Psychiatry Residency Postgraduate Year 3
In postgraduate year 3 (PGY-3) of the Psychiatry Residency, you continue to build confidence as a provider to patients with acute and subacute psychiatric needs, while shifting your focus to cultivating a new clinical skill set around more chronic symptoms within the framework of outpatient psychiatry. During the PGY-3 year, clinical experience centers around psychotherapy with a diverse patient population comprised of adults, adolescents, children, student cohorts, families, and couples. You also engage with a more rigorous psychopharmacology curriculum and outpatient psychopharmacology practice. You have individual and shared supervisors for each clinical case and various treatment modalities, both behavioral and dynamic.
Outpatient Psychiatry Clinical Training for Residents
Our clinical training sites provide a rich opportunity to treat a diverse outpatient population that includes patients of all ages and from a broad spectrum of socioeconomic and cultural backgrounds, facing varied structural challenges. You learn about multiple psychotherapeutic modalities, including but not limited to supportive, cognitive, dialectical behavioral, emotion-focused, trauma-based, and psychodynamic therapies on both a short-term and longitudinal basis.
Since the COVID-19 pandemic, each clinic has adapted to the evolving needs of patients and providers; resident clinics offer increasing video visit alternatives, and as a PGY-3 you will learn more about video visits as a growing modality in the delivery of psychiatric treatment.
NYC Health + Hospitals Outpatient Psychiatry Clinic
The resident outpatient psychiatry clinic at NYC Health + Hospitals/Bellevue constitutes one of the main outpatient training sites. Under close supervision, you serve as the primary psychiatric provider for patients coping with a wide spectrum of illness severity and pathology. A primary care clinic is embedded into the Bellevue outpatient clinic, affording the opportunity to collaborate with medical providers while learning more about the reverse-integration model. The Bellevue outpatient clinic is also home to a resident-run family and couples therapy program. Additionally, you have the opportunity to provide psychotherapy and psychotropic management for patients in the Bellevue Opioid Treatment and Chemical Dependency Clinics.
NYC Health + Hospitals/Gouverneur also offers an outpatient psychiatry clinic, where residents can request to rotate for outpatient psychiatry experience. Gouverneur provides a similar experience to Bellevue with enhanced opportunities for residents interested in working with patients who do not speak English.
NYU Langone Outpatient Psychiatry Clinic
The resident outpatient psychiatry clinic at NYU Langone constitutes another principal outpatient training site. Similar to Bellevue’s resident clinic, here you serve as the primary psychiatric provider for patients who have a wide variety of illness severity and pathology with a particular focus on mood and anxiety disorders. This clinic offers the resources to provide a more robust program in telepsychiatry, or video visits, propelling senior residents forward in their learning about this growing field.
NYU Undergraduate and Graduate Student Health Center
As a PGY-3 you spend one day per week for six months at NYU’s undergraduate and graduate student health center providing outpatient psychiatric care. Alongside an interdisciplinary team of both student counselors and mental health clinicians, you provide short-term psychotherapy and psychotropic management as well as crisis intervention. The clinic also provides PGY-3s with seminars on emerging issues within student mental health. You may also co-facilitate group therapy often focused around identity formation for student cohorts.
VA NY Harbor Healthcare System Outpatient Mental Health Clinic
As a PGY-3, you spend one day per week for six months at the VA NY Harbor Healthcare System outpatient mental health clinic. PGY-3s perform initial psychiatric evaluations for intake into the clinic, and care for a cohort of patients who have been following in resident clinic more longitudinally. Learning during this rotation parallels the VA’s emphasis on suicide prevention programs and various evidence-based psychotherapies, including cognitive behavioral therapy, dialectical behavior therapy, skills training in affective and interpersonal regulation therapy, cognitive processing therapy, and exposure therapies for post-traumatic stress disorder. The clinic additionally provides PGY-3 seminars by multidisciplinary experts in these treatment modalities.
Child and Adolescent Psychiatry Clinical Training for Residents
PGY-3s also receive further training in child and adolescent psychiatry through clinical training rotations.
Bellevue Children’s Comprehensive Psychiatric Emergency Program and the Child and Adolescent Interim Crisis Clinic
The Children’s Comprehensive Psychiatric Emergency Program (CCPEP) at Bellevue is the country’s only specialized psychiatric emergency room for children and adolescents. As a PGY-3 you spend one half-day per week for six months in CCPEP providing emergency evaluations and caring for patients in the short-stay inpatient crisis unit. For the majority of the rotation, you will see outpatient cases in the Child and Adolescent Interim Crisis Clinic, serving as a bridge to more long-term psychiatric care. You encounter a broad range of mental health needs, and interventions may include medication management, psychoeducation, brief psychotherapies, family therapy, and crisis management. Working alongside an interdisciplinary team, you learn about school and child welfare systems.
You receive weekly individual supervision in psychopharmacology, supportive psychotherapy, and career development. Weekly individual supervision for psychodynamic psychotherapy is provided by a faculty member of the Psychoanalytic Association of New York. You also receive weekly small group supervision in cognitive behavioral therapy and family or couples therapy. Depending on your site location, you receive supervision tailored to your patient population, such as for children, adolescents, students, and veterans, and healthcare system, such as private, city, or federal.
Subject to your caseload and individual interests, you receive additional supervision and expert consultation in complex psychopharmacology, advanced substance use treatment, reproductive psychiatry, integrative medicine, vocational rehabilitation, and public services.
Teaching Opportunities for Residents
As a resident in your PGY-3 year, you lead a two-week small group seminar with preclinical NYU Grossman School of Medicine medical students, introducing them to their first patient-interviewing experience and the mental status exam. There are also additional opportunities for formal and informal teaching throughout the residency program.
Residency Didactic Training and Resident Process Group
In your PGY-3 year, your cohort convenes for six hours of dedicated scholarly and clinician development time on Thursdays.
Three hours are devoted to seminar-style PGY-3 didactics focusing on outpatient evaluation and a variety of treatment modalities, including advanced psychopharmacology and numerous psychotherapies, including but not limited to dynamic, interpersonal, behavioral, trauma-based, group, family, and sex therapies. Other classes explore lesbian, gay, bisexual, transgender, and queer (LGBTQ) issues in psychiatry, women’s mental health, outpatient substance use treatment, forensics, and psychiatry in the media.
A biweekly teaching conference gives you the opportunity to present an ongoing outpatient case and observe a faculty expert interview the patient in front of your class. Additionally, residents lead discussions based on modules from the National Neuroscience Curriculum Initiative (NNCI), which aims to teach neuroscience in an interactive manner.
Two hours are devoted to residency-wide learning. PGY-3s attend departmental Psychiatry Grand Rounds, which offer innovative insights into clinical care and research presented by faculty from NYU Langone as well as other institutions across the country. Residents also have the opportunity to deliver Grand Rounds presentations periodically throughout the year. PGY-3s join their peers in the the PGY-1, -2, 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 process group, during which your cohort engages in unstructured group therapy facilitated by trained therapists to learn more about yourself and your peers.
The rest of your Thursday is protected personal scholarly time.
On-Call Shifts for Residents
In PGY-3 year, you take call three to four times per year for one week at a time as part of an evening float system at NYU Langone’s Tisch Hospital and Kimmel Pavilion. PGY-3s also take weekend call at NYU Langone covering the psychiatric emergency room, medical emergency room, consultation–liaison service, and single inpatient psychiatry unit via a buddy call system, working alongside one other PGY-3 and two attendings in service.