Clinical Rotations by Year

PGY I Rotations

Inpatient Psychiatry

3 months rotation

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives:The inpatient psychiatry rotation is intended to teach the resident to conduct a thorough biopsychosocial psychiatric assessment including a complete psychiatric history, mental status examination, and physical examination. Under attending supervision, the resident is expected to initiate appropriate work-up, consultations, and ancillary procedures. The resident makes a biopsychosocial formulation of each case and formulates and implements a treatment plan. The resident also learns to recognize, analyze, and manage the dynamics in an inpatient setting and learn how to work with an interdisciplinary team. The resident learns how to provide individual and group psychotherapy and to set appropriate boundaries in a therapeutic relationship. The resident develops skills in timely, concise, and accurate documentation, including progress notes, treatment plans, and discharge summaries.

Description of Rotation :

PGY-I residents complete a required 3-month, full-time rotation on the Inpatient Psychiatry Teaching Units in their PGY-I year. This rotation is split between two Acute Inpatient Psychiatry Wards. Ward 2-3-C has a total of 28 beds, including 12 beds that serve as a National Referral Inpatient Service dedicated to treating female veterans. This specialized unit is dedicated to providing state-of-the-art psychiatric care for female veterans. The resident evaluates, treats, and follows acute admissions to the inpatient unit. Additional inpatient psychotherapy supervision for the inpatient psychiatry residents on this rotation is provided by several senior psychotherapy-oriented psychiatrists and psychologists.The 2 teaching units are staffed by a total of 7 psychiatrists, 3 nurse practitioners, one full-time psychologist, two social workers, an occupational therapist, and designated nurses and nursing assistants. Since these wards are teaching units, the trainees can include a PGY-IV level Psychiatry Senior Teaching Resident, up to five PGY-II or PGY-I level Psychiatry Residents, one or two Psychology Interns, a Social Work Intern, and 1-2 Occupational Therapy students. Nursing students from nearby affiliated programs also receive part of their clinical experience on the unit.The resident completes a diagnostic assessment and manages all aspects of the patient’s inpatient stay. The resident interacts with the treatment team in the management of patients. This involves performing initial evaluations, daily follow-up, team participation, treatment planning, and discharge planning. The resident may also conduct community meetings on a weekly basis and may co-lead medication groups.The resident completes all necessary evaluations, paperwork, progress notes, medication adjustments, evaluation of privileges, and discharge summaries. The resident’s autonomy in his/her decision-making is based upon his/her abilities and personal comfort in management. The inpatient attending psychiatrists are ultimately responsible for the jointly-made clinical decisions.

Geriatric Psychiatry

1 month rotation

Location

McLean Hospital
Belmont, MA
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Educational Objectives:This rotation at the McLean Hospital is intended to teach the PGY-I resident how to conduct a comprehensive, biopsychosocial geriatric psychiatric assessment, enhance interviewing skills with clear and accurate history taking, formulate a differential diagnosis and treatment plan, and provide major types of therapy including short-term individual psychotherapy, pharmacological therapy, and other somatic therapies. This rotation also offers the opportunity to learn fundamental concepts of the neuropsychiatric evaluation. All these skills will be applied to patients suffering from a variety of geriatric mental health disorders with ample exposure to depression in the elderly, dementia, and delirium.

Description of Rotation :

PGY-I resident spends a required 1-month, full-time rotation on the General Geriatric Psychiatry Unit. The units are staffed by 2 psychiatrists, 2 psychologists, 2 social workers, an occupational therapist, internist, physiatrist and designated nurses and mental health technicians. The resident evaluates and manages all aspects of the patient’s inpatient stay. Residents interact with the treatment team in the management of the patients. They perform initial evaluations, daily follow-up, team participation, treatment planning, and discharge planning. The resident conducts daily rounds, writes progress notes, follows laboratory results, dictates discharge summaries, and engages patients in short-term supportive psychotherapy and makes changes to treatment as indicated under attending supervision. The residents participate in family meetings and discussions with outpatient providers and primary care physicians. “The resident’s autonomy in his/her decision-making is based upon his/her abilities and personal comfort in management.

McClean Hospital Belmont

Clinical Evaluation Center

1 month rotation

Location

McLean Hospital
Belmont, MA
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Educational Objectives:The CEC rotation at McLean Hospital builds residents’ skills in assessing and diagnosing patients with a broad range of psychiatric conditions. The rotation develops residents’ capacity to make effective and appropriate decisions regarding psychiatric admission. The resident also gains experience serving as liaison with inpatient and community resources and negotiating care provision with insurance companies. While the majority of patients seen in the CEC are admitted to locked inpatient units, some patients are able to return to outpatient care after receiving crisis intervention and/or other outpatient supports.

