Clinical Rotations

Clinical rotations progress from earlier in-patient to later outpatient experiences. In all years of training, there is an organized program of lectures, seminars, and case conferences five days a week. This program is designed to augment the resident's learning experiences in clinical services.

PGY-1
Medicine or Pediatrics: 4 months
Neurology: 2 months
Acute In-patient Psychiatry (Geriatric, general): 6 months

PGY-2
ER: 1 month
Evaluation & Referral Clinic: 1 month
Consultation/Liaison: 2 months
Adult & Adolescent In-patient: 7 months
Child In-patient: 1 month

PGY-3
Ambulatory Care Service (Adult, Alcoholism and Addiction, Child, Geriatric, Psychotherapy and Pharmacology): 12 months

PGY-4
Ambulatory Care Service: 12 months
Electives: Part time
Senior or Chief Resident responsibilities

PGY-1 CLINICAL TRAINING & CURRICULUM 

In the six months on Psychiatry, each PGY-1 resident spends three-month rotations on two of the acute care (20 to 23 bed) in-patient units in the Reiss Pavilion. Reiss-2 has an older population; Reiss-3 is a middle-aged population, and Reiss-5 a mixture of young adults and up to 6 or 7 adolescents. A fourth in-patient unit, Reiss-6 has a capacity of 16 children aged twelve and younger. 

On in-patient psychiatry, residents are part of a medical team consisting of a full-time attending psychiatrist, three PGY-1 or PGY-2 junior residents, and a PGY-4 senior resident. Unit teams additionally include medical students, social workers, occupational therapists, nurses and aides. Under the guidance of attendings and PGY-4 residents, the PGY-1 residents admit and evaluate patients, formulate treatment plans, and carry out treatments. Residents carry an average caseload of six to eight patients while on the psychiatry in-patient services. Residents are assigned weekly supervision sessions to discuss their work in a private, one-on-one environment.

The PGY-1 psychiatry curriculum provides intensive supervised experiences in interviewing skills, case formulation, diagnosis, and clinical procedures. It emphasizes the practical applications of psychopharmacology and supportive psychotherapy, all being appropriate to the first and second year in-patient experiences.

PGY-2 CLINICAL TRAINING & CURRICULUM 

Residents in the PGY-2 year rotate through a mixture of in-patient and outpatient services. All residents spend two months on the consultation/liaison (C/L) service doing consultations on the in-patient units of the medical, surgical, obstetrical in-patient services in the general hospital. They also spend at least one month rotating under the supervision of a senior resident and an attending in the emergency room. Residents spend one month on the 16-bed in-patient unit for children twelve and under. All spend at least one three-month rotation on an in-patient adult unit, and most will do a second such rotation. Some PGY- 2s will rotate through the Evaluation and Referral program, learning to assess a variety of walk-in and scheduled "first-time" patients.  Their work is supervised by an attending psychiatrists, a PGY-4 resident and the manager of the clinic.

The PGY-2 didactic curriculum includes teaching in emergency psychiatry and consultation liaison psychiatry, as well, as seminars on normal development integrated with psychopathology.  The PGY-2 residents share a journal club with the PGY-1 residents every week, and on Thursdays, all attend Grand Rounds with the entire department. PGY-2s are also exposed to group dynamics and the intricacies of working on various services during a year-long group supervision experience.

PGY-3 CLINICAL TRAINING & CURRICULUM 

PGY-3 residents spend the year in supervised ambulatory care with geriatric, adult, child, chronically mentally ill, adolescent, and substance abuse patients. Special supervisors are provided for long-term psychodynamic psychotherapy with a few patients. They also receive supervision in individual and group psychotherapy. 

The PGY-3 didactic curriculum begins with an introduction to group therapy, followed by an integrated approach to all psychiatric interventions, beginning with psychoanalysis and psychodynamic theories interwoven with a psychodynamic case seminar. Seminars on ambulatory pharmacotherapy are followed by overviews of the cognitive therapy, family therapy, and short-term therapies. The PGY-3 residents begin a two-year psychodynamic case seminar for article review and ongoing case presentation.

PGY-4 CLINICAL TRAINING & CURRICULUM

The content of the fourth training year is individualized to best suit the senior residents' talents and interests. For six to nine months, residents select three-month senior positions in a variety of Department's clinical settings, functioning as Assistant Unit Chiefs with important teaching, clinical and administrative responsibilities. They may combine some of these functions with a clinical research project. The PGY-4 residents continue long-term treatment of their assigned adult and child patients and also assume additional outpatients during the course of the year.  PGY-4 residents are encouraged to create enriching elective opportunities, with the possibility of working in a nearby college student mental health clinic or with the Asian population in St. Vincent's Chinatown Clinic.

The PGY-4 didactic curriculum offers advanced courses in a wide range of topics, including termination issues, career planning, malpractice, research methodologies and forensic issues, and senior reading on Freud. 

PGY3s and PGY-4s participate in a year-long journal club.  All residents and medical students participate in a monthly Case Conference with expert discussants and live patient interviews.

The Chief Residents of the Department of Psychiatry are PGY-4 residents selected by the Chairman of Department following consultation with the resident and attending staff.

ELECTIVES 

The flexibility of the PGY-4 year allows for residents to choose from a variety of clinical and research electives, tailored to their own areas of interest. The clinical sites include any of the in-patient or ambulatory services of the Department of Psychiatry as well as other clinical services in the general hospital. Residents may select special programs, such as the New York University Student Health Service, or community psychiatry consultations at shelters and single room occupancy hotels, geriatric programs, and child and adolescent rotations at the New York Foundling Hospital Family Court Services of New York City, or the Chinatown Clinic.  They may also choose among a variety of clinical and research electives offered by the faculty.