PGY 1 Year
The first postgraduate year (PGY1 or internship year) 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. Six weeks of the internal medicine months are outpatient, two of which are treating general medical conditions of psychiatric patients in our own behavioral health clinics (in a “reverse integrated care” model). 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 six weeks on clinical research inpatient units treating patients with eating disorders and addiction. 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, attend weekly classes with their PGY1-4 colleagues, engage in a weekly residency wide meeting, have protected time for Grand Rounds, and have their own weekly process group.
Call Responsibilities for PGY1s
During PGY1, residents provide coverage during their blocks of medicine and neurology wards as outlined by the service on which they are rotating. During the 5 months of psychiatry and one month of neurology consult, residents have NO call responsibilities.
Washington Heights Community Service Inpatient Unit (PI - 4South)
PGY1 residents spend two 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 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 diverse community living in Washington Heights.
Geriatric Psychiatry at 9 Garden North (9GN) Inpatient Psychiatry
PGY1 residents have a month-long geriatric psychiatry experience at 9 Garden North, a 24-bed Columbia Inpatient Psychiatry Service at Milstein Hospital of New York Presbyterian. 9 Garden North is a general inpatient unit with particular expertise in the treatment of affective and psychotic disorders, dual diagnosis, and complex medical/psychiatric problems. The emphasis during this PGY1 experience on 9GN is on geriatric psychiatry patients with specific geriatric psychiatry supervision. Residents also spend two half days with supervised experiences in other settings (such as an integrated care clinic) working with attendings and fellows from the NYP geriatric psychiatry fellowship program. Combined this experience includes diagnosing and managing mental disorders in geriatric patients with co-existent medical disorders, diagnosing and managing degenerative cognitive disorders, and managing drug interactions, in addition to developing general skills in interviewing, developing treatment plans, conducting psychotherapy and managing psychopharmacology, and working with families. Note that residents also have a more general experience on this service for two months as PGY2s.
Primary Care in the Washington Heights Community Service Outpatient Clinic
PGY1 residents rotate for two weeks providing primary care services to patients at the Washington Heights Community Service (WHCS) outpatient clinics. WHCS is a provider of coordinated inpatient and community-based outpatient services for people in Northern Manhattan with serious mental illness. The interns are supervised daily by the WCHS a primary care nurse practitioner and have additional primary care supervision by a family medicine attending at Columbia University Medical Center. The interns meet weekly with a psychiatry attending and the WHCS director to better understand the intersection of the psychiatric and primary care needs of the patients. The psychiatry interns attend 4 hours of didactics weekly on assessment and management of medical conditions with the Family Medicine Residents. The interns learn assessment and management of common primary medical conditions that present in the ambulatory setting, preventative care, chronic disease management, how and when to refer to specialists, and effective communication with patients, family and within the multidisciplinary team.
Child Psychiatry at the Children's Day Unit
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. During the COVID-10 pandemic, much of this work is being done via telehealth. PGY1s will receive ample supervision on telehealth during this rotation.
NYPSI 4 Center/4 South - Inpatient Clinical Research Rotation
These NYSPI units conduct a variety of research programs in the study of substance misuse disorders in adults and eating disorders in adults and adolescents. 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 six-week rotation. Resident teaching is focused on evaluation and differential diagnosis, cognitive and psychodynamic psychotherapy, and an introduction to research methodology. This rotation will also serve as a platform for residents to learn about clinical research and will include didactics and mentorship about clinical research opportunities.