Outpatient Psychiatry Service
The Ambulatory Care Division has three primary outpatient divisions through which residents rotate:
- The Adult Psychiatry Outpatient Division (OPD) is a general clinic, providing all modalities of treatment to its patients, including medication management and all forms of individual and group psychotherapy. The total number of yearly visits to the adult clinic exceeds 55,000, making it the most active ambulatory service at Mount Sinai Medical Center in any specialty.
- The Geriatric Psychiatry OPD provides ongoing clinical care for more than 3,000 patients annually and is the setting for the evaluations of all patients entering studies in the Alzheimer's Disease Research Center.
- The Child and Adolescent Psychiatry OPD provides treatment to children of all ages, with more than 10,000 visits annually. A range of therapeutic modalities is offered, including psychiatric and psychological diagnostic evaluations, individual and group psychotherapy treatments, psychopharmacologic evaluations and treatments, and parent guidance and family treatment.
The outpatient department is the primary site of PGY-3 and PGY-4 training, though residents may elect to begin a long-term psychotherapy case while at the PGY-2 level. At Mount Sinai, residents learn integrated pharmacological and psychotherapeutic approaches to psychiatric outpatient management. Residents' offices are located in a modern renovated space on Fifth Avenue, where treatment is overseen by both the extensive voluntary faculty (many of whom are on faculty at the New York Psychoanalytic Society & Institute) and by dedicated full-time senior faculty members. An average adult outpatient caseload consists of 30 to 35 patients in various modalities and phases of care. Over time, the full range of diagnoses is encountered in evaluation and management.
Outpatient Distribution of Patients
A typical distribution of these patients at any one point in time (i.e., PGY-3 caseload) would include:
- 15 patients receiving continuation and maintenance phase care with psychotropic medication (these patients also receive parallel verbal therapy) seen 1-2 times per month
- 2-5 patients in psychodynamic psychotherapy seen 1-3 times weekly
- 2-4 patients in individual supportive psychotherapy seen every 1-2 weeks
- 3-5 patients in evaluation/short-term crisis intervention and stabilization
- 2-3 patients in cognitive/behavioral therapy
- 1 couple/family (elective)
- 2-3 child or adolescent patients for long-term treatment, with several child or adolescent patients undergoing diagnostic evaluation at any given time
- 5-6 patients in the Day Treatment Program (these severely and persistently mentally ill patients are seen in a weekly group)
- Additionally, each resident manages a caseload of 15-20 patients in the geriatric service, typically seen on a monthly basis
PGY-4 Caseloads are reduced substantially to allow for extended PGY-4 elective opportunities. PGY-4s continue to treat long-term therapy cases, selected medication management cases, and others as chosen by the treating residents.
Outpatient Supervision of Residents
Each PGY-3 resident receives mandatory scheduled supervision in every area of practice continuously throughout the years of his/her involvement. This includes:
- Direct attending supervision of the evaluation and stabilization of patients seen in the “Rapid Access” Adult Evaluation Clinic: 2 hours/week, 3 times/month
- Caseload supervision: 1 hour/week
- Cognitive-behavioral supervision: 1 hour/week
- Long-term psychodynamic psychotherapy supervision: 1 hour/week per patient (residents usually have a different supervisor for each patient treated in this modality)
- Couple/family supervision: elective 1 hour/week
- Group therapy supervision: elective 1 hour/week
- Child and adolescent evaluation: 1 hour/week
- Child and adolescent ongoing treatment: 1 hour/week
- Geriatric psychiatry: 1 hour/week
- Day treatment supervision: 1 hour/2 weeks
Additional programs which are available for elective rotations but through which residents are not required to rotate include those specializing in Substance Abuse, Infant Development, PTSD, OCD, Mood and Anxiety Disorders, Personality Disorders, Eating Disorders, the World Trade Center Medical Monitoring and Mental Health Program, and others.
Icahn School of Medicine
Department of Psychiatry
One Gustave L. Levy Place
New York, NY 10029