Residency and Internship Programs

St. Luke's-Roosevelt Hospital Center
Psychiatric Residency Training Program

TABLE OF CONTENTS

Welcome
Continuum Health Partners, Inc.
St. Luke’s and Roosevelt Hospitals
Department of Psychiatry
Divisions

  Adult Inpatient and Emergency Services
Adult Acute Outpatient Service
Integrated Psychiatric Services
The Addiction Institute of New York
Child and Adolescent Service
Other Specialized Programs
Residency Program in Psychiatry
  Clinical Rotations
Didactic Curriculum
House Staff Policies
Enjoying Life in New York City
Application Procedure

WELCOME

We are pleased that you are considering St. Luke’s and Roosevelt Hospitals for your residency training in psychiatry. Our program offers a comprehensive approach to learning psychiatry in a setting that is both challenging and supportive. Our goal is to provide an excellent academic and clinical program that prepares you for a personally and professionally satisfying career in psychiatry.

St. Luke’s and Roosevelt Hospitals have a long and distinguished history in training psychiatrists in New York City. Our group of 36 residents is large enough to create a major presence in the hospital, yet small enough to encourage a friendly and personal atmosphere. Outstanding supervision and frequent contact with attendings, instructors, and researchers are major features of our program. In addition to clinical training, we have an extensive curriculum composed of lectures and seminars during all four years of training. This breadth and depth of these didactics ensure that our residents are presented with the most current psychological, sociocultural, and neurobiological theories in the field. Our proximity and close affiliation with Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute also allow for many shared research and educational opportunities for our residents.

Our hospitals serve the Lincoln Center, Upper West Side, and Morningside Heights areas of Manhattan – all vibrant neighborhoods just west of Central Park that have recently undergone a renaissance. The population in these neighborhoods is culturally, ethnically, and socioeconomically diverse, providing residents with opportunity to treat a broad range of patients. I hope you will find this booklet to be a helpful introduction to our department and program. Please feel free to contact us if you have would like to know more about our program.

Prameet Singh, MD

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CONTINUUM HEALTH PARTNERS, INC.

Continuum Health Partners, Inc. was formed in January, 1997, as a partnership of two venerable hospitals: Beth Israel Medical Center and St. Luke’s and Roosevelt Hospitals. Building upon the strengths of both institutions, the partners soon established a broad-based, integrated health services network extending throughout the New York metropolitan region. In May, 1998, the partnership was joined by a third distinguished institution, Long Island College Hospital, located in the Cobble Hill/Brooklyn Heights section of Brooklyn. Continuum continues to grow with the addition, in August, 1999, of New York Eye and Ear Infirmary – an outstanding specialty care institution.

Continuum Health Partners, Inc. delivers inpatient care through nearly 3,100 beds located in seven major hospital facilities in Manhattan and in Brooklyn. Continuum providers also see patients in group and private practice settings and ambulatory centers in the five boroughs of New York and in Westchester County. All four Continuum hospitals were established more than a century ago by civic-minded individuals with a shared commitment to improving health, and health care, in their communities. Today, participation in the Continuum partnership enables each member institution to better fulfill its traditional mission by making available an impressive array of resources for the provision of state-of-the-art and compassionate care. Together, they are superbly equipped to identify and respond to the health-related needs of their populations in a patient- and physician-friendly environment.

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ST. LUKE’S and ROOSEVELT HOSPITALS

St. Luke’s and Roosevelt Hospitals, University Hospital of Columbia University College of Physicians and Surgeons, is a 1,076-bed, full-service community and tertiary care hospital. St. Luke’s-Roosevelt was formed in 1979 by a merger of St. Luke’s Hospital, adjacent to the campus of Columbia University, and the Roosevelt Hospital, located a few blocks south of Lincoln Center at Tenth Avenue and 58th Street. Residents train in recently constructed state-of-the-art facilities: a 10-story building at the St. Luke’s Division and a 13-story building at the Roosevelt Division.

St. Luke’s-Roosevelt provides a sophisticated clinical and academic environment in which physicians can practice superior medicine, train more than 480 residents and fellows in 40 clinical specialties and carry out innovative research. The Hospital Center is widely respected for high quality clinical care and its contribution to research in cardiology, gastroenterology, metabolic disorders, psychiatry and many other areas.

Through out its history, St. Luke’s-Roosevelt also has placed strong emphasis on responding with compassion and sensitivity to he unique needs of the communities it serves, including areas whose residents have multiple social and economic challenges. It provides much of the inpatient, outpatient and emergency medical care for more that half a million residents of the West Side of Manhattan, as well as for patients throughout the New York Metropolitan region. The Hospital Center admits approximately 40,000 patients, serves more that 300,000 outpatients, and proves emergency care for over 100,000 patients every year.

You can visit St. Luke’s and Roosevelt Hospitals and Continuum Health Partners, Inc. on the web at www.slrhc.org.

