Consultation-Liaison Psychiatry Fellowship

Massachusetts General Hospital Consultation-Liaison Psychiatry Fellowship has been training fellows for nearly fifty years. The Fellowship strives to maintain its foundational values while advancing — and advancing with — the field of consultation-liaison psychiatry, and medicine and society in general. With its strong roots, diverse training experiences and investment in the intellectual, professional, and personal development of each fellow, the Mass General Consultation-Liaison Psychiatry Fellowship provides thoughtful and hard-working advanced trainees with the tools needed for a successful career in this rewarding and challenging subspecialty.

Overview of the Fellowship

• Inpatient consultation via direct patient care
• Advanced neuropsychiatric training
• Development of trainees’ identities as physicians, psychiatric specialists/experts, and as generative members of an academic professional community
• Supervised training in transplant psychiatric evaluation and participation in listing committee for all solid organ transplants
• Quality and Safety experience regarding focusing on the increasing rates of Type II violence enacted against care providers in medical settings
• Onsite outpatient experiences, including:
  • An innovative clinic for the treatment of functional neurological disorders
  • A specialty clinic elective (co-localized in either the HIV or oncology clinic)

• Extensive seminar and supervisory experiences

• As a fellow, you will have one hour of weekly supervision with fellowship director Nicholas Kontos, MD, as well as weekly group walk rounds with emeritus director Greg Fricchione, MD, daily attending rounds, and a thrice weekly one-hour process rounds with members of the fellowship faculty.
• Two didactic hours per week are set aside strictly for fellows. A breadth of talented, accomplished, and devoted faculty allows us to place special emphasis on neuropsychiatry while covering all core topics in consultation-liaison psychiatry. In addition, there are special modules on psychodynamic theory and application, and both experience-based discussions (from departmental leaders and graduates of our program currently leading departments in local hospitals) and a guided reading series focused on leadership.  A monthly 1.5 hour discussion-based seminar on “Professionalism, Physicianhood and Psychiatric Practice,” anchored by highly curated readings and led by Drs Kontos and Restrepo, further expresses our commitment to the development of your professional identity and ethical rigor.
  • Seminars and other experiences that overlap with residents on rotation include: 1) Psychosomatics Seminar (trainee-driven talks with a faculty discussant; fellows present twice each); 2) “Big Rounds” (topic-driven and free-form discussions and deep divecase presentations); 3) Fellows supervise a circumscribed allotment of resident consult interviews/exams and provide peer feedback.

Philosophical pillars of the fellowship include:

• A medical model of psychiatry that other physicians can relate to and which pays special heed to neuropsychiatry but does not depend on biology for its legitimacy.
• Rigor of both content and form of thought. We want you to know what you are doing, as well as  why and how you are doing it (also, and perhaps especially, when you are choosing not to “do”).
• Maintaining practical and existential perspective. This allows us to both appreciate the gravity of patients’ plights and our work, and to get over ourselves. Our goals are to appreciate absurdity, relate authentically with patients and each other, and to have a good time while doing hard work.

Curriculum

We promote the philosophy that in both fellowship training and in the career of consultation psychiatric care that service is education. We frame our curriculum in terms of patient-facing and non-patient-facing activities with supervision in both aspects of learning.

Patient-facing Curriculum

We are a fellowship that skews toward inpatient consultation. The year is divided into thirds based on who your primary attending(s) are and which subspecialty consultations you are partially focused on. All of our faculty are board certified in consultation-liaison psychiatry. The scheduled curriculum never has you working with your primary attending (or attending set of two) for less than one month at a time. You will also have concomitant 4 month subspecialty consultation experiences in: oncology, burns and trauma surgery, and solid organ transplantation. 

You will have one two-hour outpatient clinic per week in either an oncology or HIV clinic. An additional two-hour elective clinic is also available.

Non-patient-facing Curriculum

Seminars, supervision, and group rounding activities as noted above.

• Our most recent Core Seminar schedule
• The most recent Professionalism, Physicianhood, and Psychiatric Practice Seminar schedule
• Topics most recently presented by fellows in the Psychosomatics Seminar

Faculty

Nicholas Kontos, MD
Director of Fellowship in Consultation-Liaison Psychiatry
Assistant Professor of Psychiatry (HMS)
Areas of Interest: Ethics, Neuropsychiatry, Illness Behaviors
PMID: 37119781, 36796760
Email: nkontos@mgh.harvard.edu

Judith Restrepo, MD
Co-Director Transplant Psychiatry, Associate Program Director Consultation-Liaison Psychiatry Fellowship, Mass General Avery Weissman Consultation-Liaison Psychiatry Service
Areas of Interest: C/L psychiatry, transplant psychiatry, collaborative care, professionalism
Email: jrestrepo@mgh.harvard.edu

Gregory L. Fricchione, MD
Associate Chief of Psychiatry
Director, Benson-Henry Institute for Mind Body Medicine
Director, Chester M. Pierce, MD, Division of Global Psychiatry
Co-Director, McCance Center for Brain Health
Department of Psychiatry, Mass General
Mind Body Medicine Professor of Psychiatry, Harvard Medical School
Areas of interest: Catatonia Pathophysiology and Treatment, Neuropsychiatry, Mind Body Medicine, Global Psychiatry
PMID: 35134702, 35235940, 35573347