Description of Rotation :

Residents spend one month rotating at the CEC. Patients are referred from a variety of sources including emergency rooms, crisis teams, outpatient psychiatrists, primary care physicians, family members or friends, and self-referrals. The resident and CEC staff conduct a thorough evaluation to identify potentially unstable medical and psychiatric conditions. Subsequently, they arrange for the initiation of appropriate care. CEC staff consists of attending psychiatrists, clinical nurse specialists (advanced practice nurses), nurses, mental health workers, and triage specialists. The CEC serve as a training site for psychiatric residents, medical students, advanced practice nursing students, and pharmacy students. CEC staff work closely with the McLean internal medicine department and all inpatient and outpatient services at the hospital. While on rotation, residents also benefit from attending teaching rounds at the start of their shift.

Addiction Psychiatry

1 month rotation

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives:The inpatient substance abuse rotation at the VA Medical Center is intended to familiarize the resident with the psychiatric assessment and treatment of substance abuse patients. The resident is expected to do the following: evaluate and diagnose patients who are in withdrawal; treat and order an appropriate detoxification regimen; recognize, assess, and treat patients with co-morbid primary psychiatric disorders; and gain exposure to the various long-term rehabilitation programs available for discharge planning.

Description of Rotation :

Residents spend a required, 1-month, full-time rotation on the Substance Abuse Unit in their PGY-I year. There are 14 beds for patients who need detoxification and 11 beds for patients who need further education and rehabilitation from substance abuse (the SAARTP Program). There is also an 8-bed long-term rehabilitation program for drug abusers (Project RISE).

The resident conducts a thorough biopsychosocial assessment and manages all aspects of the patient’s inpatient stay. The resident interacts with the treatment team in the management of the patients. This involves performing initial evaluations, daily follow-up, team participation, treatment planning, and discharge planning. The resident’s autonomy and independence is consistent with his/her abilities, teaching needs, and personal comfort with clinical management.

Depending on resident’s interest, s/he may also participate in scholarly activities during this rotation. Residents may assist in reviewing manuscripts sent by journals to senior faculty for review. In addition, residents may participate in clinically-focused on-going quality improvement projects. Past residents have found these activities engaging and highly educational.

Internal Medicine

4 months rotation

Location

VA Boston Healthcare System, Brockton,
Brockton Neighborhood Health Center,
MetroWest
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Educational Objectives:The overall educational objective of the Internal Medicine block is for the HSS resident to be comfortable recognizing and treating common medical problems and to develop strong physical exam techniques.

Description of Rotation :

The Internal Medicine experience provides exposure to patients in the acute phase of illnesses(MetroWest); as they begin to recover (VABHS Step-Down); and for prevention in outpatient, primary care (Brockton Neighborhood Health Center, BNHC). While rotating through VABHS and BNHC, residents will experience one-to-one teaching from attending faculty. This close teaching fosters the development of excellent history taking and physical exam skills. Additional experiences include working with patients receiving hospice care, taking a history through an interpreter, getting exposure to a variety of specialties (e.g. infectious disease, endocrinology, and urgent care/emergency care), and reaching out in the community to care for people currently homeless.

Outpatient Neurology

2 months rotation

Location

VA Boston Healthcare System, Jamaica Plain Campus
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Educational Objectives:

This rotation is intended to teach each resident how to evaluate, diagnose, and follow patients during the treatment and/or evaluation of their neurological illness. The resident is also expected to obtain clinical experience in the diagnosis of neurological conditions that might be encountered in psychiatric practice.Emphasis is placed on training the resident to perform neurological examinations.


Description of Rotation :

In the outpatient experience at the Jamaica Plain Campus, the resident works in a variety of Neurology specialty clinics under the supervision of the Attending Neurologist. The clinics include Epilepsy, Memory, Multiple Sclerosis, Movement Disorders, as well as others. In all roles on this rotation, the resident performs initial evaluations including neurological and cognitive examinations, considers differential diagnoses, and arranges appropriate treatment and follow-up. Residents work alongside Harvard Medical School and Boston University and medical students, residents, medical students, and other trainees. Residents are also expected to attend Wednesday didactic activities and EEG conference along with these other trainees. Additional didactic sessions include Clinical Pathological Conferences.

