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, you consolidate your interdisciplinary knowledge and skills as you rotate through the Departments of Psychiatry, Neurology, and Emergency Medicine, as well as the Division of Internal Medicine and Clinical Innovation. Clinical exposure in this year helps you gain solid footing in your medical and neurological care of patients, while rotations outside of the department prepare you for an integrative career in psychiatry.

You spend the majority of the year rotating within the department, learning to treat and manage patients with serious mental health conditions from varied socioeconomic and cultural backgrounds, many facing complex structural challenges. Your “psychiatry home base” in the PGY-1 year is NYC Health + Hospitals/Bellevue’s Comprehensive Psychiatry Emergency Program (CPEP), where you learn to assess and triage acute psychiatric needs.

The year is divided as follows:

  • 12 weeks of internal medicine
  • 2 weeks of ambulatory care medicine
  • 2 weeks of emergency medicine
  • 8 weeks of neurology
  • 6 to 8 weeks in CPEP
  • 14 to 16 weeks on inpatient psychiatry units
  • 2 weeks of psychiatry electives
  • 4 weeks of vacation

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 take place at NYC Health + Hospitals/Bellevue, NYU Langone’s Tisch Hospital and Kimmel Pavilion, as well as the VA NY Harbor Healthcare System. While on these rotations, you learn alongside our interdisciplinary colleagues, functioning as an internal medicine or emergency medicine intern. Supervision and didactics, as well as on-call experiences, align with the structure of the assigned service and hospital. The majority of your formal medicine training (10 weeks) takes place on internal medicine wards during the day.

You also rotate on the internal medicine floors for two weeks of night float. In addition, you rotate for two weeks in an ambulatory care clinic and two weeks in a medical emergency room. PGY-1s do not take psychiatry call shifts during their medicine rotations.

Neurology Clinical Training for Residents

Neurology rotations are at NYC Health + Hospitals/Bellevue and the VA NY Harbor Healthcare System with the inpatient neurology consultation services and outpatient neurology clinics. You take primary responsibility for your neurological cases, supervised by senior residents and faculty. You also participate in neurology conferences, rounds, and other educational activities. During neurology rotations, you take psychiatry call shifts in CPEP.

Bellevue Comprehensive Psychiatric Emergency Program

CPEP is a core clinical rotation in in your PGY-1 year. CPEP constitutes the busiest psychiatric emergency service in New York City, providing care for thousands of presentations annually in the core emergency service alone. The program consists of the psychiatric emergency department, which in addition to crisis intervention, provides extended observation of patients for up to 72 hours; the interim crisis clinic, an innovative program for providing short-term follow-up to patients discharged from the emergency department; and the mobile crisis team, a multidisciplinary team that visits people in the community when acute psychiatric treatment is indicated.

The PGY-1 CPEP rotation consists of two segments—typically four weeks in the first half of the year and four weeks 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 (12:00AM to 9:00AM). You spend half the rotation on days and half on nights.

Additionally, PGY-1s on elective, neurology, or general psychiatry rotations cover weekend shifts in the CPEP.

As a PGY-1 in CPEP, you learn the basic principles of psychiatric evaluation, diagnosis, and treatment with a focus on urgent and emergent psychiatric issues. You learn how to manage a diverse group of patients presenting from the medical emergency room, a wide catchment area in the community, as well as New York City’s jail system. Supervised by attendings while collaborating with a multidisciplinary team, you build confidence in your ability to triage acute psychiatric needs.

Inpatient Psychiatry Clinical Training for Residents

During the PGY-1 year, you rotate on multiple inpatient psychiatry units at Bellevue, NYU Langone, and the VA, serving patients admitted on both a voluntary and involuntary basis.

NYC Health + Hospitals/Bellevue Rotation

As a PGY-1, you rotate on 2 out of the 9 total inpatient psychiatry units at NYC Health + Hospitals/Bellevue—12 South and 20 West. On these two units, you learn how to deliver high quality, caring, and evidence-based psychiatric care within a city public healthcare system. You also gain exposure to the state-run Mental Hygiene Legal Services provided to patients presenting before Bellevue’s mental health court.