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DEPARTMENT OF PSYCHIATRY

The department of psychiatry at St. Luke’s and Roosevelt Hospitals is a major provider of psychiatric care for the diverse communities of the New York Metropolitan area. Last year, our clinical divisions provided over 2000 inpatient admissions, 20,000 outpatient visits, and 70,000 substance abuse treatment visits. The faculty consists of over 35 full-time or half-time psychiatrists, 25 psychologists, and many esteemed voluntary faculty, all with academic appointments at both St. Luke’s-Roosevelt Hospital and Columbia University College of Physicians and Surgeons. The faculty in all five division of the department actively participates in the supervision and teaching of residents.

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Divisions

Adult Inpatient and Emergency Service

St. Luke’s-Roosevelt Inpatient Service provides adult short-term acute psychiatric treatment on four units to over 2000 patients a year. These units offer comprehensive assessment, treatment, and discharge planning services and utilize a multidisciplinary staff for the treatment of a broad range of psychiatric disorders. Psychiatry residents rotate on three inpatient floors at the St. Luke’s Site. Clark 8, a 32-bed designated general psychiatry teaching unit, is the core of residents training. Here, residents work alongside psychology interns, Columbia medical students and more senior residents to learn the assessment and management of acute psychiatric conditions. Clark 6 is a floor specializing in detoxification and motivational interviewing where residents learn the assessment and treatment of substance dependence for two months. Clark 9 is a floor specializing in Geripsychiatry where residents rotate for one month to learn diagnostic and treatment issues of the elderly patient with psychiatric conditions. 7G is a general psychiatry unit at the Roosevelt site providing care for a range of patients with different illness. PGY4 residents complete a Junior Attending rotation here for three months where they fine tune their autonomy, team leadership, and decision making skills.

Psychiatric Emergency Services are provided at both hospitals within Comprehensive Psychiatric Emergency Program (CPEP). These units serve over 6000 patients a year. The CPEP model of care allows residents a comprehensive approach to managing psychiatric emergencies with well-coordinated components including extended observation beds, a mobile crisis team, and crisis residence beds. Residents spend three months in the CPEP during their PGY1 and PGY2 years learning comprehensive evaluation and treatment under close attending supervision.

The Adult Consultation/Liaison Service interacts with the rest of the Hospital Center by responding to the diverse and complex psychosocial needs of medical, surgical and other inpatients. Residents work closely with attendings during their PGY 2 and PGY4 years providing assessments, crisis management and treatment recommendations.

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Adult Acute Outpatient Services

The Adult Outpatient Clinic, located at the Roosevelt site, provides short and long term treatment for the full range of adult psychiatric disorders. The staff in this clinic sees over 20,000 visits a year with a multidisciplinary team delivering both traditional and specialized treatments. Residents spend a significant portion of their PGY3 and PGY4 years in this clinic, learning outpatient diagnostic assessments, psychopharmacology, individual, group and family therapies, and specialized treatment including cognitive-behavioral and dialectic-behavioral therapies. The Clinic experience requires residents to become competent in the major types of therapies, including long-term psychodynamically-oriented therapy, both individual and group CBT, supportive psychotherapy, and pharmacological treatments. Residents receive five hours of direct supervision per week on these types of therapies by skilled specialists.

Integrated Psychiatric Services is designed to provide care to the seriously and persistently mentally ill adults by providing psychiatric treatment with case management using rehabilitation models. Other components include a large Dual Diagnosis (substance abuse and mental illness) Clinic, and a Residential Community Service which provides coordinated outreach to housing programs for the mentally ill in the City. Residents begin to see outpatients during their PGY2 year and then rotate through the IPS for one day a week during their PGY3 year learning sophisticated psychopharmacology and management of the severely mentally ill. Residents may also spend time in IPS during their PGY4elective block.

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The Addiction Institute of New York

The Addictions Institute at St Luke’s-Roosevelt is a nationally respected comprehensive alcohol and drug dependency treatment service. The breadth of services includes an evaluation service, inpatient and outpatient detoxification, residential rehabilitation, and extensive clinical services. This division is also active in nationally recognized research into treatment of alcohol and substance abuse. Residents spend two months during the PGY2 year on this service learning evaluation, detoxification, and treatment of alcohol and drug dependency in individual and group therapies. Residents often return to this division for a range of electives during their PGY4 year.

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Child and Adolescent Service

The Child and Adolescent Service provides a broad range of general and specialized services for children and adolescents. Services include an evaluation and outpatient clinic, a crisis service, therapeutic day hospital for emotionally disturbed and truant adolescents, an adolescent and pre-adolescent after school program, a language and learning disabilities unit, and an Early Childhood Center. Residents rotate within this division one afternoon a week for their entire PGY3 year evaluating and treating children and their families. Residents receive individual supervision from Child and Adolescent attendings who also serve as mentors for those interested in pursuing further training in child psychiatry. This division also offers eight full-time post-residency fellowships each year leading to Board Certification in Adult and Child and Adolescent Psychiatry.

