The Consultation-Liaison Fellowship
Inova Fairfax Hospital and George Washington University Medical Center
Although psychiatric consultations have been performed since the beginning of psychiatry as a formal specialty, modern consultative work can trace its roots to PC Knapp’s seminal paper in 1910 on the need for psychiatric consultations within the Boston City Hospital-1. Knapp suggested that psychiatric emergencies were handled in a clumsy fashion due to the isolated nature of psychiatric institutions and the paucity of psychiatrists who worked in general hospital settings
His observations were reaffirmed in 1929 by George Henry who observed the need for psychiatrists within general hospital settings-2. Henry, a student of Adolph Meyer at Johns Hopkins, cataloged consultations seen on a medical service in a White Plains hospital and forcefully argued for the importance of consultation work as a clinical and educational vehicle. Liaison psychiatry is a term coined by George Billings, who was also a student of Adolph Meyer, to denote his work at the University of Colorado-3.
Over the past three decades, consultation-liaison psychiatry has emerged as a growing and important subspecialty of psychiatric practice. The Inova Fairfax Hospital fellowship in consultation-liaison psychiatry began in 1975 and is fully accredited by the Accreditation Council for Graduate Medical Education.
It offers a broad experience of clinical activities, formal clinical and didactic supervision and research experience-4. More than 68 post-residency fellows have completed this program. They have entered a wide range of careers including academic psychiatry, private practice and administrative psychiatry.
1. Knapp, PC, “The Treatment of Cases of Mental Disorder in General Hospitals,” Nervous and Mental Diseases Monographs, 41:37-48, 1924.
2. Henry, GW. “Some Modern Aspects of Psychiatry in General Hospital Practice,” American Journal of Psychiatry, 131:623-630, 1974.
3. Billings, EG, “The Psychiatric Liaison: Department of the University of Colorado Medical School and Hospitals, ”American Journal of Psychiatry, 122 (12, Suppl):28-33, 1966.
4. Brantley, JT; Wise, TN, “A Consultation-Liaison Fellowship in a Community Hospital,” Psychosomatics, 12:205-212, 1980.
