ACADEMIC

Didactic Program

The Longitudinal Curricular Units:

Patient and Psychiatrist
Introduction to Therapeutic Relationships/Models of the Mind
Introduction to Psychopathology/Psychosocial Therapies
Human Development
Social Systems in Psychiatry
Psychopharmacology

The core seminars of the residency curriculum are organized into six longitudinal units spanning two or more years of the program. These units offer a progressive and integrated educational experience for residents over the course of training. The curricular structure reduces redundancy and fragmentation of educational experiences, maximizes continuity, and encourages multiple perspectives on clinical problems. The curriculum is structured to emphasize opportunities for resident-directed learning, clinical reasoning, and active problem solving. The entire four-year program of instruction is coordinated by a curriculum committee, which develops and evaluates the curriculum and evaluates resident learning.

In addition to these five core longitudinal learning experiences, the training program offers an array of supplemental courses and the clinical services offer service-based learning experiences, generally focused on clinical material.

Residents in each PGY class come together from their various rotations for core seminars on Wednesdays. PGY I residents meet for seminars from 12:45PM until 4:30PM; PGY IIs from 10:10AM until 4:30 PM; and PGY IIIs and IVs from 10:00AM until 4:30PM. There is also a highly acclaimed Psychiatry Grand Rounds Series on Fridays from 8:00AM to 9:00AM. Clinical coverage is arranged so that service responsibilities do not conflict with participation in seminars.

^ Top ^

Patient and Psychiatrist

This three-year longitudinal unit is structured around a series of key topics in psychiatry. Through case discussions, using residents' own cases whenever possible, residents will be exposed to core readings from psychiatry bearing on these topics: transference and countertransference, human sexuality, sexual orientation, multicultural issues, gender differences, boundaries in psychotherapy, suicide, and religious and spiritual issues. A central focus of this course is the psychiatrist's responsibility to patients. Ethical issues receive strong emphasis throughout, and will be considered within a broad social context. Through an ongoing study of these issues, the course will seek to foster residents' attitudinal development. Affective experiences-such as helplessness, aggression, and love-in relation to these topics will be identified and discussed. Sessions will be resident-directed. Active and experiential learning exercises are incorporated in the program. Central attitudinal goals of this course are to encourage the development of self-reflective abilities, to enhance residents' respect for different perspectives and values, to strengthen tolerance of emotion and ambiguity, to support residents using each other as resources for learning, to stimulate residents' responsibility for their own learning, and to enhance opportunities for mentorship and attention to professional developmental issues.

^ Top ^

Introduction to Therapeutic Relationships/Models of the mind

This two-year course explores psychological, biological, and social theories of behavior, memory, affect, and cognition. In the PGY II year, residents are introduced to different theoretical perspectives on human motivation and behavior. To enhance clinical skills in case formulation, residents are encouraged to contrast and integrate different ideas related to understanding human behavior. Through required readings and didactics from expert clinicians, this course seeks to illustrate the importance of psychological theory in shaping thoughtful and effective treatment plans for patients. The PGY III course aims to help residents deepen their understanding of the theory and practice of dynamic treatments and enhance their ability to listen and talk to patients in all therapeutic settings. Topics discussed are how to establish the framework of psychotherapy, transference, the use of defenses, and issues of safety in treatment.

^ Top ^

Introduction to Psychopathology/Psychosocial Therapies

This two year course begins in the PGY 2 year with an examination of major psychiatric symptom complexes including thought disorder, paranoia, delusions, hallucinations, disturbances of insight, the disorders of the self, trauma-related disorders, anxiety disorders, catatonia, personality disturbances and mood disorders. Residents also examine the nature of nosology and diagnosis and how classifications of psychiatric disorders have evolved, including a review of evolution of the DSM and ICD. The course is clinically grounded at all times and includes case discussions, taped interviews and live interviews for class discussion. The PGY III module is designed to prepare residents for the clinical practice of psychiatry by providing them with a solid foundation in the psychosocial treatment modalities of group therapy, couples therapy and CBT. The course uses lecture and experiential formats to both broaden and deepen residents' expertise in their clinical treatment of patients.

^ Top ^

Human Development

This two-year course is built on the premise that developmental psychology constitutes a basic science for psychiatry. The seminars offer residents a life-cycle perspective for their clinical work, and are based heavily on contemporary research in these areas. Psychosexual development, sexuality, sexual orientation, midlife development (intimacy, parenting, work issues), geriatrics, death, experience of illness, and grief are topics that will be addressed. The process of development within different cultural and socioeconomic milieus will be discussed. The module integrates material related to gender differences and theories about gender development throughout.

^ Top ^

Social Systems in Psychiatry

In this two-year course, the focus is on aspects of psychiatry that extend beyond the immediate clinical arena. The PGY III course focuses on the issues of diversity and cultural competence and on a review of the history of psychiatry. In the PGY IV year, the focus shifts to systems-hospitals, community-based systems, and managed-care models of health care delivery. Beginning with a historical perspective, residents will have the opportunity to explore the structure, funding and operations of public and private community facilities, hospitals, HMO's, and academic settings. Leaders of local psychiatric services and institutions will serve as primary instructors.

^ Top ^

Psychopharmacology

This four year longitudinal module begins in the PGY 1 year with an overview of different types of psychopharmacological agents and their appropriate uses in psychiatry, with emphasis on clinical encounters in the emergency and inpatient services. The PGY II course begins with a review of pharmacokinetics and pharmacokinetics as well as the prescribing basics (laws, regulations, transference/countertransference issues), followed by a detailed in-depth review of each of the major classes of psychotropics. Once the pharmacopeia is mastered, the course shifts focus to the application of the medications in the various clinical states of depression, psychosis, anxiety disorders, insomnia, addictive disorders, eating disorders etc. The third year course expands further upon the PGY2 year course with a review of psychopharmacologic management of more treatment-resistant cases. The PGY3 course serves to complement the site-based teaching at BIDMC and BWH where weekly psychopharmacology clinics involving "live supervision" and weekly psychopharmacology didactics are ongoing. Finally in the PGY4 year, advanced review of psychopharmacology is pursued through a critical review of both classic papers and important current publications in the field.