Interventional Psychiatry Concentration
The Interventional Psychiatry Concentration offers residents the unique opportunity for additional training, research, and education in neuromodulation techniques. Interventional psychiatry is an emerging field of psychiatry that utilizes procedural-based treatments to alleviate mental distress, often when traditional pharmacologic and psychotherapeutic treatments have failed. Many interventional approaches aim to identify and then correct dysfunctional brain circuits. While traditional neuromodulation techniques have largely centered on electroconvulsive therapy (ECT) for depression, varied interventional approaches have now expanded to include transcranial magnetic stimulation (TMS), ketamine-based therapies, magnetic seizure therapy (MST), deep brain stimulation (DBS), vagus nerve stimulation (VNS), transcranial direct current stimulation (tDCS), nerve-blocks, and psychedelics aimed to treat a variety of conditions.
Because the Accreditation Council for Graduate Medical Education has no accredited fellowships in neuromodulation or interventional psychiatry, interested practitioners must rely on the training they receive in residency or through continuing education efforts. The UT Southwestern Residency Program is one of the few programs in the country that currently offers specialized training concentrating on this evolving and emerging field.
Goals and Objectives of the Concentration
Education and Training
A major tenet of the concentration is education and training in neuromodulation techniques, notably taking advantage of the opportunities that exist within the UT Southwestern Residency Program. Residents in the Interventional Psychiatry Concentration are asked to complete electives that prepare them to manage patients with treatment resistant depression. They will learn to deliver high-quality, evidence-based ECT, and they will gain familiarity with administering ketamine-based treatments and performing TMS mappings. The ECT training curriculum offers residents the opportunity to gain procedural familiarity in preparation for credentialing, to develop familiarity with anesthesia and airway management protocols, and to master electrode-lead placement management throughout all phases of ECT.
Over the course of the 2-year concentration, residents can tailor the track to meet their career/professional aspirations. The educational component has been designed to be flexible to allow residents time to hone their skills in the neuromodulation techniques that they find most appealing, such as TMS, ECT, and esketamine. Residents will graduate with a well-rounded education in neuromodulation to become leaders in the field of interventional psychiatry.
Along with education and training, a primary focus of the Interventional Psychiatry Concentration is mentorship. From the beginning of the concentration, residents will be expected to meet with mentors in their areas of interest throughout their third and fourth years of training. Mentors will serve as guides and assist in education, research, and networking for residents.
It is also possible for residents to have multiple mentors across various modalities. For example, a resident may have an ECT mentor and a TMS mentor. The residents may act themselves as mentors to medical students, pre-med students, and other learners who are interested in expanding their education about interventional psychiatry.
The final aspect of the Interventional Psychiatry Concentration is a scholarly project to be completed by the end of residency. Scholarly projects may include, but are not limited to, original research projects, case reports, education/advocacy pieces, and legislation. The goal of the scholarly project is for it to be broad so that each resident can generate individualized products that are in line with their passions. Scholarly projects will also serve to synthesize the other objectives of education and mentorship into tangible outcomes that also have the added benefit of bolstering UT Southwestern’s reputation as a leading institution in research and innovation.
Interested residents will apply and be selected for the Interventional Psychiatry Concentration in the mid-point of their second year of residency. Selected residents will participate in the concentration throughout postgraduate years 3 and 4, and accommodations will be made for residents in the accelerated Child and Adult Psychiatry Combined Track. Unique concentration experiences will include core aspects of education, mentoring, and research. The education component will be accomplished with accreditation-focused ECT training and exposure to office-based interventional treatments for treatment-resistant depression, including esketamine and rTMS. Concentration residents will also be provided mentoring opportunities with a requirement to focus their senior scholarly project in the field of interventional psychiatry.
For more information, email Joshua Hubregsen, M.D., Interventional Psychiatry Concentration Director (Josh.Hubregsen@UTSouthwestern.edu).