Psychosomatic Medicine Fellowship

Program Director: Mark Bradley, MD

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About the Program

The NYU Fellowship in Psychosomatic Medicine provides its graduates with the clinical experience, expert skills, and fund of knowledge to function as leaders of psychiatric services for medically complex patients. The one-year program is fully accredited by the ACGME and offers three positions. With completion of the program, graduates are eligible to sit for subspecialty boards in Psychosomatic Medicine. Our clinical training sites span an extraordinary breadth of culture, socioeconomic status, and models of healthcare delivery: Bellevue is New York City’s largest public hospital, while NYU Langone is a private, non-profit university hospital, and the Manhattan VA is part of a large national healthcare system for active duty and former military personnel.

The fellowship has been in existence since 1993, and for its first 15 years was located within Bellevue Hospital. In 2008, the Consultation-Liaison Psychiatry services at NYU Langone and New York Veterans Affairs Hospital joined Bellevue Hospital to develop a unique multi-site training program. Our clinical training sites span an extraordinary breadth of culture, socioeconomic class, and models for healthcare delivery: Bellevue is New York City’s largest public hospital, while NYU Langone is a private, non-profit university hospital, and the Manhattan VA is part of a large national healthcare system for active duty and former military personnel.

Fellows spend four months as part of the inpatient CL team at each facility, providing psychiatric care which is integrated with inpatient medical and surgical services. Additionally, fellows spend one or two half-days per week while at each site in ambulatory care settings, which include HIV, Primary Care, Women’s Health, Behavioral Neurology, Oncology, Multiple Sclerosis, and Survivors of Torture clinics. Our graduating fellows consistently report that the diversity of clinical settings and wide range of teaching faculty expertise are particular strengths of the program.

Fellowship Rotations

SITE: BELLEVUE HOSPITAL (Four Months)

Teaching Faculty:

Founded 250 years ago, Bellevue Hospital Center is the oldest public hospital the United States and the largest hospital in the New York City public system. Bellevue has a culturally rich and highly diverse patient population representing nationalities and ethnic groups from around the world. It houses a vast array of clinical services and is staffed with a large and well-trained faculty with a diversity of interests.

Inpatient Rotation: Consultation-Liaison Service
Clinical Supervisor: Andrea Kondracke, MD

The CL psychiatry team at Bellevue comprises faculty with multiple areas of expertise and training, including psychosomatic medicine, double-board medicine/psychiatry, addiction psychiatry, reproductive psychiatry, and psycho-oncology. The service is overseen by Dr. Andrea Kondracke, Chief of the Bellevue Divisions of Consultation-Liaison Psychiatry & Medical Services for Psychiatry, who is both an internist and a psychiatrist by training. In addition to conducting inpatient consultations to numerous specialty services under faculty supervision, fellows also participate in all clinical and educational activities, including supervision of PGY-2 and -4 residents and medical students, teaching rounds, and case conferences. During his or her rotation, each fellow presents at Bellevue Grand Rounds.

Outpatient Rotation: Virology Clinic
Clinical Supervisor: Joseph Lux, MD

The challenging and complex mental health needs of people with HIV are best served within models of integrated care. While on this rotation, the Psychosomatic Medicine fellow functions as a member of the Bellevue Hospital Virology treatment team, and provides expertise in the diagnosis and management of mood, anxiety, cognitive, psychotic and personality disorders; antiretroviral treatment adherence; HIV-related stigma; assessment of decision-making capacity; palliative care; and neuropsychiatric side effects of antiretrovirals and antibiotics. Fellows are supervised by Dr. Joseph Lux, who is trained in internal medicine, infectious diseases, and psychiatry. There is also an opportunity to participate in ongoing HIV psychiatry academic initiatives.

Nearly half the patients receiving HIV care at this clinic have a psychiatric disorder. The clinic’s target population is heterogeneous, with diverse cultural norms and values. Patients often speak of the ‘double stigma’ of HIV and psychiatric illness as a barrier to care. Furthermore, despite decreases in HIV-related dementia resulting from highly active antiretroviral therapy, the prevalence of memory and cognitive symptoms remains significant. Bellevue’s HIV-positive patients also have a high rate of hepatitis C co-infection, which may contribute to neuropsychiatric changes and added treatment complexity..

Outpatient Rotation: Survivors of Torture Program
Clinical Supervisor: Asher Aladjem, MD

The Program for Survivors of Torture elective provides fellows with an in-depth exposure to an ntegrated care, interdisciplinary model of refugee health. Fellows participate in the initial intake process, provide psychopharmacologic evaluations and treatment, and provide ongoing group or individual therapy with cross-cultural and trauma themes. All activities are accompanied by supervision and guidance. Fellows interested in forensics may also participate in the creation of
affidavits and serve as expert testimony during the political asylum process.

The four-month elective is three hours/week. This may involve psychopharmacologic management and/or individual or group therapy as appropriate. The resident may also design a 4-month research project/literature review using the program’s database and patient records, pending prior approval.

