Geriatric Psychiatry Fellowship

About the Program

In 2030, about 1/3 of the adult US population will be over age 65. These will be the patients of today’s early-career psychiatrists. In addition to increasing in number, the older population is changing from what is traditionally considered "geriatric." Many seniors in the community are living active and engaged lives, with some continuing to work through the 70's or beyond.

In keeping with these changes, the NYU Department of Psychiatry is offering a one-year ACGME-accredited fellowship in Geriatric Psychiatry that prepares its graduates to be experienced in assessing and managing mental health issues of the mature adult. We have adapted the program so that our fellows have the opportunity to treat a variety of mature adults: from those living with comfort and independence to those needing skilled nursing services in an institution. Treatment modalities extend from psychodynamic psychotherapy, various types of cognitive and behavior therapies, to medications, and ECT.

Our mission is to produce clinical and academic leaders in the field and to prepare fellows for board certification in the subspecialty of geriatric psychiatry. We are closely integrated with the ACGME-accredited fellowship in geriatric medicine. Besides acquiring expertise in using pharmacotherapy and psychosocial interventions to treat patients with late-life mental disorders, our Fellows gain experience in understanding the relationship of their patients to their families and environment. Fellows, under the supervision of faculty, function as the team leader in all settings with supervisory responsibility for residents, medical students, and professional members of the multidisciplinary treatment team. The wide variety of clinical settings is described below. Our Fellow works with mentors in developing research projects and academic pursuits.

Clinical Rotations

Learn how to assess and manage cognitive complaints and disorders:

The Center for Cognitive Neurology
Clinical Supervisors: Melanie Shulman, M.D. and Thomas Wisniewski, M.D.

Training at the Center for Cognitive Neurology, focuses on the assessment of the elderly patient with primary complaints of cognitive dysfunction.  As part of this training, the Fellow becomes certified in use of the Clinical Dementia Rating Scale and receives training in neuropsychological assessment. The Fellow also follows patients throughout the year and, with supervision, manages their cognitive and psychiatric problems with both pharmacotherapy and psychotherapy. The Fellow works with patients’ families and caregivers through supervised participation in family and group psychotherapy. The Barlow Center provides opportunity for training in the fundamentals of large-scale research projects through involvement in the studies conducted by faculty of the Center for Cognitive Neurology. Previous Fellows who have participated in research at this Center have published and presented their findings at national conferences.

Learn how to be an effective consultant in a skilled nursing facility for residents with problems of amazing diversity:

Coler Rehabilitation and Nursing Care Center/Henry J. Carter Specialty Hospital and Nursing Facility
Clinical Supervisor: Ravindra Amin, M.D.

As sister facilities, Coler and Carter consist of over 900 long-term and 200 long-term acute beds. They are the primary provider of long-term care to the indigent population of New York City, with majority of the referrals coming from public acute care facilities. At Coler/Carter, the Fellow is trained in supervised consultations on nursing home residents with a wide variety of neuropsychiatric presentations. The Fellow also learns the basics of quality improvement and regulatory issues in the long-term setting by participating in patient safety projects. The Fellow receives training in the essential elements of behavior and psychotropic medication stewardship with the goal of efficiently providing psychiatric consultation that improves patient outcomes and staff satisfaction.

“Healing with Harmony” shows an innovative and effective non-pharmacological approach to patients at Coler Rehabilitation and Nursing Care Center that was established by Dr. Amin.

Healing with Harmony: A Music & Memory Story

​Learn the fundamentals of integrated care by working side-by-side with experienced geriatricians:

Bellevue Geriatric Clinic
Clinical Supervisors: Mary Kelleher, M.D.; David Sutin, M.D.

The Bellevue Geriatric Clinic is the primary source for medical care of outpatients aged 65 years and older. The patient population is representative of Bellevue Hospital Center, which serves a very diverse medically underserved population, including a high proportion of immigrants. The Fellow is integrated into the Clinic and does supervised psychiatric consultations on its patients, following some patients longitudinally over the course of the year.

Learn to assess and manage a wide variety of serious late-life psychiatric disorders, while becoming experienced in administering ECT:

Bellevue Geriatric Psychiatry Unit and Electroconvulsive Therapy (ECT) Service
Clinical Supervisor: Dennis Popeo, M.D.

