Psychiatry Residency Program - Curriculum + Structure

Rotations

The PGY-1 year includes six months on various psychiatry services, four months of internal medicine, and two months of neurology.

• Internal medicine: Residents spend two months on inpatient wards, one month on a consult service, and one month in emergency medicine. During emergency medicine, they gain experience managing a variety of cases in a busy level four trauma ER and learn how to consult other specialties appropriately. On inpatient wards, PGY-1 residents join a treatment team with 1-2 PGY-1 internal medicine residents, a senior resident, and an attending. Residents take “long call” every fourth day, staying until 8 pm to admit patients. Frequent lunchtime didactics provide a broad educational experience during this rotation.
• Medicine consult service: Residents work closely with a PGY-3 internal medicine resident and attending, providing consults for surgical, psychiatric, neurology, and other specialty services. There is no call requirement during this rotation.
• Neurology: During two months at Tufts Medical Center, residents work on the neurology consultation service with neurology residents and attendings. This rotation offers broad exposure to neurological conditions relevant to psychiatry and frequent educational conferences.
• Psychiatry services: PGY-1 residents spend one month on emergency psychiatry consultation at Tufts Medical Center. Working alongside a senior resident and consultation/liaison attending, they gain experience with psychiatric triage, safety evaluations, involuntary admission laws, and disposition planning, including inpatient, step-down, and outpatient referrals.
• Inpatient psychiatry and consultation: Residents spend a combined four months on the adult inpatient psychiatric unit and the consultation/liaison psychiatry service at Tufts Medical Center. They work as part of an interdisciplinary team with psychiatry residents, neurology residents, medical students, social workers, case managers, occupational therapists, and attendings. Inpatient teams typically care for 5–6 patients daily on a 20-bed unit.
• Addiction consult service: One month is dedicated to addiction psychiatry, focusing on medication-assisted treatment (e.g., buprenorphine, methadone), withdrawal management, and pain control in patients with opioid use disorder. This rotation emphasizes psychoeducation, motivational interviewing, and advocating for unbiased care.

Call and “Long Days”

During neurology and psychiatry rotations, PGY-1 residents have approximately 30 “long days” per year, staying from 5 pm to 8 pm on weekdays to assist with admissions.

They also cover about 14 weekend calls per year, from 8 am to 8 pm, with direct supervision from the senior on-call resident. During calls, they see psychiatric consults in the emergency room and on medical floors, then staff them with an attending.

During internal medicine rotations at Tufts Medical Center, PGY-1 residents do not take psychiatric call but follow a similar “long day” schedule every four days, staying until 8 pm on weekdays or weekends.

Rotations

The PGY-2 year consists of one-month rotation blocks including:

• Adult inpatient psychiatry at Tufts Medical Center (4–6 months): Residents work on a team with another resident, medical and PA students, social workers, case managers, occupational therapists, nursing staff, mental health workers, and attending physicians. The unit treats a wide range of psychopathology, including severe mood, psychotic, and personality disorders, catatonia, and complex medical comorbidities. Patients come from diverse cultural and socioeconomic backgrounds, with many covered by public insurance.
• Consultation/liaison psychiatry at Tufts Medical Center (3–4 months): Residents work with medical students, other psychiatry residents, and consultation/liaison attendings. This rotation is busy and covers a broad spectrum of psychiatric pathology, including mood, anxiety, psychotic disorders, delirium, catatonia, behavioral dysregulation, and capacity assessments.
• Inpatient child psychiatry at North Shore Hospital, Salem, MA (1 month): Residents participate in inpatient care on a 20-bed locked unit, including initial assessments, pharmacotherapy, and multidisciplinary treatment. Child/adolescent outpatient clinic exposure occurs in PGY-3.
• Inpatient geriatric psychiatry at Lawrence Memorial Hospital, Medford, MA (1 month): Residents care for older adults on both an unlocked voluntary 18-bed unit and a locked involuntary 16-bed unit, gaining experience with psychiatric and neuropsychiatric disorders often accompanied by significant medical comorbidities.
• Addiction Service (1 month): As described in PGY-1, residents focus on medication-assisted treatment, withdrawal management, and psychoeducation.
• Addictions service at Tewksbury Hospital (1–2 months): Residents rotate through one or more of the four 32-bed inpatient units, gaining exposure to public sector psychiatry. Under supervision, they diagnose and treat severely impaired patients, focusing on functional disability and rehabilitation potential.

