The Fourth Year: Promoting Professional Identity and Uniqueness

The PGY-4 experience focuses on specialty training and cultivating residents' developing expertise and readiness for independent psychiatric practice and directed professional growth.

  • Electives
  • Teaching Resident
  • Chief Residents
  • Consultation-Liaison Psychiatry
  • Outpatient practice

PGY-4 clinical curriculum

Nine to ten months of elective time in specialized settings and in areas of one’s choosing provides residents with mentorship and resources to develop clinical, research, and/or administrative expertise.

We believe that in addition to pursuit of individual career interests, residents should develop teaching facility to become future leaders in psychiatry. To cultivate these skills, we have established the Teaching Resident rotation, in which each PGY-4 resident spends 30% time for one to two months taking responsibility for educating both junior residents and medical students in programmatic, supervisory, and didactic modalities. While closely supervised by the residency training directors, the Teaching Resident provides additional supervision of junior residents on the inpatient units and teaches interviewing skills to both junior residents and rotating medical students. Residents have found this rotation to be an invaluable experience, helping them both consolidate their knowledge base as well as develop the necessary skills they will employ in future faculty positions.

Continuing their immersion in the practice of outpatient psychiatry, residents maintain a more circumscribed caseload of patients of their choosing, which allows for both an ongoing longitudinal outpatient experience as well as more time to pursue additional clinical and research interests. Together with this condensed outpatient caseload, residents continue with their psychotherapy cases and associated supervisors. The many months of elective time as well as the flexibility of the fourth year make it possible for interested residents to begin formal psychoanalytic training as candidates at the New York Psychoanalytic Society & Institute.

Three residents per year are chosen to be Chief Residents; they each perform in this role for four months and alternate this with other experiences. In addition, one resident from the Physician-Scientist Research Track is selected to be the Research Chief, focusing on facilitating the experiences of residents interested in pursuing basic science or clinical research. The Chief Residents attend weekly operations meetings of the Office of Psychiatric Education, and they are responsible—under the supervision of the training directors—for guiding much of the day-to-day operations of the residency. They hone their leadership and administrative skills through intimate involvement in the interview season, orientation, inviting speakers for Grand Rounds, teaching junior residents, organizing events for the residents (e.g., the Retreat, Chairman's Journal Club, get-togethers, etc.), and providing office hours for junior residents to discuss issues in a meaningful and confidential forum.

The fourth year also includes two months of training in Psychosomatic Medicine (Consultation-Liaison Psychiatry). As one of the preeminent academic medical centers in the United States, The Mount Sinai Hospital has expertise in a multitude of disciplines, including geriatrics, gastroenterology, cardiology and cardiac surgery, neurology and neurosurgery otolaryngology, endocrinology, rehabilitation medicine, gynecology, renal medicine, pulmonology, and cancer. In addition to evaluating and treating general medical and surgical patients who require psychiatric care, residents work with subspecialty-trained faculty who pursue clinical and research interests in transplant psychiatry, movement disorders, HIV psychiatry, the psychiatric aspects of multiple sclerosis, and post-partum and women's mental health.



As in the prior two years of training, PGY-4 residents are given protected time for their classroom didactic curriculum representing seven hours one-day per week. This year includes courses in advanced psychopharmacology and psychotherapy as well as covering special clinical and practical topics important for practicing psychiatrists.



There is no call in the fourth year.

PGY-4 vacation is scheduled and taken as desired by the individual resident, provided that it is cleared by the training office.

Contact Us

Tel: 212-659-8734

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