Psychiatry Residency Program - R-3 Curriculum
Courses in concert with R-1, R-2 and R-4 residents:
- Departmental Grand Rounds
- Journal Club
- Research Seminar
- Literature, Narrative and the Self
- Learning Practice
Research, Evidence-Based Practice and Critical Appraisal:
Overview of research methodology and study design. Formulating an answerable question, searching for the best evidence to answer the question(s), critical appraisal of the literature regardless of whether the issue is etiology, diagnosis, treatment or outcome and prognosis and application of the appropriate evidence to individuals' care.
The course will follow the structure of the ASCP Model Psychopharmacology Curriculum (6th Edition), and utilizing educational materials provided by ASCP, which have been updated and supplemented where necessary. Topics will include pharmacological management of Anxiety Disorder Syndromes, PTSD, OCD, Eating Disorders, Personality Disorders, Psychopharmacology of Sexual Dysfunction, Cross-Cultural Psychopharmacology, Mental Retardation, Child and Adolescent Disorders, and many others. Case studies will be utilized.
This course will increase the participants' understanding of the neurobiologicalunderpinnings of addictive thinking and behaviors. We will examine the distinctions between "abuse" and "dependence" clinically, physiologically, and with respect to both the unique and common factors that predispose to these patterns of behavior. The physiological and behavioral effects of various substances of abuse will also be examined, together with the social and cultural contexts that characterize the use of different agents. The public health dimension of substance abuse will be outlined. In addition, the relapsing nature of addictive disorders has lead to a variety of treatment modalities, and, in particular, innovative means of engaging patients in treatment, such as motivational interviewing. Case studies and video demonstrations of techniques will be presented.
Psychopharmacology and Treatment of Addiction Disorders:
We will study integrative forms of treatment, and examine the risks and benefits of both abstinence-based and harm-reduction models. Residents will be exposed to the range of treatment settings available, and the scientific evidence of efficacy associated with different models. Pharmacologic treatment of withdrawal, as well as relapse prevention therapies, will be reviewed. The role of behavior therapies, and contingency management in different treatment settings, will also be studied, with clinical examples and exercises for residents to complete and discuss. The principles involved with treating patients with co-morbidities will receive special focus, especially the challenges of co-morbid substance use and serious mental illness (Quadrant IV patients).
Molecular Psychiatry and Genomics II:
This course will examine current pre-clinical and clinical research elucidating mechanisms underlying mental illness, dysfunction and human behavior. Residents will be helped to understand the basic principles, concepts, and vocabulary necessary to read this burgeoning literature, including the developing field of genomics. In order to both broaden and deepen understanding, we will invite speakers who are conducting research in this area, including scientists in our healthcare system (NSLIJ), at Zucker Hillside Hospital. We will also organize at least two field trips to visit sites where research is being conducted.
Developing Assessment Skills:
In this seminar series, residents will be helped to perfect their skills in performing assessments and in drafting clinical summaries for purposes of case conferences, referral for consultation, or publication, as well as learning to concisely and effectively record pertinent history to enter into the clinical record. Residents will be expected to prepare write-ups (the nature of the which will be assigned), related to patients they see in their clinical rotations, and bring them to class to discuss and receive critical feedback from faculty. Patients will, at intervals, be interviewed in front of the class, so that residents can record their impressions, complete a draft psychiatric history and mental status exam, and bring their work to present, contrast and review with other participants. Specific training will be provided in the use of clinical tools (HAM-D, YMRS, BSDS, Beck Anxiety, YBOCS, BPRS, PANSS, QLES-Q, AIMS and others) and how to integrate them in the assessment process.
Psychological Testing and Assessment:
This course will increase the participants' understanding of the role of the psychologist in the interdisciplinary team. The range of psychological and neuropsychological testing will be presented, together with indications for referring patients for this testing, and guidance in interpreting the psychologist's findings. The use of psychological testing in research will also be reviewed, together with an introduction to the methods of statistical analysis commonly used in psychiatric an social science research.
Psychotherapy - Advanced Topics:
We will utilize video demonstrations of different psychotherapeutic techniques, as well as live interviews, to deepen residents' understanding of specific psychotherapies, with emphasis on supportive, psychodynamically-informed, and cognitive therapies. Residents will be taught how to create records of therapy sessions for use in supervision, and exposed to scales used to measure competency in the practice of psychotherapy, as well as fidelity to given models. Residents will be prepared to begin the process of certification in CBT with the Academy of Cognitive Therapy during their PGY-4 year.
This seminar will provide an opportunity for residents to become familiar with community services on Staten Island, and to be involved first-hand in observing and contributing to such activities by participation in board-level functions. Residents will be assigned a mentor who will assist them in identifying a community agency with which to become engaged, and then to approach the agency and determine a means for the resident to learn about the entity's administrative functions and operations. Residents will be required to develop a systems-based "change project," which they will identify with the help of staff at the agency with whom they have chosen to work. Residents will report on their experiences, and on their progress toward completing their "change project", in subsequent seminars, and receive feedback from peers and faculty.
Gender, Sexuality, and Sexual Psychopathology:
In this course, we will survey issues related to sexuality, sexual identity, and sexual behavior in illness and in health. In addition to didactic presentations, we will invite spokespersons from communities of interest, such as the LGBT community, to speak about their experiences and concerns, as well as clinicians who work in specialized programs addressing the needs of these individuals, including the LGBT clinic where residents may elect a rotation in their PGY-4 year.
The course will address the range of sexual roles in healthy sexual relationships; the importance of therapists' awareness of their own sexuality and biases; issues relevant to the LGBT and related communities; the role of sexuality in persons suffering from depression and other mental illnesses, and how to address these issues in treatment; sexual psychopathology, its phenomenology and evidence-based treatments; and the importance of identifying attitudes toward gender and sexuality in psychiatric/psychological theory, practice and research.
Advanced Course in Child &Adolescent Psychiatry/Psychopharmacology:
This course will build on the foundations of normal observed Child development to diagnosis and treatment of Childhood disorders with a focus on Integration of Psychopharmacological as well as psychotherapy techniques relevant to the Outpatient treatment setting. The residents will develop a detailed understanding of major childhood disorders and treatments and treatment guidelines .This course will promote an evidence based curriculum including DSM based diagnosis and evidence based medicine with a background of clinical observations. These will include case discussions as well as review of relevant and current literature as necessary. The resident should gain an adequate level of comfort in assessing, treating and developing collaboration with other care providers.
Clinical Case Conference in Child Psychiatry:
The clinical case conference will be a monthly discussion of a case identified by the resident that will be presented formally and discussed with the faculty as well as the residents. The goal of the presentation is three fold: a)The resident will learn to obtain and present a detailed yet concise history to other professionals)Allow feedback on narrative as well as diagnostic and treatment related dilemmas faced by the patient and clinician c) Foster a learning environment by case discussion as well as literature review to help understand unique situations that pose a challenge to outpatient psychiatry practices especially in the realm of child psychiatry.