Weill Cornell Medicine's Residency training program provides outstanding training in the development of clinical skills and opportunities to participate in empirical investigation. Our residents are encouraged to translate clinical experience and observation into research questions and receive training in the development of research methodology. Our residents evaluate and contribute to the academic literature to prepare for lifelong engagement in scholarship. We recognize that no single frame of reference is adequate for understanding human behavior and psychopathology. Throughout our intensive clinical, didactic and research program, residents are taught a sophisticated approach to patient care and intellectual inquiry based on the integration of phenomenological, biological, psychodynamic and socio-cultural viewpoints. An additional priority for all residents is the development of the self-awareness, personal growth and enthusiasm for learning necessary for excellence in psychiatry.
Post-graduate year one (PGY-I), the internship year of the program, is evenly divided between medicine/neurology/emergency medicine 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 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 the management of medical and neurological emergencies at a basic level of care.
Each PGY-I resident spends the other 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 over 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, 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 cover the inpatient service at NewYork-Presbyterian Hospital during night float or at the Westchester Division.
Didactics and Supervision
Supervision during the intern year is from faculty and senior residents on the clinical services, complemented by weekly protected time didactics on Tuesday mornings. A highlight of our PGY-1 didactics is the longitudinal Psychiatric Interview course, where interns learn the nuances and beauty of the psychiatric interview. voluntary faculty. In addition to weekly didactics, every service includes its own site-based curriculum consisting of academic and clinical rounds, team meetings, case conferences, and specialty rounds. 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.
Although they are dispersed throughout our hospital, we make sure to keep in contact with our PGY-I’s through weekly Friday lunches, and regular, casual 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.
Vacation: 4 weeks
Clinical work during the PGY-II year focuses on the evaluation, diagnosis, and treatment of psychiatric patients in acute care settings.
PGY-II residents rotate through the Personality Disorders Inpatient Service at the NewYork-Presbyterian Westchester Behavioral Health Center, the General Psychiatry Inpatient Service Greenberg 11N, and the Partial Hospital Program at NYP/Weill Cornell in Manhattan. At these sites, their learning is experiential, as they care for patients during high acuity illness episodes, supervised by expert faculty. 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.
During the COVID pandemic, the General Psychiatry Inpatient Service Greenberg 11N had been temporarily relocated to the 7N unit at New York-Presbyterian Westchester Behavioral Health Center. The 11N unit is now undergoing a renovation and is expected to return to the Manhattan campus in early 2022. During the pandemic, PGY-II residents have had the opportunity to rotate on 7N and gain additional experience in ECT and ketamine treatments.
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 liaison and 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.
PGY-II residents also gain Community Psychiatry and Addiction experience by 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 experience in the outpatient department through the PGYII Wellness Qlinic rotation. The Qlinic is a student-run 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 gain expertise in conducting new evaluations, medication management, and supportive therapy.
PGY-II on-call coverage is via a night float system in which residents cover emergencies in the Payne Whitney Manhattan inpatient service.
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, and a research/scholarship supervisor, who helps with the independent scholarly investigation, development of an area of academic focus, and career mentorship.
Every rotation in the PGY-II year includes a site-based curriculum, 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 weekly case conference seminar by nationally- and internationally-renowned expert psychiatrists. PGY-II residents attend Grand Rounds on both campuses, as well as Morbidity and Mortality conferences. PGY-II residents teach PGY-I residents, medical students, and sub-interns rotating through psychiatry services, and attend didactics related to their development as teachers.
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 provides an opportunity to learn about group process and discuss the task of becoming a psychiatrist.
PGY-II’s are active in the Resident’s Council and participate in Departmental academic/social activities through our Friday lunch series and Wellness “PsychOSocial” club. These meetings foster community in our residency, providing an opportunity for trainees across all years to share experiences and develop group cohesion.
The third-year clinical program includes a broad range of outpatient work with adults and children at the NYP/Weill Cornell site in Manhattan.
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 Central Evaluation Service rotation provides an 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 at processes at play. Finally, 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.
Given the shifting mental health landscape, PGY-III residents gain experience with both in-person/on-site as well as telemental health. Residents develop competency in navigating the nuances of providing care in these different settings and therefore develop an understanding of how to provide flexible care to patients in the outpatient setting.
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 weeks (24 nights) of night float. PGY-IIIs also share responsibility for covering the psychiatric Emergency Department on weekend days (averaging one day shift every 2-3 weeks).
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. Supervision in additional (non-core) areas of expertise such as DBT, couple’s therapy, or IPT is also available.
PGY-III Supervision Modalities:
Long-Term Psychodynamic Psychotherapy, CBT, Supportive Psychotherapy, Psychopharmacology, Child and Adolescent Psychiatry, Geriatric Psychiatry, Reproductive/Women’s Psychiatry, Evaluation supervision, Group Psychotherapy, selected specialty supervision including but not limited to Couple’s and Family Psychotherapy, DBT, and IPT.
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. Finally, all PGY-III residents have time in their schedules to continue independent scholarship and research, with ongoing mentorship and supervision by their scholarship supervisors. 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.
PGY-III’s lead the Resident’s Council and “PsychOSocial” Club, plan the acclaimed Friday lunch series, organize the annual residency Central Park Picnic, and are leaders in residency recruitment efforts. PGY-III’s are also the class responsible for the coordination and execution of the amazing departmental holiday show. They are leaders in community-building in our residency, providing an opportunity for trainees across all years to share experiences and develop group cohesion.
Vacation: 4 weeks
PGY-III residents may engage in moonlighting, primarily at our own Westchester Division (additional compensation for travel is provided). 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.
The goal of the PGY-IV year is to facilitate the transition to the role of independent clinician, teacher, administrator, and scholar/researcher. Our program is quite 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.
Each resident creates a unique year based on clinical and/or 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 the development of 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 to care for a small number of outpatients in the hospital’s unique Continuing Day Treatment Program. PGY-IV’s can also elect to participate in the teaching of pre-clinical courses offered to Weill Cornell Medical Students and junior residents and can also elect to participate in leadership committees active in the hospital and the Department of Psychiatry.
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.
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.
Supervision during the PGY-IV year is from a group of PGY-IV supervisors selected by the residents to round out their educational experience. All PGY-IV residents continue to work with their scholarship supervisor for help with their independent scholarly investigation, academic focus, and career mentorship. They continue to meet with at least two psychodynamic supervisors for their therapy cases and can elect to take on additional supervision as well (chid, CBT, etc).
All PGY-IV residents attend an intensive 3-hour/week didactic seminar program scheduled during protected time consisting of advanced psychopharmacology and other advanced topics in psychiatry. Additionally, all PGY-IV residents continue their e-group experience.
At the end of the PGY-III year, two to four 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 faculty and the residents. The chief resident role includes a wide variety of intensive administrative, clinical, supervisory and teaching responsibilities. One of the chiefs will also serve as chief of diversity, equity and inclusion. Our chief residents find this year to be fun, educational and exciting, a highlight of the resident experience.
PGY-IV’s continue their participation in the Residency Council and 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-IVs also continue to participate in the resident council for diversity and inclusion (RCDI) if they wish, and can continue to shape the residency’s efforts to create more inclusivity in our program.