Post-graduate year one (PGY-I), the internship year of the program, is evenly divided between medicine/neurology and psychiatry.
Each PGY-I resident spends 6 months on a selection of clinical services in medicine and neurology at NewYork-Presbyterian Hospital and Memorial Sloan Kettering Cancer Center. While on these rotations, residents work side-by-side with residents from the departments of Internal Medicine, Emergency Medicine, and Neurology, and participate in all of the clinical, supervisory and educational activities of those departments. In each clinical setting, residents treat severely ill patients and work with patients and their families during times of crisis. By the end of the PGY-I year, the resident will be familiar with the assessment, diagnosis, and management of basic medical and neurological conditions. He/she will also be proficient in ACLS and BLS, and comfortable with management of medical and neurological emergencies at a basic level of care.
11 weeks: Medicine – NewYork-Presbyterian Hospital; Memorial Sloan Kettering Cancer Center
8 weeks: Neurology – NewYork-Presbyterian Hospital; Memorial Sloan Kettering Cancer Center
4-5 weeks: Emergency Medicine – NewYork-Presbyterian Hospital
Each PGY-I resident spends six months of the year working on clinical services in psychiatry. A majority of clinical rotations in the PGY-I year occur at Weill Cornell’s Westchester Division, the second-oldest free-standing psychiatric hospital in the country. Situated on 200 acres in bucolic Westchester county, the Westchester Division houses approximately 250 inpatient psychiatric beds for children, adolescents, adults, and the elderly. Our PGY-I residents rotate through Westchester Division services including Geriatric Psychiatry, Inpatient Psychotic Disorders, Child Psychiatry, Adolescent Psychiatry, Eating Disorders and the “Second Chance Unit,” and are supervised by nationally- and internationally-renowned faculty. PGY-I residents have a selective rotation for which they may choose among Inpatient Child Psychiatry, Inpatient Adolescent Psychiatry and Inpatient Eating Disorders. During the inpatient geriatric psychiatry rotation, residents receive hands-on training in the administration of ECT. Finally, each PGY-I resident rotates through the Psychiatric Emergency Department at the Manhattan campus. PGY-I on-call responsibilities occur during evenings on the inpatient services at NewYork-Presbyterian Hospital or at the Westchester Division.
4-5 weeks: Geriatric Psychiatry Inpatient Service/ECT – NYP/Westchester Division
4-5 weeks: Acute Schizophrenia Unit – NYP/Westchester Division
4-5 weeks: Second Chance Unit (Chronic Schizophrenia Unit; novel token economy)
4-5 weeks: Psychiatric Emergency Department – NewYork-Presbyterian Hospital/Payne Whitney Manhattan
3-4 weeks: Psychiatry Selective (Inpatient Child, Inpatient Adolescent, or Inpatient Eating Disorders) – NYP/Westchester Division
2-3 weeks: Night Float - NewYork-Presbyterian Hospital/Payne Whitney Manhattan
The PGY-1 curriculum at Payne Whitney is designed to develop practical knowledge and skills essential to inpatient and emergency psychiatry. The curriculum consists of a 6-month weekly course on the anatomy of the psychiatric interview. The beloved course is considered a quintessential rite-of-passage within the residency program. It involves both didactic and experiential components, with resident psychiatrists performing observed interviews with inpatients under the direct supervision of a senior psychiatrist and psychoanalyst on faculty.
In addition to this psychiatric interview series, the second part of the curriculum is dedicated to case-based reviews of major psychiatric syndromes and treatment modalities relevant to hospital psychiatry, including discussions of schizophrenia-spectrum disorders, personality disorders in the inpatient setting, and two-day "boot-camps" for major classes of psychotropic medication and psychotherapeutic modalities. There are also introductory courses to core clinical skills, including psychiatric formulation and risk assessment.
These didactic experiences are complemented by rotation on unit-specific learning and scholarly activities run by each specialized inpatient unit at the NYP/Westchester Division, including acute psychosis, eating disorders, geriatric, child/adolescent, and our long-term token economy unit for chronically institutionalized patients.
In addition to this curriculum, all interns participate in a Process Group that provides a space for PGY-I's to begin to reflect upon their own experiences during residency, both as psychiatrist and as people, to lay the goundwork for the formal process group (known as e-group) that begins the PGY-II year. At Weill Cornell, we feel as though getting to know and understand ourselves is critical to our work as psychiatrists - and one of the more exciting and challenging parts of the job. Therefore, we consider process group to be the invaluable tool needed as we face this challenge.
In addition to the daily supervision provided by attendings and senior residents during clinical rotations, each intern participates in group supervision with the PGY4 residents; each semester, there are three meetings where the interns and all PGY4s meet together and/or in individual pairs to discuss complex cases and other challenging clinical scenarios. Furthermore, once per month, interns participate in “Chief Rounds,” where they meet with one of the chief residents to further explore clinical cases.
Although they are dispersed throughout our hospital, we make sure to keep in contact with our PGY-I’s through weekly program-wide Friday lunches, as well as quarterly PGY-I dinners with the educational leadership. These meetings foster community in our residency, providing an opportunity for trainees to share experiences and develop group cohesion. All PGY-I’s are connected with an upper-class “buddy” to help with their orientation and connection.