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Train New Trainers Primary Care Psychiatry Fellowship

An interprofessional fellowship certificate program for improved access to mental health care

The UC Irvine/UC Davis Train New Trainers (TNT) Primary Care Psychiatry (PCP) Fellowship is a year-long clinical education program for primary care-oriented trainees and providers who wish to receive advanced training in primary care psychiatry. Primary care psychiatry is targeted at the most frequently encountered mental health-related disorders and treatments.

Who benefits?

Providers in these specialties could benefit from this fellowship:

  • Internal medicine
  • Family medicine
  • Emergency medicine
  • Neurology
  • Physician assistants
  • Nurse practitioners
  • Psychiatric nursing

Mental health providers may also benefit from this fellowship and are welcome to submit an application for enrollment.

2018 TNT PCP Fellows

2018 Fellows

Mentorship and teaching

The primary goal of the TNT PCP fellowship is to provide mentorship and teaching in the area of primary care psychiatry. Trainees will learn:

  • How to complete an evidence-based and efficient psychiatric interview in the busy primary care or medical setting
  • How to effectively diagnose and treat commonly encountered psychiatric conditions such as mood, anxiety, psychotic and substance misuse disorders
  • How to teach these principles to their primary care colleagues

Note that this is not a traditional or Accreditation Council for Graduate Medical Education (ACGME)-approved fellowship.

Information regarding the 2019 Fellowship

Video regarding the TNT PCP Fellowship

Meeting the Need: Why Train Primary Care Providers in Psychiatric Care »

Meeting the Need: Why Train Primary Care Providers in Psychiatric Care

A message from the program co-directors, Robert McCarron, DO, and Shannon Suo, MD

Recent reports show an alarming disconnect between supply and demand for psychiatric services in the United States. According to a 2017 report by the National Council for Behavioral Health, the ratio of psychiatrists to population in the U.S. declined by 10 percent between 2003 and 2013. Nearly half the nation’s psychiatrists are private practitioners who operate on a cash-only basis. Fifty-five percent of counties in the continental U.S. have no psychiatrists, and 77 percent have a severe shortage.

Meanwhile, demand for mental health services is on the rise. Depression is now a leading cause of disability in the U.S. Estimates indicate one in four families are struggling with some aspect of mental illness. A recent Milbank Memorial Fund report said among children ages 9 to 17, as many as one in five may have a diagnosable psychiatric disorder.

Primary care practitioners are living with the fallout. An estimated 40 percent of patients seen in a primary care setting on any given day have an active psychiatric problem, while half the patients referred by a primary care provider for psychiatric treatment are unable to access services.

Exacerbating the gap in appropriate care: The vast majority of primary care providers have suboptimal training in psychiatric diagnosis and treatment.

Trained in the basics

UC Irvine/UC Davis is taking the lead on a novel effort to expand and equip workforce to provide basic psychiatric treatment. We call it the Train New Trainers (TNT) Primary Care Psychiatry (PCP) Fellowship to train front-line providers in the essentials of primary care-based psychiatry. We train primary care providers to:

  • Recognize symptoms of common psychiatric conditions
  • Complete a quick and targeted assessment
  • Provide evidence-based treatment using cognitive therapy techniques, motivational interviewing and appropriate medications

Are we creating a replacement for psychiatrists? No. Our fellows are trained in the basics of treating mild to moderate illnesses, including anxiety and depression. Patients with more serious conditions still would be referred to specialists.

UC Davis launched the fellowship in 2016, enrolling 35 fellows from around California. In 2017, 49 fellows from across the United States enrolled in the program. This year, the program was moved to UC Irvine. While still partnering with UC Davis, we have increased the class to 68 fellows.

Course description

The year-long program was designed so fellows can complete the training while continuing to work. Fellows attend two intensive weekends of instruction with our faculty, all of whom have dual training in psychiatry and primary care.

The rest of the course is completed remotely and involves:

  • Biweekly web-based instruction
  • An hour of individual training each month with a mentor
  • Regular call-in office hours with faculty

The cost of the program is $15,500 per fellow and we discourage providers from paying out of pocket. What we’re finding is that health plans see the value, and have stepped forward to cover the costs.

