Psychiatry
Adult Psychiatry
Adolescent Psychiatry
and Research
300.0 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 Advanced Consultation-Liaison Psychiatry
Instructor: Larkin Kao, 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.
303.0 Emergency Psychiatry
Rotation Director: Alison Duncan, M.D. , Alison.Duncan@bmc.org PES Attending Physicians, including Dr. Buczek, Wilensky, Brown, Rashid, Durham and Reid-Varley
Administrative Contact: Scott Harris
- Students should report to the Psychiatric Emergency Service at Boston Medical Center at 0900 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 will take place in the Emergency Department at Boston Medical Center. Students will work approximately five 8 hour shifts a week, under the supervision of psychiatric 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, develop treatment plans, and write notes for the patients they treat in the Emergency Department. Teaching will occur on a case by case basis. Students will participate in daily rounds and attend the Department of Psychiatry Grand Rounds. 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, and recognizing and treating emergent psychiatric conditions.
304.0 Innovative Approaches to Community Psychiatry
Instructor: Katharina Trede, M.D.
Contact: Shanae Harris – course coordinator; Shanae.Harris@bmc.org
Number of Students: One
Period to be offered: Four weeks (Blocks 9 and 10)
- Location: Students will report to the Community Behavioral Health Center at Boston Medical Center in the Solomon Carter Fuller Building at 9am on the first day of the rotation.
GOALS AND SUMMARY
This elective will provide students an opportunity to learn about various aspects of the mental health system and how it supports patients in the community who are living with psychiatric conditions. This is an opportunity for the student to experience some of the novel changes that are being made to the field of community psychiatry which aims to achieve health equity when it comes to accessing high-quality psychiatric care. Students will learn about the various resources that are available throughout the community to support the psychiatric needs of patients, particularly those who are experiencing significant psychosocial stressors and health inequities.
DESCRIPTION
In January of 2023, Boston Medical Center became a designated Community Behavioral Health Center (CBHC) and is one of 25 CBHCs established across the Commonwealth of Massachusetts to provide timely, high quality psychiatric care in the community. The CBHC helps direct patients to a continuum of care to ensure that they have the supports necessary in order to access various forms of psychiatric treatment across various levels of care. In addition, this elective provides an opportunity to learn more about the community based supports that are available for patients. Students will also be exposed to the value of educating primary care providers as well as clinicians in medical specialties about the complex medical needs of psychiatrically ill patients in the community. Students will have an opportunity to engage in population health activities which aims to identify patients who are high utilizers of emergency psychiatric services and to work with a team to create a coordinated, team based approach to meet the specific needs of these types of patients.
OBJECTIVES
By the end of this elective, the CAMED student will be able to:
- Demonstrate an understanding of the various levels of care available for patients with urgent psychiatric conditions. (HS.4, HS.6)
- Develop novel approaches to address structural inequities impacting psychosocially complex patients (HE.1, HE.2, HE.5)
- Identify strategies for maintaining a healthcare environment which aims to support a vulnerable patient population. (HS.5)
- Review tools to effectively advocate for patients with complex psychosocial needs (HE.5)
- Evaluate and determine the appropriate level of care for patients who experiencing acute psychiatric symptoms (U.2, S.4, S.6)
- Conduct and document a thorough suicide risk assessment. (C.1,C.6, R.1)
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 one day each week working in the BMC CBHC performing psychiatric evaluations on patients who are walking-in requesting mental health supports. Students will spend some of their time each week seeing patients in the psychiatric emergency room at Boston Medical Center as well.
This elective will allow for students to gain a better understanding of the full continuum of care given that they will also spend time in the Community Crisis Stabilization (CCS) unit at the Solomon Carter Fuller Building which is a program that serves adults who need short-term crisis intervention and serves as an alternative to inpatient level of care. Students will also be able to spend time in the Stabilization Care Center (SCC) in the Roundhouse, providing clinical care on this unit which supports individuals who are experiencing substance use related symptoms.
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 specialties to further advocate for the complex needs of patients experiencing serious mental illness.
EVALUATION
This elective will grade students Pass/Fail. Students will be evaluated based on the assessments of faculty and residents with whom they have worked in the various clinical settings. Dr. Trede will be responsible for providing mid-clerkship feedback and the final summative evaluation. Evaluation will be based on participation, interactions during clinical encounters, collaborative engagement and a written reflection of experience while on the rotation. Pass/fail grades will be submitted to the Registrar in accordance with CAMED policies for grading.
Electives at Affiliates:
305.0 Addiction Psychiatry
Instructor: John Renner, M.D.
Location: Boston VA Outpatient Clinic
Contact: Scott Harris Email: scotth@bu.edu
Telephone: 617 358-7499
Number of Students: One
Period to be offered: Four weeks
Description of Elective:
This elective will provide students with clinical experience in addiction problems in the outpatient service, a core training site for residents, addiction psychiatry, and addiction medicine fellows. Students will participate in substance abuse treatment with methadone maintenance patients, buprenorphine patients, and alcoholic patients with major psychiatric problems. The major goals of the elective are to improve the student’s understanding of substance use problems, associated personality and emotional disorders, assessment measures, and the behavioral, pharmacological and systems approach to problem management used in this field.
306.0 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 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 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.