Psychiatry

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Rotations and Training

A 12-month long program, the Psychology Internship at IU School of Medicine begins on the first working day of July and continues through the last working day of the following June. The training year is structured into two, six-month core rotations (two and a half days per week), which are determined by track.

Clinical Experience

To ensure breadth of training, interns are expected to complete at least one core or elective rotation in a traditional psychology clinic setting as well as one core or elective in a behavioral medicine setting. Psychology Interns are also required to complete at least one core or elective rotation with an adult population and at least one core or elective rotation with a child-adolescent population. Interns must also complete two days of elective rotations per week during each of the six month rotations. Specific elective rotations are selected via post-match discussion between each intern and the training director based on the intern’s interests and training goals.

Didactics

In addition to the core rotations and elective rotations, interns attend a series of weekly didactics presented on a wide variety of topics. These didactics take place on Fridays (1-4 pm). All interns also attend Director’s Conference weekly on Fridays (12-12:45 pm), just prior to didactics.  This is an opportunity for interns to have regularly scheduled time with the director of training and/ or the assistant directors of training.

Interns also attend the Psychiatry Department Grand Rounds on Fridays (11 am – 12 pm, September through May). Interns must attend at least 75 percent of the Grand Rounds, or they are asked to make up missing sessions by viewing recorded sessions.

Interns have the opportunity to schedule Quarterly Educational Seminars (QES) and are encouraged to develop full-day workshops, which need to include at least six hours of educational activity in areas of interest specific to the intern class. The interns, coordinated by the chief intern, can select a topic from a list of available programs or create their own seminar. These seminars are to be conducted four times a year, once per quarter. One QES is done in the memory of Dr. Robert Ten Eyck, who supervised Psychology interns for many years.Funds are available for food and other activities of a seminar.

Core Rotations

Rotation schedules are established during the spring prior to the start of the internship taking into account each intern’s training goals. Incoming interns, program leaders and supervisors work collaboratively to determine the best combination of rotations for each intern. Psychology interns train at clinical facilities in Indianapolis, including the IU Neuroscience Center/Goodman Hall, Riley Hospital for Children at IU Health, IU Health hospitals and clinics, and IU Health Primary Care clinics.

Supervisor: Kristine Chapleau, PhD

At the Adult Outpatient Clinic, interns learn to approach psychotherapy with an understanding of how social factors (e.g., belonging, racism, sexism, loss of status, interpersonal betrayal and violence) affect mental health. Interns gain experience incorporating social factors into their diagnostic assessments and in determining appropriate treatment goals. Interns also provide individual psychotherapy—this includes conducting a clinical interview and diagnostic assessment—for approximately six patients per day. Patients present with a range of mood and anxiety disorders and interns provide psychotherapy that is evidence-based and individualized to increase patient understanding of self, ability to manage symptoms, interpersonal effectiveness and well-being. Interns receive individual supervision and may have the opportunity provide supervision to practicum students.

Supervisor: Yelena Chernyak, PhD

This core rotation offers interns experience in providing health psychology services to adults in a variety of outpatient clinical treatment settings, including cardiology, oncology and behavioral sleep medicine. The setting for this rotation is divided between the IU Health Adult Outpatient Psychiatry Clinic and Study Center at the IU Health Neuroscience Center, the Simon Cancer Center Multidisciplinary Clinic, and IU Methodist Hospital’s Acute Heart and Lung Care Clinic. Specialized services include assessment, consultation, individual and group psychotherapy primarily utilizing CBT/ACT, and other empirically supported interventions to deliver behavioral medicine, psychosocial support, coping skills building, symptom management, and behavioral modification. Interns work with a medically diverse clinical population experiencing acute and chronic medical conditions, provide consultation services, interact with a multi-disciplinary medical team and attend clinical case rounds in hospital-based clinics. All clinical settings have a teaching mission, allowing interns to interact with residents and fellows from various departments.