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Other Specialized Programs

Sleep Disorders Institute
The Sleep Disorders Institute is a clinical, research, and training facility that offers evaluation and treatment to patients suffering from disorders of sleep and wakefulness. The institute includes the services of interdisciplinary team of consultants specializing in psychiatry, pulmonology, neurology, ENT, maxillofacial surgery, endocrinology, internal medicine and urology. Residents may spend time at the institute during their PGY4 year elective time.

The Women’s Health Project Treatment and Research Center
This Center develops and provides specific treatment for women who have been victims of crimes, trauma, or abuse and who suffer from addictions. Specialized group treatments focus on specific psychiatric symptoms, relapse prevention, HIV risk reduction, and parenting. The Center also conducts research in several areas including epidemiology, treatment outcome, maternal/child aggression, and in a member of the NIDA Clinical Trail Network. A resident interested in specializing in trauma follows patients under close supervision of experienced experts in trauma and substance abuse during her third year, and may spend additional time at the Center during her PGY4 year elective time.

Crime Victims Treatment Center
This center provides treatment for victims of crimes in New York State. Each year, a resident wishing to specialize in trauma treatment works in the center alongside other clinicians. The resident gains experience in the pharmacological management of acute and chronic trauma symptoms, as well as group interventions for treatment of incest survivors, victims of sexual assault, and victims of torture. This resident is supervised weekly by a trauma specialist.

The Neurobiological Disorders Service
This service conducts outpatient studies on the long term efficacy and safety of medications prior to FDA approval. Residents may elect to conduct research with this group during their PGY3 year. Residents have the opportunity to work closely with researchers in research design and implementation. Ongoing studies include a clinical trial evaluating the cost-effectiveness of the newer antipsychotic medications, a clinical trial on treatment-resistant depression, and a study on the use of newer antipsychotics with antidepressants.

St. Luke's Hospital Behavioral Science Research Unit
This research center specializes in investigations in addictions, including chronic pain treatments for people with ongoing addiction problems, motivational interviewing for adherence in several illnesses, and several other nationally funded projects. Residents are mentored by members of this unit from PGY2 on. PGY3 residents may elect to conduct research with this group in a research track. PGY4 residents also are offered electives here.

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THE PSYCHIATIC RESIDENCY TRAINING PROGRAM

The St. Luke’s-Roosevelt Psychiatric Residency is a four-year training program with a total of 36 residents. The program is approved by the American Board of Psychiatry and Neurology and fully accredited by the Accreditation Council on Graduate Medical Education. The philosophy of the program is to provide exceptional clinical opportunities combined with a didactic curriculum designed to build the skills and knowledge base our residents need to remain current in the field long after graduation from training. As a result, residents graduate with a solid grasp of basic clinical skills, a substantial understanding of current research, and a mastery of diagnostic and therapeutic techniques enabling them to pursue any career direction they choose.

Rotations and Didactics

PGY1 Year
The first year of residency training at St. Luke’s-Roosevelt includes rotations in Inpatient and Emergency Psychiatry, Internal Medicine, and Neurology. The six-month psychiatry rotation consists of a broad introduction to Inpatient and Emergency Psychiatry. All PGY1’s spend three months on Clark 8, an inpatient unit that has been designed to accommodate the needs of beginning residents, and one month on Geripsychiatry floor. In addition, residents spend one month in the psychiatry emergency room. The emphasis during these months is on clinical assessment, interviewing skills, treatment planning, and working in a treatment-team approach.

The Emergency Psychiatry experience begins with a one-month rotation during the PGY1 year during which residents are supervised by attending-level physicians at all times. In this way, the beginning trainee learns acute care psychiatry working side-by-side with an experienced clinician until he or she feels secure in assessing patients independently.

The six months rotation in Internal Medicine and Neurology takes place within the St. Luke’s-Roosevelt Hospital. Close coordination between our department and the departments of neurology and medicine ensure a comprehensive exposure to diagnosis and treatment of major medical conditions and a full immersion into the intern experience.

During the PGY1 year, residents have in house call every fourth day until 10:30PM at night during medicine rotations, at which time a night-float resident takes over care of patients. This ensures that residents work no longer than 14 hour shifts with the night off to return home and sleep. There is no 24 hour call for residents. During their psychiatry rotations, PGY1 residents do three weeks of night float in psychiatry. The first several calls are taken with senior residents who help to teach and support early trainees. During calls throughout the residency, there is an in-house attending available for teaching and consultation.

PGY2 Year
The PGY 2 year enriches and broadens the skills acquired in the first year as trainees further develop their identity as a psychiatrist. The year is divided into 3 months of inpatient psychiatry, 2 months of Emergency psychiatry, 2 months on a substance abuse/dependence rotation, 1 month in Psychosomatic Medicine, 1 month of night float, and 3 months in a Transitional Day Treatment Program outpatient clinic.

The inpatient and emergency psychiatry experience during the PGY2 year allow residents to gain a solid foundation in the diagnosis and treatment of acute psychiatric problems, managed either in a hospital or with the ready availability of an inpatient unit. Residents also spend 2 months in a substance abuse rotation which allows residents to actively learn how to diagnose and treat drug dependency with sophisticated, proven treatments. Residents learn how to conduct comprehensive psychosocial evaluations, inpatient and outpatient detoxifications, and individual and group treatments incorporating motivational and self-help concepts.

