The First Year: Getting Grounded
The PGY-1 year is divided into month-long rotations in medicine (or pediatrics), neurology, and psychiatry. We have arranged these services in an inter-digitated schedule to allow all PGY-1 residents to experience a mix of medicine and psychiatry early on and throughout the year.
Medicine/Pediatrics: 4 months
- 2 months adult or pediatric inpatient medicine
- 1 month outpatient medicine
- 1 month adult emergency medicine
Neurology: 2 months
- 1 month inpatient neurology
- 1 month neurology consult service
Psychiatry: 6 months
- Rotations on specialized inpatient psychiatric services
- Adult, Child/Adolescent, Geriatric, Mentally ill/Chemically-dependent, Forensics
In addition to residents receiving experience in general adult inpatient psychiatry, the first year rotations include subspecialty work in child and adolescent psychiatry, addiction psychiatry, geriatric psychiatry, forensic psychiatry, and emergency psychiatry. Through this approach, we hope to provide an exposure to the range of opportunities in the field, allowing residents to contemplate areas of eventual focus.
An important component of this first year is the yearlong didactic program for all PGY-1 residents. This weekly program is attended not only by those residents who are on psychiatric services, but also those on medicine and neurology. We believe this promotes greater class cohesion and augments both the personal and educational experiences of the intern year.
Beginning with an Introductory Psychiatry Course in the afternoons during the first two weeks of July, this intensive course then focuses on pragmatic issues in psychiatry:
- Inpatient treatments
- Inpatient psychopharmacology
- Supportive psychotherapy
- The on-call experience
- The Hospital as a system
- Information retrieval
- Medical, neurological, and psychiatric emergency management
Additionally, we have included a Process Group that focuses on responses to internship and group dynamics.
Augmenting the weekly classroom didactic curriculum is a series of case conferences and clinical seminars, oftentimes held on the inpatient units.
- Twice weekly morning report with Ronald Rieder, MD, the Director of Residency Training, during which residents discuss interesting cases and issues encountered during short call and night float at Mount Sinai.
- Weekly seminar "Psychoanalytic Perspectives of Inpatient Psychiatry", taught by Peter Dunn, MD, the Medical Director of the New York Psychoanalytic Society & Institute
- Weekly case conference, focusing on psychiatric case formulation, symptom-specific interviewing, and patients' subjective experiences of symptoms, taught by Asher Simon, MD, Associate Director of Residency Training
- Senior faculty members direct unit-specific case conferences on our various specialty units.
Sample Weekly Schedule
This sample does not include the didactics that are specific to each inpatient unit. Unaccounted for time is spent on the inpatient units, seeing patients, in rounds, in supervision, or teaching medical students.
Call during the first year varies depending on the service. Psychiatry residents do not take overnight call while rotating on the in-patient medicine service. In the medical emergency room, residents work a combination of day shifts and overnight shifts over the course of the month. While on all other services (except night float), residents are on call covering the inpatient psychiatry services at Mount Sinai. While on call, clinical support for all questions and concerns is provided by an attending psychiatrist and a senior resident who are both available on-site 24-hours a day at the Psychiatric Emergency Department. Psychiatry call at Mount Sinai during the first year usually consists of three short calls per month and one weekend call. The call schedule is arranged by one member of the PGY 1 class selected by the class. The call is as follows:
Weekday Short Calls:
- Monday – Thursday evenings
Weekend Long Calls:
- Friday overnight
- Saturday day
- Sunday day
Night Float consists of two two-week blocks during which a PGY-1 resident receives sign-out from the resident on-call and takes over nighttime coverage of the inpatient units at Mount Sinai. The hours are as follows:
- Saturday – Thursday overnights
When on the night float rotation, the remaining two weeks of the month are either vacation or spent rotating in the Psychiatric Emergency Service.
Icahn School of Medicine
Department of Psychiatry
One Gustave L. Levy Place
New York, NY 10029