Expected outcomes

As the program, continues, we’ll be actively measuring outcomes. Our expectation is to see:

  • Fewer hospitalizations for psychiatric issues
  • A decrease in suicides
  • A decrease in opioid use
  • An increase in appropriate use of prescriptions for psychotropic medications

For now, UC Irvine/UC Davis is the only health system in the country offering this brand of cross-training.

In addition, a new California law will help ensure that general practitioners are trained to recognize the signs of mental illness by requiring the Medical Board of California to consider including in its continuing medical education requirements a course on integrating mental and physical healthcare in primary care settings, especially as it pertains to children.

We’re on the front end of what we hope will be a nationwide movement to grow our mental health workforce and provide a quality system of integrated care.

TNT PCP Curriculum & Core Topics »

TNT PCP Curriculum and Core Topics

The curriculum includes over 50 required hours of training and will lead to a certificate of completion from the UC Irvine Department of Psychiatry & Human Behavior. 

  • Two weekend teaching sessions (24-28 CME hours)
  • One hour per month of individualized, in-person or teleconferenced mentoring sessions with a TNT PCP fellowship faculty member/mentor (12 non-CME hours)
  • Twice-per-month, live case-based discussions and patient interviews with a focus on integrated primary care psychiatry (20 CME hours). Learning sessions are held on the second Monday of each month from noon to 1 p.m. and the third Monday of each month from 5:30 to 6:30 p.m. in person or via teleconference.

A minimum of 40 CME hours will be included as part of the fellowship tuition for 100 percent attendance of all sessions.

Schedule and reading materials

Classes start every January and coincide with the first weekend learning session at the end of January. The second weekend learning session will take place in August. Both weekend sessions will be held concurrently with a Primary Care Psychiatry Update CME conference, which will be open to the public and co-sponsored by the California Psychiatric Association.

Registration for both learning sessions is covered as part of the fellowship tuition (please note that travel expenses are not included in the fellowship tuition). TNT PCP fellows will take part in some of this larger conference, but will also use meeting space to have small group supervision with TNT PCP faculty.

Reading materials will be provided, including a primary care psychiatry curriculum, which was developed by UC Irvine/Davis family medicine, internal medicine and psychiatry faculty. An emphasis will be placed on how best to provide culturally/linguistically competent and person-centered clinical care.

Pre-, midpoint and post-testing will be used to measure changes in practice patterns and general knowledge in primary care psychiatry. Upon completion of this training, fellows will receive a certificate of completion from the UC Irvine Department of Psychiatry & Human Behavior.

Core topics

Core TNT PCP topics include:

  • The primary care-based psychiatric interview using the "AMPS model"
  • The mental status examination
  • How to practice culturally and linguistically competent patient care
  • Mood disorders
  • Anxiety disorders
  • Trauma-related disorders
  • Substance misuse disorders
  • Primary and secondary psychotic disorders
  • Somatic symptoms disorders
  • Pain psychiatry
  • Neurocognitive disorders
  • Personality disorders
  • Suicide risk assessment in the primary care setting
  • Cognitive behavioral therapy
  • Supportive psychotherapy
  • Motivational interviewing
  • Fundamentals of psychopharmacology
  • Population-based/collaborative care
  • Cultural Psychiatry and utilization of the Recovery Care Model
  • Overview on how to train providers in primary care psychiatry
TNT PCP Fellowship Application Process, Program Requirements »

TNT PCP Fellowship Application Process, Program Requirements

Eligible participants must be licensed physicians, nurse practitioners or physician's assistants. To apply, complete an application and email it to the program coordinator, Wendy Cant. Upon acceptance to the program, the $15,500 tuition payment must be received before initiation of fellowship year.

Program requirements

TNT PCP fellows must complete the following to receive a certificate of completion:

  • Attend and participate in both weekend learning sessions.
  • Attend at least 80 percent of teleconferenced teaching sessions.
  • Participate in 12 hours of individualized mentorship.
  • Complete all surveys.
TNT PCP Directors & Faculty »

Contact Information

For more information or questions about the TNT PCP Fellowship, please contact Wendy Cant, Program Coordinator, at wcant@uci.edu or 714-456-5036.