Residency Training Program

Post-graduate year one (PGY-I), the internship year of the program, is evenly divided between medicine/neurology/emergency medicine and psychiatry.

Medicine/Neurology Rotations

Each PGY-I resident spends 6 months on a selection of clinical services in Internal Medicine, Emergency 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 other specialties 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, residents will be familiar with the assessment, diagnosis, and management of basic medical and neurological conditions. They will also be proficient in ACLS and BLS, and comfortable with the management of medical and neurological emergencies at a basic level of care.

• 12 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

Psychiatry Rotations

Each PGY-I resident spends the other six months of the year working on clinical services in psychiatry. Several of the 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 NewYork-Presbyterian Westchester Behavioral Health Center houses over 250 inpatient psychiatric beds. Our PGY-I residents rotate through various services including Geriatric Psychiatry, Inpatient Psychotic Disorders, and Adolescent Psychiatry, which includes additional training in Autism at our Center for Autism and the Developing Brain.

On the Manhattan campus, PGY-I residents rotate through the Psychiatric Emergency Department and 11N, the sole inpatient psychiatric unit within the main hospital complex. On these rotations, they work alongside more senior residents and medical students. PGY-I on-call responsibilities cover the inpatient service at NewYork-Presbyterian Hospital during night float and evening bridge shifts at the Westchester Division.   

• 4-5 weeks:  Geriatric Psychiatry Inpatient Service/ECT – NYP Westchester Behavioral Health Center
• 4 weeks:  Acute Schizophrenia Unit – NYP Westchester Behavioral Health Center
• 4 weeks: Inpatient Adolescent/CADB (additional training in Autism) – NYP Westchester Behavioral Health Center
• 4 weeks: 11N Medical/Psychiatric Inpatient Unit – NYP Weill Cornell Medicine in Manhattan
• 4-5 weeks: Psychiatric Emergency Department – NYP Weill Cornell Medicine in Manhattan
• 2 weeks: Night float – NYP Weill Cornell Medicine in Manhattan

Wednesday Afternoon Community Experiences and Wellness

On Wednesdays, PGY-1 residents embark on organized experiences out in the community of New York City. This includes a longitudinal rotation doing collaborative work with members of Fountain House, a clubhouse designed to support the recovery of individuals living with severe mental illness; as well as visits to a safe injection site in East Harlem (one of the first to open in the US), Manhattan Psychiatric Center on Randall’s Island and Rikers Island. Additional days are devoted to other educational activities, with several kept free so residents can schedule doctor’s appointments and catch up on other tasks that can pile up during the first year of residency.

Didactics and Supervision

Supervision during the intern year is from faculty and senior residents on the clinical services, complemented by weekly protected didactics on Tuesday mornings. A highlight of our PGY-I didactics is the longitudinal Psychiatric Interview course, where interns learn the nuances of the psychiatric interview. In addition to weekly didactics, clinical services include their own site-based curriculum consisting of academic and clinical rounds, team meetings, case conferences, and specialty rounds. At Westchester, residents also have ongoing Thursday group supervision meetings, an introduction to medicolegal issues in Psychiatry, and teaching about common issues on call. PGY-I residents attend Grand Rounds, as well as Morbidity and Mortality conferences and weekly Friday Lunch and Learns. PGY-I residents participate in the teaching of medical students rotating through psychiatry, medicine, and neurology.

One of the four chief residents is dedicated to supporting the first-year residents and each of the PGY-I’s are connected with a more senior resident “buddy” who helps orient them to residency and remains connected throughout the year.

PGY-I Didactics Schedule

Clinical work during the PGY-II year focuses on the evaluation, diagnosis, and treatment of psychiatric patients in acute care settings.

Rotations

PGY-II residents rotate through the Personality Disorders Inpatient Service at NewYork-Presbyterian Westchester Behavioral Health, the General Psychiatry Inpatient Service at Weill Cornell Medicine Greenberg 11N, and the Partial Hospital Program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in Manhattan. PGY-II residents also rotate through the New York-Presbyterian Hospital Psychiatric Emergency Service and the New York-Presbyterian Hospital Consultation/Liaison Psychiatry Service. In the Emergency Department, residents work with patients requiring acute medical and psychiatric evaluation and treatment. On the Consultation-Liaison Service, residents learn evaluation and management of psychiatric aspects of medical illness while providing consultation to medical services in the hospital. A portion of the Consultation-Liaison time is spent at Memorial Sloan-Kettering Cancer Center with a dedicated focus in psycho-oncology.

At these sites, experiential learning is supplemented by case conferences and site-based didactics. During these rotations, residents deepen their understanding of hospital psychiatry including the multi-disciplinary approach to patient care, management of the milieu, psychopharmacology, and individual, family and group psychotherapy. Residents gain expertise in Addiction Psychiatry during the Consultation-Liaison rotation and Lincoln Hospital rotation, with additional didactics regarding substance abuse.

