Psychiatry
Adult Psychiatry
Adolescent Psychiatry
and Research
300.0/MEDMD524 Consultation-Liaison Psychiatry
Instructor: Dara Wilensky, M.D.
Location: Boston Medical Center (7th Floor, Suite 7600, Doctor’s Office Building)
Contact: Scott Harris
Telephone: 617 358-7499 Email: scotth@bu.edu
Number of Students: One
Period to be offered: Four weeks (Blocks 9-14 and 17-20)
Description of Elective:
This four week elective in Psychosomatic Medicine with Dr. Wilensky is a core training site for the residency program and the psychosomatic fellowship program. This course offers a consultation-liaison experience, with a focus on clinical work designed to enhance student’s ability to understand and appreciate the psychosocial aspects of medical illness. Emphasis will be placed on the development of interviewing techniques and differential diagnostic styles and increased responsibility for the development of brief treatment strategies. Interested students may choose to focus their clinical work in a particular area of the hospital or with a specific service. In addition, the student will be required to do research in an area of interest involving psychosomatic medicine with the development of a paper and presentation to members of the Psychosomatic Medicine team at the end of the rotation.
This course is not intended solely for those interested in psychiatry as a specialty, but especially for those interested in the areas of general medicine and primary care.
301.0/MEDMD525 Consultation-Liaison Psychiatry
Instructor: Rashad Alikhan, M.D.
Location: VA Boston Healthcare System – West Roxbury
Contact: Scott Harris Email: scotth@bu.edu
Telephone: 617 358-7499
Number of Students: One
Period to be offered: Four weeks
Description of Elective:
Under close supervision, students in this elective will work as integral members of the consultation-liaison psychiatry service at the VA Boston Healthcare System, West Roxbury Campus. Students will evaluate and treat patients in the emergency room and acute medical setting for whom psychiatry consultation is requested. Common consultation requests include suicidality, substance intoxication or withdrawal, psychosis, delirium, depression, and capacity to make medical decisions. Students will work closely with attending psychiatrists as well as psychiatry residents, consultation-liaison psychiatry fellows, and addictions psychiatry fellows. Students will participate in daily teaching rounds and will receive additional teaching through formal didactic sessions. Students will receive individual supervision both at the bedside and in formal sessions. Students will carry up to four patients at any given time and will actively participate in daily patient care. Duty hours will be Monday through Friday, without night or weekend requirements. In addition to daily patient care, students will complete two brief, informal presentations on clinical questions related to their patients, as well as a thirty-minute formal presentation at the end of the rotation on a topic relevant to consultation-liaison psychiatry. The elective will expose students to a wide variety of psychiatric diagnoses, with a focus on how psychiatric issues interact with acute medical illness. By the end of the elective, students will show a nuanced understanding of how to perform a psychiatric consultation in the emergency room or acute medical setting and how psychiatric and medical issues affect one another, along with advanced skill in patient interviewing, oral presentations, and clinical documentation.
303.1/MEDMD529 Emergency Psychiatry and Crisis Intervention
Rotation Director: Katharina Trede, M.D.
Administrative Contact: Scott Harris
- Students should report to the Psychiatric Emergency Service in the Emergency Department at Boston Medical Center at 08:00 on the first day of the rotation.
Telephone: 617 358-7499 Email: scotth@bu.edu
Number of Students: One fourth year student per block
Length of Elective: Four weeks
Period to be offered: Blocks 9-20
DESCRIPTION OF ELECTIVE
This elective takes place in the Emergency Department at Boston Medical Center and associated community crises centers. Students will work approximately three 10-hour shifts a week in the Psychiatric Emergency Department and two 8-hour shifts in associated community sites, all under the supervision of psychiatry attendings. In addition, students will work closely with psychiatry residents and social work staff. Students will have opportunities to interview patients, obtain collateral information, participate in disposition determinations, complete safety assessments, develop treatment plans, and write notes for the patients they treat in the Emergency Department and crisis intervention settings. Teaching will occur on a case-by-case basis. By the end of the rotation, students will have developed skills in managing acute agitation, utilizing verbal de-escalation techniques for patients in crisis, conducting in-depth suicide assessments, assessing patients with altered mental status, recognizing and treating emergent psychiatric conditions, and assessing psychiatric disposition needs. In addition to the three days per week managing patients in the Psychiatric Emergency Department, students will have the opportunity to spend two days each week working in select associated psychiatric crisis settings. Students will be able to select among sites including, the BMC Community Behavioral Health Center (CBHC), the Community Crisis Stabilization (CCS) unit at the Solomon Carter Fuller Building, Faster Paths, the ED Addiction Service, the Addiction Psychiatry Treatment Program (APTP), the Mobile Crisis Team, the Mental Health Court team, the Wellness and Recovery After Psychosis (WRAP) Program, and the Multi Visit Patient Program (MVPP). This elective will allow students to gain a better understanding of the full continuum of care and understanding of alternative levels of care for acute psychiatric crises.
Electives at Affiliates:
306.0/MEDMD520 Acute Psychiatry in Managed Care
Instructors: Carmel Heinsohn, M.D. and attending staff
Location: Bournewood Hospital
Contact: Scott Harris Email: scotth@bu.edu
Telephone: 617 358-7499
Number of Students: One
Period to be offered: Four weeks
Description of Elective:
Bournewood Hospital, a private psychiatric hospital in the community, is a core adult inpatient training site for the residency program. This elective provides students with the opportunity to learn acute inpatient psychiatry, including patient evaluation, diagnosis, and treatment in a multidisciplinary setting. Students will learn about psychopharmacology and short-term psychotherapy management of patients with psychiatric disorders. Many patients are enrolled in managed care programs allowing students to also learn about systems of care, managed care approaches to psychiatric and substance use disorders.
