Adult Psychiatry Residency

An exceptional training experience at a Harvard Teaching Hospital

The CHA Adult Psychiatry Training Program aims to prepare residents for careers as clinicians, educators, and leaders by fostering a collaborative learning environment that emphasizes critical thinking, scholarship, leadership, social justice, humanistic care and a biopsychosociocultural approach to patient care, in the context of population health.

Program Philosophy and Educational Approach

Our program provides a broad experience that prepares residents for chosen careers in clinical practice, academic psychiatry, research, teaching, administration and leadership. Didactic and clinical responsibilities are designed to foster the development of ethical, independent, and responsible psychiatrists who will make significant contributions to the mental and global health of patients and their families. We provide a flexible environment that trains residents to excel professionally.. Graduates are competent in the diagnosis and treatment of the full range of mental disorders and working with patients from a wide variety of demographic backgrounds. The overall philosophy of the department is pluralistic: assessing each individual, couple, or family thoroughly and applying the most evidence-based, humanistic approaches to any clinical situation.

At Cambridge Health Alliance, we emphasize a bio-psycho-social-cultural approach to the understanding of mental illness. The overall goals of the training program are to prepare psychiatrists who are skilled clinicians, critical appraisers of the science and evidence behind the practice of psychiatry and medicine, and lifelong learners. We value psychotherapy and we have a deep and enduring commitment to teaching psychodynamic formulation and dynamic psychotherapy. Residents learn about psychodynamic principles through didactics and close supervision throughout the residency. Our curriculum also includes training in the use of major psychotherapies including supportive, cognitive behavioral, and dialectical behavioral therapies, utilizing both time-limited and  longer term approaches. We also have strong training in mindfulness-based therapies, trauma therapy, group, family and couples,  and internal family systems therapies.

Our curriculum also has a strong biological psychiatry component that includes neuroscience, neuropsychiatry, and the principles and practice of psychopharmacology. Psychopharmacology is taught throughout the four-year residency, as well as in each clinical rotation where population-specific and illness-specific nuances of psychopharmacologic treatment are studied. Training includes integrating psychopharmacology into psychotherapeutic treatment as well as managing the psychopharmacologic treatment of patients seen by other non-medical therapists. All residents also have exposure to ECT and TMS beginning in the PGY1 year, and interested residents may complete certification in these areas in their PGY4 years.

CHA has also been engaging in Integrated Care for over 20 years with our colleagues in our primary care centers. We have a growing program in training providers for the future of integrated care, including direct consultation, teaching, and a project involving telemedicine to provide psychiatric consultation to primary care providers throughout Cambridge Health Alliance.
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During the residency, we stress a developmental point of view through didactics on human development and clinical work with children, including outpatient psychotherapy with youth. Our goal is to enhance the understanding of adults and to provide basic skills in child psychiatry. Training is conducted with assistance from expert and senior faculty of the Department's Child and Adolescent division.

Clinical and didactic education occurs in multidisciplinary settings in which there are training programs for a full range of mental health professionals. Inter-disciplinary conferences have been developed for trainees in psychiatry, psychology, social work, and psychiatric nursing. Each residency class comes together every Wednesday for its own weekly class didactics, with didactics each year matched to the developmental learning needs of that particular year.

The Patient Population
A particular strength of our program is the diverse patient population, which includes people with a broad spectrum of mental health problems and an impressive array of ages, cultures, and socioeconomic backgrounds. Of equal importance, training in our program is integrated within a comprehensive community mental health delivery system. Residents can choose to focus part of their outpatient training in one of the linguistic minority clinics, including our Latinx, Portuguese, and Haitian Creole teams.

Service and training occur in a variety of settings: inpatient, outpatient, partial hospital, emergency service and outreach, telehealth, and in primary care/ behavioral health collaborative care outpatient clinics. Other clinics within Cambridge Health Alliance include Health Care for the Homeless, the Women’s Health Center, The Zinberg HIV Clinic and the Asylum Clinic. Residents can elect clinical rotations at other health care centers as well.

This comprehensive four-year training program has 32 residents. The training program is one of the five Harvard Medical School General Psychiatry Residencies, and the department serves as a popular training site for Harvard Medical students. Medical student teaching, teaching of junior residents, and education of interdisciplinary colleagues are an active part of the psychiatric residency program. Specialized chief residency positions provide opportunities for residents interested in pursuing particular clinical, academic, research and administrative interests. An intensive two-year psychotherapy fellowship provides an opportunity for advanced work in long-term psychodynamic therapy during the PGY4 year and an optional PGY5 year.

The Department also sponsors a two-year Child & Adolescent Psychiatry Fellowship, to which some Residents choose to apply after their PGY3 or PGY4 in our Adult Psychiatry program. The Department also sponsors ACGME accredited fellowships in Geriatric Psychiatry and Psychosomatic Medicine. Our training programs are certified and in good standing with the Residency Review Committee in Psychiatry of the Accreditation Council for Graduate Medical Education (ACGME).

Pioneering innovations in health care delivery

Our department is actively involved in developing new knowledge about patient-centered and personalized care for our diverse population, early detection and prevention, and the creation of a learning health system to continually improve quality, outcomes, and the system itself. We see the evolution in care delivery as an exciting opportunity to train residents and other health professionals to be effective clinicians, researchers, and leaders. We offer a variety of opportunities to participate in research efforts that focus on population health, health care disparities, addictions, mindfulness-based interventions, and early childhood. We are fortunate to be immersed in an outstanding academic environment that connects us with Harvard University and Harvard Medical School, and the other Harvard Psychiatry departments and training programs. We also offer unique training opportunities within the community, including school-based clinics, Healthcare for the Homeless sites in local shelters, and a variety of community-outreach opportunities.

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