The two half days each week of this core rotation must include:

  • a full day on Tuesdays (Adult Sleep Clinic)
  • a half or full day on a Monday or Wednesday (Heart/Lung Clinic)
  • a half or full day on Thursdays (Oncology Clinic)

Supervisors: Bill Kronenberger, PhD and Ann Lagges, PhD

The Riley Child and Adolescent Psychiatry Clinic offers outpatient mental health services to families with children and adolescents under the age of 19. Families present to the clinic with a wide range of psychiatric and co-morbid medical conditions, often with complex social situations. The child outpatient rotation is divided among a number of the specialty clinics that exist under the larger umbrella of this general clinic. Interns on this rotation spend a full day in the pediatric testing clinic (Thursdays)  and one and a half days (Mondays and Wednesdays) in the TAC (Tics, Anxiety and Compulsions) Clinic. In all components of this rotation, interns may have the opportunity to supervise a practicum student.

The pediatric testing clinic provides interns with experience providing intensive, full-day assessments to children and adolescents with complex issues involving cognitive abilities (90 percent of cases) and, at times, issues involving personality/symptom assessment (10 percent of cases). The intern is responsible for some test administration, behavior observation and test interpretation.

In TAC clinic, interns gain experience working as part of a tiered psychology team (which includes practicum students) to provide the evidence-based practice of psychology as applied to pediatric mood and anxiety disorders as well as OCD and tic disorders. This may include use of ESTs, but the majority of the time, due to the complex nature of patients presenting to the clinic, involves making use of the best available research to develop individualized treatment plans for each patient and family.

Interns gain experience working with children, adolescents and their families presenting with primary diagnoses of OCD, Tourette’s Disorder and other tic disorders as well as anxiety disorders, including selective mutism. Treatments include Exposure and Response Prevention (ERP) for OCD and Comprehensive Behavioral Intervention for Tourette’s (CBIT) as well as other evidence-based interventions. The clinic is multidisciplinary in nature which allows patients to receive therapy and medication management services during the same visit. The psychology team meets prior to the clinic to discuss current patients.

Supervisors: Jill Fodstad, PhD, BCBA-D and Melissa Butler, PhD

The Simon Skjodt Child and Adolescent Behavioral Health Unit at Riley Hospital for Children is a 12-bed inpatient unit that serves children, adolescents and young adults experiencing a mental health/ severe behavioral crisis. The unit’s programming is divided into two tracks:

  • WAVES program: for adolescents and older children with mental/ behavioral health diagnosis that includes group and individualized programming using modified dialectical behavior therapy skills training.
  • ZONES program: for younger children with mental/ behavioral health diagnosis or children, adolescents and young adults with mental/ behavioral health diagnosis and neurodevelopmental disabilities. ZONES includes group and individualized programming utilizing applied behavioral analysis interventions

As a core rotation, interns participate in care at this clinical facility two half-days per week. Interns participate in morning huddles and interdisciplinary team meetings as well as assist in assessing newly admitted patients and developing behavioral interventions and treatment goals. Interns may have the opportunity to co-lead groups and participate in family therapy or caregiver training meetings. Interns may be assigned patients to work with individuals and participate in milieu programming as well as assist in conducting individualized ABA programming for patients with ASD/ DD including functional analyses/ functional behavior assessments, and reinforcement interventions relying on replacement behavior training, social skills training, antecedent strategies and functional communication training.

Supervisors: Hillary Blake, PsyDJulianne Giust, MD and Amy Williams, PhD

On the Riley Pediatric Consultation and Liaison Services rotation consultation requests are received from hematology/ oncology, rehabilitation, gastroenterology, neurology, pulmonology, neurosurgery, general surgery, developmental pediatrics, critical care, endocrinology, emergency medicine, hospitalist and adolescent services and the burn unit.  IU School of Medicine psychology interns are involved in consultation requests involving diagnostic assessment, pain management, behavioral interventions, family conflict, biofeedback, coping with chronic or terminal illness, feeding issues, pre- and post-transplant evaluations, somatoform disorders, altered mental status and psychosis and overdose/ ingestion cases. Interns carry an average of two-six cases per day, including new initial assessments and follow-up therapeutic interventions. The Pediatric Consultation and Liaison team includes a full-time psychologist, psychiatrist and two social workers. In addition, interns may work with psychiatry triple board residents and medical students. Opportunities for supervision of graduate students and medical students are available.

