Women's Mental Health Fellowship

About the Fellowship

The fellowship in Women's Mental Health at Brigham and Women's Hospital (BWH), a teaching affiliate of Harvard Medical School, provides exciting subspecialty training opportunities for residents interested in the ways sex and gender can exert a major influence on the course, expression and treatment of psychiatric disorders. The purpose of the fellowship is to train expert clinicians in the psychiatric care of women, and in the assessment and treatment of psychiatric symptoms linked with female reproductive cycle transitions.  One of the main strengths of this fellowship is that the fellow's schedule is tailored to that fellow's specific clinical interests and educational goals.

Goals

The goal of the fellowship is to train leaders in women's mental health to adeptly treat women with psychiatric disorders by understanding the following concepts and developing the following skills:

• Acquire expertise in treating psychiatric disorders associated with the menstrual cycle, pregnancy, the postpartum period, and perimenopause.
• Understand the influence of sex and gender on the expression of major psychiatric illnesses, and the treatment implications of these influences.
• Understand the influence of sex and gender on medical and gynecologic disorders, as they relate to co-morbid psychiatric symptoms and emotional reactions.
• Develop an in-depth appreciation of the influence of sociocultural gender roles on psychopathology.

Background

According to the World Health Organization, the overall rates of psychiatric disorders are almost identical for men and women, but striking gender differences are found in the patterns of mental illness.  Gender differences have been reported in age of onset of symptoms, frequency of specific symptoms and disorders, course of these disorders, social adjustment and long term outcome.

Gender specific risk factors for common mental disorders that disproportionately affect women include gender based violence, socioeconomic disadvantage, low income and income inequality, low or subordinate social status and rank and unremitting responsibility for the care of others. Depression, anxiety, psychological distress, sexual violence, and domestic violence affect women to a greater extent than men.

Scientists are beginning to elucidate the contributions of various biological and psychosocial factors to mental health and mental illness in both women and men. In addition, researchers are currently studying the special problems of treatment for serious mental illness during pregnancy and the postpartum period. The emergence of data that expose the differences between the way men and women manifest mental illness illustrates why it is crucial to have clinicians trained to specifically address the mental health needs of women throughout all stages of their lives.

Educational Objectives (see Appendix I)

Faculty Leadership

• Laura J. Miller MD, Psychiatrist, Director, Women's Mental Health Fellowship and Women's Mental Health Division; Vice Chair for Academic Clinical Services, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Orit Avni-Baron MD, Psychiatrist, Director of Women's Mental Health at the Fish Center for Women's Health, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Leena Mittal MD, Psychiatrist, Director, Brigham Reproductive Psychiatry Consultation Service
• Paula A. Johnson, MD, MPH, Chief, Division of Women's Health, and Executive Director, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital
• For full list of faculty see Appendix II.

Clinical Training Sites

• Women's Mental Health Service at the Gretchen and Edward Fish Center for Women's Health: A service that offers comprehensive outpatient mental health care as part of an integrated, multidisciplinary program including women's health primary and other specialty care services.
• BWH Women's Mental Health Service:  An outpatient service offering consultation, diagnostic evaluation, pharmacotherapy and brief psychotherapy for women with reproductive-related psychiatric or psychological symptoms.  
• BWH Reproductive Psychiatry Consultation Service: A service that provides psychiatric consultation to inpatients on BWH obstetric and gynecologic units.  The service also provides diagnostic evaluation and brief interventions for women within BWH outpatient perinatal clinics. 
• Faulkner Hospital Infertility Service: A service that offers psychiatric treatment for women who are struggling with difficult emotional reactions to infertility and its treatment.
• Dana Farber Cancer Institute Women's Psychosocial Oncology Services: The Dana CI Psychosocial Oncology Department offers psychopharmacology, cognitive-behavioral and problem-focused psychotherapy to women experiencing cancer-related issues such as emotional distress, cognitive changes, body image changes, sexual health, relationship concerns, parenting concerns, existential concerns and grief.

Fellowship Structure

The fellowship begins July 1^st and lasts one full calendar year.