307.0/MEDMD521 Adolescent Psychiatry
Instructors: John Hart, M.D. and attending staff
Location: Bournewood Hospital
Contact: Scott Harris Email: scotth@bu.edu
Telephone: 617 358-7499
Number of Students: One
Period to be offered: Four weeks (Blocks 14-20)
Description of Elective:
Bournewood Hospital, a private psychiatric hospital in the community, is a core inpatient adolescent training site for the residency program. This elective is an excellent opportunity to work with adolescents with psychiatric and dual diagnosis disorders in a managed care environment. Students will be members of a multidisciplinary team learning about psychopharmacology, psychotherapy, family therapy, and other treatment modalities. Students will learn about systems of care and the interface between social and educational services for adolescents.
308.0/MEDMD528 Inpatient Psychiatric Management – Brockton
Instructor: Ajay Mehta, M.D.
Location: BMC Brockton Behavioral Health Center
Contact: Scott Harris Email: scotth@bu.edu
Telephone: 617 358-7499
Number of Students: Two
Period to be offered: Four weeks (Blocks 9-21)
GOALS AND SUMMARY
This rotation will provide a rich clinical and educational experience in an acute psychiatric hospital located in Brockton, MA. Students will have an opportunity to better understand the clinical care that is provided to patients on an inpatient psychiatric unit including assessment, diagnosis, and culturally competent treatment of a diverse patient population. Students will learn how to perform a diagnostic interview, generate a differential diagnosis and develop and implement a treatment plan to address psychiatric and substance use issues. Students will be supervised in utilizing psychopharmacological treatment for stabilization of symptoms and will gain experience in managing behavioral health emergencies. Students will understand the role of the therapeutic milieu and group therapy modalities on the inpatient unit. Students will participate in family meetings as well as ongoing care meetings with a multidisciplinary team. While on the rotation, students will gain knowledge of the systems of care related the management of acute behavioral health concerns.
DESCRIPTION
Boston Medical Center’s Brockton Behavioral Health Center provides comprehensive psychiatric care to a vulnerable patient population who often times face many barriers to accessing inpatient psychiatric units in a timely fashion. Brockton Behavioral Health Center fulfills a historically unmet need in the community by providing specialized, culturally competent care to patients in two acute inpatient psychiatric units who are primarily referred by the BMC Emergency Department. The psychiatric units serve patients aged 16 and up who pose an imminent risk of harm to themselves or others. The unit is also skilled in addressing co-occurring substance use disorder needs.
OBJECTIVES
By the end of this elective, the CAMED student will be able to:
- Distinguish various clinical psychiatric presentations while applying diagnostic criteria from the DSM-5 (CSDR.2, CSDR.3)
- Perform appropriate diagnostic evaluations with patients who have complex psychiatric needs (CSDR.2)
- Determine appropriate information needed to be elicited from patients and collateral sources to achieve diagnostic clarity (CSDR.1)
- Develop an appropriate initial management plan for patients requiring acute psychiatric care (MK.5, MK.6)
- Demonstrate an understanding of the various levels of care available for patients with acute psychiatric condition (HS.4, HS.6)
- Conduct and document a thorough suicide risk assessment. (C.1,C.6, R.1)
- Demonstrate appropriate communication of treatment plans to patients (C.1, C.2, C.3, C.8)
CURRICULUM
The elective will be comprised of a combination of clinical activities as well as attendance to a variety of team meetings focusing of coordinating systems of care for psychiatrically ill patients. Students will spend 5 days a week on the inpatient unit providing direct clinical care. They will receive teaching by a combination of faculty and residents who will be present on site. Students will be paired with a team comprised of a faculty member, resident as well as mental health providers from a variety of disciplines.
Students will meet on weekdays for morning rounds with a multidisciplinary team in which active issues for each patient will be discussed as well as treatment plans will be reviewed. Patients on the teams are discussed with the treatment team of residents, licensed independent practitioners, medical students, social workers, case managers, occupational therapists, recreational therapist, pharmacists, nursing and the treatment plan transcriber. Students will be involved in the process of admitting new patients to the unit and providing ongoing follow up with assigned patients monitoring their clinical presentation.
In addition to the clinical exposures that the students will receive on this rotation, they will have opportunities to attend complex care management team meetings as well as engage in discussions with providers from other disciplines to further advocate for the complex needs of patients experiencing serious mental illness.
EVALUATION
This elective will grade students Fail/Pass/High Pass/Honors. Students will be evaluated based on the assessments by faculty and residents with whom they have worked by use of the CSEF for Fourth Year Medical Students. Dr. Mehta will be responsible for providing mid-clerkship feedback. Evaluation will be based on participation, interactions during clinical encounters, and collaborative engagement with treatment team as well as the CSEF evaluations. Final grades will be submitted to the Registrar in accordance with CAMED policies for grading. Evaluations will be submitted by the site director via MedHub at the end of the rotation.
FACULTY
Ajay Mehta, M.D., Boston Medical Center Brockton Behavioral Health Center
CONTACT AND COURSE ORIENTATION INFORMATION
- Ajay Mehta – course coordinator; ajay.mehta.@bmc.org
- Students will report to BMC Brockton Behavioral Health Center at 8am on the first day of the rotation as well as on subsequent days.