The unit has 28 beds and specializes in the acute psychiatric problems of medically ill and elderly patients. Patients have a wide variety of diagnoses including schizophrenia, bipolar disorder, major depressive disorder, personality disorders, and dementing disorders. Patients often have co-occurring substance abuse and neurological illnesses. Therapeutic programming addresses memory skills and coping skills related to the challenges of aging. The Fellow gains expertise in the assessment and treatment of these complex patients and works with a multidisciplinary team consisting of psychiatrists, an internist trained in geriatric medicine, a psychologist and social workers. Fellows also become acquainted with neuropsychological testing which is commonly utilized for patients on this service. There is the opportunity to attend the weekly Clinical Case Conference of the Bellevue Psychiatry Inpatient Service. 

The Bellevue Hospital ECT service treats inpatients with serious psychiatric disorders for which ECT is the recommended treatment. Patients treated by the service commonly have treatment-refractory depression, bipolar disorder, acute psychotic disorders, or dementia. A large portion of the patients are elderly. The Fellow has on-site technical instruction and supervised ECT treatments.

Have your own supervised “private practice” while gaining understanding of the psychodynamics of the aging Baby Boom generation:

NYU Behavioral Health Program
Clinical Supervisor: Meera Balasubramaniam, M.D., M.P.H., Patrick Ying, M.D.

The Behavioral Health Program, the major outpatient psychiatry service at NYU Langone Medical Center, provides expert yet affordable treatment to individuals suffering from a broad range of mental disorders or emotional problems, including a large number of elderly patients, in a private-practice-like setting. The Fellow has an assessment and treatment caseload of patients suffering from late-life disorders, particularly those who can benefit from ongoing psychotherapy, and serves as a consultant for geriatric issues to psychiatric residents working in the Program. The Fellow learns about issues related to managing a practice, such as billing, coding, documentation and risk management. Additionally, the fellow meets with a faculty member from NYU’s Institute for Psychoanalytic Education for consultation on psychodynamic formulation and treatment of patients.

Learn to assess and make appropriate recommendations for medically ill patients co-existing neuropsychiatric problems:

Tisch Hospital Consultation Liaison Service
Clinical Supervisor: Jennifer Hanner, M.D., M.P.H.

Tisch Hospital is the acute-care facility of NYU Langone Medical Center. The Tisch Hospital Consultation Liaison service sees all adult medical and surgical patients who require a psychiatric consultation. More than half of the patients seen are elderly or at end-of-life. A full range of psychiatric and neuropsychiatric conditions are encountered, including co-occurring substance abuse, delirium, and patients in need of capacity evaluations. Interventions include biological and psychosocial evaluations, psychopharmacologic treatments, individual psychosocial treatments including some cognitive behavioral treatments, and involvement with family as a necessary extension of treating hospitalized patients. The Fellow performs supervised consultations of geriatric patients. The Fellow has the opportunity to participate in didactics including Psychosomatics Journal Club and Palliative Care rounds.

Additional Clinical Rotations

  • Movement Disorder rotation at NYU’s Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders
  • Palliative Care rotation at Tisch Hospital
  • Geriatric Medicine consultation rotation at Tisch Hospital
  • Neuropsychological Testing

Other Core Fellowship Faculty

  1. Dr. Robert Greenberg
  2. Dr. Ceri Hadda
  3. Dr. Daniel McGonigle
  4. Dr. Douglas Van Der Heide

Didactic Curriculum

CORE CURRICULUM IN LATE-LIFE PSYCHIATRY 
Weekly lectures covering the range of social, cultural, diagnostic, therapeutic, basic science, and health delivery issues. Relevant studies are reviewed and discussed, with focus on content as well as critical appraisal of the literature. This didactic includes the popular monthly Late-Life Psychiatry in the Community, when our Fellow visits professionals and agencies who serve important roles for older adults in the community.  
Sample topics include:

  • Assessing the Mature Adult Using Psychiatric Rating Scales
  • Normal Aging
  • Late-Life Anxiety Disorders
  • Late-Life Mood Disorders
  • ECT
  • Distinguishing between different types of Neurocognitive disorders
  • Agitation and Suspiciousness in the Elderly
  • Working with Families of Older Adults
  • Hoarding
  • Nutrition and Aging
  • Understanding Medicare
  • Neuroradiology in Geriatric Psychiatry
  • Psychotherapy with Older Adults
  • Ethical issues in Geriatric Psychiatry
  • Medicolegal and forensic issues in Geriatric Psychiatry
  • Coding, billing and documentation
  • Testifying as a Geriatric Psychiatrist

GERIATRIC PSYCHIATRY-MEDICINE INTERDISCIPLINARY CONFERENCE
Weekly interdisciplinary discussion of Bellevue Geriatric Clinic patients who have complex problems, such as medical and psychiatric diseases, social problems and nursing care problems. The emphasis is on diverse factors influencing patient care and compliance. Along with the Fellow, the Conference is attended by faculty and fellows in Geriatric Medicine as well as medical students and residents doing elective rotations in Geriatrics. 

