1. Longitudinal Ambulatory Clinical Experience – Behavioral Sciences and Mental Health Pathway (LACE-MHP): A Novel Clinical Experience Ali Asghar-Ali, MD and Christopher Martin, MD Michael E. DeBakey VA Medical Center Menninger Department of Psychiatry, Baylor College of Medicine “In participating in this LACE experience, I was reminded of what I have felt for a long time – that children are very powerful people. That …is the very reason why I went into teaching middle school and why I have been interested in child psych as a medical specialty.” CONCLUSIONS: LACE-MHP provides exposure to longitudinal ambulatory psychiatry AND Broadens students' appreciation for community based interventions The LACE-MHP supplements traditional psychiatry rotations with a longitudinal ambulatory psychiatry rotation and innovative community and classroom experiences BACKGROUND: Medical schools have extensive didactic instruction and clinical rotations that emphasize biological and hospital-based psychiatric treatments. Experiences in outpatient psychiatry, influences of psychiatry, and psychosocial treatments are greatly lacking in medical school curricula. PROGRAM STRUCTURE: The LACE-MHP is a specialized pathway in the Longitudinal Ambulatory Care Experience (LACE) students for third year medical students. Students are selected into the pathway based on an essay reflecting their interest in mental health. For the entire third year, Thursday afternoon is reserved for LACE activities The first half of the year (August-December) involves weekly visits with a board certified psychiatry preceptor in an ambulatory, community setting. The latter half of the year exposes the students to a variety of community sites and innovative seminars. WORKSHOPS & DISCUSSION GROUPS (SAMPLE): Intersection of spirituality and the practice of psychiatry Electroconvulsive therapy Movie club facilitated by Dr. Glen Gabbard Cross-cultural communication in psychiatry Book club (book selected by students) PRECEPTOR COMPONENT: Supervised one-on-one by preceptor Opportunities to sharpen psychiatry knowledge and skills Build a mentoring relationship Discuss career opportunities in psychiatry Challenges of practicing medicine Ethical dilemmas that arise during clinical care Six seminar series titled, Therapy 101: Introduction to Psychotherapy Students learn the basics of the practice of psychotherapy No such curriculum identified in our search of the literature COMMUNITY SITES (SAMPLE): AA meeting Community residential facility for persons with mental retardation Tour of shelter and transitional living facilities Center for children who have been victims of abuse Forensic unit at prison PATHWAY COMPONENTS The LACE-MHP is a third year medical student course that promotes physician competency in managing the psychiatric, social, spiritual, and cultural needs of patients. The LACE-MHP underscores the interface of psychiatry with culture and the role of psychosocial interventions. “ “My patient, who I’ll call Mr. L, came in very angry about his life and his pain… I took the time to discuss many life issues with him… I realize that his journey through addressing his mental health issues will be a long one. I feel honored to have helped him embark along that path. Just taking the time to sit and listen to him – non- judgmentally – certainly meant a lot to both of us. Yes, I will remember to always listen to my patients.” Community site - Midtown Terrace, Houston, TX Community site - Brookwood Community, Brookshire, TX ASSESSMENTS AND EVALUATIONS: Students complete evaluations of their preceptors and each of their community sites A reflection essay is required for each six-month segment of the pathway Grading is based on the number of sessions attended