The goal of the PGY-IV year is to facilitate the transition to the roles of independent clinician, teacher, administrator and scholar/researcher. By offering a large amount of choice in designing a PGY-IV program, we offer the PGY-IV a mentored experience in clinical and academic psychiatry.
The majority of the PGY-IV year is elective time. Each resident creates a unique year based on clinical and research interests. Our Clinical Scholars Institute helps with this process, exposing residents to mentors and didactics aimed at improving scholarship and expertise. Residents elect major and minor areas of study, aimed to continue with development of broad expertise as well as selected areas of concentration.
Click here for some recent examples of senior electives.
To supplement this elective program, PGY-IV residents continue their outpatient work with a selected cohort of psychotherapy and psychopharmacology patients. They also care for patients with severe and persistent mental illness who are enrolled in our hospital’s Continuing Day Treatment Program (CDTP). At the CDTP, the focus for the resident is now on collaborative work in medication management for patients with non-MD therapists based at the CDTP. The residents also learn treatment and management strategies aimed at relapse prevention, symptom management, and the establishment of social and vocational roles.
All PGY-IV residents write a scholarly paper. Scholarly papers are presented in a Senior Paper Colloquium for residents and faculty. With supervision, residents are encouraged to submit this paper for publication in the psychiatric literature. The best of these papers will be presented at Departmental Grand Rounds. Over the years, residents have written papers on a wide variety of topics. Here are some examples.
As in the PGY-III year, PGY-IV residents may moonlight in any of several New York City Hospitals, including Payne Whitney Westchester. Moonlighting provides an opportunity to do independent clinical work in a variety of settings and to supplement income.
Our PGY-IV residents design their elective year with the goal of developing individualized expertise in one or more areas. Current and prior residents have served as junior attendings on clinical services; been psychiatric consultants or embedded psychiatrists in an integrated care model to specialized medical services (including transplant teams, left-ventricular assist device, or LVAD teams, and inpatient geriatric medicine); organized reading and clinical electives in forensic or correctional psychiatry; developed new lecture series for junior residents and medical students; served in supervisory and mentor roles for junior trainees; completed clinical electives in reproductive psychiatry within our hospital and private clinics; worked with mental health outreach teams for homeless populations; provided addiction psychiatry consultations to inpatient and emergency medicine teams; completed reading and scholarly projects in the DeWitt Wallace History of Psychiatry program; organized advanced clinical training in transference-focused psychotherapy and new modalities for trauma-and anxiety-related disorders; initiated their first year of psychoanalytic training; and completed basic science or translational research projects.
The didactics in the fourth year cover advanced topics in psychopharmacology, consultation-liaison psychiatry (including HIV, transplant, and oncologic psychiatry), telepsychiatry, eating disorders, forensic psychiatry, toxicology, clinical neuropsychiatry, combining psychotherapy and medication management, ethics and professionalism, as well as unique lectures on "how to start life" after graduation. Psychotherapy case conferences continue with special focus on termination-phase with patients, as well as providing "reverse supervision", where faculty present their cases to the PGY-IV residents who learn to provide supervision to colleagues.
All PGY-IV residents attend an intensive four-hour/week didactic seminar program scheduled during protected time. Additionally, all PGY-IV residents continue their e-group experience that began during the PGY-II year.
Supervision during the PGY-IV year includes ongoing supervision for long-term psychodynamic therapy and psychopharmacology. Furthermore, most PGY-IV elect to have additional supervision in modalities, including supportive psychotherapy, CBT, DBT, TFP, IPT, other. All PGY-IV residents participate in a novel seminar in which they learn to be a clinical supervisor. A component of this seminar is participating as supervisor to the PGY-I residents in a mentored model.
PGY-IV’s participate in the Residency Council, and are active in the Friday lunch series. They are important mentors to younger residents and play a major role in setting the tone for resident life in our Department. PGY-IV’s participate in the teaching of several courses offered to junior residents and Weill Cornell Medical Students and are active on in a wide variety of committees in the hospital and the Department.
PGY-IV Chief Residency
At the end of the PGY-III year, residents are selected to serve as chief residents during the PGY-IV year. The chief residents lead the residency group, serving as liaison between faculty and residents. The chief resident role includes a variety of intensive administrative, clinical, supervisory and teaching responsibilities. Our chief residents find this year to be fun, educational and a highlight of the resident experience.