The first year focuses on building foundational clinical skills through an integrated schedule of psychiatry, internal medicine, and neurology rotations. Residents attend protected didactics alongside their clinical work, fostering class cohesion and accelerating learning during this formative period.

Clinical Experience

First-year residents develop competence in psychiatric interviewing, crisis assessment and management, and working with acutely ill patients. Training occurs under close supervision in an apprenticeship model with substantial contact with attendings and senior residents. Residents gain experience teaching medical students, further refining psychiatric interviewing skills while learning to be educators early in training. The year emphasizes learning basic clinical skills across inpatient adult psychiatry, child and adolescent psychiatry, and emergency psychiatry, alongside non-psychiatric rotations in inpatient and outpatient internal medicine, emergency medicine, and inpatient and consult neurology.

Didactics

The first-year didactic curriculum augments clinical learning and is attended by residents on both psychiatric and non-psychiatric rotations, promoting continuity and class cohesion even when rotating through different services. The curriculum provides knowledge and clinical skills relevant to inpatient psychiatric care, introduces research literacy and approaches to accessing psychiatric literature, and creates opportunities for self-assessment and reflection on the challenges of being a new physician with primary responsibilities for extremely ill patients in a busy academic urban hospital.

Residents attend a twice-weekly Morning Report led by senior residents, weekly Formulation Rounds with the training directors, Grand Rounds, and additional unit and service-specific educational events.

The second year solidifies knowledge of inpatient psychiatry while introducing extended outpatient training and subspecialty experiences. Residents round out clinical experiences across multiple settings, develop core outpatient skills in preparation for third-year independence, and begin considering areas of psychiatry in which to specialize.

Clinical Experience

Second-year residents gain extensive experience in outpatient psychiatry through multi-month immersive training, focusing on new evaluations, sub-acute stabilization, crisis management, and targeted psychopharmacology and psychotherapies. Training continues in inpatient and emergency psychiatry, and includes rotations in neuromodulation, consultation-liaison, and community psychiatry. During the Mount Sinai-Behavioral Health Center half, residents choose among immersion pathways to begin their deeper exploration of areas of clinical interest.

Didactics

The Phenomenology, Neuroscience, and Psychopharmacology course is organized into illness-specific modules teaching meticulous symptom understanding, multiple conceptual frameworks for patients' presentations, and underlying neuroscience from socially observable phenomena down to genetics and epigenetics.

Psychotherapy training focuses on fostering knowledge and skills in established and emerging evidence-based treatments. Early instruction covers attending to patients' moment-to-moment emotions, cognitions, and behaviors, and incorporating core supportive psychotherapy techniques into daily practice regardless of therapeutic orientation. This pragmatic, practice-heavy approach addresses questions such as, "What is the patient trying to tell me?" and "What do I say next?".

Other courses include topics such as Systems Psychiatry, Consultation-Liaison psychiatry, and Forensic Psychiatry, among others.

Process Group begins in PGY-2 and continues through PGY-4, offering experiential learning about group dynamics, self-reflection, and peer support in a confidential environment led by experienced voluntary faculty with no supervisory or evaluative functions in the residency.

PGY-2 residents also attend multiple case conferences and clinical seminars alongside PGY-1s.

The third year centers on developing independence in outpatient psychiatry and pursuing individualized interests. Residents immerse themselves in the overall management and long-term care of outpatients while exploring specialty areas and diverse treatment modalities through substantial elective time.

Clinical Experience

Third-year residents maintain offices in outpatient clinics and provide individual treatment under close supervision, with opportunities to work with leading experts in specialty areas, such as schizophrenia, treatment-resistant depression, interventional psychiatry, personality disorders, obsessive compulsive disorders, substance use, and geriatric psychiatry. Residents learn diverse psychopharmacological interventions and receive extensive clinical training in cognitive behavioral, psychodynamic, and supportive psychotherapies with supervision by senior psychotherapists. Residents run groups, evaluate and treat children and adolescents, and have opportunities for elective outpatient consultation-liaison work in ambulatory medical/surgical settings. Longitudinal elective time allows residents to define and pursue concentrated focuses in nearly any setting, including clinical, research, teaching, administrative, public, and forensic areas.

Didactics

The curriculum advances residents' learning commensurate with their growing clinical knowledge base, practice, and independence, prioritizing an in-depth focus on different psychotherapies, outpatient psychopharmacology, and systems of care.

The Advanced Outpatient Psychopharmacology course revisits previously encountered topics at increasing sophistication, organized by medication class and supplemented by regularly scheduled expert case conferences for complex situations.

Psychotherapy training includes several hours per week of didactics in addition to clinical supervision and work with dedicated educational consultants. A wide range of therapies is taught sequentially and in parallel, including psychodynamic, cognitive behavioral, dialectical behavioral, group, couples, positive psychology, and eclectic approaches, as well as the psychology of psychopharmacology. Reflecting the high value placed on learning psychotherapy, the department maintains a formal affiliation with the New York Psychoanalytic Society & Institute. This collaboration includes supervision of long-term psychotherapy cases, instruction in core didactics, and specific financial and time-saving provisions for residents pursuing additional psychodynamic training.

The Public Psychiatry course augments residents' community mental health experiences, emphasizing recovery, rehabilitation, and social service provisions. Process Group continues throughout the year. Regular Outpatient Formulation Rounds with training directors facilitate community building, clinical

The final year emphasizes mentored training and academic work in individualized areas, as residents cultivate readiness for independent practice and increasingly self-directed professional growth. Substantial elective time supports residents in establishing their unique professional identities.

Clinical Experience

Fourth-year residents continue treating select outpatients longitudinally under supervision, advancing psychotherapeutic and psychopharmacological skills. Senior-level experience in partial hospital or intensive outpatient settings includes running groups, supervising junior residents and non-physician practitioners, and consolidating leadership abilities. Each PGY-4 serves as a Junior Teaching Attending, teaching, advising, mentoring, and supervising PGY-1s and 2s across various clinical settings. Approximately 80 percent of the year consists of elective time for mentored training in individualized areas, including clinical specialization, research, education, administration, or other professional pursuits.

Didactics

Senior residents receive protected classroom time focusing on advanced topics in psychiatry that assume a well-integrated foundational knowledge from the first three years. Driven by the program's focus on developing specific expertise, the curriculum allows for a majority of elective time. Each PGY-4 class develops and directs its own didactic program under training director guidance. This application of progressive responsibility helps senior residents learn to guide their paths and styles of lifelong learning while maintaining community cohesion as each member pursues distinct areas of interest.

Topics frequently included women's mental health, sexuality and treatment of sexual dysfunctions, advanced psychotherapy and psychopharmacology, giving effective feedback, negotiating, and professional development. Process Group continues throughout the year.