Supervisors: Liz Begyn, PhD, HSPP, ABPP-CN and Rachel Jensen, PsyD, HSPP

The pediatric neuropsychology rotation exposes interns to outpatient neuropsychological evaluation of children with medical conditions and associated cognitive sequelae. Patients ages four through college age are seen in the clinic. The most common medical diagnoses for these patients include brain tumors, leukemia, epilepsy, traumatic brain injury, concussion, genetic disorders, spina bifida and hydrocephalus. Referrals are most commonly received from neuro-oncology, hematology-oncology, neurosurgery, neurology, physical medicine and rehabilitation, and developmental pediatrics. Evaluations (including interview, testing and feedback) are conducted in entirety in one day.

Interns on this rotation observe and participate in diagnostic interviews with caregivers and patients, observe and conduct neuropsychological testing, observe feedback of test results to families, write neuropsychological evaluation reports, and work with postdoctoral fellows and graduate students in pediatric neuropsychology. In addition, interns attend a weekly neuropsychology case conference series (on Thursday mornings), which includes lectures related to the field of clinical neuropsychology and fact findings where interns can observe a postdoctoral fellow preparing for this aspect of board certification in neuropsychology.

Additional educational opportunities may include attending a monthly pediatric epilepsy case conference, attending bi-monthly neuro-oncology case conference, observing an fMRI evaluation, and/or shadowing the pediatric neuropsychology fellows on the inpatient rehabilitation unit and neuro-oncology multi-disciplinary clinic. Interns may also have the opportunity to receive supervised experience supervising practicum students. The greater part of this rotation takes place in the outpatient clinic at the IU Health Neuroscience Center with some of the additional opportunities taking place at Riley Hospital for Children.

Supervisors: Jill Fodstad, PhD and Noha Minshawi, PhD

Psychology interns have the opportunity to participate in a variety of clinical opportunities at the Christian Sarkine Autism Treatment Center, including both assessment and treatment of individuals with Autism Spectrum Disorders (ASD) and other neurodevelopmental disabilities (NDD). The center is one of only five in the country involved in research focused on parent-management training for individuals with autism. The treatment focus of the center is behavioral in nature with a specific emphasis on the science of applied behavior analysis. Interns carry therapy caseloads that include multiple modalities (e.g., individual therapy, parent training) and a variety of presenting problems (e.g., aggression, self-injury, social skills deficits, adaptive skills training). In addition to treatment experience, interns can pursue opportunities to expand their research skills on several ongoing studies. Assessment experience includes diagnostic interviews and standardized testing experiences.

Supervisors: Lezlie Blackford, PhD, Melissa Butler, PhDSarah Landsberger, PhD, Jenifer Vohs, PhD, Jennifer Downs, MD, Amber Hunt, DO, and Rachel Yoder, MD

This rotation isn’t currently available during the 2019-2020 academic year.

Changing Health Outcomes through Integrated Care Excellence (CHOICE) is an integrated care program providing specialized behavioral health services in primary care adult and pediatric clinics.  The program strives to improve patient health and access to mental and behavioral health services through the integration of psychologists and psychiatrists into primary care practices. Interns on this rotation are part of the CHOICE team in at least one of the three program locations: IU-Methodist Family Medicine Center, Georgetown Medical Plaza, and the Riley General Pediatric Clinic located in Riley Hospital. CHOICE teams are comprised of psychologists, psychiatrists, psychiatry residents and psychology interns.