PGY-II residents also learn about Community Psychiatry and substance use disorder treatments while rotating on the Addiction Consult Service at Lincoln Hospital. Residents spend 3-4 weeks rotating at Lincoln Hospital on the CATCH team (The Consult for Addiction Treatment and Care in Hospitals.) Residents also gain early experience in outpatient psychiatry through the PGYII Wellness Qlinic rotation. The Qlinic is a student-run, free clinic focused on addressing the mental health disparities faced by the lesbian, gay, bisexual, transgender and queer (LGBTQ+) communities in New York City. During this rotation, residents are supervised as they conduct new evaluations, start and manage medications, and provide supportive psychotherapy. 

In 2022, a selective block was added to the PGY-II year to provide more opportunities for specialized clinical experiences. Residents can choose from a variety of selective options that include neuromodulation (TMS, ECT, and ketamine), HIV psychiatry, Addiction Psychiatry, Adolescent C-L Psychiatry, Telepsychiatry, Second Chance Unit (long term inpatient psychosis care unit), or mentored research/scholarship.

PGY-II on-call coverage is via a night float system in which residents cover emergencies in the Payne Whitney Manhattan inpatient service and evening bridge call coverage while residents are rotating on 11N.

• 12-13 weeks: 11 North Inpatient Psychiatry Service – NewYork-Presbyterian Hospital/Weill Cornell Medical Center
• 4-5 weeks: Personality Disorders Inpatient Service Service – NewYork-Presbyterian Westchester Behavioral Health Center
• 4-5 weeks: Psychiatric Emergency Department – NewYork-Presbyterian Hospital/Weill Cornell Medical Center
• 1-12 weeks: Consultation-Liaison Psychiatry – NewYork-Presbyterian Hospital/Weill Cornell Medical Center & Memorial Sloan Kettering Cancer Center
• 3-4 weeks: Partial Hospital Program – NewYork-Presbyterian Hospital/Weill Cornell Medical Center
• 4 weeks: Wellness Qlinic Rotation
• 3-4 weeks: Lincoln Hospital Rotation
• 3-4 weeks: Selective Rotation (resident’s choice)

• 2-3 Weeks: Night Float – NewYork-Presbyterian Hospital/Weill Cornell Medical Center

Didactics and Supervision

Supervision during the PGY-II year is from faculty and senior residents on the clinical services. As a supplement, each PGY-II is paired with a specially-selected “off-unit” supervisor who oversees their learning of psychiatric interviewing and assessment skills.

Rotations in the PGY-II year include site-based curricula, including academic and clinical rounds, resident and medical student teaching rounds in which trainees deliver scholarly presentations on the psychiatric literature, team meetings, and specialty rounds. A highlight of PGY-II site-based didactics is Professor’s Rounds, a case conference seminar with renowned expert psychiatrists invited to be discussants. PGY-II residents attend Grand Rounds, as well as Morbidity and Mortality conferences. PGY-II residents supervise PGY-I residents, medical students, and sub-interns rotating through psychiatry services, and attend didactics related to their development as mentors.

All PGY-II residents attend an intensive 3-hour/week didactic seminar program scheduled during protected time. Additionally, all PGY-II residents participate in a weekly e-group (experiential group) that continues through the remainder of their residency training, providing a longitudinal opportunity to learn about group process and discuss the task of becoming a psychiatrist.

 PGY-II Didactics Schedule

The third-year clinical program includes a broad range of outpatient work with adults and children at the NYP/Weill Cornell site in Manhattan.

Rotations

All PGY-III residents treat a continuous group of outpatients in multiple different modalities, including long-term intensive psychodynamic psychotherapy, supportive psychotherapy, time-limited psychotherapy (including CBT, DBT and IPT), group psychotherapy, couples, and family psychotherapy, and psychopharmacologic treatment. The Adult Evaluation Service rotation provides intensive experience in outpatient evaluation and crisis intervention. Each PGY-III resident rotates for two months through the Geriatric Evaluation Service where he/she gains experience in the evaluation of seriously ill older psychiatric patients with a range of diagnoses. Each PGY-III also rotates in the Women's Clinic for two months, where he/she gains experience in reproductive psychiatry and women's mental health. Residents will also actively participate in departmental Quality Improvement (QI) efforts, writing and evaluating assessments of active cases with a focus on healthcare systems processes at play. During the PGY-III year, every resident spends half the year on the Child and Adolescent Psychiatric Service learning how to assess and treat children and their families.

• 48 weeks: Outpatient Psychiatry – NewYork-Presbyterian Hospital/Payne Whitney Manhattan

Given the shifting mental health landscape, PGY-III residents gain experience with both in-person/on-site as well as telepsychiatry practice. Residents develop competency in navigating the nuances of providing care in these different settings and an understanding of how to provide flexible, personalized care to their patients.  

PGY-III on-call coverage is via a night float system in which residents cover the psychiatric Emergency Department, deepening their experience in the management of psychiatric emergencies. Each PGY-III completes a total of 4-5 weeks of night float. PGY-III’s also share responsibility for covering the psychiatric Emergency Department on weekend days and Friday nights (averaging one call shift every 3-4 weeks).

