Clinical Sites

Situated in one of the top departments of psychiatry in the country, The Mount Sinai Hospital’s Adult Psychiatry Residency Training Program thrives on our institution’s ongoing intellectual, humanistic, geographic, and financial growth. We benefit from an intimate relationship with the Icahn School of Medicine at Mount Sinai as well as from the Mount Sinai Health System’s expansion across New York—relationships which make translational science a reality. The esteem in which psychiatry is held within the institution is further personified by our leadership, who are themselves psychiatrists: Kenneth Davis, MD (President and CEO of the Mount Sinai Health System), Dennis Charney, MD (Dean of the Icahn School of Medicine); Eric Nestler, MD, PhD (Dean for Academic and Scientific Affairs).

The Mount Sinai Hospital

One of the oldest and largest teaching hospitals in the country, The Mount Sinai Hospital has consistently been named among the best hospitals in the nation and serves as the site for residents’ core rotations. PGY-2 residents also rotate at the James J Peters VA Medical Center, and select subspecialty experiences are available at additional sites across the Mount Sinai Health System.

The Mount Sinai Hospital has one of the oldest general hospital psychiatric inpatient services in the nation. Currently divided into adult and geriatric/med-psych units, our service is staffed by hospitalist attendings with whom residents work closely throughout the day. Serving both the Upper East Side of Manhattan and the East Harlem communities, our inpatient units reflect an equal gender distribution and a diverse ethnic and socioeconomic makeup. Admitted patients also come directly transferred from other hospitals (within and outside the Mount Sinai Health System), community mental health agencies, residential programs, and nursing homes.

Treatment teams consist of attending psychiatrists, residents (PGY-1 and 2), medical students, nurses, social workers, psychology externs and interns, and recreational/art therapists. Residents generally work from 8am until 5-6pm and have a cap of six patients at a time with whom they meet for daily sessions. This cap of six allows for in-depth experiences, strong therapeutic alliances, pursuit of academic interests, attendance at frequent academic case conferences, and rotations through our ECT service. Residents provide patient care, participate in daily interdisciplinary team meetings, daily patient rounds, run community meetings and medication groups, and receive ongoing direct one-on-one supervision by full-time inpatient attendings in an apprenticeship model. Residents supervise and teach medical students, gaining invaluable experience as educators early in training, further refining psychiatric interviewing skills. Residents also present patients at case conferences and clinical seminars held on the inpatient units. 

A separate dedicated, renovated, and state-of-the-art locked facility adjacent to the medical ER, the Psychiatric Emergency Service allows for intimate therapeutic contact with patients in quiet interview rooms, with dedicated security guards at all times, and provides for the safety of staff and patients. Residents learn the practice of triage, assessment, crisis management, community psychiatry, and disposition to care, as they work one-on-one with attendings and teach medical students.

In the Resident Training Clinic, residents practice a variety of treatment modalities, including psychopharmacology and multiple forms of individual and group psychotherapies, while providing care to patients with a wide range of diagnostic and socioeconomic diversity. In addition to working with full-time and voluntary faculty, residents also have numerous weekly meetings with multiple other supervisors who specialize in a variety of clinical areas. Residents have an average of five to six hours per week of supervision.

A typical PGY-3 Training Clinic caseload consists of 20-25 patients in evaluation, short-term crisis intervention, psychopharmacologic treatment, psychodynamic psychotherapy, cognitive-behavioral therapy, supportive and other therapies, and through electives (e.g., couples/family, DBT, research evals, TFP, etc.). Each resident is also responsible for 15 patients in the geriatric clinic. In the child and adolescent clinic, residents attend a weekly evaluation service in addition to treating selected children or adolescents longitudinally. In our Integrated Primary Care Psychiatry Clinics, residents experience working collaboratively with physicians from other disciplines, effectively preparing our residents for one aspect of the changing world of psychiatric practice. Residents may attend a variety of these non-psychiatric clinics (e.g., primary and specialty medicine clinics; Center for Transgender Medicine and Surgery; pain management; HIV; Ob-Gyn; liver transplant, etc.).  In the Partial Hospital Program, PGY-2 and PGY-4 residents treat severely ill acute and subacute patients in daily individual and group modalities, working alongside non-physician therapists and under attending supervision. Management of complex psychopharmacological regimens and complex psychotherapeutic interventions are mainstays of this experience.

Numerous full-time, fellowship-trained, and experienced attendings provide clinical supervision in this PGY-2 experience. Beyond treating psychiatric conditions on the general medical/surgical services, areas of faculty sub-specialization include including transplant, geriatrics, HIV, ob-gyn, neurology/multiple sclerosis, oncology, ENT, and pediatrics. 

The James J Peters VA Medical Center in the Bronx is the oldest VAMC in New York City, serving veterans since 1921. It is currently a Level 1 Clinical Referral Tertiary Care Center with more than 300 beds and an adjoining 120-bed nursing home facility. Highlighting a strong psychiatric focus, it is one of only 10 VAMCs in the country housing a congressionally-granted Mental Illness Research, Education, and Clinical Center (MIRECC).

Residents begin this VA experience with a single inpatient month in the latter half of PGY-1 or in the first half of PGY-2.  Residents then spend 6-months of PGY-2 in the full-time outpatient Rapid Access Clinic, engaged in evaluation and treatment of new patients as well as in weekly longitudinal geriatric, substance use, and Integrated Primary Care outpatient clinics. This experience provides residents an opportunity to see patients across a wide range of levels of severity in a unique medical system with extensive outpatient psychiatric resources often unavailable to patients in the private health care system. Residents have a broad experience in psychopharmacology, diagnostic assessment, crisis intervention, evidence-based psychotherapies, group psychotherapy, and collaboration with other mental health professionals. In addition to core PGY-2 didactics, residents attend weekly seminars while on this rotation.

PGY-3 and PGY-4 residents may elect to participate in the weekly DBT Training Program, as well as act as supervisors for PGY-2 residents.

In 2015, the Child and Adolescent Psychiatry Inpatient Service relocated to a renovated space at the Mount Sinai St. Luke’s site. This new unit provides training services for child fellows, triple board residents, and PGY-1 and 2 residents. Residents gain experience with running family meetings and learning about different care systems, including working with the school system and child protective services.

PGY-1 and 2 residents spend a month in this maximum-security hospital of the New York State Office of Mental Health, working with individuals charged with serious crimes who have been found unfit to stand trial as a result of mental illness, inmates transferred from jail or prison who have become mentally ill while serving their sentences, and patients who have never been charged with criminality but are felt to be too dangerous or unmanageable to be housed in less restrictive state psychiatric hospitals.