Combined Psychiatry/Neurology Program

Introduction

Psychiatry and neurology, long split from each other but sharing a common origin in the 19th-century neuropsychiatry practiced by Freud, Charcot, and Kraepelin, are becoming increasingly reunited with the advent of modern neuroscience. As new discoveries are made and disorders of mind and behavior are increasingly put in their neurobiological context, dually trained clinicians capable of providing complex and multifaceted neuropsychiatric care and driving neuroscience research will be essential.

Mission

The mission of the New York University Combined Residency in Psychiatry and Neurology is to provide a thorough, fully integrated training experience in psychiatry and neurology and, in so doing, to produce skilled clinicians capable of evaluating psychiatric and neurologic problems in the light of their full clinical context. Graduates of our program will be prepared to be academic leaders in the rapidly changing fields of psychiatry, neurology, and neuropsychiatry, as well as in the full range of subspecialties available from either field. Past graduates have gone on to specialize in epilepsy, multiple sclerosis, autonomic disorders, critical care palliative medicine, traumatic brain injury, and consultation-liaison psychiatry, among others.

NYU is home to a robust clinical neuropsychiatry community that spans both departments and that continues to grow, providing ample opportunity for resident research and mentorship. Our residents rotate at a wide range of high-caliber training sites, including historic Bellevue Hospital and the world-renowned NYU Comprehensive Epilepsy Center. The NYU combined residency provides a unique training opportunity for intellectually curious trainees interested in exploring and exploding the traditional boundaries of psychiatry and neurology in research and clinical practice.

The Training

The combined residency in psychiatry and neurology includes six years of coordinated training in the two disciplines and meets the Special Requirements for board certification in Psychiatry and Neurology as designated by the American Board of Psychiatry and Neurology. The combined residency enrolls one to two people each year. Training occurs at Tisch Hospital-NYU Langone Medical Center, Bellevue Hospital Center, The Department of Veterans Affairs New York Harbor Health Care System, and the Hospital for Joint Diseases. Most of these affiliated institutions are located close together to facilitate cohesion among the program's house staff, attendance at weekly clinics and integrated conferences, and faculty exchanges of curriculum, evaluation, administration, and related matters.

At the conclusion of six years of training in psychiatry and neurology, including an initial preliminary medicine year, trainees will be experienced in the prevention, detection, and treatment of acute and chronic psychiatric and neurological illnesses as they present in both inpatient and ambulatory settings, as well as in the socioeconomics of illness, the ethical care of patients, and the team approach to provision of patient care.

The six-year program is structured to encourage residents to begin integrating their psychiatry and neurology knowledge from an early stage. A weekly neuropsychiatry consultation clinic, supervised by Program Director Dr. Nadkarni and attended by all combined residents, begins in the PGY II year and provides regular exposure to clinical neuropsychiatric concepts. The PGY VI year is a capstone year, with at least eight months of elective time available for the senior combined resident to pursue further subspecialty exposure or a research project of her or his choice.

Program Director

Associate Program Directors

Program Coordinators

Psychiatry and Neurology Combined Program Training

 Year

 Description of Rotation

 1

This year includes 8 months of Internal Medicine plus 2 months of Inpatient Neurology and 2 months in the Comprehensive Psychiatric Emergency Program (CPEP) (12 months total).

 2

6 months Inpatient Adult Psychiatry: Tisch Hospital, Bellevue Hospital, VA Medical Center

2 months Inpatient Neurology Wards: Bellevue Hospital Ward junior, Tisch Hospital Ward and Stroke Unit/Step-down Unit junior, VA Medical Center Ward junior
1 month Bellevue Hospital neurology consult junior
1 month Comprehensive Epilepsy Center inpatient epilepsy monitoring unit
1 month night float
1 month elective
Neurology Adult Clinics twice a week while on Neurology, including a neuropsychiatry continuity clinic with Dr. Nadkarni

 3

2 months Inpatient Neurology Ward junior
1 month Neurophysiology (EEG, EMG)
1 month pediatric neurology
4-6 weeks Bellevue Hospital Neurology Consultation Service junior
2-4 weeks night float
Neurology Adult Clinics twice a week incluidng

3 months Inpatient Adult Psychiatry
1 month Inpatient Adolescent Psychiatry
1 month Inpatient Child Psychiatry
1 month consultation-liaison psychiatry

 4

Adult Outpatient Psychiatric Care (1/2 time throughout year).
1 month psychiatry night float

(Rotations performed half time when not senior)
3 months Neurology Ward Senior: Tisch Hospital and Bellevue Hospital
1 month Tisch Hospital Neuro-ICU
1 month FTE Child Neurology (2 months ½ time)
1 month Bellevue Hospital Stroke Consult senior
1 month subspecialty outpatient clinics: e.g. multiple sclerosis, movement disorders, neuro-ophthalmology, muscular dystrophy
1 month neurophysiology outpatient
2 months elective
Neurology Adult Clinics once a week

5

Adult Outpatient Psychiatric care (1/2 time throughout year)
1 month FTE Consultation-Liaison Psychiatry (1/2 time over 2 months)

2 months Bellevue Hospital Neurology Consultation Service Senior
1 month Bellevue Hospital Ward senior
1 month FTE Child Neurology (2 months ½ time)
1 month neuro-ICU night float
1 month subspecialty outpatient clinics
1 month pain management outpatient
2 months elective

 6

The final year of training includes at least 8 months of elective time (to be used for research, subspecialty exposure or to pursue special interests), 2 months equivalent of Outpatient Psychiatry (usually part-time throughout the year) and Neurology Adult Clinics once a week.

