This year-long program is designed to help psychiatrists acquire knowledge and skills in the psychosocial care of patients and families at all stages of cancer, including the end of life. Fellows are part of the Brigham and Women's Hospital Consultation-Liaison Fellowship and apply to the program via the NRMP Match process. Candidates must have completed (or be on track to complete) an ACGME-accredited general adult Psychiatry residency.
Fellows receive supervision in the psychiatric care of both oncology outpatients at the Dana-Farber Cancer Institute and inpatients at Brigham and Women's Hospital (BWH). They develop collaborative relationships with oncology subspecialty practices and other disciplines, teach non-psychiatric staff and trainees, and undertake a scholarly project for presentation and/or publication.
Responsibilities include clinical services to cancer patients and their families; consultation and follow-up with inpatients; development of collaborative relationships with oncology subspecialty practices; and other disciplines. Mentored research and teaching opportunities are also available.
Fellows work closely with the Palliative Care Service at Dana-Farber Brigham Cancer Center and Brigham and Women’s Hospital. The fellow will be supervised by Psychosocial Oncology Program faculty, as well as CL faculty at Brigham and Women's and Brigham and Women's Faulkner Hospitals.
The Harvard Medical School Center for Palliative Care, along with the faculty at Massachusetts General Hospital (MGH), provide enhanced opportunities for focused clinical learning about palliative care and the emotional support of patients with cancer.
The fellowship runs for a full year, from July 1 through June 30.
Specifically, fellows learn to:
- Assess and co-manage (a) anxiety, depression, delirium, and other common problems oncology patients experience in psychiatric consultation, and (b) emotional components of distressing symptoms such as pain, nausea, dyspnea, and insomnia.
- Identify, assess, and work therapeutically with patients who are fearful, uncertain, or struggling with dependency, loss of control, and other psychosocial issues associated with life-threatening illness.
- Apply pharmacologic principles to the treatment of seriously ill patients needing psychotropic and/or analgesic or other palliative medications. Choose non-pharmacologic therapies appropriate to the patients needs, using a psychodynamic understanding of the patient's personality style, values, relationships, and other resources.
- Work effectively with an interdisciplinary team of oncology and palliative care professionals (representing medicine, anesthesia, psychiatry, pharmacy, nursing, social work and chaplaincy) in the emotional care of patients and their families.
- Articulate ethical principles involved in choices regarding end of life care, such as designation of DNR, DNI, the use of proxies and living wills, withdrawal of treatment, and assisted suicide.
- Understand hospice services and refer appropriately to community hospice providers.
- Identify needs and provide psychosocial support to families dealing with life-threatening illness.
- Describe the bereavement process and implement appropriate interventions to support families in bereavement.