Psychiatry Medical Student Education

Clinical Psychiatry Experiences for Medical Students

Medical student education receives heavy emphasis at BIDMC and its affiliate, the Massachusetts Mental Health Center (MMHC). We are teaching sites for introductory psychopathology courses, and offer a wide variety of clinical experiences for students in their core and elective rotations. The overall emphasis is on learning about patients as people; about both who they are and the illnesses they have.

PCE students may work on a locked inpatient unit or a consultation team to the medical/surgical/emergency services at the Medical Center, or in an outpatient setting at MMHC, a community mental health center. Advanced elective students may choose an experience at any of these settings, with additional options for addiction psychiatry and neuropsychiatry electives.

On our inpatient unit, students are immersed in the treatment of acutely ill individuals, where they participate actively as part of a multidisciplinary treatment team. Students often function as the patient's primary clinician in this role. Students get a broad exposure to psychotic illnesses, mood disorders, and personality disorders, as well as to interaction of social determinants of health and health care delivery.

Our Consultation-Liaison service involves students in the complexities of treating psychiatric illness on medical, surgical, and OB/GYN services. Students become very familiar with the clinical presentations of a broad range of psychiatric diagnoses including delirium, dementia, and adjustment to medical illness, as well as with the interactions of major mental illness and medical comorbidities. Students also spend time in the emergency room, evaluating patients with psychiatric chief complaints.

The Rapid Access to Flexible Treatment (RAFT) experience at MMHC offers the option of working with individuals with serious and persistent mental illness in an outpatient community psychiatry setting. All patients have complex psychiatric histories and needs that are treated through group and individual psychotherapy, psychosocial rehabilitation, and psychopharmacology. Patients tend to participate in the outpatient program for 4-6 weeks (or longer) and are often “stepping-down” from inpatient level care and need more intensive services to assist in a successful return to the community. Many patients also reside in the onsite emergency shelter.

During the core clerkship, students have a weekly afternoon devoted to specialized didactic sessions, including teaching on substance use disorders, child psychiatry, interventional psychiatry, and the performance of mental status exams.

Residents play an integral role in psychiatric education at BIDMC. They are the "front-line" teachers and their participation in strongly encouraged. Each year two residents are honored at graduation for their excellence in student teaching.