The second year also provides an introduction to psychiatric care in the outpatient setting. In the Transitional Day Treatment Program, residents begin under supervision to treat a range of psychiatric illness with several different modalities including individual, group, and specialized treatments (e.g. dialectical behavioral treatment). This program is an intensive outpatient program that serves as an alternative to hospitalization for patients who need significant support, but not 24-hour care. Here, residents learn to achieve rapid stabilization of symptoms, rehabilitation and resocialization for their patients. Residents learn the principals of DBT and co-lead a group with a skilled leader of DBT as well as conduct an individual therapy using DBT techniques. Residents also become skilled in the pharmacological treatment of personality disorders.

In addition, PGY2 residents follow some of their discharged patients from the inpatient unit in the Continuity Clinic. This Clinic allows residents to continue to treat patients for up to three years, after they first work with them as an inpatient on Clark 8. This allows for residents to have the experience of treating severely mentally ill patients over several years to see the changes which take place only over extended time.

PGY3 Year
The PGY3 year allows residents to gain the necessary skills and theoretical base to practice psychiatry in an outpatient setting. Through their clinical experience and academic work, residents begin to master the pharmacological and therapeutic management of patients and begin to learn and incorporate the theoretical underpinnings of psychiatry. Residents master the psychotherapies in this year, including supportive, dynamic, cognitive behavioral, dialectic behavioral, group, and couples and family work.

The experience in the Adult Outpatient Clinic and Integrated Psychiatric Services clinic continues from the PGY2 year. Residents continue with their cases from the PGY2 year and take on new cases which offer greater challenges and learning experiences. All PGY3’s also co-lead a CBT group under supervision of an experienced group leader, adapting manualized treatments to a group of patients. A portion of the outpatient experience can also include a year long part time rotation in one of our research clinics. Residents are directly involved in research protocols and subject management, and design and conduct their own project leading to publication.

PGY3 residents also receive training in child and adolescent psychiatry by following a group of patients and their families for the course of the year. Residents learn to evaluate, diagnose and treat a wide range of psychiatric ills in youths, and receive weekly supervision from an expert in child/adolescent psychiatry.

Residents are highly supervised in their work during the PGY3 year, and this case load is kept to a moderate number of patients with a wide range of psychopathology. Residents receive the following supervision: 2 hours per week for psychodynamic psychotherapy cases, 1 hour per week for psychopharmacology cases, 1 hour a week for CBT group, 1 hour per week for individual CBT case work when a case is in process, 1 hour a week in child/adolescent psychiatry, and 1 hour a week supervision in IPS for chronically mentally ill clients. Additional supervision in DBT, couples and family is available for interested residents.

PGY4 Year
The fourth and last year of residency training allows the senior resident considerable flexibility to pursue specific areas of interest in depth, while continuing to hone and develop clinical skills. During the fourth year, residents chose from several months of elective time and complete their consultation liaison rotations.

The Consultation Liaison experience pairs a resident with an attending at each hospital site. Residents perform consultations on medical and surgical patients and work closely with the doctors, nurses and social workers on the inpatient medical floors to provide treatment and management recommendations. Management of delirium, capacity issues, treatment adherence, drug and alcohol detoxification, preexisting mental illness, and characterological pathology are frequent treatment concern. The clinical C/L experience is supplemented by a comprehensive curriculum and case conferences at which residents present cases and discuss management principles.

PGY4 residents complete a Junior Attending rotation on an inpatient psychiatry unit, 7G. Here residents learn to lead teams, decide on patient treatments and disposition with progressively less supervision. They also teach medical students and junior residents in basic psychiatric concepts.

The electives during the PGY4 year allow great flexibility. Electives can be research electives with members from our department, the department at Columbia University/New York State Psychiatric Institute, or other New York City institutions. This time may also be used to focus on the development of a particular clinical skill such as performing ECT, treatment of sleep disorders, or treatment in community psychiatry settings. Three residents each year are invited back to Clark 8, an inpatient training unit, to function as Chief Residents.

PGY4 residents spend two months at Fordham Student Health, conducting assessment and treatments of college students in this University located across the street from Roosevelt Hospital.

All residents also continue with a reduced caseload of patients at the Outpatient Clinic from their PGY3 year including their long-term therapy cases. PGY4 residents also take part in a year-long course on Short Term Dynamic Psychotherapy. Each resident conducts treatment with a patient using this model while he/she receives weekly supervision using videotaped sessions. Fourth year residents also present a clinical case at Departmental Grand Rounds with a guest discussant.

