The PGY1 (internship) consolidates learning from medical school and gives residents a solid foundation in clinical medicine, neurology, and psychiatry. It includes four months of internal medicine and one month of emergency medicine. During this year, interns also have two months of neurology, one of which is inpatient and one of which is on the consult service. During these months, our PGY1s are an integral and well-respected part of the medicine and neurology house staff.
Five months of the internship are spent in the department of psychiatry. PGY1s have two months on the inpatient general adult psychiatric services, one month in child psychiatry, one month in geriatric psychiatry and one month in addiction psychiatry. On each psychiatry rotation, residents receive one-on-one supervision by attending psychiatrists who guide them through these early, foundational experiences in psychiatry. In addition, during their months of psychiatry, interns have a full curriculum of introductory courses which are taught on Wednesday afternoons.
PGY1 residents rotate for one month on the Columbia Inpatient Psychiatry Service at Milstein Hospital of New York Presbyterian, a 24 bed inpatient unit located on 9 Garden North. It is a general inpatient unit with particular expertise in the treatment of affective and psychotic disorders, dual diagnosis, and complex medical/psychiatric problems. As the primary referral unit for the medical center, patients often present with complicated diagnostic and treatment dilemmas. During the rotation, each resident is paired with an attending psychiatrist and works closely with PGY4s doing senior electives, psychology interns, and Columbia third and fourth year medical students. Residents learn to work in a managed care setting (average length of stay about 14 days) and develop expertise in complex psychopharmacology, geriatric psychiatry, individual and group psychotherapy for affective illness and addiction, cognitive behavioral therapy for depressive and anxiety disorders, individual and family psychotherapy and electroconvulsive therapy.
PGY1 residents rotate for one month on 3 River East, a 30-bed, community inpatient unit at the Allen Hospital of New York Presbyterian. Given the public psychiatry mission of the Allen Hospital, residents admit geographically, ethnically and psychiatrically diverse populations. Patients often present with co-occurring psychiatric and substance abuse disorders as well as unstable medical conditions and numerous psychosocial stressors. The staff has particular expertise in the management of acutely ill patients with psychotic, affective, dual diagnosis, personality disorders and mental retardation as well as forensic histories. Each resident is paired with an attending psychiatrist and works closely with the multidisciplinary team and Columbia second year medical students. Residents learn to work in a short-term, public psychiatry setting and develop proficiency in the management of acute psychosis, mania, withdrawal, agitation and complex psychopharmacology. PGY1 residents also receive exposure to mentally ill and chemically addicted (MICA) groups, learn how to conduct supportive psychotherapy and run family and multidisciplinary team meetings in order to develop creative and appropriate treatment planning for this high-needs population.
PGY1 residents begin their exposure to child and adolescent psychiatry during a one month rotation through the Children’s Day Unit. The Children's Day Unit is an outpatient day hospital program that is a subdivision of Child Psychiatry at Columbia University College of Physicians and Surgeons, as well as a unit in the New York State Psychiatric Institute. It is both a clinical and research facility and a comprehensive evaluation and treatment program for children and adolescents ages 12-18 with a diversity of diagnoses including mood disorders, psychosis and eating disorders. Residents participate in the initial evaluation and subsequent treatment modalities including short-term individual and group psychotherapy, social skills training, recreational and art therapy and medication management if clinically indicated. Children and adolescents also attend classes on the unit which are taught by teachers from the NYC Board of Education. All patients seen by residents are individually discussed with on-site attending supervision.
PGY1 residents spend one month at the Columbia University Eastside location for training in the treatment of substance abuse disorders. This location houses a Day Treatment Program for patients with a variety of diagnosis including affective, psychotic, eating, personality and substance abuse disorders. PGY1 residents co-lead a twice weekly substance abuse group as well as daily general psychotherapy groups, and are involved in daily team rounds as well as specific weekly substance abuse rounds. Residents are also involved in the initial intakes into the day program as well as psychopharmacologic consultations with one of the attending psychiatrists at the program. Weekly didactics focus on clinical issues relating to substance abuse treatment. PGY1 residents also attend weekly meetings at the STARS clinic (Columbia’s Substance Treatment and Research Service) and gain exposure to active research efforts in the field of addiction psychiatry. Residents also have the opportunity to be trained in administering buprenorphine, one of the medications currently available to treat opioid addiction.
Geriatric Psychiatry on the Payne Whitney Manhattan Inpatient Service
PGY1 residents spend one month on the Payne Whitney Manhattan Inpatient Geriatric Service, a five-bed team for patients aged 65 and older, on a larger, mixed 32-bed unit. During this rotation, PGY1 residents work with an attending psychiatrist individually and care for up to five patients on the team. The rotation involves daily rounds and supervision from the attending, weekly didactic on a geriatric topic and other educational activities that occur on the mixed unit (such as professor rounds). Residents learn about a wide variety of psychiatric conditions common to the geriatric patient population, treatment principles (including psychopharmacology, psychotherapy, electroconvulsive therapy, group and family therapy) and approach to social and ethical challenges.