The Residency Program
- Overview of Four Year Program
- First Post-Graduate Year
- Second Post-Graduate Year
- Third Post-Graduate Year
- Fourth Post-Graduate Year
“As a former Zucker Hillside Hospital resident, chief resident and unit chief of a residency training unit, I have a very personal dedication to the education of the residents. A wonderful residency experience in a nurturing academic setting led me to stay here to practice psychiatry and train residents. By having a position in the residency program leadership at the Zucker Hillside Hospital, I am very lucky to have the unique opportunity to be involved with what has been most formative for me professionally. I am dedicated to developing outstanding experiences for current and future residents that are as rich as my education here has been.”
- Andrea Klufas, Former Chief Resident, Associate Director, Residency Training
|R1||Adult Inpatient Psychiatry
|Clinical Learning Module
|R2||Consult Liaison Psychiatry
|Geriatric Inpatient Psychiatry
|Child Emergency Psychiatry
|Adult Inpatient Psychiatry
Including Adult, Child, Geriatrics, Community and Addiction Treatment
|R4||Adult Outpatient Psychiatry 60% of the week
Elective 40% of the week
The order of rotation in each year will vary.
Vacation during R-1 — two vacations, each two weeks.
Vacation during R-2, R-3, R-4 — four weeks each year — individually scheduled.
The R-1 year is divided into 13 four-week periods. All residents spend three periods in Adult Inpatient Psychiatry at the Zucker Hillside Hospital and the North Shore University Hospital, one period in the Admitting Service, one period as Night Float, four periods of Medicine/Pediatrics, and two periods of Neurology. There are 4 weeks of vacation time, and 4 weeks of structured clinical learning.
The structured clinical learning is organized into 2 two-week blocks which book end the majority of the psychiatry experiences in the R-1 year. During the first block, residents are taught basics of psychiatry, including diagnosis, interviewing, and the use of the Structured Clinical Interview for DSM-IV (SCID). These topics are put into practice during the clinical work in the intervening months. During the second block, these topics are reinforced, and explored in further detail.
All residents spend three periods working on the Inpatient Psychiatric Services at the Zucker Hillside Hospital and The North Shore University Hospital. Residents learn the basic skills of clinical diagnosis including interviewing, mental status examination, physical and neurologic examination, history writing and the formulation of a differential diagnosis and treatment plan. In addition, residents begin their education in the short-term inpatient treatment of patients with acute psychiatric illness who are presenting either for the first time or as an acute exacerbation of chronic illness. Techniques of psychopharmacological therapy, milieu therapy and individual and family psychotherapy are stressed. Residents also treat inpatients who are participating in research studies, enabling residents to familiarize themselves with research methodology and protocols. Part of the inpatient curriculum includes didactics in psychotherapeutic techniques, such as supportive psychotherapy and motivational interviewing, which will be most helpful for this patient population. Residents also continue their SCID training, and become versed in measurement based psychiatry and the use of rating scales in clinical care. While working in Psychiatry, residents have several supervisors including on-unit supervisors, off-unit supervisors and preceptors.
The admitting service is responsible for the evaluation and assessment of all direct admissions to the Zucker Hillside Hospital. Residents will have ample opportunity to practice the initial evaluation of patients, including psychiatric interviewing, medical evaluation, and initial treatment planning.
Residents choosing to complete their Medicine/Pediatrics requirement in the Department of Medicine spend three periods in general adult inpatient medicine at either Long Island Jewish Medical Center or North Shore University Hospital and one period in the Medical Services Department of the Zucker Hillside Hospital. This service coordinates the medical treatment of the 208 psychiatric inpatients as well as the medical treatment of a small percentage of patients in Hillside’s psychiatric outpatient programs. Residents with an interest in Child Psychiatry may substitute Pediatrics for up to 2 periods of their Medicine rotation. These residents will be assigned to the Steven and Alexandra Cohen Children's Medical Center of New York for these rotations.
