PGY-1                            
Becoming a Physician

Post graduate year 1 (PGY-1) provides a foundation for new medical graduates to solidify their skills and identity as physicians. Our internships place significant emphasis on the diagnosis and treatment of seriously ill medical patients, including neurologically disordered patients.

All residents will have no fewer than 6 months of medicine or 8 months of pediatrics as the core training in our internships. Two months of Neurology is included as an addition to this minimum in medical training. One of the neurology months will be at the MGH and the second month can be with Pediatric Neurology at MGH, or the Neurobehavioral Unit at McLean, or another General Neurology month at MGH.

Each first year resident will do 3 months at MGH Blake 11 unit and 1 month of McLean Hospital with the Alcohol and Drug Abuse Treatment Program.

McLean Alcohol and Drug Abuse Treatment Program (ADATP)
The McLean Alcohol and Drug Abuse Treatment Program (ADATP) is a 14-bed inpatient addiction psychiatry unit with a partial hospital and residential component. The intern gets a good exposure to detoxification protocols, motivational interviewing and recovery treatments.

MGH Blake 11 Inpatient Unit
Blake 11 is a 24-bed, state-of-the-art inpatient unit at MGH specializing in the care of medically and neurologically impaired patients. Patients with eating disorders, major affective illnesses, acute and chronic psychotic illnesses, as well as personality-disordered patients are cared for on this general unit. An ECT service is also part of the unit and the residents learn to use this therapeutic modality.
For the PGY-1 year, the applicant chooses one of three paths:

Internship at Massachusetts General Hospital
This year includes 6 months of medicine, 2 months of neurology, 3 months of psychiatry at MGH Blake 11, and 1 month of psychiatry at McLean.

Internship at Newton-Wellesley Hospital
Newton Wellesley is a community based general hospital affiliated with Partners and the MGH Internal Medicine Residency. This internship year includes 6 months of medicine at Newton-Wellesley, 2 months of neurology, 2 months of psychiatry at MGH Blake 11, and 2 months of psychiatry at McLean.

5-year MGH/McLean combined Child & Adult Psychiatry
This option combines a pediatric internship at MGH followed by PGY 2 & 3 in Adult Psychiatry, and PGY 4 & 5 in Child & Adolescent Psychiatry. The pediatric internship consists of 8 months of pediatrics (including 1 month of Pediatric Neurology),1 month of adult neurology at MGH, and 3 months of psychiatry at MGH Blake 11.

PGY-1

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PGY-2
A New Beginning

Post Graduate Year 2 (PGY-2) fully embraces psychiatry training. The goal of this year is to lay down a foundation of knowledge in the diagnosis and treatment of acutely and chronically ill psychiatric patients. Residents become proficient in the assessment of patients in a variety of settings and become familiar with the fundamental treatment modalities now available to psychiatrists.

PGY-2 Rotations are divided into four 3-month blocks, listed below.

MGH Blake 11 Inpatient Unit
Blake 11 is a 24-bed, state-of-the-art inpatient unit at MGH specializing in the care of medically and neurologically impaired patients. Patients with eating disorders, major affective illnesses, acute and chronic psychotic illnesses, as well as personality-disordered patients are cared for on this general unit. An ECT service is also part of the unit and the residents learn to use this therapeutic modality.

McLean Schizophrenia and Bipolar Disorders Unit (AB2)
AB2 is a specialized locked inpatient unit at McLean that treats a wide variety of adult psychiatric patients with a special focus on psychotic disorders. Residents have become well versed in the diagnosis of psychotic and severe affective disorders as well as the use of traditional and novel pharmacotherapies, management of side effects, and the use of ECT.

MGH Acute Psychiatry Service (APS)
The APS is a division of the MGH Emergency Ward. It is one of the busiest emergency psychiatry services in New England. The APS serves as both a walk-in clinic and emergency evaluation unit. Residents work in a team alongside staff psychiatrists, psychology interns, social workers, and nurses in the care and disposition of patients throughout the city and greater New England.

McLean Psychiatry
This rotation is a combination of the McLean Behavioral Health Partial Hospital Program, nightfloat, research and writing, and the community rotation. The McLean Behavioral Health Partial Hospital (BHP) teaches cognitive behavioral therapy techniques and provides training in skills-based group therapy, CBT consultations, and individual therapy. Residents become familiar with evidence based treatment approaches and the fundamental principles of CBT and psychosocial milieu treatment. The patients served on this short-term partial hospital program are primarily diagnosed with depression, anxiety, and personality disorders.

Community Rotation
This The community rotation provides exposure to a diverse patient population and allows residents to consider the many social contexts that affect access to care and service delivery. The patient population is the indigent mentally ill served by the Metro-Boston area of the Department of Mental Health. They are often homeless, and they represent all ethnic groups. Their diagnoses include the full spectrum of mental illness. The goal of this rotation is to expose residents to the resources available within the community that support early recognition of mental illness as well as recovery and rehabilitation. These services include residential programs, clubhouses, transitional shelters, the Community Rehabilitation Support Team (CRS), the Boston Emergency Services Team (BEST), the Homeless Outreach Team (HOT) and the Freedom Trail Clinic.

Research Selective
Two weeks will be protected to pursue academic research projects and writing during the McLean Psychiatry and Community Rotation.

Outpatient training in psychiatry begins at the start of the PGY-2 year with a half day per week, including individual and group supervision and patient care. Residents are assigned to either the McLean or MGH campus for this experience.

