PGY 3 Year

The third year of training (PGY3) marks a transition for our residents as they shift from working primarily in inpatient settings to primarily outpatient settings and begin to function independently as psychiatrists. Each PGY3 (and PGY4) resident has an office in the Residency Education and Training Suite on the 1^st floor of the New York State Psychiatric Institute and is given primary responsibility for patient care with individual supervision from faculty. Most of their patients will be from the Psychiatric Institute Resident Clinic (PIRC).

Residents are trained in many forms of outpatient treatment during the third year, including advanced psychopharmacology and multiple psychotherapeutic modalities, including cognitive behavioral, interpersonal, dialectical-behavioral, supportive, and psychodynamic psychotherapy. We take pride in the quality and amount of supervision provided to PGY3 residents in these modalities. In addition to supervision, residents have daily didactic sessions building on themes first explored as PGY1s and PGY2s. Twenty percent of the year is set aside as a selective. During this time, residents may pursue a specific research interest or receive more intensive training in college mental health (at Columbia University College Psychiatric Services), public psychiatry (at clinics of the Washington Heights Community Service), or psychotherapy (learning Interpersonal Psychotherapy and Dialectical Behavioral Therapy).

During this longitudinal experience, residents gain expertise in understanding the outpatient and community continuum of care. Learning how to manage acute outpatient crises, rapid stabilization, and linkage to ongoing care requires an understanding of the importance of the social determinants of health and network of psychiatric services. PGY3s learn to formulate a treatment plan in collaboration with the supervisor and patient to reduce acute symptoms, ensure safety, and optimizing individual functioning. Residents also learn how the unique contributions of gender, sexuality, medical complexity, and culture affect evaluation and treatment. Residents work within multidisciplinary teams to provide intensive treatment to high-risk/ high acuity patients and participate in weekly rounds. As part of the outpatient experience, residents learn how to establish a therapeutic alliance and set a treatment frame. Residents also learn the tenets of recovery-oriented treatment, including person-centered care, shared decision making, cultural humility, and fostering patient agency.

Call Responsibilities for PGY3s

During the third year, residents share night team and weekend call with on-site supervision from an attending physician at the New York Presbyterian Hospital Psychiatric Emergency Room.

Psychiatric Institute Resident Clinic (PIRC)

The Psychiatric Institute Resident Clinic (PIRC), located in the New York State Psychiatric Institute, is a free clinic that offers residents the opportunity to see patients in myriad therapeutic modalities, including advanced psychopharmacology and multiple psychotherapies (cognitive behavioral, interpersonal, dialectical-behavioral, supportive, and psychodynamic psychotherapy). Individual supervision and team meetings are a hallmark of this clinic. We take pride in the quality and amount of supervision provided to PGY3 residents in each of these modalities. 

Adult Outpatient Community Psychiatry Clinic (PB2)

A subset of PGY3 residents also rotate through the Adult Outpatient Community Psychiatry Clinic at NYP, where they learn about the rich tapestry of community and cultural services within Northern Manhattan. The clinic offers comprehensive and diverse outpatient services to a predominantly Hispanic community in Washington Heights/Inwood population as well as those receiving care at the CUIMC Medical Center.  Residents have the opportunity to treat a wide range of diagnostic disorders including anxiety, bipolar, depression, psychosis, trauma, personality disorders, and psychiatric comorbidities with medical conditions.   In the spirit of community and public psychiatry, residents learn about hospital and community resources to address social determinants of mental health including transportation, finances, housing, and other barriers to care. Residents gain expertise in evaluating and treating patients using telepsychiatry/tele mental health interventions and the spectrum of clinic to community care.

Washington Heights Community Service Outpatient Clinics (WHCS)

A subset of PGY3 residents are assigned to the outpatient clinics of the Washington Heights Community Service, a comprehensive community-based mental health treatment service for individuals diagnosed with serious mental illness who live in or near Northern Manhattan. The mission of the service is to provide culturally responsive, recovery-oriented, evidence-based treatment of the highest quality to those we serve.  Residents work as part of a multidisciplinary team and work closely with the patients' families and outpatient primary clinicians to ensure outstanding community care. The clinics include the Audubon Clinic, the Inwood Clinic, and OnTrackNY.

In collaboration with Primary Clinicians and other members of the team, residents provide direct care to a panel of patients with severe mental illness, including primary psychotic disorders. They work with existing clinic patients as well as new admissions to the clinic and have the opportunity to prescribe and manage long-acting injectable medications (LAI, antipsychotics) and clozapine. Depending on resident interest, they may also be involved in home visits, group work, or quality improvement projects.