The second year of training (PGY2) offers a rich and diverse exposure to psychiatric illness and treatment through rotations in inpatient, outpatient, emergency and consultation liaison psychiatry. Inpatient rotations include four months on the community service at NYSPI, one month on an inpatient general adult psychiatric service, and one month on our specialized eating disorders inpatient research unit. PGY2 residents also spend two months in the Comprehensive Psychiatric Emergency Program (CPEP) working as part of a team evaluating patients in a busy urban adult psychiatric emergency room and two months on the Consultation Liaison Psychiatry service at New York Presbyterian Hospital. Additionally, PGY2 residents spend an additional month working in the child CPEP and Consultation service. During the year, PGY2 residents share night float responsibilities and weekend call admitting and covering the inpatient services of NYP and NYSPI. As in the first year of training, PGY2 residents receive substantial faculty supervision in psychotherapy and psychopharmacology in each clinical setting.
A highlight of the PGY2 is the Long Term Therapy (LTT) program. PGY2 residents are assigned outpatients for treatment with twice weekly, long-term psychodynamic psychotherapy. The residents are closely supervised on these cases by psychoanalysts from the clinical faculty. A theory and case-conference course for PGY2 residents augments this work.
The PGY2 also includes daily didactic sessions that include coursework in psychiatric interviewing, neuroscience, pathophysiology, psychotherapy, ethics, community psychiatry and others. The core curriculum in the PGY2 stresses a thorough understanding of the clinical syndromes and the biologic, psychological, familial and cultural factors that influence patients. Residents also develop sophisticated interviewing techniques for diagnosis and treatment. The integration of these clinical experiences with the core curriculum provides the essential foundation for each PGY2’s professional development.
Call Responsibilities for PGY2s
During the year, PGY2 residents share night float responsibilities and weekend call admitting and covering the inpatient services of New York Presbyterian and New York State Psychiatric Institute.
Washington Heights Community Service Inpatient Unit (PI-4South)
PGY2 residents spend four months on the Washington Heights Community Service, a state-funded urban community mental health center which provides a comprehensive system of inpatient and outpatient care for the seriously ill patients in Washington Heights. Residents treat acutely ill patients on the NYSPI inpatient unit as part of a team, and work closely with the patients' families and outpatient case managers to ensure a smooth return to the community. The average length of stay is ample, usually three to four weeks. A program on cross-cultural psychiatry focuses on the Latino community living in Washington Heights.
9 Garden North (9GN) Inpatient Psychiatry
PGY2 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.
NYPSI 4 Center - Inpatient Eating Disorders Research Unit
This NYSPI unit conducts a variety of research programs in the study of eating disorders in adults and adolescents. Recent research has focused on studying phenomenological and biochemical changes associated with suicide and eating disorders, and investigating new treatments. Research patients do not pay for their care. The average length of stay for patients is two to three months, which allows residents to work with patients intensively during their month rotation. Resident teaching is focused on evaluation and differential diagnosis, cognitive and psychodynamic psychotherapy, and an introduction to research methodology.
Adult Consultation-Liaison Service
PGY2 residents rotate for two months on the adult Consultation-Liaison Service at NYPH, one of the oldest and largest departments in the country. Residents are trained in a wide spectrum of psychological and pharmacological techniques. Special emphasis is directed towards treating patients with a variety of medical and surgical illnesses and in working in the consultative mode with patients and their physicians. Residents also gain experience in forensic issues, especially capacity assessments. Residents participate in daily clinical rounds run by an attending psychiatrist. These rounds serve as direct, case-oriented educational experiences. Residents have the opportunity to teach non-psychiatric house staff and learn how to conduct case conferences. Each week there is an active schedule of lectures and case presentations covering a variety of topics in general psychiatry as it impacts the medical setting.
Adult Comprehensive Psychiatric Emergency Program (CPEP)
PGY2 residents rotate for two months in the Comprehensive Psychiatric Emergency Program (CPEP) where they gain proficiency in diagnostic interviewing and treatment of acute psychiatric emergencies. During this rotation, residents are trained in the evaluation and treatment of patients whose problems range from substance induced psychosis to family crisis. This emergency room setting is unique in that patients are able to stay for up to 72 hours, allowing time for a thorough evaluation and the best treatment and disposition.
Pediatric Psychiatry Emergency Service and Immediate Treatment Clinic
PGY2 residents rotate for one month on the Pediatric Psychiatry Emergency Service in the Morgan Stanley Children’s Hospital of NYPH. Residents work on a team with the first-year Pediatric Psychiatry fellows where they are trained in diagnostic interviewing of children and adolescents, focused family work and integrating information from broader systems of care. Educational activities include daily Emergency Psychiatry Rounds, weekly attending rounds on the Consultation-Liaison service and weekly Case Conference. Additionally, residents follow one child or adolescent patient in the Immediate Treatment Clinic (ITC), a rapid linkage clinic located within the Pediatric Psychiatry Outpatient clinic.