Outpatient Rotation: Reproductive Psychiatry/Women’s Health Center
Clinical Supervisor: Sarah Kim, MD

Psychosomatic Medicine fellows pursuing this elective spend one-half day per week over four months in the Women’s Health Center at Bellevue Hospital Center, which provides prenatal care for approximately 120 new women per month. Patients are referred for mental health treatment by their on-site OB/GYN clinician. During this rotation, fellows develop expertise in the assessment and treatment of psychiatric symptoms that occur during the perinatal period, particularly among underserved, minority and lower-income women. Fellows also see patients with psychiatric disorders associated with the menstrual cycle, pregnancy, and the postpartum period. Participants in the rotation are also welcome to attend a weekly interdisciplinary reproductive psychiatry journal club led by Dr. Cathy Kondas, Director of Women’s Mental Health at Bellevue, and program director for the NYU Fellowship in Women’s Mental Health.

SITE: VA NEW YORK HARBOR MEDICAL CENTER (Four Months)

Teaching Faculty:

The New York VA is an integrated system of healthcare for former and active duty military personnel, providing full continuity of inpatient and outpatient primary and specialty services. The facility is the primary point of care for veterans who served across multiple military periods, including World War II, the Korean and Vietnam Wars, and the conflicts in Iraq and Afghanistan, with specialized programs for PTSD, military sexual trauma, substance use, and women’s health. The VA has an aging population with a high prevalence of dementias, delirium, post-stroke psychiatric sequelae, and other problems commonly seen in older persons. In addition, the New York VA Hospital serves as a regional hub within the VA system for neurosurgical and cardiothoracic surgical services, with frequent consultation related to the specific neuropsychiatric problems that develop in these populations. This site has strong divisions of neuropsychology, health psychology, pain medicine, and neurology, with whom the fellows interface closely. At the VA, fellows also use one of the most advanced electronic medical record systems in the world.

Inpatient Rotation: Consultation-Liaison Service

The VA Consultation-Liaison service includes fellows in Psychosomatic Medicine, residents in psychiatry and neurology, fellows in pain medicine, and post-doctoral fellows in health psychology. Under close faculty supervision and support, the Psychosomatic Medicine fellow functions as the team leader, overseeing the daily operations of the service, as well as the educational activities of junior trainees. In this process, fellows develop progressive confidence in leading a CL psychiatry service. Weekly clinical neuropsychology and neuroimaging teaching rounds are held on Friday mornings. In addition, the fellow is also supported in pursuing quality improvement and research activity related to their work on the service.

Outpatient Rotation: Primary Care-Mental Health Integration (PC-MHI)
Clinical Supervisor: Mark Bradley, MD

The PC-MHI program provides screening, detection, and early intervention for common mental health disorders in primary care. In the model of “immediate, co-located and collaborative care,” primary care providers and nurses screen for common mental health conditions, and a multidisciplinary mental health team on-site provides same-day mental health assessment,, timely comprehensive evaluation, brief individual and group treatments, and outside referrals as indicated. The approach emphasizes accessibility and reduction of stigma in order to reduce barriers to psychiatric care.

Target disorders for the program include depression and anxiety, post-traumatic stress, and alcohol use disorders. Additional areas of focus include traumatic brain injury, smoking cessation, cognitive disorders, and psychological adaptation to chronic illness.

The population served is highly varied, and includes women veterans and younger veterans returning from active military duty in Iraq and Afghanistan. While the majority of referrals come from primary care, a substantial number also come from medical specialty areas such as HIV, transplant, neurology and pain management. The fellow in primary care conducts new evaluations and short term follow-up, focusing on patients with psychiatric symptoms co-morbid with chronic medical diseases. This rotation occurs for one half-day weekly, for four months.

SITE: NYU LANGONE MEDICAL CENTER (Four Months)

Teaching Faculty:

Inpatient Rotation: Consultation-Liaison Service, Tisch Hospital

Tisch Hospital, a tertiary care center with 705 beds, draws patients from the community and around the world. Fellows work closely with faculty to provide psychiatric consultations across all inpatient medical/surgical units as well as the Rusk Institute for Rehabilitation. Fellows benefit from the experience of training in a private, not-for-profit university hospital, with a unique patient population and state-of-the-art medical services.  General psychiatry residents, medical students, and a geriatric psychiatry fellow also rotate on the service.

Outpatient Rotation: Clinical Cancer Center
Clinical Supervisor: Jane Rosenthal, MD, FAPM

The Laura and Isaac Perlmutter Center Center, which is an integral part of the NYU Langone Medical Center, is an National Cancer Institute designated Cancer Center.  The Center has been fortunate to continue to recruit top-notch researchers whose work is translated here, as well as outstanding clinicians, allowing our patients to participate in state-of-the-art cancer treatment.  Patients receive most of the care they need in our outpatient locations on 34th and 38th streets, near the main campus of Tisch Hospital, but our presence is extending through Brooklyn, Queens, and Long Island as the NYU Langone enterprise expands. 