Interns spend half of their time in scheduled face-to-face therapy sessions and diagnostic evaluations with patients referred by primary care physicians and pediatricians. The other half of the time, interns are available, along with other CHOICE team members, for consultations and “warm-hand offs” from primary care physicians and pediatricians. Many referrals tend to be for common psychiatric conditions, such as depression and anxiety; however, a number of referrals also deal with adjustment difficulties, health behavior change (including management of chronic health conditions) and more severe forms of mental illness. Pediatric referrals tend to focus on depression, anxiety, and behavioral and developmental problems. Interns use evidence-based practice methodology to provide appropriate evaluation and treatment for patients seen in these settings.

Elective Rotations

Supervisor: Kristine Chapleau, PhD

The Adult Outpatient rotation is a half or full day per week. Interns have the opportunity to conduct diagnostic assessment and psychotherapeutic treatment for mood, anxiety and personality disorders in an outpatient treatment setting at the Adult Psychiatry Clinic and Study Center at IU Health Neuroscience Center. Interns have the opportunity to interact with multi-disciplinary treatment team members, social workers, physicians and psychologists.

Supervisor: Yelena Chernyak, PhD

The Adult Psychosocial Oncology rotation is a full day per week and is available only on Thursdays. Outpatient psychosocial services are provided as part of the IU Simon Cancer Center Complete Life Program. The treatment team, which consists of a psychiatrist, psychologist, social worker, dietitian and a chaplain, meets on a weekly basis for rounds and staffing. Psychological services provided include individual, family and group therapy using CBT and other empirically supported interventions for skills building, symptom management, behavior modification and psychosocial support.  This elective is also part of the Adult Health Psychology core.

Supervisor: Yelena Chernyak, PhD

The Cardiac Psychology rotation is a full day per week and occurs on Mondays and/ or Wednesdays. Specialized psychological services are provided to the Acute Heart and Lung Care Clinic at Methodist Hospital, including pre-transplant psychological evaluations, individual therapy using CBT and other empirically-supported interventions and group therapy for thoracic transplant patients. Interns have the opportunity to work with a medically diverse clinical population, provide consultation services, and interact with a multi-disciplinary medical team in a hospital-based outpatient cardiology clinic. One hour of weekly individual supervision is provided as part of this specialty rotation. This elective is also part of the Adult Health Psychology core.

Supervisor: Yelena Chernyak, PhD

The Adult Behavioral Sleep Medicine rotation is a full day per week and is available only on Tuesdays. Psychology interns participate in an adult behavioral sleep medicine clinic in the IU Health Adult Outpatient Psychiatry Clinic in collaboration with the IU Sleep Disorders Center under the supervision of a psychologist with board certification in behavioral sleep medicine. The intern provides assessment and treatment services to adults ages 18 and over for sleep-related presenting problems, including insomnia, hypersomnia, circadian rhythm disorders, narcolepsy, anxiety disorders and noncompliance with medical treatments such as CPAP for sleep apnea as well as possible coexisting psychiatric disorders. Skills training, education and structured learning experiences (e.g. readings, webinars) are provided to develop skills and knowledge in behavioral sleep medicine respective to intern experience.

Initially, the intern shadows the supervising psychologist, gradually providing more services independently. Treatments are typically short-term (four-eight sessions), are highly focused and specific to sleep problems, and have a strong basis in cognitive-behavioral psychology.  Previous experience in behavioral sleep medicine is desirable but not required. This elective is also part of the Adult Health Psychology core.

Supervisors: Rachel Holmes, PhD and Audrey Krause, PhD

The rotation is a full day per week either on Tuesday, Wednesday or Thursday. Interns have the opportunity to conduct diagnostic assessments, pre-transplant evaluations, brief interventions/ psychotherapy, and provide consultation to different medical teams in both an outpatient and inpatient hospital setting. Opportunities to participate in the monthly transplant support group and weekly transplant meetings for the liver, pancreas and multi-visceral teams are also available. Experience in this rotation is partially determined by the intern’s learning objectives and prior training experience. The patient population is mostly organ transplant candidates and recipients (90 percent), but kidney donors are also assessed. Most patients have no previously identified psychopathology, but the full diagnostic range can present.