Outpatient experience

PGY-2 residents are expected to complete 10 outpatient hours per month, managing their own psychotherapy and psychopharmacology patients. Each resident meets weekly with two supervisors—one in-house and one out-of-house—to discuss diagnoses, treatment plans, therapy techniques, and relevant outpatient psychiatry topics.

Call

PGY-2 residents begin 24-hour call, averaging about three calls per month. The yearly total includes approximately 34 calls: 12 weekend calls from 8 am to 8 am and 24 weekday calls from 5 pm to 8 am. Residents receive a post-call day free from clinical responsibilities following overnight calls.

Rotations

The PGY-3 year is focused on outpatient care with several six-to-eight week rotation blocks

Adult clinics

• Mood and Anxiety Disorders Intake Clinic at Tufts Medical Center with Dr. David Adler. This clinic serves adults with major depression, bipolar disorder, chronic refractory mood disorders, panic disorder, PTSD, anxiety disorders, and phobias. It also provides evaluation and treatment for psychiatric disorders coexisting with medical and surgical illnesses.
• General intake clinic at Tufts Medical Center with Dr. Paul Plasky. Residents perform comprehensive biopsychosocial psychiatric assessments of new patients referred from inside and outside Tufts Medical Center. After assessment, patients are referred to individual care with PGY-3 residents.
• Mood Disorders Consultation Clinic at Tufts Medical Center with Dr. Nassir Ghaemi. Residents work with a leading psychotherapy expert, conducting evaluations and consultations for complex psychiatric cases referred by psychiatrists and other healthcare providers.
• Forensic psychiatry rotation with Dr. Ingrid Li at the Dr. Solomon Carter Fuller Mental Health Center inpatient unit in Boston’s South End. Residents gain experience with competency to stand trial, criminal responsibility evaluations, probation assessments, risk assessments, and mental health law. Optional observation of correctional institution audits and court testimony is available. Residents write forensic reports and observe evaluations.
• Community psychiatry with Dr. Robert Diener. Residents gain experience in public psychiatry, working in outpatient and residential settings. Rotations include PACT (program for assertive community treatment) teams, providing outreach and support for patients with severe, long-term mental illness.
• Eating Disorders Program with Dr. James Greenblatt. Residents rotate at an inpatient facility in Dedham, MA, part of Walden Behavioral Care, which provides multi-level treatment for eating disorders. Residents participate in evaluations, pharmacotherapy, and multidisciplinary group treatments.

Child and adolescent clinics

• ADHD clinic with Dr. Judith Robinson and Dr. Hope Schreiber. Residents gain experience diagnosing and treating ADHD with pharmacologic and behavioral approaches. Both providers have expertise in ADHD across the lifespan.
• Child and adolescent family therapy clinic with Dr. John Sargent and Ted Green, PhD. Residents participate in interdisciplinary care with child and adolescent psychiatry attendings, psychologists, fellows, social workers and medical students. The clinic emphasizes family therapy techniques and didactics alongside clinical experience.
• Child Anxiety Disorders Clinic with Dr. Sandra Lucio. This clinic treats a broad range of mood and anxiety disorders in children and adolescents. The setting includes teaching components and interdisciplinary care with medical students and social work interns.
• Trauma clinic with Dr. Krinsky and Alice Connors-Kellgren, PhD. Residents provide consultations for patients with developmental trauma, supported by didactics and interdisciplinary expertise.

Call

Overnight call averages one to two calls per month, with about 17 weekday calls and 5 weekend calls annually.

Rotations

The PGY-4 year is dedicated to providing opportunities for residents to explore their particular areas of interest and to prepare for the transition to independent practice. In addition to an outpatient continuity clinic and two months of emergency psychiatry, this year consists of a flexible schedule that allows for elective rotations and research. Each resident fulfills a specific chief responsibility during this year, gaining valuable experience in leadership and administrative skills.