General Goals
and Objectives

The Massachusetts General Hospital/McLean Hospital Child and Adolescent Psychiatry Residency Training Program has been designed to offer residents a well-balanced clinical experience, a broad range of exposure to normal and abnormal children and families for diagnostic assessment, treatment and prevention of psychopathology. The program utilizes clinical experience and a formal curriculum covering major areas in child and adolescent psychiatry, supervision in outpatient, inpatient, acute residential and partial hospital settings and consultation experiences in the context of a graduated learning experience throughout the two training years. Residents will develop growing competence in clinical service, consultation, teaching, research and administration.

Upon completing this program, the resident is expected to be well grounded in normal child and adolescent development and able to differentiate normal from abnormal development. He or she must be able to conduct a comprehensive evaluation of children, adolescents and families, including assessment of biological, psychological, behavioral and sociocultural dimensions leading to an accurate diagnosis, differential diagnosis and treatment plan. The resident must be familiar with a wide range of patients from different cultures, socioeconomic backgrounds and educational levels. He or she must be familiar with a broad spectrum of psychopathology, including neurologic and other organic disorders, mental retardation, developmental disabilities, learning disorders, the full range of DSM IV TR Axis I and II conditions, psychosomatic disorders, behavioral and adjustment disorders, acute crises, including suicidal and homicidal behavior, alcohol and substance abuse and family disorders. The resident must be comfortable and knowledgeable working as a part of a multidisciplinary evaluation and treatment team that includes pediatricians and other medical specialists, clinical psychologists, social workers, nurses, speech and language therapists, audiologists, teachers, recreational and occupational therapists and representatives of community and social agencies. He or she must have achieved considerable competence in the major treatment modalities, including long-term and time-limited individual psychotherapy, psychodynamic psychotherapy, play therapy, supportive therapy, family therapy, pharmacotherapy, crisis intervention, cognitive and behavior therapy, group therapy and combined psychotherapy and psychopharmacology. The resident must be able to carry out these treatments in a wide range of settings, including the outpatient clinics, psychiatric inpatient wards, acute residential treatment units and day treatment programs, residential schools and treatment centers, community health centers, pediatric inpatient wards and a general hospital emergency department. Finally, the resident must have clinical experience with patients within a continuum of care.

The resident, upon completing this program, will be able to plan, carry out and/or supervise both the long-term and short-term management of children and their families, in a modality suitable for their particular disorder. The resident is expected to be competent as a consultant/ liaison to other medical and non-medical professionals in pediatric settings, courts, schools and a wide range of social and community health centers and agencies. He or she must understand the principles of and be competent in primary and secondary prevention. Residents completing this program must have considerable experience as teachers of professional students (in psychiatry, psychology, medical school, social work, nursing, etc.), professional colleagues in other disciplines, parents and members of community and social agencies. Residents are expected to be familiar with research methodology and be able to evaluate critically past and current child psychiatric literature. In addition, residents should be competent as clinical administrators of inpatient, acute residential, partial hospital and outpatient evaluation and treatment teams.

The two-year residency in child and adolescent psychiatry is seen as part of a continuum from medical school through internship and general psychiatry training to a career in child and adolescent psychiatry. We expect a high level of clinical competence and a thorough understanding of the principles in all the areas described above. Upon completion of the program, residents are expected to be competent in the core areas of patient care, medical knowledge, interpersonal and communication skills, practice-based learning and improvement, professionalism and systems-based practice. The program takes into account differences in each resident’s prior training, clinical skills and future interests, and is flexible in tailoring the program to individual needs. Each resident will have the same core clinical and educational experience, as well as elective time each year to pursue special areas of interest.