Psychiatry Residency Postgraduate Year 1 | NYU Langone Health

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Psychiatry Residency Curriculum Psychiatry Residency Postgraduate Year 1

Psychiatry Residency Postgraduate Year 1

In postgraduate year 1 (PGY-1) of the Psychiatry Residency in NYU Langone’s Department of Psychiatry, residents focus on developing and consolidating medical knowledge and skills. You learn to treat and manage patients with serious mental health conditions from all socioeconomic and cultural backgrounds, many with complex social issues.

The year is divided as follows:

  • 3.5 blocks (12 weeks) of internal medicine
  • 0.5 blocks (2 weeks) of ambulatory care medicine
  • 0.5 blocks (2 weeks) of emergency medicine
  • 2 blocks (8 weeks) of neurology
  • 1.5 to 2 blocks (6 to 8 weeks) in the Comprehensive Psychiatry Emergency Program
  • 3.5 to 4 blocks (14 to 16 weeks) on inpatient psychiatry units
  • 0.5 blocks (2 weeks) of electives

All residents complete their medicine rotations by April of the PGY-1 year. There are opportunities for dedicated research time for select individual residents interested in a research career.

Internal Medicine Clinical Training for Residents

Medicine rotations occur in the inpatient medical services of NYC Health + Hospitals/Bellevue, NYU Langone’s Tisch Hospital, and the VA NY Harbor Healthcare System. While on these rotations, you function as a first-year medical intern. Supervision and didactics, as well as on-call experiences, align with the policies of the assigned service and hospital. Medicine residents function on a two-week night float system. In addition, you rotate for two weeks in ambulatory care medicine and two weeks in emergency medicine at Bellevue.

Neurology Clinical Training for Residents

Neurology rotations are at Bellevue and the VA NY Harbor Healthcare System on the consultation services and neurology clinics. On the wards, you have primary responsibility for neurological patients, supervised by the senior resident and faculty. You also participate in neurology conferences, rounds, and other educational activities. During neurology rotations, you take weekend call shifts in psychiatry, in the psychiatric emergency room at the Bellevue Comprehensive Psychiatric Emergency Program.

Bellevue Comprehensive Psychiatric Emergency Program

The Bellevue Comprehensive Psychiatric Emergency Program (CPEP) is a core clinical rotation in emergency psychiatry in your first year. It is the busiest psychiatric emergency service in New York City, providing care for more than 13,000 presentations annually in the core emergency service alone. The program consists of the psychiatric emergency department (with 6 beds reserved for extended observation of patients for up to 72 hours); the interim crisis clinic (an innovative program for providing short-term follow-up for patients discharged from the emergency department); and the mobile crisis team (a multidisciplinary team that visits people in the community when there is a concern that they may have a mental illness and need treatment).

The rotation consists of two segments—four weeks in the first half of the year and two four-week periods in the second half of the year. Two residents rotate in CPEP at the same time, one on day shifts (8:30AM to 4:30PM) and the other on night shifts (12:00 to 9:00AM). Each resident spends half the rotation on days and half on nights.

As a resident, you learn the basic principles of psychiatric evaluation, diagnosis, and treatment with a focus on emergency psychiatric issues. You learn how to manage an array of patients, functioning as their primary clinician. Supervised by an attending and working with a multidisciplinary team, you evaluate and plan treatment. You also work day shifts in the interim crisis clinic. Residents rotating in elective, neurology, or general psychiatry cover weekend shifts in the CPEP.

Inpatient Psychiatry Clinical Training for Residents

During your first year, you rotate on three inpatient psychiatry units.

Bellevue

You rotate at 20 West at Bellevue. This unit, of the nine adult inpatient psychiatric units at Bellevue, is the only one designated as the resident teaching service. This is a 28-bed unit for men and women with the most atypical, complex, and unusual psychopathology and neuropsychiatric diseases admitted through the CPEP.

Diagnoses include the entire spectrum of major Axis I disorders, chiefly schizophrenia and bipolar disorders. Many people present with comorbid personality disorders and substance abuse problems. The unit admits patients from all walks of life regardless of means, but tends to focus on public psychiatry, serving a multicultural population with severe and persistent mental illness.

NYU Langone Medical Center

At NYU Langone Medical Center you rotate at the Health Care Center (HCC). The HCC includes a 22-bed inpatient unit that treats only voluntary patients and functions as the inpatient psychiatric hospital for NYU undergraduate students, although as a resident, you also work with geriatric, dual-diagnosis, and neuropsychiatric patients. This rotation enables you to serve as a patient’s primary psychiatrist, while being supervised by an attending psychiatrist, a dedicated social worker, and nurses.

In this unit, you learn the differential diagnosis of mood and personality disorders. You gain introductory experience in a variety of psychotherapies and electroconvulsive therapy (ECT). Site-based didactics focus on psychopharmacology, methods of patient formulation, therapeutic use of the milieu, and leadership of an interdisciplinary team.

VA NY Harbor Healthcare System

At the VA NY Harbor Healthcare System, Manhattan campus, you rotate at 17 North, a 23-bed inpatient unit, as well as at 17 South, a 19-bed inpatient dual-diagnosis unit. Most patients are admitted voluntarily to the units, although a small number are eventually converted to involuntary status. The diverse patient population includes people with severe and persistent mental illness, post-traumatic stress disorder (PTSD), personality disorders, substance use disorders, and complicated medical comorbidities.

On this rotation, you work closely with nurses and social workers to help patients take advantage of the wealth of resources available to meet their complex psychosocial needs. You also work within an integrated system of care and a comprehensive electronic medical record. During your time at the VA NY Harbor Healthcare System, you participate in seminar series that examines race, gender, and military issues and the role they play in our work as clinicians.

Residency Didactics and Intern Support Group

First-year residents meet for four hours of dedicated time on Thursday mornings. One hour is devoted to didactics focusing on basic psychiatry, risk assessment, substance abuse, interviewing, psychopharmacology, forensics, inpatient consultation, and clinical case material. The second hour functions as a support group to help you manage the stresses of working with people who have mental illness and issues surrounding death and dying. The group also explores ways to cope with sleep deprivation, critical decision-making, and other stressors.

The third and fourth hours are devoted to weekly Psychiatry Grand Rounds and to an all-residents meeting where trainees in each of the classes gather together for morbidity and mortality conferences, journal club, residency town hall meetings, and lecture series focused on career, race and racism, research skills, and systems of care. This is a time when residents build collegiality and have the opportunity to learn from and with one another across the classes.

Residency Electives

As a first-year resident, you choose two weeks of elective experiences based on your interests. Electives focusing on integrative care and the reverse-integration model are also available. Please see our PGY-1 and PGY-2 electives catalog for further details.

On-Call Shifts for Residents

The medicine services use a night float system in which you participate for two weeks. The CPEP rotation consists of both night and day shifts; during general psychiatry and neurology rotations, you cover weekend shifts, from 8:30AM on Saturday to 8:30PM on Sunday.