Supervisor: Bill Kronenberger, PhD

The Pediatric Psychology Testing Clinic rotation is a full day per week and is only available on Thursdays.  Psychological testing is conducted two days per month with one patient per day. Contact hours average six-eight hours per child. Approximately 90 percent of testing cases involve evaluation of cognitive abilities (intelligence, achievement, memory, executive functioning, etc.), and 10 percent of testing cases involve personality testing (projective and/ or objective). The other two days per month are used for didactics, additional supervision, learning new tests, test interpretation and review of results. The intern is responsible for some test administration, supervision of a graduate student, behavior observation and test interpretation; there is no report-writing. Supervision is provided by live observation of test administration, individual meetings to discuss results and didactics covering major topics. This elective is also part of the Child Outpatient core.

Supervisor: Ann Lagges, PhD

The Child and Adolescent Mood/Tics, Anxiety and Compulsions (TAC) Clinic rotation is a half or full day per week and occurs on Wednesdays. Interns gain experience in the evidence-based practice as applied to pediatric mood, anxiety, OCD and tic disorders.  This may include use of ESTs, but the majority of the time, due to the complex nature of patients presenting to the clinic, it involves a modular approach to therapy, making use of the best available research to develop individualized treatment plans for each patient and family. Experiences include diagnostic assessments and therapy. Interns may have the opportunity to assist in supervision of practicum students. Patients present with a wide range of primary diagnoses, including depressive disorders, anxiety disorders, OCD and tic disorders as well as comorbid secondary diagnoses, including ADHD, ODD, Autism Spectrum Disorder and intellectual disabilities. Co-occurring medical conditions and complex social situations in families are very common. This elective is also part of the Child Outpatient core.

Supervisor: Ann Lagges, PhD

The Child and Adolescent Tics, Anxiety and Compulsions (TAC) Clinic rotation is a half or full day per week and occurs on Mondays. Interns gain experience working with children, adolescents and their families presenting with primary diagnoses of OCD, Tourette’s Disorder and other tic disorders as well as other anxiety disorders. Treatment includes ERP for OCD and Comprehensive Behavioral Intervention for Tourette’s (CBIT) as well as other evidence-based interventions as appropriate. The clinic is multidisciplinary, allowing patients to receive therapy and medication management services at the same visit. The team, including a psychologist, psychiatrist, psychiatric residents, psychology interns and psychology practicum students, meet prior to the afternoon clinic to discuss patients and review relevant literature. Interns may have the opportunity to assist in supervision of practicum students. This elective is also part of the Child Outpatient core.

Supervisor: Hillary Blake, PsyD

This rotation is a half or full day per week available on Mondays. This clinical specialty rotation is within the Riley Headache Clinic which is a joint venture with Pediatric Neurology and is charged with providing excellent clinical care to children and adolescents presenting with headaches. The treatment team is comprised of a pediatric psychologist, pediatric neurologist and a nurse practitioner. Interns learn specialty skills on this rotation, including assessment of patients with headache, CBT intervention for headache, and basic and advanced biofeedback skills.

Supervisor: Amy Williams, PhD

The Pain Center Specialty Clinic rotation can be a full day per week on Tuesday or Thursday. Interns gain experience in assessment and treatment of pediatric patients with chronic pain. Treatment involves CBT for chronic pain (and other evidence-based interventions) and biofeedback. Interns also have the opportunity to co-lead a pain coping skills group for teens. The pain center is an interdisciplinary treatment team comprised of two pediatric anesthesiologists, a nurse, one pediatric psychologist and a physical therapist. Interns have the opportunity to gain experience in supervision of practicum students.

