History and Description of Training Facilities: The Setting
The Columbia University Department of Psychiatry is located at the Columbia-Presbyterian Medical Center in northern Manhattan, part of an urban neighborhood that is ethnically and economically diverse in a city that has been called the capital of the world. The institutions which comprise the teaching facilities of the Department are described below.
The Columbia University College of Physicians and Surgeons
Now part of Columbia University, the College of Physicians and Surgeons was founded in 1767 and was the first school in North America to award doctoral degrees in medicine. 'P&S' has developed extensive new facilities over the past few years, including the Hammer Health Sciences Center - a 20-story structure housing an excellent medical library, amphitheatre and teaching facilities. The medical school is considered to be among the finest in America, and has traditionally been one of the nation's primary sources of academicians, investigators and clinical teachers.
The New York State Psychiatric Institute
The New York State Psychiatric Institute (NYSPI), established in 1895, was one of the first institutions in the United States to integrate teaching, research and therapeutic approaches to the care of patients with mental illnesses. In 1925, NYSPI affiliated with Presbyterian Hospital, adding general hospital facilities to the Institute's psychiatric services and research laboratories. These treatment, training, and research facilities were supplemented in 1983 by a 14-floor Psychiatric Research Building, the Kolb Annex.
The NYSPI was further modernized in 1998 by opening of a new hospital building to replace the original one. Overlooking the Hudson River and George Washington Bridge, the new Psychiatric Institute provides a state-of-the art environment for patient care, education, and research. The approximately 320,000 square feet offer space for 60 inpatient beds, 23 specialized outpatient research clinics, educational facilities, and research laboratories. Walkway bridges to and from the Kolb Annex and New York Presbyterian Hospital provide comfortable and efficient all-weather avenues for patient and staff travel within the Columbia University Medical Center.
Since its inception, NYSPI has been at the forefront of psychiatry, making major contributions to the clinical care and understanding of the mentally ill. Among these accomplishments are: the discovery of the spirochaetal origin of general paresis, the earliest use of lithium in the United States, the first data describing a genetic predisposition to schizophrenia, leadership in the discovery of the genes causing Huntington's and Wilson's disease, and the development of DSM-III, DSM III-R and DSM-IV.
Through the years, distinguished figures in American psychiatry have served as directors of the Psychiatric Institute, including Drs. Ira Van Gieson, Adolph Meyer, August Hoch, Lawrence Kolb, Edward Sachar and Herbert Pardes. It is now led by a noted academic psychiatrist, Dr. Jeffrey Lieberman. The excellence of the Institute is reflected in the rare perfect score received in the most recent hospital accreditation.
The New York Presbyterian Hospital
In 1921, the Presbyterian Hospital formed an alliance with Columbia University's College of Physicians and Surgeons, leading to the formation of the Columbia University Medical Center. This affiliation allowed for coordinating the care of the sick with the educational and research programs of the College. The core Presbyterian Hospital structure, adjacent to the NYSPI, is the 745-bed Milstein Hospital building, which has expanded the hospital's advanced medical procedures and its critical care capability. Other components of Presbyterian Hospital, each with its own history prior to joining the medical center complex, include the Morgan Stanley Children's Hospital, the Harkness Eye Institute, Sloane Hospital for Women, the Neurological Institute, and Vanderbilt Clinic. The Allen Pavilion, a 300-bed community hospital component of Presbyterian, is located at the northern tip of Manhattan. In total there are approximately 1,200 beds. Each year, over 46,000 patients are treated in the hospital and approximately 700,000 patients are seen in the outpatient clinics and doctors' offices. The professional staff consists of over 1,100 attending physicians, 500 residents and many clinical and research fellows.
Combining forces as leaders in the current healthcare marketplace, in 1999 Presbyterian Hospital merged with New York Hospital, a Cornell affiliate, to become New York Presbyterian Hospital (NYPH). NYPH has and will continue to have two major sites, with separate academic affiliations; ours is the Columbia Campus. Thus both the Columbia and Cornell Departments of Psychiatry conduct care in the different sites of NYPH. Our services and our training programs collaborate. In fact, the Child and Adolescent Psychiatry Residencies of Columbia and Cornell have combined. The Adult/General Psychiatry Residencies, however, are administratively and functionally independent.
Columbia University Medical Center offers superb primary care to the Washington Heights community and is also a tertiary care facility providing advanced specialty care. Psychiatric services at the Columbia campus of NYPH include 50 inpatient beds, an outpatient department with 100,000 visits/year, a comprehensive emergency service with 3,500 visits/year, a child psychiatric clinic, and a consultation-liaison service. Construction on a new inpatient unit was completed in 2002, and new child psychiatry facilities recently opened.
The Department of Psychiatry at Columbia has recently taken the initiative in developing its own clinical outpatient services, at times in partnership with other health care organizations. These services, not directly connected with either New York Presbyterian Hospital or the New York State Psychiatric Institute, respond to the growing managed care environment while maintaining high academic standards.
The Psychoanalytic Center for Training and Research
The Center, founded in the Department of Psychiatry of the College of Physicians and Surgeons in 1945, was the first psychoanalytic institute affiliated with the American Psychoanalytic Association to be established in a university medical school. This step was taken with the firm belief that psychoanalysis and medicine would each benefit through a close relationship and that a psychoanalytic training institute would be advantageously located in the department of psychiatry of a medical school, with access to patients, facilities, teaching programs, and research opportunities. The Center is located in the New York State Psychiatric Institute, and its large faculty teach and supervise psychoanalytic candidates, residents and other trainees.