PGY II Rotations

Inpatient Psychiatry

Duration

2 months

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

The inpatient psychiatry rotation teaches the advanced psychiatry resident to conduct a thorough biopsychosocial psychiatric assessment including a complete psychiatric history, mental status examination, and physical examination. The resident is expected, under attending supervision, to initiate appropriate work-up, consultations, and ancillary procedures. The resident makes a biopsychosocial formulation of each case and formulates and implements a treatment plan appropriate to their more advanced level of training. The resident also learns to recognize, analyze, and manage the dynamics in an inpatient setting and learns how to work with an interdisciplinary team. The resident learns how to provide individual and group psychotherapy and to set appropriate boundaries in a therapeutic relationship. The resident develops skills in timely, concise, and accurate documentation, including progress notes, treatment plans, and discharge summaries. The resident also evaluates patients for ECT and participates in ECT treatment of patients.


Description of Rotation :

PGY-II residents complete a required 2-month, full-time rotation on the Inpatient Psychiatry Teaching Units in their PGY-II year. This rotation is split between two Acute Inpatient Psychiatry Wards. Ward 2-3-C has a total of 28 beds, including eight beds that are dedicated for use by female inpatients in a separate wing of the inpatient unit. If needed, the unit can accept up to 12 female inpatients. The resident evaluates, treats, and follows acute admissions to the inpatient unit. Additional inpatient psychotherapy supervision for the inpatient psychiatry residents on this rotation is provided by several senior psychotherapy-oriented psychiatrists and psychologists.

The 2 teaching units are staffed by a total of 7 psychiatrists, 3 nurse practitioners, one full-time psychologist, two social workers, an occupational therapist, and designated nurses and nursing assistants. Since these wards are teaching units, the trainees can include a PGY-IV level Psychiatry Senior Teaching Resident, up to five PGY-II or PGY-I level Psychiatry Residents, one or two Psychology Interns, a Social Work Intern, and 1-2 Occupational Therapy students. Nursing students from nearby affiliated programs also receive part of their clinical experience on the unit. The resident manages all aspects of the patient’s inpatient stay. The resident interacts with the treatment team in the management of patients. This involves performing initial evaluations, daily follow-up, team participation, treatment planning, and discharge planning. The resident may also conduct community meetings on a weekly basis and may co-lead medication groups.

The resident completes all necessary evaluations, paperwork, progress notes, medication adjustments, evaluation of privileges, and discharge summaries. The resident’s autonomy in his/her decision-making is based upon his/her abilities and personal comfort in management. The inpatient attending psychiatrists are ultimately responsible for the jointly-made clinical decisions.

The resident partners with an attending psychiatrist to co-lead a group using a supportive psychotherapy approach. This group experience enhances the resident’s understanding of group dynamics and the effectiveness of this treatment modality.


Child & Adolescent Psychiatry

Duration

2 months

Location

McLean SouthEast
Middleborough, MA
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Educational Objectives :

Residents learn how to conduct a comprehensive psychiatric and medical assessments, formulate differential diagnosis and treatment plans, and provide major types of therapy for children and adolescents. There is ample exposure to eating disorders, attention deficit disorders, personality disorders, substance use disorders, gender dysphoria, and OCD.


Description of Rotation :

PGY-2 residents spend six weeks on the Adolescent Residential Unit. The resident evaluates and manages all aspects of the patient’s residential stay including: initial evaluations, daily follow-up, team participation, treatment planning, family meetings and discharge planning. Residents have the unique opportunity to participate in the Massachusetts Child Psychiatry Access Project (McPAP), a consultation service to regional pediatricians in the community. In addition, residents spend two weeks on the OCD unit learning how to help children manage their severe OCD symptoms.


Women’s Health Clinic

Duration

1 month

Location

Brockton Neighborhood Health Center
Brockton, MA
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Educational Objectives :

The goal of this rotation is for residents to develop a broader understanding of mental health issues in women patients. In addition, residents will learn how to safely prescribe psychopharmacological agents to women before, during, and after pregnancy. Residents will also learn how to provide psychiatric care and perform a mental status exam through an interpreter.


Description of Rotation :

PGY-2 residents spend a full-time, 1-month rotation at the Brockton Neighborhood Health Clinic (BNHC). BNHC is an outpatient community health center, which serves a diverse patient population including Brazilian, Cape Verdean, Haitian, Latino, Portuguese, African American, and Caucasian patients, 74% of whom live in poverty. Besides obtaining experience with treating female patients, residents will get exposure to Cross-Cultural Psychiatry and understand the social roles of women in a variety of cultures. Furthermore, residents will experience a model of care where behavioral health and primary care are integrated.


