500 Boylston Street, Boston, MA 02116 617-419-4700
The intern year consists of 4 months of internal medicine, 2 months of neurology, 1 month of addiction, 2 months of geriatric psychiatry, 3 months of inpatient psychiatry, and 1 month of consult/liaison (13 blocks of 4 weeks each).
St. Elizabeth’s Medical Center has a 32 bed adult inpatient unit that is staffed by a multidisciplinary team of psychiatrists, social workers, nurses, occupational therapists, and mental health workers. The inpatient unit has three teams, each led by a supervising attending physician. Residents are assigned to a team for periods of approximately one month and participate in rounds with the attending on a daily basis. Spending time on more than one team over the course of the PGY1 and PGY2 years ensures a diverse experience. Residents supervise medical students and physician assistant students assigned to their team. The clinical population is very diverse with a wide variety of psychopathology including mania, depression, schizophrenia, anxiety, organic mental disorders, substance abuse and withdrawal states, suicidal or homicidal ideation, and personality disorders.
Consult / Liaison Psychiatry
Residents provide consultations throughout the hospital and in the emergency department under the supervision of an attending physician. Residents provide services to all medical and surgical specialties within the hospital. Residents learn to fill the liaison role in their interactions with physicians and care managers and also learn about providing psychiatric treatment to medically ill patients. St. Elizabeth’s opened a new state of the art emergency department in June 2009. Residents provide emergency assessments, crisis intervention, and the initial treatment of patients presenting in the emergency department. Residents spend time on this service during the PGY1 and PGY2 years.
A 16 bed geriatric psychiatry unit opened in 2010. Residents are involved in evaluation and follow-up of patients as well as interacting with physicians from other departments. Residents have an opportunity to treat patients with dementia and learn to adjust treatment approaches to the needs of older patients.
The St. Elizabeth’s Comprehensive Addiction Program (SECAP) provides inpatient, partial hospitalization, and outpatient services to patients seeking treatment for addiction. The program is run by an addiction specialist together with a team of nurses, social workers, and psychologists.
Residents spend 4 months rotating through Internal Medicine during the PGY1 year. Residents participate in didactics and follow the call schedule of an internal medicine intern during this time. One of the 4 months is devoted to emergency medicine. Supervision is provided by hospitalists and senior residents in Internal Medicine. The experience is similar to that of a medical intern and residents have the opportunity to perform procedures under the guidance of a senior physician. Extensive didactic training is incorporated into the rotation.
Residents spend 2 months rotating through Neurology, usually during the PGY1 year. The service is primarily a consultation model. Residents attend didactic sessions in neurology during this rotation including case conferences and neuroradiology seminars. Residents gain experience in working with patients with epilepsy, strokes, Guillain-Barre Syndrome, Parkinson’s disease, multiple sclerosis, movement disorders, dementia, brain tumors, head trauma and headaches. Residents are supervised by attending physicians as well as senior neurology residents from Tufts.
The PGY2 year consists of 2 months of child and adolescent psychiatry, 5 months of inpatient psychiatry, and 5 months of consult/liaison psychiatry.
Child and Adolescent Psychiatry
Residents spend 2 months on the adolescent unit at Carney Hospital, a member of the Steward Hospital system, located in the Dorchester neighborhood of Boston. Residents are involved in clinical interactions with patients and families. Residents are supervised by the medical director of the adolescent unit at Carney. Beginning in the fall of 2013, residents will spend one month at Carney Hospital and one month at the Home for Little Wanderers treating children in a community setting.
Residents dedicate their PGY3 year to seeing patients in the outpatient clinic. They see weekly psychotherapy patients, monthly psychopharmacology patients, and perform intakes for new patients. Residents also have an opportunity to lead group therapy sessions in the clinic. They have one hour of individual supervision in psychodynamic psychotherapy and one hour of individual supervision in cognitive behavioral therapy.
Residents continue to see patients in the outpatient clinic and also gain experience in forensic psychiatry, community psychiatry, ECT, and the partial hospital program. Residents may also pursue a junior attending experience on the inpatient or geriatric unit. Some residents incorporate specialized elective experiences into the PGY4 year.
Residents spend one day per week for one month at Lemuel Shattuck Hospital during the PGY3 or PGY4 year. The hospital is part of the state hospital system and residents work on the forensic unit. Many of the patients have legal issues in addition to psychiatric disorders and substance abuse.
Residents spend one day each week for 4 months at either the Tufts South Boston Behavioral Health Clinic or the G.B. Wells Clinic affiliated with Harrington Hospital in Southbridge, MA. Residents have the choice of an urban or rural community clinic experience. Residents are responsible for intake evaluations and psychopharmacology visits. The clinics offer counseling and medication management for adults and children.
Electroconvulsive Therapy (ECT)
Residents rotate through the ECT service for 2 months during the PGY4 year. They evaluate patients and learn to perform ECT under the guidance of an attending. During this period residents spend 2-3 hours in the morning in the ECT service and then spend the remainder of the day in the outpatient clinic.
Adult Partial Hospitalization
Residents rotate through the Partial Hospitalization Program under the guidance of a social worker and nurse practitioner. They run groups and gain experience with cognitive behavioral and other types of group therapy and psychoeducation.
Senior residents have the opportunity to assume a leadership role in overseeing one of the clinical services or teaching medical students. Leadership experiences are tailored to the interests of the individual residents. Rising chief residents have an opportunity to attend a training session at Tufts University School of Medicine.
Elective options are developed based on the interests of individual residents and the availability of suitable mentors. Off-site electives may be approved by the Graduate Medical Education Committee for PGY3 and PGY4 residents when a similar experience is not available at St. Elizabeth’s Medical Center. Electives are typically arranged on a weekly basis rather than as a full time experience for a single month in order to provide continuity of care to clinic patients. Recent electives have included specialized child psychiatry experiences, behavioral neurology, early psychosis, and college mental health.