Andy Melaragno discusses a patient he recently evaluated in the Clinical Evaluation Center with his attending, Susan Szulewski.

Andy Melaragno discusses a patient he recently evaluated in the Clinical Evaluation Center with his attending, Susan Szulewski.

PGY1: Becoming a Physician

The PGY1 year serves to ground the developing psychiatrist as a physician. The future of psychiatry demands clinicians with a solid medical background and the first postgraduate year emphasizes the diagnosis and treatment of seriously ill medical patients. The MGH-McLean PGY1 program offers a solid clinical medical experience in internal medicine based at both Massachusetts General Hospital and Newton-Wellesley Hospital, an intensive neurology experience, and early exposure to clinical inpatient psychiatry. Massachusetts General Hospital is a tertiary/quaternary medical care center with a world-class internal medicine residency training program. Newton-Wellesley Hospital is a community hospital that is an affiliated teaching site of the MGH internal medicine residency. MGH/McLean psychiatry interns get to know their medical colleagues and form relationships that continue throughout residency and beyond, forging both their professional identity and lasting referral networks for the residents and our program. The MGH/McLean residency offers a combined program in adult, child and adolescent psychiatry. This unique program begins with a pediatrics internship at MGH which includes rotations in adult and child neurology and early exposure to adult inpatient psychiatry. Following internship, residents spend either two or three years (depending on resident preference) in the MGH/McLean Adult Psychiatry Residency, followed by two years in the MGH/McLean Child and Adolescent Fellowship. Applicants may choose one of the following paths of entry to the MGH-McLean Psychiatry Residency:  
  • The MGH Internship

    Six months of medicine at MGH, two months of neurology (one month on the MGH Adult Neurology Consult service and the second month either in the McLean Neurobehavioral Program or MGH Pediatric Neurology) and four months of adult inpatient psychiatry at MGH and McLean.
    • The Newton-Wellesley Internship

      Six months of medicine at NWH, two months of neurology (one month on the MGH Adult Neurology Consult service and the second month either in the McLean Neurobehavioral Program or MGH Pediatric Neurology), and four months of adult inpatient psychiatry at MGH and McLean.
    • The Combined Adult-Child/Adolescent Program

      Six months of pediatrics at the MGH hospital for Children (MGHfC), two months of neurology (one month on the MGH Adult Neurology Consult service and the second month on the MGH Pediatric Neurology service) and four months of adult inpatient psychiatry at MGH and McLean. Following the internship year, residents spend either two or three years in the adult psychiatry program (at resident’s discretion) and finally, two years in the child/adolescent psychiatry fellowship.
 
  • Core Rotation – MGH Blake 11 (Three months)

    This unit is located in the heart of MGH’s Medical/Surgical inpatient facility. A wide variety of psychiatric problems in patients with concurrent medical illness are treated. Residents will treat patients with a variety of acute and severe mental illness, including bipolar disorder, depression, obsessive-compulsive disorder, eating disorders, personality disorders, and substance use disorders. Residents become well-versed in the use of pharmacotherapies, management of side effects, and the use of electroconvulsive therapy. A didactic curriculum during the rotation provides a comprehensive understanding of affective illnesses, resiliency, and medical/psychiatric conferences.
 
  • Core Rotation – McLean Clinical Evaluation Center (One month)

    The Clinical Evaluations Center (CEC) functions as an urgent assessment and admission unit at McLean Hospital. While working on this unit, residents develop skills in psychiatric evaluation, diagnosis, triage, and treatment initiation. Patients are referred to the CEC from a variety of sources. These include area emergency rooms, crisis teams, other McLean Hospital programs, outpatient psychiatric clinicians, primary care physicians, family members or friends, or via self-referral. After a supervised training period, residents conduct evaluations to identify potentially unstable medical and psychiatric conditions.

    PGY-1 Timeline

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I have found everyone I have met to be incredibly friendly, compassionate, and supportive, both of patients and of staff. I feel particularly lucky to have received excellent teaching in medicine from our MGH senior residents and NWH attendings, and have learned a remarkable amount during just three months Allison Brandt, Class of 2020

One of the many perks of this program is the ease at which trainees can connect with renowned leaders in their fields. I have mentors who encourage me to reflect on my identity as a psychiatrist and a female physician and teach me to shape my personal qualities into professional strengths. Cordelia Ross, Class of 2020