Felicia A. Smith, MD
Associate Chief of Psychiatry, Division of Psychiatry & Medicine
Director, Psychiatry Consultation Service, Mass General
Areas of interest: Emergency psychiatry

Caitlin Adams, MD
Attending Psychiatrist, Mass General Hospital - APS, Psycho Oncology, Embedded Psychiatrist in the Division of Cognitive Behavioral Neurology
Areas of interest: Neuropsychiatry, Functional Neurological Disorder, Psychiatric Aspects of Neurological Disease
PMID: 35189644, 31146322, 29764988

Ashika Bains, MD, MS
Attending Physician, Acute Psychiatry Service, ID Psychiatry, Transplant Psychiatry - Mass General
Co-Leader Clinical Educator Program
Director of Resident Outpatient Clinic
Areas of interest: C/L psychiatry, Emergency psychiatry, ID care, medical education

Scott Beach, MD
Mass General Psychiatric Consultation Service
Associate Professor of Psychiatry, Harvard Medical School
Areas of interest: QTc prolongation and psychiatric medications, catatonia and related syndromes, deception syndromes, COVID-19
PMID: 36592693, 36966063, 36521681  

Donna Greenberg, MD
Director, Harvard Medical School Psychiatry Clerkship
Associate Professor of Psychiatry
Areas of interest: Cancer psychiatry, medical education 

Mila Grossman, MD
Attending Psychiatrist, Consultation-Liaison Service, Acute Psychiatry Service, and Center for Women’s Mental Health
Areas of Interest: Women’s Mental Health, Medical Education, Emergency Psychiatry

Charlotte Hogan, MD
Director of Inpatient Women’s Mental Health Consultation Liaison Psychiatry, Mass General
Areas of interest: Reproductive Psychiatry, General CL Psychiatry, Emergency Psychiatry, and Medical Education.
PMID: 32828569, 27514299, 31651971, 30763197

Ana Ivkovic, MD
Director, Transplant Psychiatry, Mass General
Instructor of Psychiatry, Harvard Medical School
Areas of Interest: Transplant psychiatry

Charles Masaki, MD, PhD
Attending, Mass General Consult Psychiatry Service
Areas of interest: Psychosocial oncology, Transplant psychiatry, Translational research

Mladen Nisavic, MD
Director, Burns/Trauma Psychiatry Service
Instructor in Psychiatry, Harvard Medical School
Areas of interest: C/L Psychiatry, trauma/surgical care, addiction psychiatry

Diana Punko, MD
Attending Psychiatrist, Consultation-Liaison Service, Acute Psychiatry Service, and HOPE Clinic
Areas of interest: Perinatal mental health, transplant psychiatry, biomedical ethics
PMID: 36949318, 34256179

Linda Herrera-Santos, MD, PhD
Director of the Hispanic Psychiatry Clinic at Mass General
Attending Psychiatrist, Consultation-Liaison Psychiatry at Mass General
Attending Psychiatrist, Acute Psychiatric Services at Mass General
Areas of interest: Hispanic Psychiatry, Consultation-Liaison Psychiatry
PMID: 35414163

Emily Sorg, MD
Clinical Director, Center for Psychiatric Oncology & Behavioral Sciences
Psychiatrist, Avery D. Weisman Psychiatry Consultation Service
Instructor in Psychiatry, Harvard Medical School
Areas of interest: Cancer psychiatry, demoralization, care at end-of-life, psychotherapy, and medical education

Academic Opportunities

We are a predominantly clinically focused fellowship that also highly values academic generativity. The latter critically involves research, but fellows are encouraged to search out, continue, or consider their activity and fit for other venues such as academic writing, teaching medical students and residents (consultation is an inherently teaching task), innovating, and leading. Our division and department are full of people ready to help you participate in or develop projects depending on your levels of interest and energy. With multiple faculty on the editorial boards of both General Hospital Psychiatry and Journal of the Academy of Consultation-Liaison Psychiatry, involved in Academy committees and special interest groups, engaged in research, writing, and teaching, there are abundant opportunities for academic engagement, toe-dipping, and mentorship.

Mentorship and Collegiality

We are a tight-knit group who enjoy one another’s company and colleague-ship. With representatives of multiple “generations” of Fellows on hand with a wide array of interests and styles, we are almost pathologically eager to pay it forward to motivated physician-learners. It would be hard to avoid developing mentor relationships during the fellowship year. Fellow classes typically form tight bonds that last long past the fellowship year.

Fellowship Alumni

Since the launch of the fellowship, we have trained over 100 fellows in consultation-liaison psychiatry. Our alumni practice in a variety of programs across the country.

Application Process

Applicants must be slated to graduate from an ACGME certified program in adult psychiatry. USMLE Steps I-III must be completed/passed. A full Massachusetts medical license, Massachusetts Controlled Substance Registration and Federal DEA Registration will be expected to be attained by matched applicants in advance of arrival at Mass General. Applicants with J1 visas will be considered.

Application Requirements

1. CV
2. Three letters of recommendation, one of which must be from your training director.
3. A letter of interest (shorter than a personal statement; a brief “this is who I am, why I’m interested in CL, and why I’m interested in a fellowship at Mass General”)