 Total

30 months (post internship) Psychiatry required rotations

30 months (post internship) Neurology required rotations

Please note: This schedule serves as a guideline; specific rotations may vary depending on service needs.

Neurology Training

During the 30 months of neurology, each resident has 18 months (or its full time equivalent) of clinical adult neurology with primary responsibilities in patient care. In addition, each resident has experiences with neurological disorders in children, consisting of three months (full time equivalent) in clinical pediatric neurology with primary responsibility for patient care. Residents are trained in neurological history and examination and differential diagnosis. Clinical exposure encompasses inpatient and outpatient experiences, as well as general and subspecialty neurology including behavioral neurology, epilepsy, movement disorders, and stroke. Indications for and interpretation of specialized diagnostic tests including CT, MRI/MRA, carotid doppler, cerebral angiogram, EEG/EMG, continuous video EEG monitoring, and radioisotope studies are also covered. In addition to patient care, each resident will obtain the basic science and background upon which clinical neurology is founded: neuroanatomy, neuropathology, neurophysiology, and the applications of genetics and epidemiology to neurological disorders.

Psychiatry Training

During the 30 months of psychiatry, each resident assumes significant responsibility for an appropriate number and variety of psychiatric inpatients for a period of 9-18 months. In addition, clinical experience includes at least one year (or its equivalent if done on a part-time basis) in an organized and well-supervised outpatient program that includes a wide variety of disorders, patients, and treatment modalities with experience in both brief and long-term care of patients using psychodynamic, cognitive-behavioral, and biological approaches. Other supervised clinical experiences include: evaluation and treatment of children, adolescents, couples and families; psychiatric consultation/liaison involving medical and surgical patients; 24 hour psychiatric emergency room service; community psychiatry including forensic or court evaluations; collaboration with other mental health professionals; experience with common psychological tests and procedures and clinical management of patients with alcoholism and drug abuse including detoxification and long term management.

Research

As our knowledge expands, the traditional boundaries between psychiatry and neurology are breaking down. The need for interdisciplinary research and researchers with interdisciplinary understanding of psychiatric and neurological disorders is expanding every year. A wide range of research in clinical psychiatry, neurology, and the fundamental neurosciences takes place at NYU and affiliated programs and residents in the Psychiatry-Neurology joint program are expected to participate in some research activity during the course of their residency training.

Core Curricular Requirements

Residents usually enter the combined program at the PGY-1 year and spend their first year primarily on the medicine services at Bellevue, Tisch and the VA Hospitals. Under certain circumstances, residents may be accepted into the program at the PGY-2 level after completing a preliminary medicine year in another ACGME accredited training program. Training in psychiatry and neurology incorporates progressive responsibility for patient care, supervision and teaching of medical students and junior residents.

The curriculum assures a cohesive, planned educational experience and does not simply comprise a series of rotations between the two specialties. At the NYU School of Medicine, we have made every effort to develop an integrated program. Although the first three years consist of full-time rotations in each discipline, years 4-6 provide the resident in the combined program with simultaneous training in psychiatry and neurology. Elective time is available to pursue particular areas of clinical interest and basic or clinical research. Trainees will also fully participate in the didactic curriculum in each department as well as in special seminars devoted to integration of the two fields. All residents will meet quarterly with the co-directors of the program to evaluate their progress and to provide feedback about the program to the directors. A block diagram of residency rotations can be found under Psychiatry and Neurology Combined Program Training.

Evaluation and Certification

Periodic evaluation of the education progress of each resident is performed and discussed with the resident biannually. Included in this evaluation are an assessment of the resident's clinical skills, fund of knowledge, and professional and personal development.

The written certifying examinations in each specialty are taken after all required years of training in each specialty are satisfactorily completed.

Application Procedure

Applications are accepted for one-two positions in a six-year program, which includes a categorical psychiatry internship followed by five years of post-internship training.

All applications to the New York University School of Medicine Department of Psychiatry and Neurology Residency Training Program are accepted through the Electronic Residency Application Service (ERAS).  This includes the following:

  • Curriculum Vitae
  • Personal Statement
  • Dean’s Letter
  • Official Medical School Transcript
  • Three Letters of Recommendation

International Medical Graduates must also submit the following documentation:

  • Valid ECFMG certificate
  • USMLE scores, Parts I and II, no minimum score requirement
  • Proof of Visa status or US citizenship

NYU is able to consider applicants with J-1 and H-1 Visas; however, please note that for H-1 Visas, applicants must have passed all three steps of the USMLE exam at the time of application. 

Applicant Interviews

Interview days are from October to the beginning of February. The Residency Training Office will contact all applicants accepted for interviews. During the interview day you will have the opportunity to tour our facilities, meet with residents, and spend time with the training directors. All applicants are also welcome to return on a regular working day to attend classes, go to grand rounds or spend time with faculty or any service they are most interested in.

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.