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General Clinical Rotation Schedule




Year 1

4 months
2 months
1 month
I month
3 months
1 month

Internal Medicine

Neurology
Geriatric Psych
ER Psych
Inpatient General Psychiatry

Night Float






Year 2

1 month
.9 FTE
2 months
.9FTE
3 months
.9FTE

2 months
.9FTE
1 month
.9FTE
3 months
.9FTE
Night Float
ER Psych
Outpatient Day Treatment Program
Substance Abuse
Psycho-somatic Med
Inpatient General Psychiatry
Outpatient Continuity Clinic – Community Psychiatry
0.1FTE for 12 months




Year 3
Clinical Track
Roosevelt Hospital Outpatient Clinic
.7 FTE for 12 months
St Luke’s Outpatient Clinic – Community Psychiatry
0.1FTE for 12 months
Child/Adolescent Outpatient Clinic
0.2FTE for 12 months

 





Year 3
Research Track
Roosevelt Hospital Outpatient Clinic
.5 FTE for 12 months
St Luke’s Outpatient Clinic – Community Psychiatry
0.1FTE for 12 months
Child/Adolescent Outpatient Clinic
0.2FTE for 12 months
Outpatient Research Clinic
.2FTE for 12 months



Year 4

3 months
.75 FTE
2 months
.75 FTE
5 months
.75 FTE
2 months
.75 FTE
Psychosomatic Medicine
Junior Attending on General Inpatient Unit
Electives
Student Health Service
.25 FTE Outpatient Clinic

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Didactics -Summary of Scheduled Courses and Conferences

PGY1
Introduction to the Practice of Psychiatry
The course is a general review of areas of major importance to a beginning resident. It includes an overview of the major Axis 1 and 2 disorders and their treatment, the mental status examination, principles of managing patients while on-call and introductory lectures covering basic psychopharmacology. The concept of evidence-based medicine is also introduced: each resident presents on a topic after a literature search.
Weekly, for 12 sessions.

Emergency Psychiatry
This course reviews the assessment and management of psychiatric emergencies, emphasizing areas of major importance to beginning residents. Topics covered include depressive and anxiety disorders in the ER setting, assessment and management of suicidal and violent patients, substance use and dependence, and assessment of medical needs on the psychiatric ill.
Weekly, for 9 sessions.

Introduction to Clinical Psychopharmacology
This course gives an overview of the medications used in psychiatry. All major drug classes are discussed including antipsychotics, mood stabilizers, antidepressants, antianxiety agents, stimulants, cognitive enhancers, and medications for addictions. Clinically relevant safety issues are discussed as are common drug-drug interactions.
Weekly, for 18 sessions.

Inpatient Case Conference
Residents present clinical cases to visiting attendings in a formal case conference on the inpatient unit. Patients are presented, interviewed and then discussed. The discussant gives diagnostic impressions and treatment recommendations.
Weekly, throughout the year.

Journal Club
The Chief Residents and inpatient attendings conduct a journal club with the PGYI and II residents and the psychology interns on Clark 8. Relevant and recent articles are retrieved by the resident and are discussed in a critical manner.
Weekly, throughout the year.

Departmental Grand Rounds
Each week academic presentations are given by guest faculty on a range of topics, followed by a question and answer period. Presentations are of original research or a scholarly review of an area. A clinical case conference is presented once quarterly by a psychiatry resident with a discussion. During the summer months, an eight part lecture series is given focusing on one aspect of mental health, such as substance abuse, trauma, or developmental issues.
Weekly, throughout the year.

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PGY2
Diagnostic Interviewing and Clinical Evaluation
This course is an introduction to interviewing techniques and diagnostic evaluation. Sessions alternate between residents interviewing a patient on videotape and live interviews by faculty. Interviews are discussed and critiqued. A portion of the course (6 sessions) reviews diagnostic and clinical rating instruments (e.g. SCID, HAM-D) and emphasizes psychological testing (e.g. MMPI, neuropsychological testing).
Weekly, 35 sessions.

Neurobiology and Neuropsychopharmacology – Part 1
The course presents the neurobiology and neuroanatomy behind the pharmacological treatment of certain psychiatric disorders often seen on an inpatient unit. Topics include receptor studies, neurotransmitters, biological theories of etiology, and mechanisms of action of psychiatric drugs. Brain mechanisms behind psychosis, depression and mania are emphasized.
Weekly, 6 sessions.

Clinical Psychopharmacology – Part 1
This course reviews the clinical use of medications and other somatic treatments for all the disorders seen on inpatient acute units. Residents are exposed to treatment guidelines and algorithms for the treatment of psychotic disorders and severe mood disorders. Specifics of how to use the medication clinically are emphasized.
Weekly, 8 sessions.

Neuropsychological Testing and Clinical Rating Instruments
This course covers the indications and use of psychological and neuropsychological testing. Residents are taught how to interpret reports and integrate the results into their treatments. This course also exposes residents to several commonly used rating scales for psychopathology.
Weekly, 8 sessions.

Introduction to Psychodynamics
This course is an introduction to psychodynamic theory and practice. The course begins with explanations of basic terms and concepts and then progresses to an overview of psychodynamic theory and the practice of psychoanalytic psychotherapy.
Weekly, 11 sessions.

