Psychiatry Residency Program - Second Year (R-2)
The Inpatient Adolescent Psychiatry rotation will take place at Zucker-Hillside
Hospital. All other rotations are at SIUH. Residents will have both a
general psychiatry adult inpatient experience, as well as a rotation on
an inpatient unit that treats geriatric patients. The Consultation-Liaison
experience will deepen the resident's exposure to and comfort with
both Emergency Psychiatry and the practice of psychiatry with patients
with co-morbid medical conditions. The Neurology Consultation/Clinic rotation
will allow residents to fulfill the requirements for ABPN certification,
and also expose them to a rich and constructive clinical experience.
This is a required 4 week rotation on the Adolescent Pavilion during the
R- 2 year, and occurs at Zucker-Hillside Hospital.
Faculty consists of two full time child and adolescent psychiatrists, one
full time psychologist, a 0.75 FTE psychologist, two full time social
workers, two full time rehabilitation therapists in addition to the nursing
staff and four mental health workers.
Two hours of supervision by child and adolescent psychiatrists are provided
weekly. This is in addition to the bedside discussion and other didactic
discussion and/or consultations. Case loads are carefully monitored and
controlled to provide a diverse and enriching experience in child psychiatry.
The residents are expected to participate in team meetings twice a week
where patient status, treatment plan and disposition are discussed. This
is in addition to the core lecture and didactics provided on an annual
basis to the residents.
There are approximately 400 admissions to the Adolescent pavilion every
year. The Adolescent Pavilion is a co-ed inpatient unit whose population
is characterized by heterogeneity of age, race and diagnosis. The mean
age is 15 with a range from 12-18. Race: 45% Caucasian; 40% African American;
5% Hispanic; 5% Asian; 5% Other. Diagnoses: 45% Affective Disorders, 30%
Disruptive Disorders; 20% Psychotic Disorders; 5% Personality Disorders.
Each patient is given a full psychiatric and medical assessment. Treatment
provided on the unit includes: individual, group and family therapy, psychopharmacology
and cognitive/behavioral treatment approaches. While rotating on the adolescent
pavilion, the resident becomes an integral part of the treatment team,
attending all clinical meetings.
The average case load for each resident consists of four patients at a
given time. A case load of this size affords the resident the opportunity
to work-up each patient comprehensively, from a medical and biopsychosocial
perspective, as well as treat patients from a wide variety of diagnostic
categories. In addition, the resident has time allotted to participate
in the rich clinical and academic environment of the unit, including,
five community meetings per week, daily morning reports, and didactic
classes. Each resident's case load is carefully monitored and supervised
by the assigned attending psychiatrist. Therefore, the resident's
level of responsibility increases as their knowledge base and clinical
skills increase. The resident is in charge of both individual and family
treatment for the patients in their case load. Also on this rotation,
residents participate in the management of the medical and neurological
conditions that their patients are afflicted with. This is done with the
guidance of attending pediatricians and neurologists. This rotation is
equivalent in its depth and scope to a general adult inpatient rotation
with residents functioning in a manner identical to that of a general
adult inpatient rotation.
All residents have two hours of supervision provided by the attending psychiatrist.
Additional supervision is provided on an individual basis. There is also
one and a half hour per week of supervision for family meetings. This
is supervised by the unit social workers.
Inpatient Psychiatry Rotation (R-1, R-2 and R-4):
This constitutes a required 4 month rotation in the R-1 year; two (2) required
four month rotations in the R-2 year; and a 2-3 month part-time required
rotation as team leader during the R-4 year (can be lengthened if elected).
There are a total of 3 full-time psychiatrists on our inpatient unit: The
unit consists of a 15 bed mixed geriatric and adult unit contiguous with
a 20-bed adult psychiatry unit. There are additionally a total of 30 registered
nurses, 30 Patient Care Assistants, 4 Patient Engagement Specialists,
4 social workers, 2 Activities Therapists, one Nurse Managers, who is
a registered nurses and two Assistant Managers.
Residents will attend 8 hours weekly of scheduled seminars and lectures,
and as well unit-specific case conferences weekly, and team rounds daily.
Teaching will take place in all these venues, and attending psychiatry
staff will additionally be available at all times for consultation and
informal teaching opportunities.
The inpatient rotations will occur one each of two acute inpatient psychiatry
units having a mean length of stay of approximately 10 days. One unit
includes an inpatient geriatric psychiatry unit as noted above, where
the length of stay is slightly longer due to occasional discharge planning issues.
There is a mixture (males and females) of patients ranging in age from
18 years old to 65 years old on the adult inpatient services; and adults
over 65 on the geriatric psychiatry unit. The 29-bed adult unit provides
care for predominantly young adult psychiatric patients with psychotic
and major affective disorders, frequently complicated by comorbid substance
abuse disorders. The unit has a high number of individuals retained by
court order, and unit psychiatrists are frequently testifying in court,
providing an opportunity for residents to be exposed to forensic psychiatric issues.
The second, 15-bed adult unit typically serves a slightly older population
with major affective disorders. The geriatric psychiatry unit treats individuals
with major affective disorders, as well as persons with comorbid psychiatric
and cognitive disorders.
Patients at all sites are predominantly middle class, with commercial insurance
covering approximately 40%, Medicare 35% and Medicaid 25%. The demographics,
including ethnicities, reflect the heterogeneous nature of Staten Island's
The unit provides assessment and treatment with; individual, family and
group treatment as well as utilization review, quality/performance improvement,
educational seminars, discharge planning and advocacy.
Residents would have a typical case load of six patients and would be closely
supervised by the attending psychiatrists as well as participating in
the various unit therapeutic activities, including group therapies.
All residents will receive individual supervision twice weekly, including
one on-unit and one off-unit supervisor, as well as weekly group supervision
with the unit medical director.
The unit faculty includes psychiatrists with a breadth of clinical experience,
as well as a board-certified geriatric psychiatry specialist, who is also
board-certified in forensic psychiatry. Supervising faculty will include
psychiatrists and social workers with expertise in psychopharmacology,
as well as cognitive behavioral therapy, psychodynamic psychotherapy and
Addiction and Recovery Services Rotation (R-2):
Residents will rotate through the Inpatient Detox, Inpatient Rehabilitation
and Outpatient Rehabilitation programs during each of these years, with
increasing outpatient exposure and independent practice responsibility
commensurate with their training. Programs will also in the coming year
include a new Outpatient Detox Program that is part of the New York State