Clinical rotations are structured so that while fulfilling all ACGME training requirements, residents are immersed in an array of exciting and challenging clinical settings.
This approach is designed to promote advanced competency in the assessment and treatment of the full range of psychiatric disorders, while also addressing psychosocial and environmental stressors, and issues of culture and diversity, in a largely underprivileged and underserved patient population. Note that the U.S. Census considers the Bronx to be the most diverse area in the country!
Treatment is taught emphasizing the use of a wide range of psychotherapeutic modalities including psychodynamic psychotherapy, cognitive behavioral therapy, family therapy, and group therapy amongst other techniques, in combination with somatic and psychopharmacologic interventions. Rotations are located in a variety of nearby institutions including a state hospital, a primary teaching hospital, a municipal hospital and several community-based settings.
Courses are an essential part of our training program. Classes are scheduled to provide a full day free from clinical responsibilities. This is truly protected time, during which attendings on each rotation address all clinical needs of the service. This leaves residents free to thoughtfully and fully focus on their educational experience. In addition to this dedicated didactic time, there is also unit- and hospital-specific instruction that includes, among other things, case conferences, grand rounds and special programs with prominent leaders in the field from other prestigious institutions in the New York area. Participation in scholarly pursuits is voluntary and can be customized to suit the needs and interests of the individual resident.
Each PGY group receives a program designed to complement the clinical experiences. Psychotherapy, pharmacology, family and group therapy, and other areas are taught in advancing segments during the four-year core curriculum. A new and exciting addition to the educational experience is an enhanced opportunity for residents to engage in scholarly activity projects. In addition to protected didactic time, interested residents are allotted up to four hours per week to conduct scholarly work. Such scholarly endeavors may include but are not limited to research and publications, creation of poster or workshop presentations for national conferences, curriculum planning and development activities.
A weekly "T" group provides peer support and allows residents to observe and participate in group process. Residents collaborate in designing their curriculum, thus allowing the course work to be tailored to the group's interests.
The Department also sponsors many preeminent Continuing Medical Education (CME) seminars in the New York City area. Residents are invited and given time off to attend these free conferences. Click here to view the curriculum chart.
Supervision and Evaluation
The supervisory process is psychiatry's time-honored approach to developing and refining the residents' psychotherapeutic and other clinical skills. Residents receive a variety of supervisory experiences throughout their training to ensure that their encounter with each modality is enriched with a high level of expertise.
Weekly supervision in a variety of modalities occurs beginning in the PGY1 year. During the PGY3 and PGY4 years, each resident receives weekly supervision with two supervisors trained in psychodynamic and supportive psychotherapy. There is also weekly CBT supervision, and biweekly family and child psychotherapy.
An essential part of the training program is timely and clear feedback. The major goal of evaluation is to provide residents with a personalized guide for fully developing their clinical skills. In a collegial atmosphere, supervisors complete written evaluations toward the end of each rotation and at three- or six-month intervals, depending on rotation length. There is also an annual written exam called the Psychiatry Residency In-Training Exam (PRITE), given in compliance with the standards of the ACGME Psychiatric Residency Review Committee, offered in the spirit of facilitating professional growth and ensuring that the training program is providing appropriate clinical and didactic input. Residents also provide feedback to supervisors and course instructors and evaluate the clinical rotations. Additionally, residents participate in the annual revision of our didactic curriculum.
Our Call System:
During the PGY1 year, there are no overnight call coverage responsibilities. This was an intentional decision made by our program to ensure the best possible environment for learning. As a junior resident, the priority is to build competence and confidence in managing acute psychiatric issues. As such, residents cover evening shifts on Klau 2, our acute inpatient unit and the adult and child consult service. In addition, they cover daytime weekend shifts, either in our Psychiatric observation suite or on our inpatient unit, with the support of an attending psychiatrist. Residents are on call an average of 4-6 times per month. An attending psychiatrist is always available for consultation. In addition, all PGY1s are given 4 “buddy call” shifts, where they are partnered with a senior resident and are oriented to the process of taking call early in the PGY1 year.
During the PGY2 year, residents begin overnight coverage, which is felt to be a critical period of development as a psychiatrist. Residents are given considerable autonomy and are the primary psychiatrist covering the ED during the evenings and all psychiatric services during overnight.
Shifts are 8pm-9am Saturdays and Sundays and 24 hours during M-F. Post call days are given the day after the scheduled call shift. An attending is in house 24/7 and available for consultation by phone or pager. On average, PGY2s are on call 2-3 times per month.
During the PGY3 year, residents are on call on average twice a month. They take non-weekend overnight calls in which they are responsible for emergency, inpatient and consultation and liaison services, as well as weekend day call, during which they cover the consultation and liaison service and assist.
PGY4s participate in the call system by providing orientation to PGY1s during their initial calls as "buddies." They assist the PGY1 covering the inpatient and C/L services, sharing practical guidance and clinical pearls about the practice of acute psychiatry. "Buddy call" continues to provide our PGY4s with an opportunity to serve as leaders and role models. PGY4s serve as buddies over the course of the entire year, heavily emphasizing July, August, and September as our PGY1s become more experienced with the call system.
Our Community of Trainees
Twice a year, an "All Resident Retreat" is held, usually in the fall and the spring. The purpose of the retreat is to foster a sense of belonging within the program, and to build connections among the residents of different training years. Retreat settings and activities that enable exploration of themes related to the intersection of art, culture, history and psychiatry are frequently selected. While it is an opportunity to have fun and join together as a community, enhanced communication and problem solving are additional goals.
Residents are an essential link in the policy- and decision-making process. Representatives participate in the Residency Training Program Evaluation Committee, a departmental advisory committee made up of faculty from all training sites and academic divisions. In addition, the Chair and the Director of Training have regular luncheons with all of our residents. Access is direct and candid.
Our Commitment to Diversity, Equity and Inclusion:
At Montefiore Einstein, we are proud of our ongoing commitment to providing a safe, inclusive environment for members of all communities. Since it’s inception, Albert Einstein College of Medicine has aimed to diversify the medical field, providing opportunities to historically disadvantaged communities. In fact, Albert Einstein himself agreed to the use of his name, if and only if the program focused on these principles. We have also served a foundational role in the development social medicine practices, and have historically been a leader in social and community based medical and psychiatric interventions. We strongly believe that inclusivity helps institutions to thrive and that their excellence is dependent on an environment that celebrates diversity in race, ethnicity, gender identity, sexual orientation, religion, disability, and socioeconomic status. We have both a Departmental committee focused on enriching the clinical experience and training and a resident-led DEI committee with a mission to continue to provide educational and training opportunities for residents and faculty in DEI relevant theoretical and clinical areas as a critical component of the training experience. We are also focused on recruitment and retention of a diverse group of residents and faculty.
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