Elective Experiences

MUSC Health has been at the forefront of brain stimulation therapy, including the first published use of Transcranial Magnetic Stimulation (TMS) for depression (1995), the first Vagus nerve implant for depression (1998), an Epidural prefrontal cortical stimulation (EpCS) performed in 2008, and the first Focal Electrically-administered Seizure Therapy (FEAST) done outside of New York (2010).

Residents will have the opportunity to rotate through the brain stimulation department, participating in a variety of experiences, including:

• Completing new consultations for patients seeking brain stimulation services
• Observing and assisting with Electroconvulsive Therapy (ECT)
• Observing and assisting with Transcranial Magnetic Stimulation (TMS)
• Learning about the management of medications during brain stimulation therapy

This is a 1 to 12 month part-time elective that allows the resident to function in the role of consultant regarding forensic mental health issues. Residents will participate in court-ordered evaluations, discuss cases and application of legal statutes, and draft forensic reports. There are multiple opportunities for participation, including:

• Criminal court ordered evaluations for competency to stand trial and criminal responsibility
• Civil court ordered evaluations under the state’s Sexually Violent Predator Act
• Family court evaluations for child custody, termination of parental rights, and adoptions
• Civil court evaluations for workers’ compensation and disability claims
• Group treatment of persons who have committed sexual offenses
• Probate court assessments
• Other forensic evaluations, treatment settings, and research projects

The resident is also able to observe courtroom testimony and etiquette by attending trials and other legal proceedings. As mental health education is a primary goal of this rotation, the resident may also attend and facilitate seminars on mental health issues relevant to the legal system. Supervision is provided by forensic psychiatrists and psychologists, and is coordinated by Dr. Fields, Dr. Lewis, and Dr. Gottfried.

Women's Reproductive Behavioral Health

Residents have the opportunity to rotate through our Women’s Reproductive Behavioral Health Division, typically in the 3rd and/or 4th years of training. This clinic serves a wide range of pregnant and postpartum women, including those with pre-existing and new mental health and substance use disorders. Residents will be able to participate in a walk-in clinic for new evaluations as well as to follow patients over time, both for psychotherapy and medication management.

Postpartum depression is a severe condition which affects upwards of 20% of women. Brexanolone is the first drug to be specifically approved for postpartum depression, gaining its FDA approval in March of 2019. The administration of Brexanolone is available through a restricted program called the Risk Evaluation and Mitigation Strategy Program and takes place through a continuous 60 hour infusion. Women who receive this treatment are enrolled in this program and receive the infusion at a certified health care facility under the close supervision of a health care provider.

In addition to clinical experience for residents, the department also offers a fellowship in reproductive psychiatry.

Meet the full reproductive behavioral health team here.