Dr. John C. Corrigan Mental Health Center

Community-Based Inpatient Psychiatry

Duration

1 month

Location

Dr. John C. Corrigan Mental Health Center
Fall River, MA
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Educational Objectives :

Residents develop skills in acute care and integrated inpatient-outpatient treatment in a community-based setting. The inpatient rotation at Corrigan provides residents with experience in managing acute episodes of a wide range of psychiatric illness within a public system of care, enabling them to interact with hospital diversion and follow-up services and other clinical disciplines. The rotation emphasizes the biopsychosocial assessment and treatment of psychotic disorders and also offers some experience with assessing the appropriateness of civil commitment in the community setting. Elective rotations in these services and in research are available for advanced residents.


Description of Rotation :

PGY-II residents spend a required, full-time 1-month rotation at the Corrigan Mental Health Center during their PGY-II year. The Dr. John C. Corrigan Mental Health Center in Fall River, MA is a DMH-funded facility serving a catchment area that includes Fall River, New Bedford, and surrounding towns. The center is a fully accredited, JCAHO facility that provides a variety of training experiences. The center has multiple facilities including a busy crisis unit which operates on a 24-hour basis, a locked inpatient unit with 16 beds, and a day treatment rehabilitation unit which has a capacity of 20 beds. In addition, the Center provides acute inpatient care and follow-up outpatient care including case management and residential programs, and oversees a number of contracted services for other day treatment and residential needs.

The Inpatient Unit is composed of two treatment teams, both of which are staffed by a Team Leader, a social worker, a psychiatrist, and designated nurses and mental health workers. The Medical Director for Inpatient Services leads one team and provides overall supervision of the resident’s clinical work during the rotation, while the second team is under the psychiatric leadership of another faculty attending.

The resident evaluates, treats, and manages acute admissions to the inpatient unit under the supervision of the Unit attending. Preceptor teaching is provided by senior attending psychiatrists. Each resident has the opportunity to evaluate and work with a variety of inpatients and to present cases at one or more conferences during the rotation. Psychopharmacology and general psychiatry case conferences complement the clinical bedside teaching. The rotation may involve experience with the closely affiliated Day Treatment Program, permitting residents to follow their own inpatients as they re-enter the community and to better appreciate the course of these disorders through time and phases of illness.

The resident also is assigned off-unit supervision two hours per week to explore issues, reactions, or specific interests generated by the rotation. A monthly journal club involving the psychiatry resident and on-site psychology interns and graduate students is also available. The resident presents cases regularly during the rotation at a clinical case conference held bi-weekly.


west roxbury vamc

Consultation-Liason Psychiatry

Duration

2 months

Location

VA Boston Healthcare System,
West Roxbury Campus
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Educational Objectives :

This rotation in the PGY-II year provides the core educational experience in consultation-liaison psychiatry. The resident learns both principles of psychopharmacology in the medical setting and the application of time limited psychotherapy, supportive therapy, couples therapy and cognitive behavioral therapy including hypnosis.


Description of Rotation :

PGY-II residents spend a required, 2-month rotation training in medical psychiatry. The West Roxbury Campus is a tertiary care medical center that serves veterans from throughout New England. The medical psychiatry service is staffed by two attending psychiatrists.

The resident receives training in managing medical patients and surgical patients with psychiatric needs. The patient population includes patients with neurologic, renal, oncologic, respiratory, orthopedic, and cardiac disorders, with a heavy representation of complex patients in the geriatric age range. Specialty foci include sleep disorders, pain disorders, and spinal cord injury. There is an active academic program including training in forensic psychiatry and systems-administrative psychiatry.

There are ongoing didactics for Psychosomatic Fellowship Program fellows, and residents can attend while they are on service, including an ongoing course in advanced psychopathology. There are intensive supervision, daily teaching rounds and allied meetings with social work and nursing staff. Residents are expected to review and present a formal academic topic during the rotation. They are encouraged to attend Schwartz Rounds-Harvard-sponsored multidisciplinary conferences that focus on compassionate humanistic care; topics have included the care of the difficult patient, the homeless patient, the returning Iraqi veteran, and staff conflict around specific patient care issues. Residents also have an opportunity to teach Boston University and Harvard University medical students.


Forensic Psychiatry

Duration

1 month

Location

Dr. Solomon Carter Fuller Mental Health Center
Boston, MA
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Educational Objectives :

The inpatient forensic rotation at Dr. Solomon Carter Fuller Mental Health Center provides PGY-II residents with exposure to the interface between psychiatry and the law. The goals of the rotation are to give each resident clinical experience in recognizing and evaluating patients committed under the various subsections of Massachusetts General Law and to assess and manage the clinical needs of these patients. Residents will learn about forensic evaluations to determine criminal responsibility and competency to stand trial.


