Emergency Psychiatry Fellowship

Overview

The Denver Health Emergency Psychiatry Fellowship is designed to train physician leaders in the subspecialty of emergency psychiatry. Over 10% of emergency department (ED) visits in the United States involve a psychiatric or substance use disorder — over 17 million visits per year. This volume continues to increase. Upon presentation, behavioral health patients experience longer lengths of stay, increased resource utilization, and significant morbidity and mortality after ED discharge. Thus, EDs play a vital role in identifying and treating behavioral emergencies and substance use disorders.

Fellows in this program will master core clinical skills and develop experience and expertise in team leadership and program development with mentorship from renowned faculty in psychiatry and emergency medicine. Although other training programs offer exposure to practice in EDs, the Denver Health Emergency Psychiatry Fellowship specifically trains emergency psychiatrists and emergency medicine physicians under faculty who specialize in the field. Fellows benefit from practice as part of Denver Health’s Level I Trauma Center and dedicated Psychiatric Emergency Services unit.

Fellowship Objectives

Upon successful completion of the program, Fellows will be able to:

• Assess patients’ emergent needs for medical and/or psychiatric management.
• Treat patients with psychiatric emergencies including acute suicidal and violent ideation, intoxication, withdrawal, and/or delirium.
• Apply psychotherapeutic and pharmacologic treatments for psychiatric emergencies.
• Lead a multidisciplinary team in the treatment of psychiatric emergencies.
• Apply an understanding of health systems in the care of patients with psychiatric emergencies.
• Utilize a biopsychosocial framework in assessment that considers cultural and social factors in assessment and treatment.
• Teach junior trainees (including medical students and residents) in the emergency psychiatric setting.
• Generate an original product of scholarship, quality improvement or program evaluation.

Fellowship Curriculum and Experience

The Fellowship curriculum offers significant flexibility in scheduling and training sites to maximize and individualize the training experience. The curriculum reflects Fellows’ background in either psychiatry or emergency medicine.

Fellows primarily work in Denver Health’s Psychiatric Emergency Services (PES) unit, which provides acute psychiatric treatment at Denver Health. PES faculty provide 24/7 on-site coverage and lead a team of dedicated technicians, nurses, and mid-level providers with substantial experience in crisis psychiatry. The PES provides consultation services across Denver Health’s emergency services system. Fellows will achieve progressive autonomy over the course of the one-year program with dedicated faculty supervision always available. Fellows spend time each month in the PES in order to immediately integrate skills learned on elective experiences into their clinical practice. Fellows will see children and families and will have the opportunity to moonlight at the University of Colorado Hospital, a Level 1 Trauma Center.

The Fellowship offers a unique and robust training experience in emergency psychiatry with core experiences in emergency medicine and administration:

• Toxicology: Fellows with prior psychiatry training participate in a one-month toxicology rotation that includes a dedicated lecture series and practice on consultation services at Denver Health and the University of Colorado.
• Prehospital care: Fellows gain field experience in Mobile Crisis Services and elective rotations with the Denver Health paramedic division.
• Substance treatment: Fellows practice on Denver Health’s Screening, Brief Intervention and Referral to Treatment (SBIRT) team alongside dedicated addiction counselors and emergency medicine physicians. The SBIRT model is the most common framework for providing substance use treatment in trauma centers, and fellows will be prepared to develop and lead an SBIRT service. Fellows may also rotate with Denver Health’s Addiction Consult Services.
• Inpatient and consultation-liaison psychiatry: Fellows with prior EM benefit from supervised training on hospital-based psychiatric services.
• Administration and business leadership: Emergency psychiatrists work in complex care systems, and physicians must understand these systems to lead them. Fellows gain experience with utilization management and public health care through field placements with leaders at Colorado Access and the Mental Health Center of Denver. Fellows receive dedicated training and certification in quality improvement through Denver Health’s Lean Academy.
• Didactics and scholarship: A weekly didactic curriculum and mentored scholarly exercise allows Fellows to advance their core foundation of knowledge in emergency psychiatry. Fellows also teach medical students and residents at the bedside and in the classroom.

These training experiences are embedded in the sample monthly schedule (actual order of rotations will vary) for Fellows with prior training in psychiatry:

Admission Requirements

Criteria for admission include a record of compassion and excellence in medicine and potential for leadership in the field. The Fellowship values a diverse workforce. A competitive application process selects physicians based on the following:

• Board eligibility/certification in psychiatry or emergency medicine.
• Eligibility for credentialing as medical staff at Denver Health and academic appointment at the University of Colorado School of Medicine. These appointments require pre-employment background checks and drug testing.
• Submit an application using the Denver Health physician recruitment portal. Applicants should be prepared to discuss their interest in the Fellowship and provide at least two professional references.

Important Dates

• We accept one Fellow each year for the 12-month program. Applications are accepted on a rolling basis to start by July 1
• Contact the Fellowship Program Director Scott Simpson for questions about start date accommodations

Stipend and Additional Information

• Fellows receive a competitive salary and generous $3,500 educational stipend
• Competitive benefits as full-time employees of Denver Health, including paid time off, retirement matching and more
• The Fellowship is approved by our institutions’ Graduate Medical Education Committees; this Fellowship is not ACGME accredited.

To start the application process, contact Scott Simpson, Emergency Psychiatry Fellowship Program Director, via email: Scott.Simpson@dhha.org

Contact the Program

If we can provide you with any further information, please contact Dr. Simpson or Francine Ramirez.

Scott Simpson, MD, MPH
Program Director
Scott.Simpson@dhha.org

Francine Ramirez
Fellowship Coordinator
Francine.Ramirez@dhha.org
303-602-7195

Fellowship Faculty and Staff

Psychiatry

Scott Simpson, MD, MPH
Program Director
Associate Professor, Department of Psychiatry, University of Colorado School of Medicine (CU-SOM)
Medical Director, Denver Health Psychiatric Emergency Services (PES)

Francine Ramirez
Fellowship Coordinator
Emergency Psychiatry Fellowship

Charles Ashbrook, MD
Visiting Associate Clinical Professor, Department of Psychiatry, CU-SOM
Denver Health PES

Katherine Camfield, MD, MPH
Clinical Instructor, Department of Psychiatry, CU-SOM
Denver Health PES

Audrey Dumas, MD
Senior Clinical Instructor, Department of Psychiatry, CU-SOM
Denver Health PES

Michael Mizenko, DO
Senior Clinical Instructor, CU-SOM
Denver Health PES

Christopher Piatz, MD
Clinical Instructor, Department of Psychiatry, CU-SOM
Denver Health PES

Daniel Severn, DO
Senior Clinical Instructor, CU-SOM
Denver Health PES

Emergency Medicine

Bradley Shy, MD
Associate Program Director
Medical Director, Adult Emergency Department, Denver Health
Associate Professor, Department of Emergency Medicine, CU-SOM

Jason Haukoos, MD
Medical Director of Screening, Brief Intervention, and Referral to Treatment Team, Denver Health
Professor Department of Emergency Medicine, CU-SOM

Christopher Hoyte, MD
Program Director, Toxicology Fellowship
Rocky Mountain Poison and Drug Center
Associate Professor, Department of Emergency Medicine, CU-SOM

Lara D. Rappaport, MD
Associate Professor, Department of Emergency Medicine, CU-SOM
Associate Medical Director of Denver Health Paramedic Division
Denver Health EMS Fellowship Director

Adjunct Faculty

Michael Allen, MD
Professor, Departments of Psychiatry and Emergency Medicine, CU-SOM

Kimberly Nordstrom, MD, JD
Chief medical Officer, Rocky Mountain Health Plans