Supervisor: Sarah Morsbach Honaker, PhD

Psychology interns participate in pediatric behavioral sleep medicine clinics conducted through the Division of Pulmonology, Allergy, and Sleep Medicine in the Department of Pediatrics. Under the supervision of a psychologist with board certification in behavioral sleep medicine and in collaboration with several sleep physicians, the intern provides assessment and treatment services for youth up to 18 years of age presenting with sleep problems. Initially, the intern shadows the supervising psychologist, gradually providing more services independently.

The intern also makes follow-up phone calls to families to discuss treatment progress and engage in structured learning experiences (e.g. webinars, readings) to develop skills and knowledge in behavioral sleep. During the second half of the rotation, the intern takes the lead conducting co-therapy with patients. Treatments are typically short-term (two-four sessions), are highly focused and specific to sleep problems and have a strong basis in cognitive-behavioral psychology. While the most frequent presenting complaint is insomnia, treatment also addresses problems such as nightmares, circadian rhythm disorders and hypersomnia. In addition to developing a strong foundation and understanding of normal sleep and behavioral sleep medicine treatments, the intern gains experience using actigraphy, observe part of an overnight polysomnogram and learn to screen for medical sleep disorders. The training experience also includes opportunities to work with infants and toddlers. This rotation is offered on Wednesdays in the IU Health North location and/or Thursday mornings at Riley Hospital for Children. A full day experience is preferred, though half-day can be considered. Previous experience in behavioral sleep medicine is desirable but not required.

Intern hours accrued during this rotation can be applied toward certification in behavioral sleep medicine.

Supervisors: Jill Fodstad, PhD, BCBA-D and Melissa Butler, PhD

The Simon Skjodt Child and Adolescent Behavioral Health Unit at Riley Hospital for Children is a 12-bed inpatient unit that serves children, adolescents and young adults experiencing a mental health/ severe behavioral crisis. The unit’s programming is divided into two tracks:

  • WAVES program: for adolescents and older children with mental/ behavioral health diagnosis that includes group and individualized programming using modified dialectical behavior therapy skills training.
  • ZONES program: for younger children with mental/ behavioral health diagnosis or children, adolescents and young adults with mental/ behavioral health diagnosis and neurodevelopmental disabilities. ZONES includes group and individualized programming utilizing applied behavioral analysis interventions

As an elective, interns participate in care at this clinical facility one full day per week. Interns participate in morning huddles and interdisciplinary team meetings as well as assist in assessing newly admitted patients and developing behavioral interventions and treatment goals. Interns may have the opportunity to co-lead groups and participate in family therapy or caregiver training meetings. Interns may be assigned patients to work with individuals and participate in milieu programming as well as assist in conducting individualized ABA programming for patients with ASD/ DD including functional analyses/ functional behavior assessments, and reinforcement interventions relying on replacement behavior training, social skills training, antecedent strategies and functional communication training.

Supervisor: Zack Adams, PhD

This rotation may occur on one full or two half days per week. Interns join an established treatment team and gain experience working with adolescents and their families in the evaluation and treatment of co-occurring substance use and mental health disorders. Interns are trained in delivery of ENCOMPASS, an integrated, evidence-based treatment model that involves standardized diagnostic assessment (using the KSADS structured interview), motivational enhancement, CBT, contingency management and family sessions. Youth receive both therapy and medication management through this clinic, and interns have ample opportunities to interact and coordinate care with an interdisciplinary team of psychiatrists, psychologists, psychiatric residents, social workers and medical students in this rotation.

Interns attend weekly team meetings and weekly individual supervision sessions. Opportunities to obtain training in the delivery of services outside the conventional in-person clinic setting (e.g., school-based services; telemedicine) may be available. Opportunities for scholarly work such as didactic material development, patient handouts and scholarly articles for publication are also available.