NURSING HOME CASE CONFERENCE
Weekly (during rotation) interdisciplinary conference conducted at Coler Rehabilitation and Nursing Care Center. Nursing home residents with challenging psychiatric and behavioral problems as well as ethical dilemmas will be interviewed and discussed.

PSYCHIATRY GRAND ROUNDS
Weekly formal presentations of topics in psychiatry and health care conducted by the NYU Department of Psychiatry.

CONSULTATION LIAISON CASE CONFERENCE
Weekly didactic presentations and case discussions. The focus is on the interface between psychiatric morbidity and medical illness, end-of-life existential issues, cognitive impairment with behavioral disturbances, and ethical/legal issues.

BELLEVUE PSYCHIATRY CLINICAL CONFERENCE
Weekly interactive case conference. The focus is on clinical management of patients who have complex clinical, legal, ethical or systems problems.

SCHOLARLY PROJECT
With faculty support, our Fellows are required to develop at least one scholarly project a year. Theses have resulted in peer-reviewed publications and poster presentations at the annual meeting of the American Association for Geriatric Psychiatry.
 

Application Information

Eligibility

We look for superior applicants who must have completed an ACGME-accredited general psychiatry residency prior to entering the program, with very good evaluations. In selecting our Fellows, we consider such factors as leadership potential, writing ability, research experience, emotional maturity, and career goals.

Application materials for the upcoming training year may be submitted beginning April 15. The complete core application should be emailed in PDF form to Ms. Young-Nuzzi.

  • Please email all core application materials at once.
  • Submit to: Tanisha.Young-Nuzzi@nyumc.org
  • The subject line of this email should be: Geriatric Psychiatry Fellowship Application [APPLICANT LAST NAME, APPLICANT FIRST NAME]

Application Procedure

Please submit the following materials:

  • A completed application form (Download PDF) (Download DOC)
  • Your curriculum vitae/Resume
  • A personal statement about why you wish to train in this Fellowship (one to two pages)
  • A letter from your Medical School Dean
  • Photograph
  • International applicants must also submit a valid ECFMG certificate AND a proof of visa status OR of US citizenship
  • Letters of reference*

* Please arrange for a minimum of two (but not more than three) letters of reference from faculty who are familiar with the nature and quality of your work; one of those persons must be the Director of your General Psychiatry Residency Program. Letters of reference should be submitted directly by their authors to Ms. Young-Nuzzi. Electronic submission in PDF form is preferred

Applicant Selection

The program begins reviewing applications on April 15 and interviews are usually scheduled to take place through the summer. The Fellow is selected by early fall. No application is considered until all required materials have been received, including the Training Director’s letter of recommendation.

Applications are first reviewed by a screening committee who identifies those candidates who will be invited to interview. Interviews generally take a full day and include meetings with faculty representatives of several different rotations as well as a chance to meet the current Fellow.

A phone offer is made to the selected candidate, and an official letter of offer is issued upon acceptance of the position. However, the offer of employment is not final until the fellow has been successfully credentialed by the NYU Office of Graduate Medical Education. Terms of employment, including current year salary levels, benefits, duty hours, moonlighting policy, etc., may be found at http://med.nyu.edu/gme/policies-procedures.

For more information contact:

Meera Balasubramaniam, M.D.
Program Director, Geriatric Psychiatry Fellowship
Clinical Assistant Professor of Psychiatry
New York University School of Medicine
Meera.Balasubramaniam@nyumc.org

Tanisha Young-Nuzzi, M.A.
Senior Program Coordinator
NYU School of Medicine
Department of Psychiatry, 8th Flr.
1 Park Avenue, New York, NY 10016
(646) 754-5438
Tanisha.Young-Nuzzi@nyumc.org