PGY-III residents may engage in moonlighting, primarily at our own Westchester Division. Moonlighting provides an opportunity to do independent clinical work in a variety of settings and to supplement income. Moonlighting must be approved by the Residency Training Director and NewYork-Presbyterian GME.

Didactics and Supervision

Individual supervision is a highlight of the PGY-III year. A team of supervisors with expertise in psychopharmacology and in each of the modalities of psychotherapy supervises all outpatient clinical work.

PGY-III Supervision Modalities:
All PGY-III residents receive supervision in Long-Term Psychodynamic Psychotherapy, CBT, Supportive Psychotherapy, Psychopharmacology, Child and Adolescent Psychiatry, Geriatric Psychiatry, Reproductive/Women’s Psychiatry, Evaluation supervision, and Group Psychotherapy. Supervision in additional (non-core) areas of expertise such as DBT, couple’s therapy, or IPT is also available.

In addition to supervision, the PGY-III educational program includes a series of weekly case conferences (supportive psychotherapy, psychopharmacology, child psychiatry, long-term psychodynamic psychotherapy, and psychotherapy supervision with Otto F. Kernberg). "Differential Therapeutics" is a highlight of the year, in which complicated cases are discussed from different clinical perspectives. PGY-III residents attend Grand Rounds, weekly Lunch & Learn seminars, as well as Morbidity and Mortality conferences. Transitioning to senior residents, PGY-III residents teach PGY-I and II residents, medical students and sub-interns rotating through the psychiatric emergency department.

All PGY-III residents attend an intensive 3-hour/week didactic seminar program scheduled during protected time. All PGY-III residents continue their participation in the weekly e-group experience. As part of a monthly scholarly writing seminar, residents continue independent scholarship and research, with ongoing mentorship and supervision by scholarship mentors. By the end of the year, each PGY-III resident is prepared to submit a plan for the PGY-IV elective year, including a proposal for research/scholarship activities.

Vacation: 4 weeks

PGY-III Didactics Schedule

The goal of the PGY-IV year is facilitating the transition to the role of independent clinician, teacher, administrator, and scholar/researcher. Our program is unique in that the vast majority of the year is elective in nature. By offering a large amount of choice in designing one’s PGY-IV program, we offer our PGY-IVs a mentored experience in designing their own clinical and academic program according to their personal interests, preparing them for the tasks of independent psychiatric practice.

Rotations

Each resident creates a unique year based on clinical and/or research interests.  Our Clinical Scholars Institute, which begins in the second year, helps with this process, linking residents to mentors and providing group supervision on scholarly projects.  Residents design a personalized course of study, continuing the development broad expertise as well as selected areas of concentration.

To supplement their elective program, PGY-IV residents continue their outpatient work with a significantly reduced census compared to the PGY-III year. In addition, PGY-IVs learn to collaborate with an interdisciplinary team caring for a small number of outpatients within the hospital’s unique Continuing Day Treatment Program.  PGY-IV’s can teach pre-clinical courses offered to Weill Cornell Medical Students and junior residents and can choose to participate in leadership committees active within the hospital and the Department of Psychiatry.

As in the PGY-III year, PGY-IV residents may moonlight in any of several New York City Hospitals, including NewYork-Presbyterian Westchester Behavioral Health Center and Gracie Square Hospital. Moonlighting provides an opportunity to do independent clinical work in a variety of settings and to supplement income. Moonlighting must be approved by the Residency Training Director and NewYork-Presbyterian GME.

PG-IV Senior Projects

At the conclusion of the PGY-IV year, all graduating residents present a senior project to their peer residents and the department faculty. This project can consist of anything from a publication or research project to a presentation highlighting the outcomes of their elective experiences. Residents are supported and directly supervised by faculty mentors and program leadership in choosing and putting together their senior project. 

All PGY-IV residents continue to meet with at least two psychodynamic supervisors for their therapy cases, receive psychopharmacology supervision as a group, and can elect to take on additional supervision as well (child and adolescent, CBT, couples therapy, IPT, and transference focused psychotherapy). Starting in 2022, a didactic course and ongoing supervision on problem focused psychodynamic psychotherapy was introduced as an additional short-term psychotherapeutic modality taught to 4th year residents by one of its developers, Fredric Busch, who is on our voluntary faculty.

All PGY-IV residents attend an intensive 3-hour/week didactic seminar program scheduled during protected time. It includes advanced psychopharmacology, ethics, classes focused on career development, and other advanced topics in psychiatry. Continuing the process started in preceding two years of residency, the PGY-IV residents meet weekly for their e-group experience.

PGY-IV Didactic Schedule

PGY-IV Chief Residency

At the end of the PGY-III year, a few residents are selected to serve as chief residents during the PGY-IV year. The chief residents lead the residency group, serving as an important liaison between residency leadership and the residents. The chief resident role includes a wide variety of intensive administrative, clinical, supervisory, teaching responsibilities, and a focus on diversity, equity and inclusion.

Vacation: 4 weeks