Dartmouth Hitchcock Medical Center
Dartmouth Hitchcock Medical Center is a 400-bed, tertiary medical center set in Lebanon, New Hampshire, that draws patients from multiple states throughout New England. It is home to two psychiatry inpatient units, psychotherapy and psychopharmacology outpatient clinics, ECT, TMS, Esketamine, a large CL service, and multiple psychiatric subspecialty clinics. These include sleep medicine, neuropsychiatry, embedded primary care, women’s mental health, treatment resistant depression, child psychiatry, transgender mental health and geriatric psychiatry. It serves patients with a full range of psychiatric disorders, from all sociodemographic backgrounds, throughout the life span.
Dartmouth Hitchcock Medical Center is our flagship teaching site and geriatric psychiatry fellows participate in many activities there including the geriatric psychiatry outpatient clinic (where fellows supervise residents, medical students, and internal medicine residents and provide didactic teaching), the behavioral neurology clinic, a neuromodulation service including ECT, TMS, and esketamine, the consultation-liaison service, and neuroradiology.
Dartmouth Hitchcock Medical Center is also the home to many formal teaching activities. Fellows have an opportunity to deliver several core curriculum sessions for the Psychiatry Residency Program, present a grand rounds style lecture to the geriatric medicine group, and participate in invited presentations to various other departments at the hospital.
Veterans Affairs Medical Center, White River Junction
The Veterans Affairs Medical Center (VA) is a 60-bed, acute care hospital, in White River Junction, Vermont, only a short drive from Dartmouth Hitchcock Medical Center. It is a clinical affiliate of Dartmouth Hitchcock Medical Center, a teaching and training site for Geisel Medical School, and home to inpatient psychiatry, residential treatment for substance and trauma-related disorders, outpatient psychiatry, CL, TMS, and ECT. It also has community and geriatric psychiatry clinics.
The VAMC sees patients with a full spectrum of psychiatric diagnoses, with an emphasis on PTSD and substance use disorders. It is also the home of the National Center for PTSD, and a robust research program of the Department of Psychiatry.
New Hampshire Hospital
New Hampshire Hospital, established in 1842, is the state psychiatric facility for New Hampshire. It is a 184-bed, JCAHO-accredited and CMS-certified facility that offers state-of-the-art acute and long-term care to adult patients with serious and persistent mental illness. Our geriatric psychiatry inpatient rotation is based in the 38-bed Older Adult Unit at NHH. There, fellows see a challenging mix of geriatric patients with early-onset, and late-life psychiatric disorders, co-morbid, chronic medical illness, and functional impairment. During this rotation, fellows assume management of a treatment team, functioning semi-autonomously under the supervision of the attending faculty. The experience exposes fellows to the challenges of complex geriatric care and accompanying forensic and medical-legal issues, and it is an excellent setting in which to sharpen geriatric team leadership skills.
NHH is also a main teaching and training site for the Geisel Medical School, and while at NHH, fellows will supervise psychiatry residents and medical students, and deliver a lecture in the NHH Grand Rounds Series, a continuing education activity.
Glencliff Home
The Glencliff Home is New Hampshire’s specialized, psychiatric nursing home. Fellows spend one day per week for six months at Glencliff, located in a bucolic, picturesque setting in New Hampshire’s White Mountains. The experience provides a unique opportunity to master team leadership in long-term care. Under the supervision of faculty, fellows gradually assume responsibility for managing one unit in the facility. This provides an immersive chance to see what types of behavioral and environmental approaches can be effective for managing severe behavioral and psychiatric symptoms in nursing homes, and to appreciate why such approaches are more difficult to implement in conventional nursing homes.
Wheelock Terrace
Wheelock Terrace is a conventional assisted living and memory care facility located adjacent to the Dartmouth Hitchcock Medical Center campus. Fellows spend time at Wheelock Terrace during monthly rounds there with residents and faculty. At Wheelock Terrace, fellows gain a more nuanced appreciation of assisted living facilities and the nature of the psychiatric disorders that affect their residents. This setting also provides an opportunity for fellows to supervise psychiatry residents.
Kendal at Hanover
Kendal at Hanover is an independent living, continuing care retirement community just a few minutes away between Dartmouth Hitchcock Medical Center and Dartmouth College. It serves retirees from the Dartmouth-Hanover-Upper Valley community, and gives fellows exposure to working longitudinally with more robust, healthier older adults, and to gain a greater understanding of late-life developmental tasks and crises they face.