Clinical Sites
The clinical year is broken into two six month blocks: inpatient services and outpatient services.
Geriatric Specialty Unit, CHA Everett Hospital
This required 6-month part-time rotation at Everett Hospital's Geriatric Specialty Unit (a secure unit on Lewis 2), offers fellows the opportunity to work within an active 22-bed inpatient facility. This unit serves a diverse population of patients over the age of 60 who often have comorbid medical and psychiatric conditions.
During this rotation, the average caseload consists of 5-6 inpatients, with full responsibility for managing psychopharmacologic treatment, individual psychotherapy if appropriate, and communicating with outside providers. Fellows will be expected to write daily notes and orders, to assist in coordination of aftercare plans, and to lead family meetings and team meetings. Fellows will have one hour of scheduled supervision each week and daily clinical supervision of ongoing cases, with additional supervision as needed. Other trainees including general adult psychiatry residents, pharmacy and medical students rotate on the unit monthly, providing fellows with opportunities to teach and supervise other trainees. While on this rotation, fellows will have the opportunity to perform palliative care consults on geriatric patients on the medical floors at Everett Hospital.
Geriatric Outpatient Services
Fellows spend part of their time over 6 months with Geriatric Services at the Central Street Care Center in Somerville, MA and at the CHA All Inclusive Care for the Elderly (PACE) program. Fellows also spend time at Hebrew SeniorLife Nursing Home where they see patients in different settings (rehabilitation, memory care, etc.) During the training year, fellows provide psychopharmacologic and therapeutic management for a broad range of elderly patients (over age 60) living in the community at various levels of care. Caseloads are monitored to maximize fellows' exposure to a variety of clinical experiences. In addition to their experience in the outpatient setting, fellows will have the opportunity to work with faculty members performing nursing home evaluations at the Hebrew Senior Life.
Didactics
The Geriatric Psychiatry Fellowship Program at Cambridge Health Alliance has a strong didactic program.
Geriatric Seminar Series at Hebrew Senior Life:
This year long lecture series is taken in conjunction with Harvard Medical School Geriatric Medicine fellows and provides an introduction to important concepts in the diagnosis and treatment of psychiatric and medical disorders in older adults. Lectures are given by geriatricians and geriatric psychiatrists throughout the Harvard system.
Medical Psychiatry Seminar:
This monthly seminar is combined with the Cambridge Health Alliance Consultation/Liaison Fellows and emphasizes the development of a lecture. Fellows will learn valuable teaching and presentation skills.
Geriatric Psychiatry Departmental Case Conference and Seminar:
Fellows have the opportunity to participate in a monthly case conference involving inpatient and outpatient team members of the CHA Geriatric Services, demonstrating a collaborative model in the treatment of older adults in a community setting. In addition to the conference, fellows and Geriatric Service team members participate in a monthly seminar series emphasizing more advanced and specialized topics in geriatric psychiatry.
Supervision
Supervision in the Geriatric Psychiatry Fellowship Program at Cambridge Health Alliance through formal weekly meetings with Alec Morgan, MD, and informally through discussion with attendings on individual rotations. Supervision focuses on advances the fellows knowledge and manner in clinical care, guidance of self-direction and academic pursuits and cultivating a professional identity.