Sample Clinic Rotations

*Except for selected C/L lectures 8 - 10 AM

Supervision, Rounds and Didactics

Individual supervision with L. Miller                                Mondays 4:30 - 5:30 PM

Weekly WMH Group Rounds                                           Wednesdays 12:00 - 1:00 PM

Harvard-Longwood Psychiatry Grand Rounds                Thursdays 12:00 - 1:00 PM

C/L Fellowship Didactics                                                 Fridays 8:00 - 10 AM

Scholarly Project

This fellowship emphasizes clinical experience, but also includes a scholarly project, the nature and scope of which depends on the fellow's interests. These projects can range from conducting an independent research project and publishing the results, to collaborating on an ongoing research project, to co-authoring a journal article or book chapter, to peer-reviewing others' research or publishing a book review. Those fellows anticipating a career in academic psychiatry will be encouraged to submit a paper for publication and/or present at a regional or national conference. 

Evaluation

Fellows will meet weekly with their supervisor at each clinical site for case review as well as general feedback. These weekly meetings also provide an opportunity for discussion of strengths and weaknesses and to formulate constructive plans for improvement, and meeting fellows' career goals. More formal career mentorship and counseling will occur between the Fellowship Director and the fellow as the year progresses. At the conclusion of the fellowship the program supervisor fills out a formal written review that evaluates the skills and attitudes of the fellow. Fellows will also have an opportunity to provide feedback about their experience through evaluation forms of the program and faculty. The feedback gathered from these evaluations is discussed at the next quarterly meeting of the program leadership and used to adapt and improve the program year to year.

Fellowship Benefits

Fellows will be paid according to the Partners Residency Salary pay scale.  Fellows are given four weeks of vacation time, three days for educational pursuits, and four days for research/scholarly projects.  Fellows also have access to the full range of Partners health benefits.

Academic Appointment
Successful applicants must qualify for a Harvard Medical School and Brigham and Women's Hospital clinical appointment.

The application cycle for Academic Year 2014 (beginning 7/1/13) is closed. Applications for Academic Year 2015 (beginning 7/1/14) will open in July 2013. Applications will be accepted through October 15, 2013 or until we fill the position.

The applicant must have completed a Psychiatry residency before the fellowship. Please send the application below and three letters of recommendation to the Women's Mental Health Fellowship Coordinator, Audrey Carr at acarr5@partners.org or call her directly at 617-732- 70

Click here for an application

Faculty 

• Orit Avni-Baron MD, Psychiatrist, Director of Women's Mental Health at the Fish Center for Women's Health, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Sharon Bober PhD, Psychologist, Director of the DFCI Sexual Health Program, Division of Psychosocial Oncology, Dana Farber Cancer Institute, Department of Psychiatry at Brigham and Women's Hospital
• Jennifer Boisture MD, Psychiatrist, Fish Center for Women's Health, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Karen Fasciano, Psy.D., Clinical Psychologist, Director of Young Adult Mental Health, Division of Psychosocial Oncology, Dana Farber Cancer Institute, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Jill M. Goldstein PhD, Director of Research, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital; Professor, Department of Psychiatry, Harvard Medical School
• Florina Haimovici MD, Psychiatrist, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Paula A. Johnson MD, MPH, Executive Director, Connors Center for Women's Health and Gender Biology; Chief, Division of Women's Health, Department of Medicine at Brigham and Women's Hospital
• Fremonta Meyer, MD, Psychiatrist in Women's Cancers and Cancer-Associated Cognitive Assessments, Division of Psychosocial Oncology, Dana Farber Cancer Institute, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Laura J. Miller MD, Psychiatrist, Vice Chair for Academic Clinical Services, Director, Women's Mental Health Division, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Leena Mittal MD, Psychiatrist, Director, Reproductive Psychiatry Consultation Service, Department of Psychiatry, Brigham and Women's Hospital
• Geena Athappilly, MD, Geriatric Psychiatrist, Brigham Psychiatric Specialties, Department of Psychiatry, Brigham and Women's Hospital
• Erica Veguilla, MD, Psychiatrist, Oupatient Director, Addiction Recovery Service, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Halyna Vitagliano, MD, Psychiatric Liaison to Hematologic and Neuro-Oncologic Services, Division of Psychosocial Oncology, Dana Farber Cancer Institute, Department of Psychiatry at Brigham and Women's Hospital
• Pamela Wiegartz PhD, Psychologist, Director of CBT Services and Training, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals

Clinical teaching staff

• Lynn Curran, LICSW, clinical psychiatric social worker, The Fish Center for Women's Health, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals
• Sue Etre, LICSW, clinical psychiatric social worker, The Fish Center for Women's Health, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals