NARRATIVE DESCRIPTION
COMMUNITY PSYCHIATRY
1. Narrative description of course: The purpose of this offering is to provide
students who have had a psychiatry clerkship with a more in-depth look at some
of the clinical, academic, and socioeconomic issues affecting the practice of
psychiatry in the public sector. The
student will be based at the Massachusetts Mental Health Center (MMHC) and
become a member of an outpatient multidisciplinary team. The student will evaluate patients in the
MMHC Triage Service; perform various
tasks at Webster House, an MMHC-affiliated clubhouse-style psychosocial
rehabilitation program; attend meetings
at an MMHC-affiliated residential program;
see patients admitted for trials on experimental anti-psychotic
medications at the Commonwealth Research and Evaluation Unit (CREU) at the
Erich Lindemann Mental Health Center;
and follow patients along with Harvard Longwood PGY-III psychiatry
residents in various community settings, including McInniss House, Parker
Street-West (PKW), and the Committee to End Elder Homelessness (CEEH), all in
conjunction with Boston’s Health Care for the Homeless Program.
Students will attend Harvard Longwood Psychiatry Grand Rounds
and the MMHC Psychopharmacology Lecture Series on a weekly basis. In addition to on-site supervision with
program staff, students will be supervised by Robert M. Goisman, M.D., HMS
Assistant Professor of Psychiatry and MMHC Director of Medical Student Education,
and by Jim Feldman, M.D., M.P.H., HMS Instructor in Psychiatry and MMHC Medical
Director. Students will be expected to
read and discuss a selected body of literature in community psychiatry and to
complete a 10-20 page paper on a topic integrating this literature with some
aspect of their experience during this month.
The course is designed to be of interest not only to students
planning on residency training in psychiatry but also to those desiring careers
in primary care, family medicine, public health, and health care
administration.
2. Goals: This course has a number of goals:
a.) To provide an
opportunity to learn about the day-to-day life of functional patients with
chronic mental illness living in community settings, participate in medication
clinics and multidisciplinary collaboration, and see the range of clinical
problems encountered by outpatient clinicians in the public sector;
b.) To provide exposure
to the delivery of mental health care to homeless or otherwise severely
impoverished individuals;
c.) To allow students to
witness and participate in the process of psychosocial rehabilitation, through
supervised work at MMHC-affiliated day and residential programs; and
d.) To provide an
intellectual framework with which to understand the above issues, through
supervised work at the CREU, conferences and directed reading, and the writing
of a paper.
3. Monitoring: Dr. Goisman as MMHC Director of Medical Student Education will be
responsible for the student’s experience throughout the month. individual
supervision will include 1 hour weekly with Dr. Goisman and 1 hour weekly with
Dr. Duckworth, in addition to supervision provided at the various sites. Dr. Goisman will maintain contact with
faculty and staff members at the various rotation sites in order to assure
accurate and timely feedback to the student and to identify any problems early
in the month.
4. Grading: The student’s grade (High Honors, Honors, Satisfactory, or
Unsatisfactory) will be determined as follows:
25% Individual
supervision with Dr. Goisman
25% Individual supervision
with Dr. Duckworth
25% Composite feedback
from supervisors at other rotation sites
25% Final paper.
Robert
M. Goisman, M.D.
January 31, 2000