Core Didactic Seminars are provided after Wednesday morning rounds throughout the year. These 5 hours of protected time allow the resident to focus on learning from the leaders in our field. These seminars are in addition to the substantial formal and informal teaching and direct supervision provided by each rotation site. Didactics include Clinical Neuroscience, Introduction to Psychotherapy, Case Formulation, Law and Psychiatry, Medical Ethics, Child Psychiatry, Cognitive Behavioral Therapy (CBT), Group Therapy, and Journal Club. The PGY-2 curriculum also includes a four-course seminar to initiate an academic project.

The on-call obligation averages 1 night per week throughout the year.

PGY-2

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PGY-3
Perfecting Skills

Post Graduate Year 3 (PGY-3) refines the diagnostic and therapeutic skills of the developing psychiatrist with a focus on outpatient individual and group treatment and consultation in a variety of settings including the medical hospital, community sites, and inpatient psychiatry units. By early winter of the PGY-3 year, residents confer with mentors and the Training Director to sculpt an individualized PGY-4 curriculum to be submitted to the Residency Training Committee for approval in the spring.

The PGY-3 clinical rotations are divided into three 4-month training blocks listed below.

MGH Avery D. Weisman Consultation Service
Duties during this 4-month rotation keep the residents on the cutting edge of psychiatry, emphasizing our field's increasingly collaborative relationship with our medical and surgical colleagues. Each resident will present at two psychosomatic conferences. These presentations often serve as the foundation of a peer-reviewed journal article.

Community Psychiatry
During this 4-month rotation, each resident will spend one full day per week at one of several superb community-based mental health centers affiliated with the MGH and McLean. Activities at these community sites include clinical care, consultation with medical staff, educators, the courts, nursing homes, and supervised housing and other community agencies. Additionally, residents can elect to travel one month internationally.

McLean Psychiatry
Residents will provide advanced consultation services to the inpatient units with the McLean Addictions Consultation Service for 2 months. Residents will work with special populations including one month at the Obsessive-Compulsive Disorders Institute (OCDI), one month at the Klarman Eating Disorders Center, and one month on the ECT service at McLean. This rotation also includes opportunities to pursue selective experiences, to continue a research project, and to prepare a review article.

Outpatient Training continues in PGY-3, with half of the residents’ time devoted to a variety of outpatient treatment and supervision settings, including psychotherapy with individuals, groups, children and adolescents, families and couples as well as a rigorous Psychopharmacology curriculum and outpatient Psychopharmacology clinical practice.

Core didactic seminars continue every Wednesday afternoon between September and June. The seminars include: Psychodynamic Psychotherapy, Cognitive Behavioral Therapy, Dialectic Behavioral Therapy, Group Therapy, Couples Therapy, Short-Term Psychotherapy, Social and Community Psychiatry (to include Multicultural, Historical & Spiritual Psychiatry), and Human Development.
The on-call obligation for seniors will be once every 3-4 weeks at MGH.

PGY-3

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PGY-4                                                
Mastery & Transition

Post Graduate Year 4 (PGY-4), the final year of residency in the MGH-McLean program, encourages an in-depth commitment to the pursuit of individual interests and perfection of clinical skills as a preparation for a career in basic or clinical research, medical practice, teaching, administration or a mix of these activities. Mentors throughout Harvard's vast academic community are available to aid the resident in his or her specific area of interest.

Elective Senior Program
The PGY-4 year is highly elective to allow individuals to pursue their own interests. Options include Chief Residencies, development of research activities, and other elective interests.

Senior Conference Week
Each graduating resident is given an additional week of time off to attend the conference of his/her choice, with a stipend to offset costs.

Senior Talks Seminar
Seniors present an overview of their years' work to MGH/McLean residents and faculty in the spring of their graduating year. This multi-week conference culminates the training experience. Each presentation allows integration of the elements of personal interest, core psychiatric knowledge and in-depth topic mastery in a collegial conference setting.

Outpatient Continuity Clinic allows residents to manage a caseload of patients over time. This clinic is approximately 10 hours per week including supervision.

Core Didactic Seminars continue on Wednesday afternoons. Seminars include Advanced Clinical Neuroscience, Neurology for Psychiatrists, Advanced Psychodynamic Psychotherapy, Law and Psychiatry, Gender Issues & Sexuality in Psychiatry, Positive Psychology, How to Teach and Supervise, Leadership and Team Development, and Transition to Practice.
The on-call obligation for seniors will be once every 4 weeks at MGH.
 

PGY-4

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5-Year Pediatrics/Adult & Child Psychiatry Program

This exciting Program combines an MGH Pediatric internship followed by PGY 2 & 3 in Adult Psychiatry, and PGY 4 & 5 in Child & Adolescent Psychiatry, all with one application to Adult Psychiatry. This 5 year program develops strong working relationships with the faculty and residents of the Massachusetts General Hospital for Children, beginning in the internship. This collegial contact with both Pediatrics and Child Psychiatry provides great professional development for the 5 year residents. The pediatric internship includes 8 months of pediatrics, 1 month of adult neurology at MGH, and 3 months of psychiatry at MGH Blake 11. To apply for this program, simply apply to the MGH/McLean Adult Psychiatry program.

More about MGH Hospital for Children.
More about MGH/McLean Child & Adolescent Psychiatry.

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  Year At-A-Glance 2009-2010

PGY-1

PGY-2

PGY-3

PGY-4

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