Part of a well-rounded Psychosomatic Medicine Fellowship is exposure to and integration with other medical and surgical disciplines throughout the hospital. Fellows spend six months based at the Mount Sinai Health System and six months based at the James J. Peters VA Medical Center. During both of these experiences, fellows work with subspecialty teams with the goal of fostering liaison relationships and becoming an integral part of a multidisciplinary treatment team.
Integration into the team involves rounding with the specialty team on a weekly basis, attending departmental grand rounds, attending team meetings, and working closely with social workers, case managers, and medical colleagues in the collaborative care of the patient. Fellows also provide staff support and appropriate in-service education to the teams when requested.
Rotations are as follows:
Mount Sinai Health System (6 months)
1. General Medical/Surgical Inpatient Services: This two-month rotation in inpatient Psychosomatic Medicine is based at the Mount Sinai Health System. Each fellow acts as a key member of the team and is assigned general inpatient psychiatric consults for which he or she will act as the primary consultant. Inpatient consults will cover a broad depth of medical and psychiatric knowledge.
The overall goal of the rotation is to provide fellows with the knowledge, skills, and understanding of this unique population of patients and enable fellows to gain the expertise necessary to provide psychiatric liaison services to various medical teams throughout the hospital
2. HIV/AIDS Psychiatry: Fellows spend six weeks focusing on HIV psychiatry. Fellows spend two half-days per week in the outpatient HIV clinic, doing initial psychiatric evaluations as well as follow-up visits for medication management and individual psychotherapy. Fellows provide consultations for HIV-positive medical inpatients as well as continue to do general psychiatric consultations.
Fellows develop a liaison relationship with the Infectious Disease service and attend weekly team meetings. They also give two or three in-service lectures on topics relating to HIV psychiatry and/or psychosomatic medicine.
Fellows have the option to co-lead the HIV support group with one of the clinic social workers and to work with the Obstetrics/Infectious Disease team, following pregnant HIV-positive women through the pregnancy and postpartum period. Fellows follow several outpatients throughout the year.
3. Transplant Psychiatry: Fellows spend six weeks at the Recanati/Miller Transplantation Institute, working with patients undergoing liver, kidney, lung, small bowel, and pancreas transplants. Fellows provide pre- and post-transplant psychiatric evaluation and appropriate follow-up. Fellows also provide living related organ donor evaluations, pre-transplant evaluations, post-transplant consultations, and follow-up on an outpatient basis.
Fellows attend a biweekly recipient review committee meeting in which clinicians present psychiatric evaluations of pretransplant patients to a multidisciplinary transplant team to determine patients’ candidacy for transplant. An attending psychiatrist who has expertise in transplant psychiatry supervises all cases.
4. Elective: For one month, fellows focus on a specific medical, obstetrical, or surgical subspecialty and the psychiatric issues seen most commonly in patients in this subspecialty. Fellows liaison with the primary team, attend team rounds, see all consults called by the team, become familiar with the literature pertaining to the subspecialty area, and provide several in-service training sessions to the team.
Elective options include Multiple Sclerosis, Obstetrics, Oncology, Rehabilitation Medicine, Neuropsychiatry, Geriatrics, Palliative Care, Intensive Care Unit, and Gastroenterology.
5. Administrative: Throughout the rotations at Mount Sinai, fellows focus on learning the administrative skills necessary to function as an attending and run a service. Fellows act as junior attendings, supervising the consults of medical students and psychiatry residents who rotate on the service.
Fellows attend weekly departmental meetings with the Division Director and monthly hospital-wide meetings in order to observe the role of the Consultation Psychiatry service within the psychiatry department and the hospital as a whole. Fellows also run rounds, learn how to assign consults, and provide feedback to other trainees of the service.
James J. Peters VA Medical Center (6 months)
Silvana Riggio, MD, an Associate Professor in both Psychiatry and Neurology at Icahn School of Medicine, is the Director of the Psychiatry Consultation Liaison Service at the VA Medical Center as well as the Site Director for VA site.
1. General Medical/Surgical Inpatient Services: This six-month rotation in inpatient Psychosomatic Medicine is based at the VA Medical Center. Each fellow acts as a key member of the team and is assigned general inpatient psychiatric consults for which he or she will act as the primary consultant. Inpatient consults will cover a broad depth of medical and psychiatric knowledge. Fellows act as junior attending, supervising the consults of medical students and psychiatry residents who rotate on the service.
2. Substance Abuse Service: Fellows spend ½ day per week doing new intakes at the Substance Abuse Clinic, based at the VA Medical Center.
3. Traumatic Brain Injury Program: Fellows spend ½ day per week working with different team members in the Traumatic Brain Injury Program, including Dr. Jesse Siminoy from Rehabilitation Medicine, and the neuropsychologists.
Contact the Psychosomatic Medicine Fellowship Program
Kimberly G. Klipstein, MD
Psychosomatic Medicine Fellowship
Carrie L. Ernst, MD
Psychosomatic Medicine Fellowship