Postgraduate year four (PGY-4) is an opportunity to consolidate the knowledge and skills developed over the previous three years of training. PGY-4 offers additional focus on gaining expertise in systems of care, aimed at developing leaders in community and public psychiatry.

Sunset Terrace Family Health Center at NYU Langone Behavioral Health Services

PGY-4 residents continue to treat outpatients from PGY-3, which allows them to cultivate longitudinal clinical relationships and observe the process of change and growth in psychiatric care.

While faculty supervision is always provided, PGY-4 trainees have more independence caring for patients. Residents receive weekly individual supervision in psychopharmacology, supportive psychotherapy, and career development from clinic-based faculty. There are also opportunities available for psychodynamic psychotherapy supervision. Residents may receive weekly small group supervision in cognitive behavioral therapy and family or couples therapy. Subject to caseload and individual interests, residents can receive additional supervision and expert consultation in complex psychopharmacology, advanced substance use treatment, integrative medicine, and public services.

Consultation–Liaison Psychiatry

Residents return to the hospital-based consultation–liaison team in PGY-4 to revisit and strengthen skills in acute psychiatric evaluation and management. During this rotation, residents also take an active role in providing education to more junior residents.

Senior Rotation

PGY-4 residents each serve as a senior resident on a Brooklyn-based psychiatry service. This experience may be based in the Family Health Centers at NYU Langone or at NYU Langone Hospital—Brooklyn. During this longitudinal rotation, residents work with the respective unit or clinical director to assume the role of a junior attending and to supervise junior residents and medical students, lead journal clubs, and teach didactics for trainees on-site. Residents also acquire experience with some of the more administrative and organizational aspects of psychiatric care.

Electives

In PGY-4, residents have ample time for electives tailored to their interests. Senior residents can receive advanced training in cognitive behavioral therapy, dialectical behavioral therapy, psychodynamic psychotherapy, LGBTQ+ mental health, trauma-focused psychotherapy, the psychodynamics of leadership, medical student education, reproductive psychiatry, sex therapy, and the treatment of eating disorders. PGY-4 residents may also work on specialized inpatient services, on assertive community treatment teams, and on mobile crisis teams to sharpen skills in areas of interest.

Chief Residency

PGY-4 trainees serve as chief residents and provide leadership and administrative support to the program. Chief roles may provide support to residents across classes interested in research and scholarly projects. Chief residents receive additional supervision and meet to collaborate with the residency program director on a weekly basis.

Teaching Opportunities for Residents

Residents have opportunities to teach medical students throughout the training program but take on additional education roles in PGY-4. Residents are encouraged to host medical students on clinical clerkships, develop on-service didactics for medical students, and guide junior residents in their clinical education. Residents also have additional opportunities for formal and informal teaching throughout training.

On-Call Shifts for Residents

There are no required on-call shifts for PGY-4 residents.

Postgraduate Year 4 Didactic Education

Didactics are shared with NYU Grossman School of Medicine’s Psychiatry Residency. PGY-4 didactics advance topics covered in the previous three years of training, including neuropsychiatry, psychopharmacology, psychotherapy, forensics, addiction, eating disorders, and reproductive psychiatry. PGY-4 residents also attend a lecture series on various applications of integrated care models, including collaborative care, psycho-oncology, HIV psychiatry, palliative care, and pain management. PGY-4 didactics explore material related to career choices and leadership skills, as well as mental health administration and policy.

PGY-4 residents also take part in group supervision for advanced psychopharmacology and have access to additional specialized supervision and expert consultation based on patient cohort needs and resident interests.