People with mental illness suffer increased morbidity and mortality. 12 South, Bellevue’s Medical Psychiatry/Geriatric Psychiatry Inpatient Unit aims to decrease this disparity by providing comprehensive care for patients that might be considered too medically ill for most inpatient psychiatry units. You work with an interdisciplinary team to provide quaternary care to some of the most complex cases admitted to Bellevue from the community, the medical–surgical floors, and often directly from other hospitals in the region. Here, you have a decreased clinical load so that you can focus on speaking to patients and family members, while learning how acute and chronic medical complications intersect with psychiatric illness.

20 West, Bellevue’s principal inpatient psychiatric teaching unit, often serves patients admitted through CPEP and the medical–surgical floors presenting with a full range of psychiatric symptoms. Most patients on this unit have a spectrum of psychotic conditions, though you encounter a wide range of psychiatric conditions. Here, you learn to transform complex clinical concepts into clear case formulations and individualized treatment planning, following closely for the resolution of acute psychiatric decompensation.

VA NY Harbor Healthcare System Rotation

At the VA NY Harbor Healthcare System, you rotate on 17 North, an inpatient psychiatry unit serving U.S. veterans and their families. On this unit, you work closely with an interdisciplinary team to help patients take advantage of the wealth of resources provided by a federally based healthcare system tailored to the complex needs of veterans. Working at the VA affords the unique opportunity of caring for patients who have been treated by providers in various specialties all under the same health home often over the course of decades. Many patients presenting to this unit suffer from trauma-related illness, substance use disorders, or the psychiatric complications of combat related injury such as traumatic brain injury, though you encounter a wide range of psychiatric conditions.

NYU Langone Health Rotation

Providers at NYU Langone Health Tisch Hospital’s Health Care Center (HCC) 10 unit have particular expertise in treating people with mood, personality, and psychotic disorders. All admissions to this unit are on a voluntary basis, and patients work with their treatment team to gain privileges that typical inpatient psychiatric units do not have the resources to support such as access to personal electronics. On this unit with high patient turnover, you sharpen your skills in developing and coordinating personalized treatment plans alongside an interdisciplinary team.

Residency Didactics and Intern Support Group

In your PGY-1 year, your cohort convenes for five hours of dedicated scholarly and clinician development time on Thursday mornings.

Two hours are devoted to seminar-style PGY-1 didactics focusing on clinical case material, differential and diagnosis, patient interviewing skills, risk assessment, psychopharmacology and various subspecialties including but not limited to forensics, addiction, and consultation.

Two hours are devoted to residency-wide learning. PGY-1s attend departmental Grand Rounds, which offer cutting-edge insights into clinical care and research presented by faculty from NYU Langone and beyond. Residents also have the opportunity to deliver Grand Rounds presentations periodically throughout the year. PGY-1s join their peers in the PGY-2, -3, and -4 resident classes for an additional hour of shared learning.

Together the entire residency gathers for morbidity and mortality conferences, journal club, community meetings, and lecture series focused on career development, race and racism in psychiatry, 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 four classes.

The last hour of dedicated time on Thursdays functions as a support group to help you manage stress associated with working as a physician, caring for medically and mentally ill people who have tremendous social stressors as well as morbidity and mortality. This group also encourages you to explore alongside your peers’ various ways of coping with and adapting to critical decision making, sleep deprivation, and other stressors faced in residency.

While on psychiatry rotations, the rest of your Thursday is protected personal scholarly time.

Residency Electives

As a PGY-1, you choose two weeks of elective experiences based on your individual psychiatry 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

During general psychiatry and neurology rotations, your class covers weekend shifts, from 8:30AM on Saturday to 8:30PM on Sunday, broken up into 12-hour shifts per individual resident.