Child and Adolescent Psychiatry
This course reviews the major theories concerning cognitive, psychosexual, moral and social development. The major illnesses in children and adolescents are discussed including learning disabilities, conduct problems, ADHD, and depression and anxiety in children.
Weekly, 8 sessions.

Major Psychiatric Syndromes, DSM Diagnoses, and Somatic Treatments
This course reviews the major disorders in psychiatry focusing on phenomenology, epidemiology, etiology, neurobiology, and somatic treatments for these disorders. The underlying neurobiology of the syndromes is presented along with extensive lectures in psychopharmacology.
Weekly, 36 sessions.

Community Psychiatry
This course is a review of the history, current concepts and treatment methods in public psychiatry. Clinical work with the chronic and persistently mentally ill population is discussed. The course includes trips in the community to clubhouses and residential hotels served by out outreach program, as well as a prison, a state mental hospital and community based case management programs.
Weekly, 6 sessions with additional field trips.

Substance Abuse and Dependence
This course is an overview of the field of substance abuse. Topics reviewed include a review of the major substances of abuse, the concepts of abuse and dependence, the biopsychosocial model of substance abuse, epidemiology, diagnosis, and treatment of substance-related disorders.
Weekly, 8 sessions.

Ethics
This course if a review of ethical issues in clinical and research psychiatry. Issues covered include boundary violations, treatment against will, confidentiality, and ethics of working with managed care. Clinical examples are utilized and discussion of transference and countertransference is emphasized.
Weekly, 9 sessions.

Forensic Psychiatry
This course is a review and discussion of forensic issues, such as duty to warn, competency evaluations, and legal definitions of insanity. There are also practical issues on Assisted Outpatient Treatment and risk reduction in chronic patients.
Weekly, 8 sessions.

Principles of Group Psychotherapy
This course is an introduction to the theory and practice of group psychotherapy. Topics reviewed include general group dynamics, leading a group, types of groups and patient selection.
Weekly, 4 weeks.

Trauma: Sexual Assault, Domestic Violence, Child Abuse and Catastrophe
This course introduces the phenomenology, epidemiology, neuropsychiatric aspects, and psychological
sequela of trauma. Topics include rape, pharmacology of trauma symptoms/adaptations, domestic
violence, natural catatastropies, and substance abuse and trauma.
Weekly, 8 sessions.

Cultural Issues in Psychiatry
This course is a review of the concepts of cultural psychiatry and the impact of culture on the expression of psychiatric illnesses. Specific minority cultures are introduced including African-American, Hispanic American, African-Caribbean, and gay/lesbian cultures.
Weekly, 6 sessions.

History of Psychiatry
This course introduces views and treatments of mental illnesses from antiquity to modern times. Topics include early treatments, the history of psychoanalysis, abandoned treatments, and the history of psychopharmacology.
Weekly, 8 sessions.

Family Evaluation and Treatment: Chronically Mental Illness
This course uses readings and videotapes to introduce residents to family treatment. Residents are introduced to the concepts of viewing the family as a system and identifying and modifying family dynamics. There is a course component on techniques in working with families with a chronically mentally ill member.
Weekly, 8 sessions.

Geriatric Psychiatry
This course is a general introduction to issues in geriatric psychiatry including diagnosis and treatment of dementia, psychopharmacology in the elderly, use of ECT, and late life depression.
Weekly, 6 sessions.

Character Disorders – Theory. Phenomenology, and Treatment
This course is a review of personality character structure and disorders from a phenomenological and psychodynamic perspective. The various personality disorders are examined in addition to topics such as theories of character formation, defense mechanisms, and character traits.
Weekly, 8 sessions.

Departmental Grand Rounds- see description above
Inpatient Case Conference- see description above
Journal Club- see description above

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PGY3
Evaluations and Differential Therapeutics
This course reviews basic principles of evaluating patients and the assigning of treatment based by on evidence of effectiveness. Residents present by audiotape evaluations of recently seen patients. Techniques in evaluation are taught as well as the choice of treatment. Diagnosis is discussed as well and patient management in the early stages of treatment.
Weekly, 11 weeks.

Consultation-Liaison Psychiatry
This course is a review of topics in consultation-liaison psychiatry, including delirium and dementia, pain, the psychological effects of medical illnesses, and the role of psychiatric liaison. This course supplements 4 case conferences during the year highlighting issues in CL psychiatry presented during the Grand Rounds time.
Weekly, 10 sessions.

Neurobiology and Psychopharmacology – Part 2
This course presents the neurobiology and neuroanatomy behind the pharmacological treatment of psychiatric disorders. Topics include receptor studies, neurotransmitters, etiology, and mechanisms of action. Emphasis is on depression, anxiety, and substance abuse.
Weekly, 8 weeks.

Clinical Psychopharmacology – Part 2
This course reviews the clinical use of medications for the psychiatric disorders most often seen in outpatient settings. Residents learn how to use the major medications including drug-drug interactions and the treatment of refractory cases.
Weekly, 8 sessions.

