Psychiatry Residency Postgraduate Year 4
In postgraduate year 4 (PGY-4) of the Psychiatry Residency, you consolidate the knowledge and skills developed over the previous three years of residency. PGY-4s continue to work in at least two outpatient clinics they started in as PGY-3s, cultivating longitudinal clinical relationships with a select group of patients. During PGY-4 year, you also enhance your leadership and clinician–teacher skills, providing direct and indirect supervision to medical students and more junior residents during a senior selective rotation in either an outpatient, inpatient, or emergency psychiatry setting.
PGY-4s also return to a consultation–liaison service, taking on more clinical and supervisory responsibility as a senior trainee. You have opportunity to tailor your PGY-4 year to your interests, choosing from a wide array of short and long-term electives and by designing individualized scholarly projects that can be clinical or academic in nature. The final year of residency prepares you to pursue a career in academic psychiatry and research, clinical practice, teaching, as well as administration. Our mentors help you solidify both fellowship and career plans.
Outpatient Psychiatry Training for Residents and Resident Supervision
As part of your PGY-4 experience, you continue to treat a core group of patients first encountered in your PGY-3 year in at least two outpatient clinics, typically the NYC Health + Hospitals/Bellevue and NYU Langone resident clinics. Faculty supervision is always provided, though PGY-4s take on more autonomy in their patient care. You continue to receive individual weekly supervision from clinic-based faculty and in psychodynamic therapy from a member of the Psychoanalytic Association of New York. PGY-4s take part in weekly group supervision for advanced psychopharmacology. PGY-4s can pursue additional specialized supervision and expert consultation based on patient cohort needs and resident interests.
Residency Senior Selective
During your PGY-4 year, you gain leadership experience as a senior resident on an inpatient unit, in the Bellevue Comprehensive Psychiatric Emergency Program (CPEP), or at the 125th Street Clinic of the Manhattan Psychiatric Center. With the guidance of the respective unit or clinic director, you assume the role of a junior attending, supervise junior residents and medical students, lead journal clubs, and teach didactics for trainees on site. You also learn more about how to execute some of the more administrative and organizational aspects of psychiatric care.
Consultation–Liaison Psychiatry Training for Residents
As a PGY-4, you spend one month as a psychiatry consultant to other medical disciplines at Bellevue, NYU Langone, or the VA NY Harbor Healthcare System. You also teach and supervise rotating junior residents and medical students in our consultation–liaison clinical training services at these three sites.
The rest of your PGY-4 year is dedicated to electives, which enable you to create a senior experience tailored to your interests. Elective choices are wide-ranging, making use of the incredible network within our department. Our senior residents spend time receiving 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. Senior residents also work on specialized inpatient services, on assertive community treatment teams, and on mobile crisis teams.
Residency Scholarly Project
Throughout the PGY-4 year, you develop a personalized learning plan culminating in a final presentation to your residency colleagues and faculty. Residents often choose to advance scholarly projects they have started in previous training years. Reflecting the intellectual diversity of our residency, PGY-4s choose to deepen their understanding of highly varied topics within psychiatry. Recent PGY-4 projects fostered ongoing research on the striatum as a node for internal preoccupation, psilocybin facilitated psychotherapy for major depressive disorder, and psychological impacts of the COVID-19 pandemic on the postpartum period. Other recent projects explored psychiatrists’ roles in developing methadone policy, plea bargaining, and providing emotional support to medicine trainees.
Five PGY-4s serve as chief residents in their final year of residency. Chief residents provide leadership and administrative support to a single postgraduate class. There are opportunities to develop chief roles that provide support to residents across classes interested in research and scholarly projects. Chief residents receive additional supervision and meet to collaborate with residency program directors on a weekly basis.
Didactic Training for Residents
In your PGY-4 year, your cohort convenes for six hours of dedicated scholarly and clinician development time on Thursdays.
Three hours are devoted to seminar-style PGY-4 didactics that advance topics covered in the previous three years of training, such as to neuropsychiatry, psychopharmacology, psychotherapy, forensics, addiction, eating disorders, and reproductive psychiatry. PGY-4s also receive 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 also explore material related to career choices and leadership skills, as well as mental health administration and policy.
Two hours are devoted to residency-wide learning. PGY-4s attend departmental Psychiatry Grand Rounds, which offer cutting edge insights into clinical care and research presented by faculty from NYU Langone and other institutions. Residents also have the opportunity to deliver Grand Rounds presentations periodically throughout the year. PGY-4s join their peers in the PGY-1, -2, and -3 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
There are no required on-call shifts in the PGY-4 year.