Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers an introduction to consultation-liaison psychiatry with Dr. Raed Hawa and Dr. Alan Wai, both from the University of Toronto.

Dr. Raed Hawa is an esteemed CL psychiatrist and educator. Dr Hawa's interests are in the areas of undergraduate, postgraduate, and continuing medical education. He also practices general sleep medicine with particular clinical interest in the areas of insomnia, co-morbid psychiatric and medical illnesses, and sleep-related movement disorders. He currently serves as the President of the Canadian Academy of Consultation-Liaison Psychiatry (CACLP) and holds the position of Professor at the Faculty of Medicine, University of Toronto. Additionally, Dr. Hawa is the Deputy Psychiatrist-in-Chief at the Centre for Mental Health, University Health Network. Dr. Hawa has earned American Board Certification in Psychiatry, with subspecialty certifications in Sleep Medicine and Psychosomatic Medicine (Consultation-Liaison Psychiatry). His expertise and contributions to the field have been recognized through his designation as a Distinguished Fellow of both the American Psychiatric Association (APA) and the Canadian Psychiatric Association (CPA).

Dr. Alan Wai is a psychiatrist at the University Health Network in Toronto and an Assistant Professor in the Department of Psychiatry at the University of Toronto. He provides inpatient CL psychiatry care and mental health and psychiatric care embedded in the Immunodeficiency Clinic at Toronto General Hospital, where he sees both persons living with and at risk of HIV. He received his medical degree from the University of British Columbia and completed his psychiatric residency training at the University of Toronto.

The learning objectives for this episode are as follows:

By the end of this episode, the listener will be able to…

1. Outline the history and evolution of CL psychiatry

2. Define the role and scope of CL psychiatrists in diverse medical settings

3. Identify and assess common psychiatric disorders in CL settings

4. Provide differential diagnoses and a general approach to a CL patient through a sample case

Guests: Dr. Raed Hawa and Dr. Alan Wai

Hosts: Annie Yu (PGY3), Sena Gok (MD), and Matthew Cho (CC3)

Audio editing by: Sena Gok

Show notes by: Sena Gok

Interview content:

• Introduction - 00:13
• Learning objectives - 01:09
• First guest introduction - 01:36
• History of CL psychiatry - 03:18
• Subspecialties within CL psychiatry - 10:33
• Collaborative care of CL psychiatry - 14:00
• Preparation for CL Rotation - 20:03
• Bariatric clinic and CL psychiatry - 22:32
• Future of CL psychiatry, AFC Certification - 27:45
• Second guest introduction - 33:29
• Role and scope of CL psychiatry - 34:18
• A day in CL psychiatry - 39:32
• Cultural competence in CL psychiatry - 44:08
• Introduction to patients in CL clinics - 47:53
• Resources for CL psychiatry rotation - 50:14
• Clinical vignette - 53:08
• CL psychiatric assessment approach - 01:00:25
• Agitation management in CL psychiatry - 01:09:24
• Closing - 01:13:51
• End credits - 01:15:05

Resources:

• Massachusetts General Hospital Handbook of General Hospital Psychiatry: https://www.sciencedirect.com/book/9781437719277/massachusetts-general-hospital-handbook-of-general-hospital-psychiatry
• Academy of CL Psychiatry (ACLP) educational resources: https://www.clpsychiatry.org/educationcareers/
• AFC (Area of Focused Competence) in CL Psychiatry: https://news.royalcollege.ca/en/eligibility-and-exams/areas-of-focused-competence.html
• Canadian Academy of Consultation-Liaison Psychiatry website: https://www.clpsychiatry.ca
• Our previous CL psychiatry-related episodes:
  • PsychEd Episode 22: Psycho-Oncology Assessments with Dr. Elie Isenberg-Grzeda
  • PsychEd Episode 35: Pain Psychiatry with Dr. Leon Tourian
  • PsychEd Episode 36: Understanding Eating Disorders with Dr. Randy Staab
  • PsychEdEpisode 37: Treating Eating Disorders with Dr. Randy Staab
  • PsychEd Episode 57: HIV Psychiatry with Dr. Adriana Carvalhal and Dr. Leigh van den Heuvel

References:

• Ali, S., Ernst, C., Pacheco, M., & Fricchione, G. (2006). Consultation-liaison psychiatry: How far have we come? Current Psychiatry Reports, 8(3), 215–222. https://link.springer.com/article/10.1007/s11920-006-0026-y
• Beran, C., & Sowa, N. A. (2021). Adaptation of an Academic Inpatient Consultation-Liaison Psychiatry Service During the SARS-CoV-2 Pandemic: Effects on Clinical Practice and Trainee Supervision. Journal of the Academy of Consultation-Liaison Psychiatry, 62(2), 186–192. https://pubmed.ncbi.nlm.nih.gov/33288272
• Lipowski, Z. J. (1974). Consultation-Liaison Psychiatry: An Overview. American Journal of Psychiatry, 131(6), 623–630. https://doi.org/10.1176/ajp.131.6.623
• Lipowski, Z. J. (1992). Consultation-liaison psychiatry at century’s end. Psychosomatics, 33(2), 128–133. https://doi.org/10.1016/S0033-3182(92)71988-4
• Swenson, J. R., Abbey, S., & Stewart, D. E. (1993). Consultation-liaison psychiatry as a subspecialty. A Canadian survey. General Hospital Psychiatry, 15(6), 386–391. https://doi.org/10.1016/0163-8343(93)90007-b
• Taylor, G., & Doody, K. (1979). Psychiatric Consultations in a Canadian General Hospital. The Canadian Journal of Psychiatry, 24(8), 717–723. https://doi.org/10.1177/070674377902400803

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