Last year’s class present papers at CLP 2019
The class of six selected for the Academy’s William Webb Fellowship Program 2018-2019 are presenting papers at this year’s annual meeting:
Erica Baller, MD, MS, Massachusetts General Hospital (MGH), will present her oral paper Menstrual Mysteries, on Friday, November 15, from 4:00 PM.
“Premenstrual dysphoric disorder is a common, treatable condition that affects approximately one in 20 women,” says Dr. Baller. “Before the 1980s, there was virtually no research exploring this condition. My oral paper, based on my clinical commentary, Premenstrual Dysphoric Disorder: From Plato to Petri Dishes, will discuss some of the elegant research that led to a biological characterization of the condition.”
Dr. Baller, an undergraduate at Yale majoring in computer science and psychology, undertook a Research Fellowship at the National Institute of Mental Health and a master’s at Georgetown University in physiology and biophysics. She was at medical school at Drexel University College of Medicine; fulfilled her Residency at University of Pennsylvania; and is now undertaking a C-L Psychiatry Fellowship at MGH.
“After spending five years studying the effects of gonadal steroid hormones on cognition and the brain using PET and fMRI,” says Dr. Baller, “I have transitioned my work into using machine-learning techniques to study cognitive and neural heterogeneity in psychiatric illnesses, specifically depression.
“I am particularly interested in harnessing big data and data-driven approaches to better characterize psychiatric illnesses in patients with medical comorbidities, as these patients are usually excluded from classical research paradigms. I am also passionate about science communication and work extensively with the National Neuroscience Curriculum Initiative. Recently, I co-authored a clinical commentary on Premenstrual Dysphoric Disorder to Biological Psychiatry.”
Dr. Baller says it has been a pleasure to be an ACLP member this last year, especially as a trainee. “I have been welcomed into a family of clinicians, teachers, scientists, and lifelong learners who are passionate about existing in the space within and between medical specialties. I came out of my first meeting with a handful of new mentors as well as new ideas for how to continue to grow as a researcher, clinician and teacher. Moreover, C-L psychiatrists are a blast!”
Daniel Shalev, MD, currently C-L Psychiatry fellow at Columbia University, graduated with highest honors in field and Phi Beta Kappa from Harvard with an AB in Women, Gender, and Sexuality Studies.
He earned his MD at Weill Cornell Medical College. As a resident and chief resident at Columbia, his work on medical humanities, palliative care, and medical education was presented at national meetings and published in journals including JAMA, General Hospital Psychiatry, and Academic Psychiatry. During his residency, he was selected as a Webb Fellow by ACLP, leadership fellow by the American Psychiatric Association, and a Laughlin Fellow by the American College of Psychiatrists.
“My research focuses on the intersection of hospice and palliative medicine and psychiatry, particularly around issues of workforce and ethical challenges in providing care to individuals with comorbid psychiatric illness and serious medical illnesses,” says Dr. Shalev. “Next year, I will be completing a hospice and palliative medicine fellowship and then likely pursuing further research training.”
He adds: “The ACLP has been an academic and professional home for me throughout residency. As a psychiatry trainee with a strong interest in the intersection of medicine and psychiatry, the ACLP has offered me opportunities in mentorship, research, and networking that have been invaluable. Being exposed to the diverse world of C-L Psychiatry through the annual meeting has expanded my own sense of what is possible in my career and helped me develop a professional identity.”
Dr. Shalev will present at the general session Optimizing Fit for Residents on C-L: How to Tailor a Rotation to a Particular Training Year on Thursday, November 14, from 1:30 PM. “I will be presenting data from a national survey of C-L Psychiatry program directors on training C-L Psychiatry fellows in palliative care,” he says. “My prior research has described significant gaps in provision of care for patients with comorbid palliative care and mental health needs. My hypothesis is that part of this dearth is a lack of experts at the intersection of mental health and palliative care.
“This dearth is likely due in part to siloes in training practices—for instance, the ACGME has paltry cross-training requirements between psychiatry and palliative care. C-L psychiatrists are naturally equipped to serve as leaders in bridging mental health/palliative care gaps, but there has been no data on training practices for C-L psychiatrists. My project will elucidate current attitudes towards and practices of training C-L Psychiatry fellows in palliative care.”
Dr. Shalev will also present an oral paper Palliative Care and C-L Psychiatry Cross-Training: Preparing a Workforce to Promote Mental Health at the End of Life, on Friday, November 15, from 10:30 AM.
Juliet Edgcomb, MD, PhD, fourth-year general psychiatry resident at the Department of Psychiatry and Biobehavioral Sciences, UCLA, will present an oral paper on High Risk Phenotypes of Suicidality following Medical Hospitalization on Friday, November 15, from 4:00 PM. It won her this year’s Dlin/Fischer award presented for significant achievement in clinical research and the best paper submitted for presentation at the annual meeting.
See: Algorithms Identify Patients Most at Risk of Suicide After Hospital Discharge, this issue.
“The ACLP excels at providing support and mentorship for junior investigators interested in C-L Psychiatry,” says Dr. Edgcomb. “I am very grateful for the opportunity to connect to early career psychiatrists and senior mentors in the collegial and warm environment of ACLP.
“Participating in ACLP has enabled me to advance my interest in seriously medically and mentally ill populations by learning at the annual meeting, networking with the research committee, and meeting leaders in C-L Psychiatry at a national scale.
“As a new clinician, these opportunities have been critical to generating enthusiasm and measured insight when working with our vulnerable and resilient population of patients. I am excited to work with ACLP during the remainder of the Webb Fellowship and in the future.”