Two periods of the R-1 year are in the Department of Neurology. One period is spent on the Neurology inpatient service at either Long Island Jewish Medical Center or North Shore University Hospital. Residents are the primary caregivers for the patients on this service. The second period in Neurology is located predominantly at the Zucker Hillside Hospital. Here, residents work with an attending neurologist taking histories and performing examinations on the psychiatric patients who also have neurologic components to their illness. Along with the attending neurologist, the resident follows the treatment of these patients throughout their hospital course. In addition, residents spend approximately 25 percent of their work week in outpatient Neurology clinics at the Long Island Jewish Division. These clinics treat patients who are primarily referred with movement disorders, neuropathic pain, or epilepsy.
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“I chose Hillside because I really liked the people I met here from the residents to the staff. I felt comfortable and knew that I would graduate with a superior education and wide range of experience.”
Rotations include: twenty weeks on General Adult Psychiatry Inpatient Units, three weeks on Geriatric Psychiatry Inpatient Units, and four weeks on the Adolescent Psychiatry Inpatient Unit, twelve weeks on Consultation-Liaison Services, 5 weeks in Emergency Child Psychiatry, and four weeks in the Psychiatric Emergency Room. Residents also have a four week night float rotation at Hillside. Four weeks vacation time is spread throughout the year at times chosen by the residents.
The goal of the R-2 year is to continue to advance the resident's knowledge and skills of clinical diagnosis and treatment of acutely ill adult psychiatric patients. In addition, the R-2 year focuses on the treatment of the acutely ill child, adolescent, and geriatric patients.
Another goal of the R-2 year is to have residents gain knowledge and experience working as part of a Consultation-Liaison Service in two tertiary care hospitals. Twelve weeks are spent on this service. As a member of this service, residents perform consultations on medical inpatients with psychiatric issues and attend daily teaching rounds. In addition, weekly classes, case conferences and individual supervision are provided.
Twenty weeks are spent working on adult general inpatient services organized for residency training. While working on these units, residents continue to have on-unit and off-unit supervision and a weekly case conference. Besides working with individual patients, residents treat the families of several of their inpatients and participate in on-going group therapy.
Three weeks of the R-2 year consist of a rotation on the Geriatric Psychiatry Inpatient Units. Supervision is provided by a team of geropsychiatrists as well as specialists in Internal Medicine and Neurology.
A four-week rotation is spent on the Adolescent Inpatient Psychiatry Unit at the Zucker Hillside Hospital. There are approximately 180 admissions per year to the Adolescent Pavilion. This co-ed inpatient unit has a population characterized by heterogeneity of age, race and diagnosis. The residents are in charge of psychiatric and medical assessment and the individual and family treatment for the patients assigned to them. They also participate in five community meetings held each week.
There are a total of 9 weeks of psychiatric emergency room rotations in the R-2 year, 4 weeks of adult ED coverage and 5 weeks of child ED coverage. Staffing during these rotations include psychiatrists, psychologists, social workers and nurses, and is organized to provide both excellent clinical service and well-supervised education and training for students and house staff. Residents evaluate several patients per shift and are able to see the patient and their families for initial triage, and continue working with the patients until a final disposition is reached. Residents are supervised by attending psychiatrists on every patient evaluated in the Psychiatric Emergency Rooms.
For four weeks of the year (during the Adult Inpatient rotation) each resident becomes an active participant in the Electroconvulsive Therapy (ECT) treatment program. This includes performing ECT three mornings per week under the supervision of an attending psychiatrist.
The R-2 residents participate in a Research Mentorship in which each resident is paired with a psychiatrist or psychologist from the Department of Research with similar interests as the resident. The goals of the research mentorship are to facilitate access and orientation to department research projects, to offer practical orientation to research methods, to develop research paper writing skills, and to provide residents with a greater understanding of the research literature in their practice of medicine and psychiatry.
During the R-2 year residents learn many aspects of Forensic Psychiatry as they evaluate patients and accompany their supervisors who testify about these patients in court. All residents also visit Rikers Island, New York City’s main jail complex, where they learn about psychiatric care in the incarcerated population.
Medical students are assigned to R-2 residents for supervision on inpatient rotations. Courses in the R-2 year are generally scheduled two days a week and residents from all rotations join in these courses. A special feature of the R-2 year is the "Experiential Group" during which residents learn about group process as they share their training experiences.
Night and weekend on-call during the R-2 year is covered partially by the night float resident and partially by the other 16 residents. There are approximately three calls per month. R-2 residents cover the Zucker Hillside Hospital as well as the emergency room at Long Island Jewish Medical Center.
