiology.  Moreover, he has translated one psychosomatic medicine book to Arabic and co-authored another book entitled (Medical Specialty Selection Guide for Medical Graduate Book).

Apart from his affiliations in KSU where he currently works, he is also a member of the American Psychiatric Association, Academy of Psychosomatic Medicine, Saudi Psychiatric Association, and Scientific Council of Psychiatry at the Saudi Commission for Health Specialties (SCFHS) and of the General Supervisory Board for Mental Health Care in Saudi Arabia.