During the fourth year (PGY4), residents continue to see outpatients and to receive psychotherapy and psychopharmacology supervision, helping them to consolidate their learning in these areas. Didactics and the weekly process group continue, which help to maintain a sense of class cohesion. PGY4 residents share day-call on the consultation liaison service of NYP on weekends and holidays. In addition the year is designed to allow residents the maximum flexibility in pursuing special interests with 80% time available for electives. The range of electives is exceptionally broad and may be tailored to suit individual needs. Residents who are interested in research careers may elect to use some or all of the year to immerse themselves in a research project under the tutelage of a member of the faculty. Research opportunities are available in both clinical and basic science research. Many residents choose to serve as junior attendings on one of the inpatient units or in outpatient clinics or consultation liaison service. Other recent electives have included senior rotations at the undergraduate student health center, the psychoanalytic center, the women's mental health center, and mental health clinics for the homeless. All residents teach medical students through a small group preceptorship. Additional electives are also available in medical student teaching and in how to plan and teach a course. This year solidifies the residents' psychiatric knowledge and skills, and helps them to prepare for their future psychiatric careers.