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|“The patients are your own, you make your own schedule and have your own office. What's not to like?”
-Mordechai Gampel, Former Resident ’10
The goal of the R-3 year is to have residents learn the evaluation and outpatient treatment of adults, adolescents and children. Residents gain experience working with patients who can benefit from a single course of treatment as well as patients with chronic illness who require long-term maintenance therapy. Patients are carefully selected from the various specialty outpatient clinics and tracks within the Ambulatory Care Center so that residents treat patients covering the full spectrum of psychiatric disorders. During this time, residents conduct intake evaluations, treat patients in comprehensive general psychiatric care, and conduct exploratory, insight-oriented psychotherapy and cognitive behavioral therapy. During this assignment, residents have supervisors for psychotherapy, intakes, psychopharmacology/comprehensive general psychiatric care and for cognitive behavioral therapy. Residents also participate in a weekly intake conference.
For six months of the year, residents spend a portion of their time in the Ambulatory Service of the Division of Child and Adolescent Psychiatry. The goal of the training in this rotation is to teach the resident diagnosis and treatment of children and adolescents as well as to provide an understanding of the biological, psychological, social, economic, ethnic and family factors that significantly influence physical and psychological development in infancy, childhood and adolescence. Residents also gain experience in the diagnosis and treatment of children with mental retardation and other developmental disabilities. Residents are assigned to two supervisors during this experience.
For six months of the year residents are also assigned to a Community Psychiatry/Outpatient Addiction Treatment rotation. Residents see patients at our on-campus Methadone Maintenance Treatment Program and two of our local community programs. These programs focus on the structured group treatment of chronic alcohol and other drug dependencies, and on patients whose chemical dependency is complicated by other psychiatric illnesses.
During the R-3 year, residents choose a preceptor to assist them in the writing of a paper during the R-3 and R-4 years. This paper may be a review of the literature, a clinical case presentation or a research project. By the end of the R-4 year, residents are required to submit their papers for review. All papers are reviewed by several senior faculty members who do not know who wrote the paper. Papers are then returned to the resident with comments that will be helpful should the resident want to publish the paper.
During night and weekend call in the R-3 year residents are responsible for evaluating patients in the Emergency Room as well as emergency consultations in the general hospital. R-3 residents are also responsible for supervising R-2 residents and medical students assigned to taking calls in the Emergency Room. All R-3 residents share in this call and, therefore, residents are on-call approximately two weekday nights and one weekend day per month. There is always an attending psychiatrist on the Zucker Hillside Hospital campus 24-hours a day for supervision.
The didactic part of the curriculum, consisting of approximately six hours of courses per week, continues during the R-3 year.
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The entire R-4 year is divided into approximately 60 percent core and 40 percent elective time. The core includes a full year of individual psychotherapy of patients followed from the R-3 year as well as additional patients treated with couples therapy, group therapy and short-term psychotherapy. Supervisors are assigned for each of these treatment modalities.
During this year, residents also participate in the Psychopharmacology Consultation Service. Patients being treated in any of our Ambulatory Care Programs who present with particularly difficult diagnostic or treatment/management problems are referred to this service for an in-depth work-up including a literature review and presentation to a conference chaired by either senior faculty members or invited consultants.
Included in the R-4 year is a specially constructed didactic and experiential program designed to develop the resident’s teaching skills. As part of this supervised program each resident creates and teaches lectures to medical students.
Forty percent of the work week is elective time chosen from either a group of planned electives or those electives developed individually by the resident. Some of the planned electives include: multiple opportunities in Hillside's Research Department participating in on-going studies or developing new projects; an advanced program in dynamically-oriented exploratory psychotherapy; treatment of drug and/or alcohol abusing patients at the Medical Center's community-based programs; medical student teaching and program administration; adolescent psychiatry including inpatient, outpatient and day hospital; brief contact psychotherapy; community psychiatry; Hillside Day Treatment Programs; geriatric psychiatry; consultation-liaison psychiatry (clinical and research); and forensic psychiatry.
The didactic portion of the curriculum, consisting of approximately five hours of courses per week, continues in the R-4 year.
There is no night or weekend on-call in the R-4 year, but residents may choose to join the Senior Psychiatrist-on-Call rotation for which they receive additional remuneration.
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