Supervisors: Lezlie Blackford, PhD, Melissa Butler, PhDSarah Landsberger, PhD, Jenifer Vohs, PhD, Jennifer Downs, MD, Amber Hunt, DO, and Rachel Yoder, MD

This rotation isn’t currently available during the 2019-2020 academic year.

Changing Health Outcomes through Integrated Care Excellence (CHOICE) is an integrated care program providing specialized behavioral health services in primary care adult and pediatric clinics.  The program strives to improve patient health and access to mental and behavioral health services through the integration of psychologists and psychiatrists into primary care practices. Interns on this rotation are part of the CHOICE team in at least one of the three program locations: IU-Methodist Family Medicine Center, Georgetown Medical Plaza, and the Riley General Pediatric Clinic located in Riley Hospital. CHOICE teams are comprised of psychologists, psychiatrists, psychiatry residents and psychology interns.

Interns spend half of their time in scheduled face-to-face therapy sessions and diagnostic evaluations with patients referred by primary care physicians and pediatricians. The other half of the time, interns are available, along with other CHOICE team members, for consultations and “warm-hand offs” from primary care physicians and pediatricians. Many referrals tend to be for common psychiatric conditions, such as depression and anxiety; however, a number of referrals also deal with adjustment difficulties, health behavior change (including management of chronic health conditions) and more severe forms of mental illness. Pediatric referrals tend to focus on depression, anxiety, and behavioral and developmental problems. Interns use evidence-based practice methodology to provide appropriate evaluation and treatment for patients seen in these settings.

Supervisor: Stephanie Hullmann, PhD

This rotation is one full day or two half-days per week. Interns have the opportunity to conduct intake assessments, psychotherapy, and consultations with children and adolescents with cancer and their families. Interns may see patients in the outpatient pediatric hematology/ oncology clinic, infusion center and/or inpatient medical unit at Riley Children’s Hospital. Presenting problems include adjustment disorder, anxiety, depression, behavior problems, nonadherence, symptoms management and end-of-life issues.

Treatment is primarily cognitive-behavioral and this rotation takes a developmental approach. Initially, interns shadow the supervising psychologist and gradually gain more independence. There are opportunities to attend weekly interdisciplinary treatment team meetings in which the interns may collaborate with pediatric hematology/ oncology medical and psychosocial staff.

Supervisor: Kelly Donahue, PhD, HSPP

Interns will participate in gender health clinics conducted through the Department of Pediatrics in the Divisions of Adolescent Medicine and/or Endocrinology. This rotation is available as a full day per week, although half-days are also possible. Thursday clinics (recommended) occur at the Riley Physicians Meridian Crossing office in Carmel. Monday (half day only) and Wednesday clinics occur at Riley Hospital downtown.

Interns will receive supervision in the provision of gender-affirming care for gender-expansive children and teenagers. This will include: conducting comprehensive diagnostic evaluations and “readiness” assessments for patients interested in medical transition options; ongoing supportive therapy as patients explore their gender identity or pursue gender-affirming social or medical transition; and, ongoing therapy to address co-occurring depression or anxiety using a primarily cognitive-behavioral approach. Interns gain skills in providing psychoeducation to parents and families and address parent concerns or misperceptions about their child’s gender identity.

Interns participating in this rotation on Thursday afternoons will have the opportunity to participate in a multidisciplinary adolescent medicine clinic, which includes providers in medicine, psychology, social work, nursing and nutrition. This dedicated team gender health clinic occurs on two Thursdays each month. Outside of this dedicated gender health clinic, the majority of patients seen are for evaluations or therapy related to gender dysphoria. Remaining patients include referrals from providers in adolescent medicine (Wednesday AM/ Thursdays) or endocrinology (Monday PM/Wednesday PM) for anxiety, depression and management of health conditions. Students interested in working in endocrinology-based clinics will also gain experience providing brief health and behavior assessments and interventions for children with complex medical conditions.