MGH McLean Adult Psychiatry Residency Program

PGY3: Perfecting Skills

The PGY-3 year is focused on refining the residents’ diagnostic and therapeutic skills, and extending their experience and ability in longitudinal outpatient treatment settings. In addition, several core clinical rotations provide training in areas that are required for specialty board certification and are crucial to the practice of psychiatry.

 

The PGY-3 year includes the following major components

• Longitudinal treatment of outpatients (approximately 55%)
• Didactic seminars,  psychopharmacology and psychotherapy case conferences
• Core clinical rotations –
  
  
  1. 1. General Hospital Consultation service (MGH)
  2. 2. Child Psychiatry (longitudinal outpatient experience)
  3. 3. Community Psychiatry
  4. 4. Addictions Partial Program (McLean)
  5. 5. Nashua Street Jail Rotation

Longitudinal Treatment of Outpatients

Slightly more than half of each resident’stime in PGY-3 is devoted to their longitudinal outpatient clinicexperience, which begins in PGY-2, and continues through PGY-3 and PGY-4 as the outpatient experience grows and deepens. Required components of this rotation experience are as follows:

• Longitudinal psychotherapy (includes supportive, psychodynamic, and CBT);
• Supervision and education related to outpatient psychotherapy
• Child and Adolescent Psychiatry evaluations, longitudinal treatment (individual or group), and supervision;
• 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 30-40 patients throughout the year, and have intakes scheduled weekly

 

Core rotations

MGH Consultation & Liaison Psychiatry Service (4 months)

The Consultation Liaison (CL) Rotation at MGH requires approximately 1/2 time effort and includes an orientation lecture series, Psychosomatic Conferences, rounds, and individual bedside supervision. The consultation-liaison service is a robust i npatient 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.Residents also h ave t he opportunity to rotate on sub-specialty CL services, including the Addictions Consultation Team, and the Burns and Trauma Service.

 

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.

 

Nashua Street Jail Rotation (2 months)

Residents spend 1 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.

 

MGH Community and Public Psychiatry Rotation (4 months)

This rotation provide residents with further exposure to outpatient work in Community settings, 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).

 

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 theirunderstanding 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: Once every 3-4 weeks at MGH. Moonlighting options are available at McLean Hospital

Vacation: 4 weeks vacation, scheduled at the discretion of the resident

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PGY3 Rotations

4 Months		4 Months		4 Months
Longitudinal Outpatient Clinic (~25 hours/per wk)
Consultation-Liason(CL) MGH		Addictions Partial (1 day/wk)	Nashua St Jail (1 day/wk)	Community Psychiatry (1 day/wk)
		Longitudinal Community Clinic (1/2 day per week)
		Elective Time (1/2 day per week)
Wednesday Core Didactics (1/2 day per week)

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

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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

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