Brandon Hamm, MD, MS, is currently C-L Psychiatry faculty at Northwestern Memorial Hospital, and was an ACLP Webb Fellow during his fellowship at Cleveland Clinic. Areas of research include agitation management, caregiver experience, decision-making capacity evaluation, psychiatric education, bioethics, resident empathy and burnout. Clinical interests also include neuropsychiatry, epilepsy, psychodermatology, somatoform disorders.
“I highly enjoyed my psychiatry residency at Cleveland Clinic, where I served as chief resident of academics, psychiatry department Quality Improvement Liaison, and on the neurological institute Engagement Committee. My research on the impact of generational affiliation on resident burnout and empathy is currently under peer review, and my research on decision-making capacity and agitation management has been published in Psychosomatics and the Journal of Law, Medicine & Ethics. During my C-L Psychiatry fellowship at Cleveland Clinic, I piloted a psychodermatology clinic, and my research focused on my Webb Fellowship project, as well as a study examining the additional ‘ethical context factors’ in decision-making capacity evaluations.
“Since graduating fellowship, I have been thrilled to be serving in a clinician educator role on the C-L Psychiatry service at Northwestern. I will soon expand my role to collaborative care consultation for one of Northwestern’s primary care practices in downtown Chicago. I am continuing the translational work started during the Webb Fellowship and collaborating with colleagues at Cleveland Clinic on decision-making capacity evaluation studies in the pipeline.”
Dr. Hamm’s oral paper General Hospital Agitation Management Under the Lens of Leadership Theory and Health Care Teamwork Best Practices will be presented on Friday, November 15, from 4:00 PM.
Leadership and teamwork standards for optimizing patient outcomes exist in medical emergencies and surgical procedures. However, to date there has been minimal consideration of these areas for acute agitation management—”but may offer vital knowledge, skills, and attitude development to improve outcomes,” says Dr. Hamm. “Greater academic study and education for trainees on these aspects of agitation management could optimize patient care and lessen deleterious effects of care for medical personnel.”
“My oral paper will focus on the TeamSTEPPS model that has been applied to (and studied in) several other emergency medical interventions, such as rapid response cardiopulmonary resuscitation. I will describe the model and translate each step into potential applications in acute agitation management.”
Asked why he is an ACLP member, Dr. Hamm says: “ACLP plays an essential role in enabling connection and organization among a field of professionals with different practice approaches, working at institutions with varied resource offerings, and sometimes working with different patient populations. In addition to believing in the utility of ACLP, my experience has been that ACLP members are good people, great conversation, and helpful colleagues to bounce ideas off in clinical practice when caring for complex patients.”
Rebekah Nash, MD, PhD, assistant professor, UNC Chapel Hill, will present her oral paper Genetic Risk Factors of Depression, Chronic Pain and PTSS in Solid Organ Transplant Recipients, on Friday, November 15, 10:30 AM.
“The demand for solid organ transplantation consistently outpaces the supply of organs available,” says Dr. Nash. “Therefore, it is necessary to optimize the recovery and survival of recipients following solid organ transplantation. While many patients respond to transplantation with a renewed commitment to their health, others struggle with depression, pain, and treatment adherence. Predicting how patients will respond following transplantation remains a challenge.”
Dr. Nash received her bachelor’s degree in chemistry from Furman University. She then joined the MD/PhD training program at the UNC Chapel Hill, completing her PhD in Biological Chemistry. She stayed at UNC for her Psychiatry Residency and C-L Psychiatry Fellowship training and developed an interest in the impact of solid organ transplantation and immunosuppression on the mental health and cognitive function of solid organ transplant recipients, as well as the role of premorbid psychiatric conditions on long-term recipient survival.
As assistant professor in psychiatry, she is focusing her clinical and research expertise on the psychiatric care of patients awaiting, and living with, solid organ transplants. She is also one of the attending psychiatrists on the C-L Psychiatry service, where she supervises and teaches psychiatry residents, C-L Psychiatry fellows, medical students, and residents from other specialties. Her long-term goal is to improve the care of patients awaiting, and then living with, a solid organ transplant.
Luis Pereira, MD, MS, instructor in psychiatry at Columbia University, will be presenting his oral paper Mental Illness and Adherence to Antiretrovirals: Results from a Comprehensive Diagnostic Assessment of Mental Disorders in Mozambique, on Friday November 15 10:30 AM.
Thirty-seven million people are currently living with HIV/AIDS worldwide, 70% of whom are from countries in sub-Saharan Africa. Mozambique is among the 10 countries in the world with the highest infection rate, and has a nationwide prevalence of 13.2%. Within Mozambique, Maputo City has the third highest prevalence, at 16.9%.
“HIV infection and mental illness have a bi-directional relationship,” says Dr. Pereira. “Several studies have identified HIV infection as a risk factor for the development of mental illness, in particular anxiety and depression. Moreover, mental illness is associated with vulnerability to risky behaviors and poor adherence to antiretroviral treatments, among others, which increase the risk of HIV infection.
“For this reason, screening for mental illness in both HIV-positive and HIV-negative persons is of utmost importance, as it may affect risk, prognosis, and outcomes. To our knowledge, this is the first study that assesses the prevalence of mental health disorders in HIV-positive and HIV-negative patients in three different settings in Maputo City: two primary health care clinics and a tertiary hospital.”
Dr. Pereira graduated from the Faculty of Medicine of the University of Lisbon and completed a five-year residency program in internal medicine. He gained a master’s in HIV/AIDS from the University of Barcelona and graduated from Mount Sinai Beth Israel’s Psychiatry Residency Program. He completed a Fellowship in C-L Psychiatry at Columbia University Medical Center/New York-Presbyterian Hospital, and is currently an instructor in psychiatry at Columbia University/New York-Presbyterian Hospital.