Description of Rotation :

PGY-II residents spend one month full-time at Dr. Solomon Carter Fuller Mental Health Center. This facility has three forensic psychiatric inpatient units which provide forensic assessments for the Commonwealth of Massachusetts, while providing ongoing psychiatric care. Psychiatrists and forensic psychologists provide both clinical and didactic supervision. Residents provide ongoing psychiatric care for patients, as members of a multidisciplinary team. Residents also have the opportunity to observe forensic evaluations and court hearings. Patients are culturally and diagnostically diverse; most have severe mental illness, substance dependence, and / or neuropsychiatric impairment.


Partial Hospital Program

Duration

1 month

Location

23 Isaac St, Middleborough, MA 02346.
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Educational Objectives :

In this partial hospital treatment setting, the resident further develops skills in comprehensive biopsychosocial assessment and treatment of individuals with serious mental illness who are too impaired for outpatient treatment. Residents also gain experience in intensive group therapy with the goal of developing greater understanding of the potential benefits and challenges of group treatments. The resident also learns the relative indications and contraindications for group treatment. Residents learn to define strategies for group formation and deepen their understanding of group process and how this process may be employed therapeutically.


Description of Rotation :

PGY-II residents spend a required full-time, 1-month rotation at the McLean SouthEast Partial Hospital Program, a component of the satellite inpatient/ outpatient site of McLean Hospital located on the grounds of the Brockton campus of VABHS. The program provides comprehensive diagnosis of and treatment for individuals experiencing psychiatric illness. It offers a continuum of care that includes an acute psychiatric inpatient service and a partial hospital program.

The Partial Hospital Program offers a highly structured therapeutic environ-ment for individuals who are in crisis but can safely reside in the community. The program is available as either a step-down level of treatment from an inpatient unit or as a direct admission to avoid hospitalization. The partial hospital level of care offers more intensive psychiatric supervision and treatment than the traditional outpatient setting. McLean SouthEast utilizes a multidisciplinary approach with case management, rehabilitation therapy, structured group programming and psychiatry.

The resident is a full participant in the partial hospitalization program, including involvement in several group therapy sessions during the day. Patients involved with groups may be recent discharges from a psychiatric inpatient unit or they may be community referrals. Caseload is varied, including bipolar, MDD, anxiety disorders, eating disorders, Axis II disorders, partially compensated schizo-phrenia, and post-partum depression. Treatment modalities include cognitive behavioral groups, supportive psycho-therapy groups, and medication management groups. The resident is involved in all groups and leads the medication management group under attending supervision. The resident also collects information from outpatient clinicians, monitors patient improvement daily and adjusts medications accordingly. The resident takes part in individual psychotherapy sessions wherein a member of the group is taken aside to focus on a particular issue that may not have been totally explored or discussed in group. Family meetings are also an integral part of partial hospital treatment, and the resident is involved in these interventions as well.


Night Float

Duration

1 month

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

This rotation at VABHS is intended to teach the PGY-2 resident how to conduct a comprehensive psychiatric and medical assessments, triage patients, screen medical records for patients to be transferred, and manage psychiatric and medical concerns that arise from the inpatient and residential units. This rotation will foster autonomy and cultivate clinical skill confidence.


Description of Rotation :

The rotation is three consecutive weeks. Patients are referred from a variety of sources including emergency rooms, crisis teams, outpatient psychiatrists, primary care physicians, family members, and self-referrals. The resident and Urgent Care staff conduct a thorough medical and psychiatric evaluation in order to determine an appropriate level of care.


Continuity Clinic

Duration

12 months, half day a week

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

The Continuity Clinic at the VA Brockton provides an opportunity for residents to follow patients over 2-3 years, emphasizing psychotherapeutic modalities.


Description of Rotation :
The Continuity Clinic introduces psychiatric care delivery in the outpatient setting. Residents acquire a caseload of four to six patients over the course of the year and continue to follow these same patients into their PGY III and IV years. This allows the resident to learn the vicissitudes of chronic psychiatric illness by following the patients over a longer course of illness. The Continuity Clinic emphasizes developing and managing a long-term psychotherapeutic relation-ship. The resident has the opportunity to improve skills in all core competencies during the rotation, with special emphasis on improvement in interpersonal communication, managing transference, interpretation, and intervention. Both psychotherapeutic and pharmacologic interventions are utilized. Residents perform psychiatric assessments with a supervisor present and advance to meeting independently with patients based on their skill and comfort level. Each resident meets weekly with an individual faculty supervisor to review and discuss their clinical work in the Continuity Clinic. In addition, residents meet with their rotation supervisor in a seminar format to discuss topics relevant to outpatient clinical work.

