Rotations PGY 3
Third Postgraduate Year
Outpatient Adult Psychiatry Boston Medical Center
Residents continue the second year outpatient clinic and expand the rotation to include evaluation of new patients and the addition of more patients for year-long (or more) treatment. Some residents have a supervised group therapy experience at BMC while others will have this experience at Boston VA Outpatient Clinic. This training experience is a 12 month clinic where residents provide long-term care for patients using both psychotherapy and psychopharmacological treatments. Residents meet weekly for clinic group supervision (2 residents) for psychopharmacology and case management and as part of their core education receive 2 hours of weekly educational psychotherapy supervision. A weekly team multidisciplinary team meeting provides additional experience in being a psychiatrist member of the team, provides additional attending oversight and ensures a diverse an active caseload for residents to begin the learning of two important and integrated components of psychiatric treatment and professional identity. The expanded outpatient psychiatric clinic residency allows excellent continuity of patient care with a highly diverse patient population. Residents will continue with patients from the second year clinic and a cohort from this expanded third year training clinic through the fourth year of training, providing long-term patient care.
Outpatient Clinic (Addiction and Dual Diagnosis Psychiatry Clinic and Cognitive-Behavioral Therapy Clinic)- VA Boston Healthcare System
The rotations at the VA Boston Healthcare include year-long Outpatient training experience at the Boston VA Outpatient clinic in the historic North End, renowned for its culinary experiences and a 6 month CBT rotation on the Jamaica Plain campus.
In the Outpatient Clinic residents rotate for 2.5 days with core curriculum seminars in Addiction and Dual Diagnosis Psychiatry, and specialized treatments including Motivation Interviewing Therapy for people suffer from addictions and Seeking Safety for patient with PTSD and Substance use disorders, and relapse prevention. All seminars are in the morning to ensure residents capacity to attend while meeting all duty hour requirements. Resident learn Addiction Psychiatry from John Renner MD, a national leader in Addiction Psychiatry and the Program Director of the Boston University Medical Center Addiction Psychiatry Fellowship. Resident evaluate and treat veterans with psychiatric illness who suffer from substance abuse or dependence and a psychiatric disorder. Treatment approaches for this population are psychopharmacological management including buprenorphine with FDA approved training for all residents by Dr. Renner. Residents with a full license to practice medicine and the required state and federal drug licenses are able to treat patients with opioid addictions with buprenorphine. Residents on a training license co-treat patients on buprenorphine with their attending psychiatrist. Residents learn Motivation Interviewing/Motivational Enhancement Therapy for patients with substance use disorders and Seeking Safety for patients with PTSD and substance use disorders. These specialized evidence based treatments enhance residents skills for current treatment of complex patients. Resident continue to practice long-term treatments including supportive and dynamic therapies. All psychotherapy modalities are typically integrated with psychopharmacology to meet the patients’ full psychiatric needs. Supervision includes a weekly one hour individual therapy as well as case conference. Residents will continue to treat a selected cohort of clinic patients through the fourth year of training to provide a 2 year long-term treatment.
The Jamaica Plain CBT rotation is a 6 months that includes an every other week morning of didactics in a variety of CBT and DBT protocols with every afternoon in direct clinical care practicing CBT and DBT in individual and group therapy settings. Supervision is provided by psychiatrists and psychologists under the leadership of Barbara Kamholtz, PhD, a national leader in CBT.
Outpatient Child Psychiatry- Boston Medical Center
This 6 month 7 hour/week rotation in Child Psychiatry complements the second year training in Adolescent Psychiatry. The focus in on children under 12 years of age and their families. The rotation begins each week with a didactic series on Child Psychiatry to educate residents in development, psychopathology, treatments, and family systems. Residents work closely with senior fellows from Boston Children’s Hospital Child and Adolescent Fellowship in the evaluation and treatment of child and families. The Chief of Child and Adolescent Psychiatry supervises this training experience integrating the Children’s fellows and our residents in a treatment team to meet the needs of complex children and families at Boston Medical Center. Residents with an interest in Child and Adolescent Psychiatry have the opportunity to continue to treat a small number of children long-term, over 1 or 2 years depending on the time of entry into a Child and Adolescent Fellowship.
Call is a training experience where residents develop more independence while receiving indirect supervision for an experienced attending psychiatrist. Residents on call cover consultation-liaison and emergency services at Boston Medical Center or Boston VA Healthcare. Third year residents have call 36 times a year, 12 weekend days and 24 weekdays but no holiday calls. Weekend calls are a 24 hour shift, beginning at 8 AM. Weekday calls begin at 6 PM and end at 8 AM. Residents at this level are permitted to attend morning educational activities when post-call but not to conduct patient care.