The First Year: Getting Grounded

The first year in residency is focused on helping you learn the basic skills of a practicing physician. This includes learning not only the requisite medical knowledge but also how to work with acutely ill patients in a likely unfamiliar system. We have arranged your initial postgraduate year to have a wealth of contact with attendings and senior residents, with a goal being to instruct you in interviewing, diagnosis, treatment, independence, communication, institutional requirements, information retrieval, and professionalism.

The PGY-1 clinical curriculum is divided into month-long rotations in internal medicine (or pediatrics), neurology, and psychiatry. We have arranged these services in an inter-digitated schedule to allow all residents a mix of medicine and psychiatry early on and throughout the year.

Internal Medicine/Primary Care: 4 months

  • Inpatient adult or pediatric medicine: 2 months
  • Outpatient medicine: 1 month
  • Emergency medicine: 1 month

Neurology: 2 months

  • Inpatient neurology: 1 month
  • Consult neurology: 1 month

Psychiatry: 6 months

  • Inpatient psychiatry: 5 months
  • Emergency psychiatry: 1 month

Residents rotate for 4 months on our adult inpatient teaching service (2 months as first years and 2 months as second years). While there are other inpatient psychiatry services at The Mount Sinai Hospital (geriatric, addiction), we have selected the core adult service to be included in our educational mission, so as to 1) not dilute residents’ experiences, 2) limit the use of residents for service provision, 3) concentrate the best teachers, teaching cases, and case conferences, and 4) always have a mixture of PGY-1 and PGY-2 residents present for a textured learning/teaching environment. PGY-1 rotations also include subspecialty experiences in child and adolescent inpatient psychiatry, Veterans inpatient psychiatry (JJP Bronx VAMC), forensic inpatient psychiatry (Manhattan State and Kirby Forensic Psychiatric Hospitals), and in The Mount Sinai Hospital’s Psychiatry Emergency Service. (Residents get substantial experience in geriatric psychiatry in the outpatient setting in PGY-2 and 3. Addiction psychiatry is likewise learned in an outpatient setting as well as during the VA adult inpatient rotation.) Through this approach, we hope to provide a breadth of experience and exposure to a range of opportunities in the field, allowing residents to develop grounding as well as contemplate areas of eventual focus. Senior residents may elect to rotate on any inpatient unit as appropriate for their particular concentration.

 


Didactics

An important component of this first year is the yearlong didactic curriculum for all PGY-1 residents. This weekly program is attended not only by those residents who are on psychiatric services, but also the majority of those on medicine and neurology. We believe this promotes greater class cohesion and augments both the personal and educational experiences of the intern year. We have also augmented the weekly classroom didactic curriculum and the clinical-based education on the units with a series of case conferences and clinical seminars:

  • Twice weekly morning report run by the Chief Residents with selected faculty during which residents discuss interesting cases and issues encountered during short call and night float at Mount Sinai

  • Weekly case conference (July-Sept)—“CBT and DBT for Inpatients”—taught during the first 3 months of each academic year

  • Weekly case conference (Sept-May)—“Psychodynamic Perspectives of Inpatient Psychiatry"—taught by Peter Dunn, MD, the Medical Director of the New York Psychoanalytic Society & Institute

  • Weekly case conference (year-round) on psychiatric case formulation, symptom-specific interviewing, patients’ subjective experiences of symptoms, and how to think deeply and flexibly about patients, taught by Asher Simon, MD, Associate Director of Residency Training and Antonia S. New, MD, Training Director Designate

  • Weekly case conference (year-round) on the VA adult inpatient unit, with invited faculty leaders

 


Sample Weekly Schedule


Mon Tues Wed Thurs Fri

8-8:30am
Morning Report

12-1:00pm
Resident Lunch

1-3pm
PGY-1 Didactics

11:30am-1pm
Grand Rounds

 

 

2:00-3:30pm
CBT and DBT for
Inpatients, or
Psychodynamic
Perspectives of
Inpatient Psychiatry

 

8-8:30am
Morning Report

12:30-2pm
Psychiatric Formulation Conference

4-5pm
Weekend Sign-out



Call

Call during the first year varies depending on the service. Psychiatry residents do not take overnight call while rotating on the inpatient medicine service. In the medical emergency room, residents work a combination of day shifts and night shifts over the course of the month. While on all other services (except psychiatry night float), residents are on-call covering the inpatient psychiatry services at The Mount Sinai Hospital. 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 24/7 in the Psychiatric Emergency Service. Psychiatry call at The Mount Sinai Hospital during the first year usually consists of three short calls per month and one weekend call. The call schedule is arranged by a 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

Night Float consists of two 2-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 The Mount Sinai Hospital.

The hours are as follows:

  • Saturday – Thursday overnights

Contact Us

Tel: 212-659-8734

Icahn School of Medicine
Department of Psychiatry
Box 1230
One Gustave L. Levy Place
New York, NY 10029