McClean Hospital Belmont

Inpatient Psychiatry

Duration

1 month rotation

Location

McLean Hospital
Belmont, MA
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Educational Objectives :

PGY-II residents complete a required 1-month, full-time rotation on the Short-term Inpatient Psychiatry Teaching Units at McLean Hospital in Belmont. The Short-Term Unit cares for patients suffering from a variety of psychopathologies but are focused mainly on mood disorders and personality disorders. The resident evaluates, treats, and follows acute admissions to the inpatient unit. The unit is staffed by several psychiatrists, mental health specialists, social workers, psychologists, and designated nurses and nursing assistants. Other trainees may include medical students from Harvard Medical School and social work interns.


Description of Rotation :

The resident manages all aspects of the patient’s inpatient stay. The resident interacts with the treatment team in the management of patients. This involves performing initial evaluations, daily follow-up, team participation, treatment planning, and discharge planning. The resident may also conduct community meetings on a weekly basis and may co-lead medication groups.
The resident completes all necessary evaluations, paperwork, progress notes, medication adjustments, evaluation of privileges, and discharge summaries. The resident’s autonomy in his/her decision-making is based upon his/her abilities and personal comfort in management. The inpatient attending psychiatrists are ultimately responsible for the jointly-made clinical decisions.


PGY III Rotations

General Mental Health Outpatient Clinic

12 months

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

The outpatient psychiatry rotation at the Mental Health Clinic is intended to develop residents’ skills in performing a comprehensive biopsychosocial assessment of their patients in an outpatient setting; formulating individualized treatment plans; working effectively with a multidisciplinary treatment team in a recovery-based care setting; and treating and monitoring patients with various forms and combinations of somatic therapies and psychotherapy, with a strong emphasis on pharmacotherapy.


Description of Rotation :

Residents spend a required, 1-year rotation (approximately 2 days/week) at the General Mental Health Clinic in their PGY-III year. The residents evaluate, diagnose, and treat outpatients needing psychiatric care.

The PGY-III resident works closely with the Mental Health Clinic Team, a multidisciplinary team which meets regularly to discuss those outpatients with treatment issues requiring interdisciplinary input and to review administrative issues relevant to clinic practice. The resident typically sees his/her patients at least every 4-6 weeks for pharmacotherapy and weekly/biweekly for individual or group therapy. Each resident meets individually on a weekly basis with his/her assigned caseload supervisor. Residents discuss their initial assessment of their patients and review their full patient caseloads over the course of the PGY-III academic year.

The autonomy and independence of the resident’s decision-making is consistent with his/her clinical abilities. The outpatient supervisor assigned to each PG-III resident provides caseload oversight and in-depth biopsychosocial supervision for individual patients. This caseload supervision is supplemented by additional psychotherapy supervision.

Post-Traumatic Stress Disorder Clinic

12 months

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

The PTSD Clinic rotation at the VA Medical Center is intended to provide the resident specialized experience in performing a comprehensive biopsychosocial assessment of PTSD patients in an outpatient setting; formulating individualized treatment plans for this population; working effectively with a multidisciplinary outpatient treatment team; and treating and monitoring patients with various forms of somatic therapies and psychotherapy.


Description of Rotation :

Residents spend a required, 1-year rotation (approximately 1/2 day/week) at the PTSD clinic in their PGY-III year. The residents evaluate, diagnose, and treat outpatients with posttraumatic stress disorder.

The PGY-III resident works closely with the PTSD Team, a multidisciplinary clinical team of psychiatrists, psychiatry residents, psychologists, and social workers. The resident evaluates, diagnoses, and treats assigned outpatients under the supervision of the attending psychiatrists. Supervision is augmented by psychotherapy supervision by team psychologists for individual patients. Residents join PTSD Team meetings regularly for clinical case supervision and review. Close coordination with the Returning Veterans Program (for Iraq/Afghanistan veterans) ensures exposure to PTSD in both women and men across multiple generations.

Alcohol and Drug Treatment Program Clinic

12 months

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

Residents learn how to diagnose different levels of severity of alcohol and other psychoactive substance use disorders consistent with DSM-5 criteria, formulate individualized treatment plans, apply evidence-based treatment, and work effectively with an interdisciplinary team. Residents will learn the basic principles of Motivational Interviewing (MI) through a seminar series and in work with patients. Residents will manage buprenorphine prescribing under the supervision of the attending addiction psychiatrist.


