<html><body dir="auto"><head><meta http-equiv="content-type" content="text/html; charset=utf-8"></head><blockquote type="cite"><div><div class="WordSection1"><p class="MsoNormal"><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<span style="mso-bookmark:_MailOriginalBody"><b><span style="font-size:18.0pt;line-height:115%;font-family:"Arial",sans-serif">Rural & Underserved Interprofessional Postgraduate Fellowship Training Program
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<span style="mso-bookmark:_MailOriginalBody"><b><span style="font-size:18.0pt;line-height:115%;font-family:"Arial",sans-serif">GULF COAST VETERANS HEALTH CARE SYSTEM</span></b></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<span style="mso-bookmark:_MailOriginalBody"><b><span style="font-size:18.0pt;line-height:115%;font-family:"Arial",sans-serif">(Gulf Coast Veterans Health Care System—Joint Ambulatory Care Center)</span></b></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Scientist-Practitioner training model with developmental and interprofesional approach to training</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l0 level1 lfo1">
<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Interprofessional Training—1 postmasters Social Work Fellow, 2 postdoctoral Psychology Fellows, 1 postgraduate Pharmacy Fellow.
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<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Interprofessional Seminars & Interprofessional or shared clinical work; this is a model of training which is patient-centered and interprofessional,
meaning that trainees from several disciplines all have input and provide treatment for a shared caseload. They also all present cases and offer consultation for cases.</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l0 level1 lfo1">
<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Multiple optional Training Emphases with embedded Seminars--when Fellows are obtaining targeted clinical training and seeing patients
they are also meeting with assigned Preceptors and discussing broader related concepts, issues, and treatments through embedded seminars (not core seminars which happen on Thursdays)</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l0 level1 lfo1">
<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">1 required major training emphasis with 8 elective minor training emphases, coordinated supervision with assigned Preceptors</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l0 level1 lfo1">
<span style="mso-bookmark:_MailOriginalBody"><i><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">All trainees complete the<u> Rural & Underserved
</u></span></i></span><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">major emphasis training, which involves home visits, telehealth visits, and in-office visits. This typically consists
of one-half to one day of telehealth appointments and one day of home visits or clinic specific clinical care. Home visits not required.
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<span style="mso-bookmark:_MailOriginalBody"><i><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">There are 8 potential minor emphases which can be selected, only one at a time:
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<span style="mso-bookmark:_MailOriginalBody"><i><u><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Health Psychology/Behavioral Medicine (B-Med)</span></u></i></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<span style="mso-bookmark:_MailOriginalBody"><i><u><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Posttraumatic Stress Disorder (PTSD),
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<span style="mso-bookmark:_MailOriginalBody"><i><u><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Home Based Primary Care (HBPC),</span></u></i></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<span style="mso-bookmark:_MailOriginalBody"><i><u><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Hospital Administration,
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<span style="mso-bookmark:_MailOriginalBody"><i><u><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Research,
</span></u></i></span><span style="mso-bookmark:_MailOriginalBody"><i><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">and</span></i></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<span style="mso-bookmark:_MailOriginalBody"><i><u><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">Evidence Based Practices<o:p></o:p></span></u></i></span></p>
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<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">The Minor Emphases can be either be 3 or 6 months in duration (based on Fellow’s interests). As such, there are a number of combinations
of training. Over the course of the year, a Fellow can have 4 minor emphases (4 sequential 3-month trainings) or 3 minor emphases (one 6-month training plus two 3-month trainings, in any order), or 2 minor emphases (two 6-month trainings).
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<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">75% clinical care emphasis and 25% research emphasis</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l2 level1 lfo3">
<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">2 days per week focused on Rural and/or Underserved, with .5 focused on Telehealth Treatment and Care</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l2 level1 lfo3">
<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">1 day or equivalent hours per week dedicated to working in a minor emphasis area</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l2 level1 lfo3">
<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">1 day or equivalent hours per week dedicated to conducting research</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:10.0pt;mso-add-space:auto;line-height:115%;mso-list:l2 level1 lfo3">
<span style="mso-bookmark:_MailOriginalBody"><span style="font-size:14.0pt;line-height:115%;font-family:"Arial",sans-serif">1 day or equivalent dedicated to seminars and didactics</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></li></ul>
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<span style="mso-bookmark:_MailOriginalBody"><b><span style="font-size:18.0pt;line-height:115%;font-family:"Arial",sans-serif">Clinical Emphasis in Treatment of Underserved Populations
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<p class="MsoNormal" style="line-height:150%"><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">The following paragraphs describe specific clinical training opportunities wherein trainees
will be able to obtain exposure to and experience in working with underserved populations. It should be noted that programmatic work can also be undertaken with respect to any of the clinical emphases. That is, some training experiences could mostly be focused
on development of programs and/or evaluation of programs as opposed to only involving clinical treatment to individuals.
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<p class="MsoNormal" style="text-indent:.5in;line-height:150%"><span style="mso-bookmark:_MailOriginalBody"><b><u><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">Seriously Mental Ill (SMI) or Chronically Mentally Ill (CMI).</span></u></b></span><span style="mso-bookmark:_MailOriginalBody"><b><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">
</span></b></span><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">Focus on SMI/CMI can be obtained via participation in Interprofessional clinics including working in the Mental Health
Outpatient Clinic, Homeless Programming, and in the Mental Health Intensive Case Management (MHICM) Program. The latter program specifically focuses on helping chronically mentally ill patients stabilize and decrease admittance into the Inpatient Psychiatric
Ward. In all of the above programs, Fellows would attend interprofessional team meetings and take part in a patient centered care planning and treatment process which would model a shared decision making process. Additionally, in several of those meetings,
the shared decision making process includes the Veteran as an active member, providing input in the development of their recovery-oriented treatment plans.