The Perlmutter Cancer Center’s Medical Psychosocial Services provides emotional and practical support services to enhance the quality of life for patients living with cancer, their family members, loved ones and caregivers. Psychiatrists work closely with the Center social workers to identify patients in need, providing psychiatric evaluations and referrals, crisis intervention, psychopharmacological assessment and treatment, counseling, clinical staff training, and patient seminars and workshops.  Psychiatrists also collaborate with pain management and palliative care, provide physician and clinical staff consultation, and help to coordinate inpatient services when patients are hospitalized at Tisch. Fellows spend one-half day per week for four months, on site in Perlmutter Cancer Center’s Psycho-Oncology Program at 34th Street.

Outpatient Rotation: Behavioral Neurology Clinic
Clinical Supervisor: Siddhartha S. Nadkarni, MD

During their rotation in the Behavioral Neurology Clinic at NYU, Psychosomatic Medicine fellows are supervised by Dr. Sid Nadkarni, who is trained and boarded in both neurology and psychiatry, and serves as program director for the NYU Neurology/Psychiatry double-board residency. Fellows work alongside neurology/psychiatry double-board residents who also rotate in the clinic. Referrals are primarily made to this specialty clinic from neurologists and psychiatrists, and comprise neuropsychiatric diagnostic challenges, or individuals requiring comprehensive neurologic/psychiatric care.  As such, the clinic sees patients with movement disorders, conversion disorders, epilepsy, psychosis, mood disorders, anxiety disorders, brain injuries, developmental delays/autism, dementias, strokes, tumors, tics/Tourettes, encephalitides (autoimmune and otherwise,) among a host of other issues, and often in combination.  The clinic sees patients across the life cycle from children to the elderly.  

Outpatient Rotation: Multiple Sclerosis Center 
Clinical Supervisor: Erik Charlson, MD
 
The NYU Multiple Sclerosis Comprehensive Care Center is a unique multispecialty care center for patients with MS. The faculty include two double-boarded psychiatry/neurology-trained physicians who offer neurologic and psychiatric care for MS patients from across the region. The clinic sees a broad range of mood, anxiety and cognitive disorders in the MS context. Treatment approaches for MS are also integrated into most visits. Rotators will have the opportunity to correlate cognitive and affective symptoms with imaging, as well as to learn about neuropsychiatric symptoms  associated with disease-modifying treatments used in MS. There is also a focus on involving social support and other modalities in the treatment of MS-related psychiatric conditions. The clinic is supervised by Dr. Erik Charlson, who completed residencies in psychiatry and neurology, and subspecialty training in psychosomatic medicine.

Didactic Curriculum

The weekly fellowship didactics seminars provide fellows with of the theoretical foundation and fund of knowledge required to become experts in the psychiatric care of medically ill patients. In addition to the core CL faculty, teaching faculty come from multiple specialty areas from across the NYU Langone Medical Center, including reproductive psychiatry, neurology, neuropsychology, neuroradiology, health psychology and addiction psychiatry, among others. Core didactics sessions focus on the management of psychiatric syndromes in the medical setting, acquisition of scholarship competencies, and the development of best practices at the systems level. Additionally, each of the three CL teaching services incorporates its own unique set of weekly academic conferences and teaching rounds. Fellows also attend weekly Psychiatry Grand Rounds at NYU.

Application Information

Eligibility

We have 3 positions available for each academic year. We look for mature, motivated applicants who have satisfactorily completed an ACGME-accredited general psychiatry residency prior to entering the program. NYU does not discriminate with regard to race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity or expression,  or any other applicable legally protected status.

Application Procedure

Application materials for the upcoming training year may be submitted beginning May 1st. Interview dates will begin in September 2017, and typically finish by mid-November.  Applicants in Psychosomatic Medicine should apply through the NRMP Specialties Match Program. ERAS applications will not be used. 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: Psychosomatic Medicine Fellowship Application [APPLICANT LAST NAME, APPLICANT FIRST NAME]

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 proof of Visa status or US citizenship
  • Letters of reference*

* Please arrange for a minimum of two (but not more than three) letters of reference from persons who are familiar with the nature and quality of your work; one of those persons must be the program 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.

*We also accept the APM Common Fellowship Application, which can be found at:
http://www.apm.org/career/common-app-pm-fellowship.shtml. Kindly note that we will still ask you to supplement the Common Application with Page 2 of the NYU Application Form.

Applicant Selection

The program begins reviewing applications in May and interviews are usually scheduled to take place in late summer/early fall, completing by mid-November, No application is considered until all required materials have been received, including the training or clinical director’s letter of recommendation. Applications are reviewed by a screening committee which identifies a list of short listed 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 current Fellows.

An 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.

Contact Information

Mark Bradley, MD
Program Director, Psychosomatic Medicine Fellowship
(212) 686-7500, ext. 7180
mark.bradley2@va.gov

Tanisha Young-Nuzzi, MA
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