PGY3: Perfecting Skills

The PGY3 year is focused on refining the residents’ diagnostic and therapeutic skills and extending their experience and ability in longitudinal outpatient treatment settings. In addition, several core clinical rotations provide training in areas that are required for specialty board certification and are crucial to the practice of psychiatry.

The PGY3 year includes the following major components:

  • Longitudinal treatment of outpatients
  • Didactic seminars, psychopharmacology and psychotherapy case conferences
  • Core clinical rotations:
    1. MGH Psychiatric Consultation Service (MGH)
    2. Community Psychiatry
    3. Addictions Partial Program (McLean)
    4. Nashua Street Jail Rotation
Click for Didactic Curriculum Overview

Longitudinal Outpatient Treatment

Slightly more than half of each resident’s time in PGY3 is devoted to their longitudinal outpatient clinic experience, which begins in PGY2 and continues through PGY3 and PGY4, as the outpatient experience grows and deepens. Required components of this rotation experience are as follows:

  • Longitudinal psychotherapy (includes supportive, psychodynamic, and CBT)
  • Supervision and education related to outpatient psychotherapy
  • Child and Adolescent Psychiatry evaluations, longitudinal treatment (individual or group), and supervision
  • Group therapy and supervision
  • Psychopharmacologic management and specialized outpatient clinical experiences
  • Psychopharmacology and psychotherapy case presentations and conferences
  • Residents typically carry a caseload of 30-40 patients throughout the year, and have intakes scheduled weekly
  • Over 100 hours of dedicated didactics on outpatient work
  • Dedicated supervision in the management of patients with substance use disorders
  • A longitudinal community experience at one of 10 different health centers, each focused on a different patient population

Core rotations

MGH Psychiatry Consultation Service (4 months)

The Psychiatry Consultation Service at MGH represents the capstone rotation for residents, allowing them to serve as ambassadors for psychiatry to the rest of the hospital. Residents draw on their medicine, psychiatry, psychotherapy and group therapy knowledge to serve a diverse population of patients, helping to manage up to 20% of all patients receiving care at MGH. The consultation-liaison service is a robust inpatient service where residents see patients throughout the hospital who have psychiatric issues complicating their medical or surgical care. Residents also have the opportunity to rotate on sub-specialty CL services, including the Psycho-oncology and Burns and Trauma Services. During the rotation, residents see new consults 3 days per week, with one day protected for their outpatient clinic and another day protected for didactics.

McLean Addictions Partial Program (2 months)

Residents spend 1 day per week working in two partial hospital programs at McLean that serve the military and law enforcement populations, and specialize in the treatment of substance use disorders. Residents co-lead treatment groups including specialized therapy approaches such as Group Drug Counseling, Motivational Interviewing, Acceptance and Commitment Therapy, and Mentalization-Based Treatment.

Nashua Street Jail Rotation (2 months)

Residents spend 1 day per week working in the Nashua Street Jail in a rotation designed to give residents the opportunity to care for mentally ill patients in a correctional setting. They learn about the unique needs and challenges of this population, and become skilled at performing psychiatric assessments and implementing treatment plans for patients who are detained in the jail.

MGH Community and Public Psychiatry Rotation (4 months)

This rotation provides residents with further exposure to outpatient work in Community settings and includes both longitudinal and integrated care components. Residents evaluate and treat patients at one of two community mental health clinics and interface with members of an interdisciplinary team.

Didactics Seminars and Psychopharmacology Conferences

Required core didactic seminars and psychopharmacology conferences round out the curriculum.

  1. Didactic Seminars are held on Wednesday afternoons. Residents attend a series of seminars designed to build upon their basic knowledge, adding breadth and depth to their understanding of mental illness and its treatment. Topics include Community and Sociocultural Psychiatry, Child Psychiatry, Psychoanalytic Theory and Practice, Group therapy, Cognitive Behavioral Therapy, Family Therapy, Couples Therapy and Dialectic Behavioral Therapy.
  2. Required teaching exercises in clinical psychopharmacology take place every Tuesday mornings at both MGH and McLean sites.

Call: In addition to periodically scheduled senior call at MGH, there are also internal moonlighting options are available at both MGH and McLean.

Vacation: 4 weeks vacation and 1 week of conference time, scheduled at the discretion of the resident

PGY3 Rotations

4 Months

4 Months

4 Months

Longitudinal Outpatient Clinic (~25 hours/per wk)

Consultation-Liason(CL)
MGH

Addictions Partial

(1 day/wk)

Nashua St Jail
(1 day/wk)

Community Psychiatry
(1 day/wk)

Neuromodulation (1 day/wk)

Longitudinal Community Clinic (1/2 day per week)

Elective Time (1/2 day per week)

Wednesday Core Didactics (1/2 day per week)

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