Shriners Burns Hospital

Residents may rotate through the Shriners Burns Hospital in their first or second year elective time. The Shriners Burns Hospital is an international referral center for burn injuries and a major center of research on burn injuries in children and adolescents. It is located across the street from Massachusetts General Hospital. A splendid new nine-story hospital opened on the same site in December 1995. There are extensive opportunities for child and adolescent psychiatric research: diagnostic, psychotherapeutic and psychopharmacological. There are two inpatient units: a 12 bed acute burn unit and an 18 bed plastic and reconstructive surgical unit. Approximately 7,000 children who have survived burns are followed at the hospital, seen in the clinic and periodically readmitted. Many patients are under 5 and all ages through 19 are represented. All patients have acute or postoperative pain management problems.

Approximately 50% have PTSD symptoms, 20% ADHD, 20% conduct disorders, 25–35% mood disorders, up to 60% phobic anxiety disorders and about 10% enuresis at some time. The population includes normal children, but also those who are accident-prone, neglected or abused children and children of parents with PTSD, depression or alcoholism. Many children and families have survived near-death experiences due to burns or have grieved the loss of a loved one. Modalities include diagnostic assessment, preoperative preparation, crisis intervention, short and long-term psychotherapy, group and family therapy, hypnosis and pharmacotherapy. There are extensive opportunities for child and adolescent psychiatric research. Average caseload consists of two to six inpatients. The residents may perform two or three outpatient consultations during a 10-week rotation. All residents have individual once-weekly supervision, as well as conferences and seminars. Faculty consists of one two-thirds time senior child and adolescent psychiatrist, one half-time pediatrician, two full-time trauma surgeons, several part-time plastic and reconstructive surgeons, one half-time psychologist, three full-time social workers, one fifth-time senior research child and adolescent psychiatrist, one half-time child psychiatry research fellow and other staff in associated disciplines, such as anesthesiology, nursing, physical therapy and special education.