Fellowship in Psychosomatic Medicine

The Psychosomatic Medicine Fellowship at Mount Sinai Beth Israel is a 12-month, integrated program in Consultation-Liaison (CL) Psychiatry, beginning July 1 of each year. We are fully accredited by the American Council on Graduate Medical Education (ACGME), and ours was among the very first programs to receive this designation.

Training consists of several year-long, fully supervised activities, including inpatient and outpatient clinicals; liaisons with multidisciplinary teams; didactics; teaching and supervising residents, medical students and non-medical staff; administrative duties; academic projects and research; and participation in the Education and Quality Improvement committees.

Our Psychosomatic Medicine Fellowship program includes a wide range of diverse rotations. 

Inpatient Consultations

Completing four consults each week, you see a wide range of patients, dealing with complex cases and discussing them during two weekly case conferences. In time, you lead rounds and meeting. 

The Peter Krueger Clinic for the Treatment of Immunologic Disorders

In this required outpatient rotation, you work part-time in a multidisciplinary team and follow outpatients for half a day each week. You are supervised by attendings and participate in a weekly HIV Journal Club and in weekly team meetings with case presentations. Eventually, you lead these meetings, collaborating with psychologists, social workers, care coordinators, psychology interns, and externs. 

Sidney Hillman Family Practice

For six months, you spend a half-day per week at a family medicine clinic using an integrated care model focused on teamwork and shared expertise with the family medicine residents and interns. You come in contact with psychiatric problems seen among medically ill outpatients and collaborate with the primary physician to establish appropriate diagnostic and treatment plans.

Outpatient Women’s Mental Health

We hold a weekly Reproductive Psychiatry clinic for four months, during which you see patients and collaborate with a multidisciplinary team. This rotation takes place at the Payne Whitney Women’s Program at New York-Presbyterian Hospital/Weill Cornell Medical Center. You gain experience with obstetrics patients suffering from psychiatric disorders (pre-conception counseling, antenatal care, postpartum) and gynecology patients with issues such as peri-menopausal mood disorders.  

Outpatient Oncology

In the Outpatient Oncology Center, you spend half a day each week for four months seeing patients with the Director of Beth Israel Cancer Center Supportive Services. You manage two patients each week and follow their progress throughout your rotation. You learn about psychiatric issues patients face when they are diagnosed, treated for, and living with cancer, and how disorders manifest in cancer patients. You may explore issues of pain management, insomnia, and their treatment. The attending gives eight psycho-oncology lectures and uses case vignettes with questions. 

Outpatient Psychotherapy

In this rotation, you follow medical outpatients in psychotherapy, touching upon adjustment to medical illness, effect on family and loved ones, existential issues, disclosure, and effective interaction with the medical team. Your team might use audio or video with patients.

Palliative Care Rounds Liaison

As a team, you examine complex cases and the psychosocial issues they raise. You attend a 90-minute multidisciplinary conference each week, held by the Division of Palliative Care and attended by chaplains and chaplaincy students, social workers, music therapists, music therapy students, and physicians. 

Electives

It is important to us that you explore areas of special interest to you. To this end, you may take elective rotations in areas such as pain management, palliative care, or more in-depth aspects of women’s health.

We provide several formal didactics. The first is a 22-week-long course on CL psychiatry. We invite experts in this field as guest lecturers to complement our own faculty. Topics you will cover include psychopharmacology; neuropsychiatry; substance abuse; psycho-oncology; psychiatric aspects of movement disorders, liver transplant, obstetrics and nursing, death, dying and palliative care; cross cultural issues; pain management; coping and adaptation to illness; somatic symptom disorders; malingering; and factitious disorders.

Seminar with Joel, Wallack, MD: Introduction to Advanced PM

In this seminar you review classic papers in Psychosomatic Medicine on such topics as coping and adaptation to medical illness, approach to managing the difficult patient, and working as liaison to a medical or surgical team.

Fellows' Seminar

This year-long, weekly seminar with didactics explores advanced topics in Psychosomatic Medicine, including severe drug reactions, pain management, and CL aspects of cardiac, renal, endocrine, gastrointestinal and other areas. You review classic papers, current text books and papers, and meet with a journal club each month to critically evaluate recently published studies.

HIV Seminar

This weekly journal club is centered on the care of patients with HIV. You read and discuss journal articles and material on the psychiatric care of patients with HIV.

Research and Academic Project Meeting 

In this weekly meeting you discuss academic projects and elements of your eventual Grand Rounds presentation. You learn basics of research design, how to run a literature search, write abstracts, create posters, workshops and presentation format. Many of our fellows present at the Academy of Psychosomatic Medicine and the American Psychiatric Association annual meetings. 

Case Conferences

In this weekly conference you evaluate patients with diverse diagnoses, led by senior faculty or visiting attendings with a breadth of specific expertise, you learn how to teach in the case conference format, gain skills in interviewing in front of a group, and understand how and what to teach trainees at different educational levels.      

Teaching, Supervising, Administration, and Committees

Part of your training entails the supervision of Family Medicine third-year residents rotating through CL, as well as PGY-2 Psychiatry residents and third and fourth year medical students. You teach in journal club, seminars, formal lectures, rounds and in the case conference format. 

During six months of administrative duties you coordinate consult services, work with non-psychiatry physicians, triage consultation requests, and collaborate closely on the patient log and database. You learn about financial aspects of the CL service, clinical information systems, diagnostic codes, and the Medicare, Medicaid, and other third party payer processes. You serve on key committees and participate in program development, evaluation, and improvement at multiple levels as well. 

Research, Academic Projects, and Conferences

You are required to participate in academic projects, either joining one already in progress or developing your own. You make presentations throughout the year at various functions and are encouraged to write up findings for publication.

You attend the Annual Meeting of the Academy of Psychosomatic Medicine in November with expenses paid for by the division.

Supervision and Evaluation

Our full-time faculty supervises all of your clinical work, teaching, administrative, liaison, and academic activities. As a fellow you meet daily with your supervisor to review cases. You are directly observed in your duties as clinician, teacher, and administrator, progressing toward indirect supervision.

You are formally evaluated three times a year and at other points (following a presentation, after a patient encounter, etc.) by attendings, patients, non-physician staff, your trainees, and peers, on your skills in clinical information hand over, communication, professionalism, and teaching.

Benefits

We offer a generous benefits package including stipend, discounted housing, full-service libraries, access to computers and research databases, as well as VPN remote access. 

The Division of Consultation-Liaison Psychiatry and Department of Psychiatry at Mount Sinai Beth Israel strive for a pleasant and collegial working environment. We take your concerns seriously and foster many opportunities for socializing throughout the Health System.

For an application and other inquiries, please contact:

Daniel Safin, MD
Chief and Fellowship Program Director
Division of Psychosomatic Medicine
Mount Sinai Beth Israel
First Avenue at 16th St., Fierman Hall, 5F09
New York, NY 10003
Tel: 212-420-2435
dsafin@chpnet.org
 
or
 
Joel Wallack, MD
Associate Program Director, Fellowship in Psychosomatic Medicine
Tel: 212-420-2398
mailto:jwallack@chpnet.org