Description of Rotation :

Residents spend 1 day/week in the ADTP clinic during PGY-3 year, during which they will acquire a caseload of 10 patients (8 patients for psychopharmacology and 2patients for Motivational Interviewing). A psychologist will provide adjunctive supervision for psychotherapy cases. The major goal of treatment in the ADTP Outpatient Clinic is to motivate behavioral change related to alcohol and/or drug useand provide evidence-based medication-assisted treatment (MAT). Other goals include psychiatric stabilization, establishment of a support network, improved relationships in the community, improved physical health, and resolution of employment, legal, and other psychosocial problems.

Clozapine Clinic

3 months

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

The Clozapine Clinic rotation at the Brockton Campus of VA Boston Healthcare System provides residents with experience in the comprehensive psychiatric assessment and ongoing treatment of patients with severe mental illness. This rotation also provides residents with specific training and experience in the use of clozapine to treat patients with treatment-resistant Schizophrenia. Residents collaborate with colleagues as part of a multidisciplinary team, and thus gain experience and guidance in functioning as an effective member of a clinical team.


Description of Rotation :

Residents spend ½ day per week for 3 months during their PGY-III year in the clozapine clinic. The experience includes direct assessment of patients and adherence to standardized protocols for clozapine initiation, maintenance, and monitoring. In addition to clozapine maintenance, each patient’s overall psychopharmacologic treatment plan is evaluated and modified with the goals of maximizing the patient’s quality of life and functional status and minimizing polypharmacy. An attending psychiatrist directly supervises the clinical work of each resident. A Clinical Pharmacy Specialist also staffs the clinic; she is an integral member of the clinical team and works closely with the residents.

Residents spend a required, 1-year rotation (approximately 2 days/week) at the General Mental Health Clinic in their PGY-III year. The residents evaluate, diagnose, and treat outpatients needing psychiatric care.

The PGY-III resident works closely with the Mental Health Clinic Team, a multidisciplinary team which meets regularly to discuss those outpatients with treatment issues requiring interdisciplinary input and to review administrative issues relevant to clinic practice. The resident typically sees his/her patients at least every 4-6 weeks for pharmacotherapy and weekly/biweekly for individual or group therapy. Each resident meets individually on a weekly basis with his/her assigned caseload supervisor. Residents discuss their initial assessment of their patients and review their full patient caseloads over the course of the PGY-III academic year.

The resident’s autonomy in his/her decision-making is based upon his/her abilities and personal comfort in management. The outpatient supervisor assigned to each PG-III resident provides caseload oversight and in-depth biopsychosocial supervision for individual patients. This caseload supervision is supplemented by additional psychotherapy supervision.

Homeless Veterans Program – PROJECT REACH

2 months

Location

VA Boston Healthcare System,
Brockton Campus
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Educational Objectives :

This domiciliary-based rotation at the VA Boston Healthcare System’s Brockton Campus is intended to provide the PGY-III resident experience in assessment and treatment of a predominantly homeless, substance-abusing population, including performing a comprehensive biopsychosocial assessment of his/her patients; formulating individualized treatment plans; working effectively with a multidisciplinary treatment team in a recovery-based care setting; and working closely with the primary care physician on problems on the interface between medicine and psychiatry. There is a strong emphasis on use of evidence-based, cost-effective psychopharmacology of mood and anxiety disorders and insomnia.


Description of Rotation :

Residents augment their outpatient substance abuse experience with a required 2-month rotation at the Domiciliary Program (Project REACH) in their PGY-III year. The residents evaluate, diagnose, and treat psychiatric disorders affecting outpatients living in the Domiciliary Unit.

The Domiciliary Unit is staffed by the following personnel: a psychiatrist, a psychologist, an internist, social workers, and mental health workers. The PGY-III resident evaluates, diagnoses, follows, and treats his/her assigned outpatients under attending supervision.

