McLean Psychopharmacology Consultation Service

Contact: Ross J. Baldessarini, M.D.; 855-3203

Duration: Two months during PGY III.

Educational Goals: 1. Residents will gain competence in consulting to psychiatric and other mental health professional colleagues in the comprehensive care of complex psychiatric patients in various inpatient and partial-hospital settings within the major psychiatric teaching hospital of Harvard Medical School and Partners HealthCare Corporation.

2. They will gain special competence in the use of psychotropic medicines with severely mentally ill patients with complex, atypical, treatment-resistant, or otherwise complex conditions.

3. The role of psychotropic medications will be evaluated critically within the comprehensive care of such patients, and within the parameters defined by present-day mental health treatment systems.

Course Description: Residents rotate on this service for two months during the PGY-III year. Their duties include primarily the conduct of psychopharmacologically-oriented but comprehensive consultative clinical reviews of typically 2-3 cases per week, including discussions with relevant staff. The PGY-IV chief resident in Psychopharmacology provides immediate supervision and scheduling. During rotations of 1-2 months each year, senior attending psychiatrists with special expertise in the use of psychotropic medicines for severely mentally ill patients provide two-hour case review rounds twice each week. At these afternoon rounds early (currently Mondays and Thursdays, 3:00-5:00 PM), each case is presented and discussed in detail with the other residents, the Chief Resident and the rotating Attending Consultant, with varying participation of Psychopharmacology Fellows and other trainees (including doctoral trainees in Clinical Pharamacy). A consensus plan for specific recommendations is developed, with the leadership of the presenting PGY-III consulting resident. Selected current research literature pertinent to the case is strongly encouraged for inclusion and discussion. In addition, the current schedule provides for Service Director, Dr. Baldessarini, to serve as the Attending Consultant for at least one of the weeks in each two-month rotation.

Expectations: Residents are expected to conduct a minimum of two consultations per week for two months, and to attend all of the twice-weekly rounds, with strong encouragement to include one or two reprints pertinent to each case. Consultations require a complete and pertinent written report that summarizes salient findings and the specific recommendations of the case conference in response to the consultees’ queries. In addition, all residents are invited to attend the weekly McLean Psychopharmacology Grand Rounds in de Marneffe 132 at noon to 1:00 PM on Thursdays, which are organized by the Chief Resident in Psychopharmacology. Residents report directly to the Chief Resident of the McLean Psychopharmacology Service.