PGY3 residents take a break from their clinical duties to take a stroll around campus.

PGY3 residents take a break from their clinical duties to take a stroll around campus.

PGY3: Perfecting Skills

The PGY3 year is focused on refining the residents’ diagnostic and therapeutic skills and is centered around the outpatient longitudinal care of patients across a variety of academic and community settings. Residents balance this comprehensive outpatient experience with several core clinical rotations focused on the medical/surgical interface with psychiatry as well as exposure to subspecialty areas crucial for the developing psychiatrist.

 

The PGY3 year includes the following major components:

  • Longitudinal treatment of outpatients (approximately 55%)
  • Didactic seminars,  psychopharmacology and psychotherapy case conferences
  • Core clinical rotations
    1. General Hospital Consultation service (MGH)
    2. Child Psychiatry (longitudinal outpatient experience based at primary clinic site)
    3. Community Psychiatry (various sites)
    4. Addictions Partial Program (McLean)

Longitudinal Treatment of Outpatients

Slightly greater than half of each resident’s time in the PGY3 year is devoted to treating patients in their longitudinal outpatient clinic. The longitudinal outpatient clinical experience begins in the PGY2 year and continues to build and deepen throughout the PGY3 and PGY4 years, as the resident gains confidence managing a variety of complex psychiatric illnesses. The outpatient clinical experience includes:
  • Longitudinal psychotherapy (includes CBT) and supervision
  • Child and adolescent clinical evaluations,, longitudinal treatment (individual or group) and supervision
  • Weekly new patient clinical intakes
  • Group therapy and supervision
  • Psychopharmacologic management and specialized outpatient clinical experiences
  • Elective Seminars (substance abuse, borderline personality disorders, family and couples, advanced psychodynamic psychotherapy, etc)
  • Psychopharmacology and psychotherapy case presentations and conferences
Residents typically carry a caseload of 20-35 patients throughout the year.

 

Core rotations

MGH Consultation & Liaison Psychiatry Service (4 months)

The consultation-liaison service, directed by Dr. Ted Stern, is a robust inpatient service where residents see patients throughout the hospital who have psychiatric issues complicating their medical or surgical care. Approximately 20% of all patients hospitalized at MGH receive a psychiatric consultation at some point during their admission. This rotation is a half-time experience and is balanced by the resident’s outpatient longitudinal clinic. Residents are supervised by key faculty members with specialized training in consultation and liaison psychiatry. It includes an orientation lecture series, weekly psychosomatic conferences, team and service rounds and individual bedside teaching and supervision.

 

McLean Addictions Partial Program (2 months)

Residents spend 1 day per week working in two partial hospital programs at McLean that serve the military and law enforcement populations, and specialize in the treatment of substance use disorders. Residents co-lead treatment groups including specialized therapy approaches such as Group Drug Counseling, Motivational Interviewing, Acceptance and Commitment Therapy, and Mentalization-Based Treatment.

 

MGH Community and Public Psychiatry Rotation (4 months)

This rotation is directed by Drs. Derri Shtasel and Oliver Freudenreich and includes both longitudinal and integrated care components. Residents evaluate and treat patients at a community mental health clinic and interface with members of an interdisciplinary team. Residents also have a longitudinal community experience at various area health centers, each focused on different patient populations. This community experience serves to balance the resident’s longitudinal clinic, which is based at a large academic medical center (either MGH or McLean outpatient clinic sites).

 

Nashua Street Jail Rotation (2 months)

Residents  spend one day per week working in the Nashua Street Jail in a rotation designed to give residents the opportunity to care for mentally ill patients in a correctional setting. They learn about the unique needs and challenges of this population, and become skilled at performing psychiatric assessments and implementing treatment plans for patients who are detained in the jail.

 

Didactics Seminars and Psychopharmacology Conferences

Required core didactic seminars and psychopharmacology conferences round out the curriculum.

 

1. Didactic Seminars are held on Wednesday afternoons. Residents attend a series of seminars designed to build upon their basic knowledge, adding breadth and depth to their understanding of mental illness and its treatment. Topics include Community and Sociocultural Psychiatry, Child Psychiatry, Psychoanalytic Theory and Practice, Group therapy, Cognitive Behavioral Therapy, Family Therapy, Couples Therapy and Dialectic Behavioral Therapy.

 

2. Required teaching exercises in clinical psychopharmacology take place every Tuesday mornings at both MGH and McLean sites.

 

Call Obligations

The on-call obligation for senior residents (PGY3 and 4) is once every 3-4 weeks at MGH. Moonlighting options are also available internally at McLean Hospital.


PGY3 Timeline

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It has been a true privilege to be part of the MGH/McLean community over the past two years. I feel I have grown and matured as a physician and individual, while being inspired and challenged by the faculty and peers around me. Katie Koh, Class of 2018

PGY3 year marks the transition from focusing on core clinical psychiatry to independent practice, teaching, and flexibility to pursue individual interests. Alok Kanojia, Class of 2018