Clinical Sites

The Mount Sinai Hospital has one of the oldest general hospital psychiatric inpatient services in the nation. Currently divided into adult and adult/geriatric 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 and potential PGY-4 Junior Teaching Attending), 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 weekly 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. This space includes 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 and therapy modalities. Starting the year with  35-40 patients, PGY-3 residents evaluate new cases each week and build their caseloads to a maximum of approximately 50 patients. In addition to patients seen for medication management, this caseload includes approximately 4-6 patients in weekly psychotherapy, 5 geriatric patients, several children or adolescents in a variety of outpatient clinical settings, and a few patients undergoing longitudinal evaluations at any one time. Residents also may elect to run groups, treat couples/families, and focus their caseloads according to their areas of interest.

In our Integrated Primary and Specialty Care Psychiatry Clinic electives, PGY-2, 3, 4 residents can 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 an outpatient consultation-liaison role.

In the Partial Hospital Program (PHP) and Intensive Outpatient Programs (IOP), 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 transplant, geriatrics, HIV, ob-gyn, neurology/multiple sclerosis, oncology, and pediatrics. 

Reflecting one of the largest private investments ($140M) in psychiatry in the history of NY state, the wrap-around services of the MSBHC allow for a seamless integrated continuum of care in one location. These include experiences in outpatient (adult, child/adolescent, and geriatric), acute and subacute evaluations, partial hospital and intensive outpatient programs, inpatient (adult, geriatric, and substance use), intensive crisis residence, Assertive Community Treatment (AOT), primary care clinics, and detox/rehab (outpatient + inpatient).

Residents begin their experience at MSBHC with inpatient rotations in their first two years. In PGY-2 year, residents have a full-time six-month outpatient rotation, providing care in adult, geriatric, and substance use psychiatry. This experience provides residents an opportunity to see patients across a wide range of levels of symptom severity in a context with extensive psychiatric resources often unavailable under one roof. Residents gain experience in psychopharmacology, diagnostic assessment, crisis intervention, evidence-based brief psychotherapies, groups, and collaboration with other mental health professionals. In addition to core PGY-2 didactics, residents attend weekly seminars while on this outpatient rotation.

In the PGY-3 outpatient Resident Training Clinic, the experience parallels that described for the rotation at the sister MSH clinic.

During their substantial elective time (PGY-2: 1 d/wk x 6 mos; PGY-3: ¾ d/wk all year; PGY-4: ~4 d/wk x 9 mos), residents can take advantage of the wealth of resources and opportunities at the MSBHC.

In 2015, the Child and Adolescent Psychiatry Inpatient Service relocated to a renovated space at the Mount Sinai Morningside site. This 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.

Additionally, general and specialty child and adolescent outpatient psychiatry clinics are available at The Mount Sinai Hospital and the Mount Sinai-Behavioral Health Center. MSH also has a separate pediatric consultation-liaison service, where residents can rotate in PGY-1 or 2.

PGY-1 and 2 residents may elect to spend a month treating patients in this 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. 

The Arnhold Global Health Institute supports this interdepartmental, longitudinal, two-year track combining a didactic series on global health with international field work. Residents learn to advance global mental health through experiences in underserved areas, both locally and internationally.