Dr. John C. Corrigan Mental Health Center

Community Mental Health

12 months

Location

Dr. John C. Corrigan Mental Health Center
Fall River, MA
or
Brockton Multi-Service Center
Brockton, MA
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Educational Objectives :

The Community Psychiatry rotation at the Brockton Multi-Service Center (BMSC) is intended to provide residents with experience in making a comprehensive biopsychosocial assessment of patients in the community psychiatry setting, formulating individualized treatment plans for outpatients, working effectively with a multidisciplinary outpatient itreatment team, and treating and monitoring patients using various forms of somatic therapy and psychotherapy. In addition, a formal didactic component broadens residents’ understanding of mental health care delivery in community-based clinics. The Community Mental Health rotation at the Dr. John C. Corrigan Mental Health Center is intended to provide residents with experience in making a comprehensive biopsychosocial assessment of patients in the community psychiatry setting. Residents develop skills in acute care and integrated inpatient-outpatient treatment in a community-based setting.


Description of Rotation :

PGY-III residents spend a required 1-year rotation (1/2 day/5 hours/week) either at Brockton Multi-Service Center or the Corrigan Mental Health Center. The Brockton Multi-Service Center is a facility of the Massachusetts Department of Mental Health (DMH) Southeastern Area network. This DMH-funded facility serves as a catchment area that includes Brockton and surrounding towns. The center is a fully-accredited Joint Commission facility.

Residents evaluate, diagnose, and treat clients in the Intake Department, the Outpatient Clinic, and in Emergency Services. Residents spend a half-day a week in the outpatient clinic, seeing their patients every 2-4 weeks for pharmacotherapy and/or weekly for individual therapy. At the Center’s Intake Department, residents are the first to provide comprehensive assessments of clients who have just been made eligible for DMH services; residents will follow some of these clients throughout the year with regular participation in the client’s treatment team. During the rotation, residents also spend a half-day or more a month working in Emergency Services, where they evaluate, diagnose, and treat patients in crisis and make decisions about disposition under supervision. Residents also have the opportunity to visit the various community programs at the center and in the community, including Program for Assertive Community Treatment (PACT teams), residential programs, and the peer-run Club House. Supervision is provided for intake, psychopharmacology, psychotherapy and crisis work. A seminar series on topical issues in community psychiatry is also held on a monthly basis.

PGY-III residents spend a required, one-year rotation (1/2 day per week) at the Corrigan Mental Health Center. The Dr. John C. Corrigan Mental Health Center in Fall River, MA is a DMH-funded facility serving a catchment area that includes Fall River, New Bedford, and surrounding towns. The Center is a fully accredited, JCAHO facility that provides a variety of training experiences. The Center has, among its multiple facilities, a busy Crisis or emergency services unit which operates on a 24-hour basis; a locked Inpatient Unit with 16 beds; and a Day Treatment rehabilitation unit (Partial Hospital Program) which has a capacity of 20 beds. Residents rotate in the Crisis Intervention Service/Urgent Care and the Day Treatment Rehabilitation Unit (Partial Hospital Program).

The Crisis Intervention Service/Urgent Care is staffed by two full-time psychiatrists who have extensive experience in the area of crisis intervention and assessment. Urgent Care is a crisis unit-related outpatient clinic where clinical evaluations, initial treatment and referrals are completed. Residents’ clinical supervision is supplemented by case-based teaching thru “mini-lectures” addressing relevant topics. The Resident learns skills necessary for rapid assessment, differential diagnosis, formulation, clinical planning and intervention. Residents work in this service seeing new patients under the supervision of an attending psychiatrist. 

A parallel component of this rotation is the Partial Hospital Program. The Partial Hospital program is designed as a step-down to hospitalization both for patients coming from the Crisis Unit and for patients who might enter the hospital or come out of the hospital. The program is organized around medical and recovery-oriented interventions involving individual assessment and management. The resident performs assessments on admissions to the Partial Hospital program. S/he participates in varied activities which include assisting or leading group sessions and providing brief individual therapy to patients who need additional support beyond that provided by group meetings. The resident also attends family meetings and interdisciplinary treatment meetings that may occur in the course of care for an individual in the program. This part of the rotation provides an opportunity to follow a patient for longer periods. 

The rotation provides an opportunity for supervision of individual cases with one of the Attending supervisors. Supervision involves review of relevant clinical issues and fosters understanding of the nature of community patient problems.

PGY IV Electives

  • Psychotherapy
  • Harvard Undergraduate Clinic
  • Advanced Psychotherapy
  • Sub-specialty Care
  • Serious Mental Illness
  • Child/Adolescent Forensics Geriatrics Women’s Health Substance Abuse Substance Abuse Homelessness Residential Care
  • Community Care
  • Medical / Surgical /Neurological Interface
  • Psycho-Oncology Neurosurgery Pain Management Integrated Care Internal Medicine Endocrinology
  • Research / Scholarship
  • Resident Pathways to Research Scholarship
  • Leadership
  • COOL
  • State-level Policy