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<p class="MsoNormal" style="text-indent:.5in;line-height:150%"><span style="mso-bookmark:_MailOriginalBody"><b><u><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">Veterans with a history of Military Sexual Trauma (MST).</span></u></b></span><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">
With respect to exposure and clinical experience in treating MST, a trainee will likely have said training in almost any clinic throughout the facility. Likely however, this experience will be gained through working in the Mental Health Outpatient Clinic
or the Posttraumatic Stress Disorder Clinical Team (PCT). As described above for the SMI/CMI rotation, Fellows working with Veterans having experienced MST will also engage in a treatment planning and consultation process which focuses on recovery and seeks
to involve the Veteran as much as possible in the coordination of planning.</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<p class="MsoNormal" style="text-indent:.5in;line-height:150%"><span style="mso-bookmark:_MailOriginalBody"><b><u><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">Homeless Veterans.</span></u></b></span><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">
Homelessness is an important clinical issue, like the others mentioned above, which will likely be found in several clinics across the hospital. In particular, there is a high rate of homelessness found in the Mental Health Outpatient Clinic. Additionally,
trainees may work in our Homelessness Programming through the Social Work Service, which emphasizes programming that facilitates both provision of housing and other services designed to meet clinical needs. Following initial housing establishment, this programming
focuses on housing stabilization via focused and interprofessional delivery of services and case management. In addition to this Homelessness Programming, there also is specific programming for homeless Veterans which takes place within the Psychosocial, Rehabilitation,
and Recovery Treatment Program (PRRTP). That programming’s purpose is to support Veterans experiencing homelessness via utilization of the Compensated Work Therapy (CWT) program, helping Veterans obtain and sustain gainful employment in the community. During
enrollment in the CWT program, Veterans receive supportive, Cognitive-Behavioral, and psychoeducational psychotherapy treatment. Trainees would be able to work within this Interprofessional program, having direct observation of treatment and participation
in interprofessional treatment staff meetings. As with the other highlighted populations enumerated here, trainees working in clinics wherein they would be charged with treatment of Veterans suffering from homelessness would engage in coordinated interprofessional
treatment approaches. Likewise, trainees working with such individuals would also meet with patients individually and provide psychoeducation as well as engage the Veteran in their own treatment planning.</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<p class="MsoNormal" style="text-indent:.5in;line-height:150%"><span style="mso-bookmark:_MailOriginalBody"><b><u><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">Lesbian, Gay, and Bisexual (LGB) Veterans.</span></u></b></span><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">
LGB focused work can be obtained throughout the facility, but will most likely be obtained within three specific clinics: Mental Health Outpatient Clinic, Posttraumatic Stress Disorder Clinical Team, and the Women’s Clinic. Each of these clinics may be understood
as somewhat general, having a broad range of clinical presentations and issues occurring in the patients who are seen therein. Trainees interested in gaining training related to LGB issues and clinical practice would prioritize consults for treatment related
to LGB issues. Additionally, trainees may work with providers in said clinics to offer support groups and psychoeducational groups related to LGB concerns. Again, trainees working with LGB patients would be doing so as an interprofessional member of an established
clinic, interacting with staff from diverse backgrounds, training, and professions. As such, trainees would be able to observe and engage in interprofessional consultation and treatment coordination as well as foster a direct conversations with patients about
clinical issues, recovery, and treatment as needed.</span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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<p class="MsoNormal" style="text-indent:.5in;line-height:150%"><span style="mso-bookmark:_MailOriginalBody"><b><u><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">Transgender or Intersexed.</span></u></b></span><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">
Veterans identifying as Transgender or Intersexed also present widely across various clinics in the facility. The opportunity to be part of the Patient Aligned Clinical Team of a Veteran who identifies as Transgender or Intersexed would stem from participation
in specialty clinics throughout the hospital, such as the Mental Health Outpatient Clinic and Women’s Clinic. Interprofessional work is a critical feature of treatment with this population, and would be a prominent aspect of training for those who choose this
emphasis. The clinical work that Dr. Cardin have undertaken in recent years at the Gulf Coast Veterans Health Care System, in provision of provider education and patient education alike, along with helping Veterans to transition and improve their quality of
life is changing the nature of the facility. Trainees would benefit significantly in obtaining first-hand knowledge of very specific logistics and therapeutic issues related to helping Veterans who identify as Transgender or Intersexed. An approach to offering
trainees opportunities wherein they are exposed to and participate in shared decision making and recovery oriented treatment coordination and consultation will be emphasized with this patient population as well.
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<p class="MsoNormal" style="text-indent:.5in;line-height:150%"><span style="mso-bookmark:_MailOriginalBody"><b><u><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">Rural and Remotely Living.</span></u></b></span><span style="mso-bookmark:_MailOriginalBody"><span style="font-size:12.0pt;line-height:150%;font-family:"Arial",sans-serif">
This VA and its community outpatient clinics are all in urban areas, but the Veterans we serve often live outside of the beach towns where the clinics are. The facility catchment area spans areas which are considered highly rural and remote. Veterans with
rural addresses are seen and treated across the clinics. As such, opportunities to work with rural and remotely living Veterans is likely most easily obtained through clinical work in the Mental Health Outpatient Clinic, but can also be obtained through any
of the specialty clinics. </span></span><span style="mso-bookmark:_MailOriginalBody"><o:p></o:p></span></p>
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