Practical Psychopharmacology- Case Presentations
This course complements the Neurobiology and Psychopharmacology course. Residents present outpatient psychopharmacological cases in which there is poor response to previous medication trials, medication intolerance, complicating medical problems, or diagnostic questions. Basic and more advanced treatment algorithms are used to guide residents through treatment trials.
Weekly, 12 sessions.

Combined Treatments: Psychotherapy and Pharmacology
The treatment model of “split treatments” are discussed with directed readings. The transference and countertransference aspects are discussed as well as adherence, splitting, and informed consent.
Weekly, 4 weeks.

Classic Papers in Psychoanalytic Theory
This course is a more advanced presentation of the techniques and concepts of psychodynamic psychotherapy. Topics include patient selection, therapeutic interventions, transference, countertransference, resistance, acting out, and a discussion of the beginning, middle and end phases of treatment.
Weekly, 16 sessions.

Principles of Supportive Psychotherapy
In this course, the theory and practice of supportive psychotherapy are presented. Topics include understanding defenses, interventions, assessment and case formulation, goal setting, therapeutic relationship maintenance, crisis intervention and special populations.
Weekly, 9 sessions.

Cognitive-Behavioral Psychotherapy
This course is an introduction to the theory and techniques of cognitive-behavioral psychotherapy. The treatment of depression, anxiety, eating disorders, sleep disorders, and borderline personality disorder is reviewed. The course has several clinical correlation classes where videotapes are used as teaching aides.
Weekly, 10 sessions.

Hypnosis and Biofeedback
This course covers the principles of hypnosis and its use in relaxation and pain management. Biofeedback for insomnia, headaches and pain are taught.
Weekly, 3 sessions.

Family and Couples Treatment
This course uses readings and videotapes to introduce residents to family and couples treatment. Residents are introduced to the concepts of viewing the family as a system and identifying and modifying family dynamics. Basic principles of working with couples are presented along with clinical examples.
Weekly, 9 sessions.

Psychiatry and HIV
This course uses distinguished guest speakers in HIV psychiatry. Topics include HIV and the chronically mentally ill, the recognition and treatment of psychiatric conditions in HIV positive patients, and drug-drug interactions.
Weekly, 8 sessions.

Models of the Mind
This course is an overview of the major psychoanalytical theories of human behavior and pathology. Theories covered include Freudian and ego psychology, interpersonal, Kleinian, object relations, self-psychology and more contemporary theories.
Weekly, 10 sessions.

Introduction to Research and Evidence-Based Psychiatry
This course is a basic and clinically oriented introduction to evidence-based medicine providing the skills to critically evaluate psychiatric literature. Methodological topics reviewed include control groups, randomization, bias, double-blinded studies, generalizability, reliability, and validity. Statistical topics include statistical significance, variance, t-tests, ANOVA, chi-square, confidence intervals, power analysis, correlation, and odds ratios.
Weekly, 11 sessions.

Suicide and Self Injury
This course reviews the assessment and treatment of suicidal patients and those patients who self-injure. Topics include assessment, treatment planning, chronic suicidality, and care of survivors.
Weekly, 8 sessions.

Careers in Psychiatry
Residents are exposed to different areas of specialty and careers. Fellowships are discussed and previous residents return to discuss the application process and value of fellowships.
Weekly, 5 sessions.

Outpatient Case Conferences
In both the OPC and IPS, monthly case conferences are held with a guest consultant. Residents write up and present cases of ongoing treatments to the entire clinic.
Weekly, 16 sessions.

Journal Club
Each month, residents read and present a current paper to the class with a senior attending leading the discussion. Emphasis is on the critical evaluation of the study design and conduct of the research. Generalizability is discussed, as well as general principles in critically evaluating the literature.
Weekly, 12 weeks.


Departmental Grand Rounds- see description above

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PGY4
Short-Term Dynamic Psychotherapy
In this year-long course, residents learn the principles of short term (40 sessions) dynamic psychotherapy. Videotapes are used each week. Each resident treats a patient under supervision and presents the work in videotape form to the class.
Weekly, 48 weeks.

Human Sexuality
This course introduces residents to the diagnosis and treatment of sexual dysfunctions, the paraphilias, and techniques in sexual history taking. Residents conduct and present a sexual history of a patient to the group and present on the paraphilias.
Weekly, 8 weeks.

Administrative Psychiatry
This course in an overview of administrative psychiatry. Topics include leadership of interdisciplinary teams, departmental administration, hospital administration, and economic and governmental considerations in administration. This course also includes a review of the financing and regulation of mental health care. Topics include the history of financing for the poor including Medicaid, Medicare reimbursement, graduate medical education funding, and government and regulatory influences on the provision of mental health care. The history and current status of managed care is discussed.
Weekly, 7 sessions.

Teaching and Supervising
This course reviews the principles of teaching medical students and residents and concepts of supervision. Residents prepare a class and teach the class to PGY1's and received feedback on their teaching.
Weekly, 6 weeks.

Termination
This course reviews readings on the different ways clients leave treatment providers. The issue of terminating from the residency training is integrated into the course. Topics include working through, transference cures, techniques in ending various types of treatment, impasses, and stages of termination.
Weekly, 6 weeks.

