Department of Psychiatry
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Residency Program in PsychiatrySchedulesPGY-I | PGY-II | PGY-III | PGY-IV PGY-IThe PGY-I year is divided between medicine (four months, including one month in the medical emergency room and one month of medical elective), neurology (two months), and adult inpatient psychiatry (six months). These services are interdigitated, so that all residents do a mixture of medicine and psychiatry in the early part of the year. The first year rotations introduce residents to the specialties of child psychiatry, addiction psychiatry, geriatric psychiatry and forensic psychiatry, as well as providing a general psychiatry inpatient experience. An important component of the PGY-I year is a year-long didactic course for all PGY-I residents which begins with an Introductory Psychiatry Course in the afternoons during the first two weeks of July. This intensive course focuses on pragmatic issues in psychiatry: Inpatient admissions; the on-call experience; and medical, neurological and psychiatric emergency management. Call during the first year varies depending on the service. While on inpatient medicine, residents are on call with the medical team. In the medical emergency room, residents do not take call, While on all other services (except night float), residents are on call for the psychiatry services at The Mount Sinai Medical Center (MSMC). The call at MSMC is "short call" during the week (5:00 P.M. - 10:00 P.M.), 24 hours on Saturday, and 13 hours on Sunday. While on call, clinical support for all questions and concerns is provided by the attending psychiatrist and senior resident in the Psychiatric Emergency Room. Psychiatry call at MSMC during the first year usually consists of three short calls per month and one weekend call. Night Float (10:00 P.M. - 8:00 A.M.) consists of two consecutive weeks during which a PGY-I or PGY-II resident covers the inpatient units at Mount Sinai; there is no night float on Saturdays, and the remaining two weeks of the month are vacation time. While on night float, post-call supervision is provided by the Inpatient Chief Resident and the Director of Acute Care. Clinical Rotations
Weekly Schedule
NB: This does not include the Introductions to Psychiatry course for PGY-Is during the first two weeks of July, nor does it include didactics that are specific for each inpatient unit. Unaccounted for time is spent on the inpatient units. PGY-IIIn the PGY-II year, residents are further exposed to psychiatry specialties (i.e. Consultation-Liaison Service) and revisit inpatient units as more advanced residents. Residents rotate through the various units at The Mount Sinai Medical Center and also spend three months on the inpatient psychiatry service at the James J. Peters VA Medical Center, where they work with veterans and gain exposure to some other special populations (i.e. PTSD patients). Furthermore, all PGY-II residents complete one month of Consultation-Liaison Psychiatry at the VA, one month in the psychiatric Emergency Room at The Mount Sinai Medical Center, and one month of Psychiatry Elective. Residents are encouraged to begin treating long-term psychotherapy patients in the outpatient clinic during the PGY-II year. Call during the PGY-II year is at the VA Medical Center from 4 P.M. until 8 A.M. the next morning, with an attending available by phone (or in person when necessary) throughout the night. This provides an opportunity for expanded responsibilities as residents cover the inpatient psychiatry service and provide consultation services to the ER and to the general medical/surgical floors. In compliance with Bell Commission and ACGME standards, residents go home in the morning after handing over the on-call beeper to the attending of the day. PGY-II residents do not take call during their rotation in the Psychiatric Emergency Room. Call frequency varies from every ninth to every eleventh day. In addition, all PGY-II residents complete two weeks of Night Float, which consists of covering the inpatient psychiatry services at Mount Sinai; there is no night float on Saturdays, and the remaining two weeks of the month adjacent to Night Float are vacation time. Clinical Rotations
Sample Weekly Schedule
NB: These class times do not include didactics that are specific for each inpatient unit. Other unaccounted for time is spent on services as described above. PGY-IIIThe PGY-III year consists of outpatient psychiatry. Residents choose either the Mount Sinai Medical Center or The James J. Peters VA Medical Center for their general clinic experience, and they choose outpatient electives which can be based at either site. Electives include the following:
Call during the PGY-III year takes place at the MSMC Psychiatric Emergency Room, which is staffed by a supervisory attending psychiatrist 24-hours a day, seven days a week. Shifts are 12 hours, from 8:30 P.M. until 8:30 A.M. the next morning, except on weekends when daytime shifts are also available. Again, according to Bell Commission and ACMGE standards, after finishing call in the morning, residents are excused from clinical duties. Call frequency varies from every ninth to every eleventh day. Clinical Rotations
Sample Weekly Schedule
NB: Only the various clinics in which residents participate are listed above. Time apart from this is used to see outpatients, including all individual psychotherapy cases, family therapy cases, child and adolescent cases, and medication management cases. The table above lists a partial list of sample supervisions. PGY-IVThe PGY-IV year focuses on specialty training, which is accomplished by generous amounts of elective time and close mentoring by expert faculty. At Mount Sinai we believe that the development of teaching skills is essential for our residents in preparing them to become future leaders in psychiatry. To cultivate residents' teaching skills, each PGY-IV resident spends two months as the Teaching Resident, taking responsibility for working with and supervising junior residents on the inpatient units. Three residents per year are chosen by the faculty to be the chief residents; they each perform in this role for four months and alternate this with other experiences. The other clinical experiences in the fourth year also include two months of Consultation/Liaison Psychiatry at MSMC. Areas of elective focus include:
There is no call during the fourth year. Clinical Rotations
Weekly Schedule
NB: This is a sample of the various responsibilities of the PGY-IV. Senior Residency experiences are offered in the following domains: Administration, Outpatient Department, Psychiatric Emergency Service, James J. Peters VA Medical Center Inpatient, and others. Residents continue to treat their psychodynamic psychotherapy patients, cognitive behavior therapy patients, and some of their medication management / supportive psychotherapy patients during the fourth year. Thus, individual supervision continues throughout the fourth year, continuing to enhance residents' theoretical knowledge and clinical skills in psychotherapy. |
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