Office Practice Course
This course provides basics in setting up an office and the different styles of practices. Basics such as malpractice, managed care panels, and HIPPA regulations are covered.
Weekly, 4 weeks.

Neurology for Psychiatrists
This course reviews neurological issues which are relevant to the practice of psychiatry. Topics include headaches, movement disorders, neoplasms, Parkinson’s disease, stroke, anmnesia, traumatic brain injury, multiple sclerosis.
Weekly, 16 sessions.

Journal Club- monthly journal club as described above for PGY3 residents
Department Grand Rounds- see description above

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House Staff Policies
Residents at St. Luke’s and Roosevelt Hospitals are members of the Committee for Interns and Residents, a union representing the needs of interns and residents around the country.

Work Hours
All residents participate in the on-call duties of the Department of Psychiatry. The on-call responsibilities are in compliance with New York State Public Health Law, Part 405, which safely limits resident working hours. Comfortable on-call accommodations are provided. Residents are not expected to remain in the Hospital Center after overnight call duties.

Salaries and Benefits
Psychiatry residents receive a salary that is commensurate with other residency programs in New York City. The Hospital Center offers a comprehensive set of benefits including individual and family health insurance, vision care, dental coverage, and accidental death and disability insurance. Full malpractice coverage for all clinical activities performed in the course of duty is provided. Residents receive four weeks of paid vacation each year, four personal days, and five days of paid conference time. There is also sick leave, and maternity/paternity leave. The department encourages conference attendance by residents, and provides up to $500 in stipends to attend conferences. The department also pays for residents APA dues and provides required books at no charge to residents.

In addition, residents are appointed to the academic position of Visiting Clinical Fellow at Columbia University College of Physicians and Surgeons. A Columbia ID may be obtained free-of-charge which permits access to the university’s outstanding sports facilities which include pools, courts for squash, tennis, and racquetball, an indoor and outdoor track, and weight and exercise rooms.

Housing and Parking
As a service to residents and other professional staff, St. Luke’s and Roosevelt Hospitals maintain buildings near the St. Luke’s Division on Manhattan’s Upper West Side and near the Roosevelt Division in midtown Manhattan. The buildings offer convenient locations and cheerful accommodations at below market rates. Studio, one-bedroom and two-bedroom apartments are available as is parking. Rent and parking fees are paid by payroll deduction.

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Enjoying Life in New York City

St. Luke’s and Roosevelt Hospitals is located on Manhattan’s West Side – close to the mix of cultural, educational and recreational opportunities offered by the nation’s largest city. From the dazzle of Broadway and the music, opera and dance of Lincoln Center, to the river views and running paths of Riverside Park and Central Park, the West Side offers endless possibilities for enrichment and enjoyment. For those who enjoy eating out, New York City offers some of the finest dining in the world, with access to small neighborhood eateries, countless ethnic restaurants and more extravagant fare.

The Roosevelt Division is located near the center of the city. Broadway theatres, Lincoln Center, the Metropolitan Opera, the New York City Ballet, the American Museum of Natural History, Carnegie Hall and Madison Square Garden are a short distance away. A walk across Central Park leads to some of the country’s leading art museums, including the world-renowned Museum of Modern Art, the Metropolitan Museum of Art and the Guggenheim. Downtown are the clubs, restaurants, theatres, shops and galleries of Greenwich Village, SoHo, and Tribeca, and the old-world atmosphere of Chinatown and Little Italy.

The Morningside Heights, where the St. Luke’s Division is located, is also home to Columbia University, Barnard College, the Cathedral of St. John the Divine, Riverside Church, Union Theological Seminary and the Manhattan School of Music. The West Side is close to all of the New York’s major highways, bus and train terminals and airport transportation. Suburban and country environments and short trips away in Westchester County, New Jersey, Connecticut and Long Island.

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Application Procedure

The St. Luke’s-Roosevelt Psychiatric Residency Training Program participates in the National Resident Match Program (#207041) and the Electronic Residency Application Service (ERAS). Applications are accepted from August 15th to December 15th for each academic year beginning on the following July 1st.

Complete applications include:

ERAS Common Application Form
Personal statement of 500 words or less describing your interest in psychiatry and your career goals
Three letters of recommendation
Medical school transcript
Dean’s Letter from your medical school (if available)
Official USMLE transcript
(If you are a graduate of a medical school outside the United States or Canada, you must also provide
An ECFMG Certification Status Report.)


Our interview and selection process begins in early October and runs through early February. Because of the large number of applications, we are not able to interview all applicants. After receipt and processing of your completed application, your material will be reviewed by the Admissions Committee.

Inquiries concerning the program are welcome and should be forwarded to:
Prameet Singh, MD
Director of Education and Training,
St. Luke’s and Roosevelt Hospitals
1090 Amsterdam Avenue, 16F
New York, New York 10025
Phone: (212) 523-5089
Fax: (212) 523-1685
Email: psingh@chpnet.org

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