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PGY 1 residents spend 2 months on rotation in the Psychiatric Observation Suite (POS). Accommodating more than eight thousand visits a year, the POS (the psychiatric emergency room
at Montefiore Medical Center) offers an incomparable education in emergency psychiatry and crisis intervention and allows residents the opportunity to perform comprehensive evaluations, initiate treatment, observe patients, and/or refer them for admission. Intensive, on-site supervision by attendings is provided days and evenings.

During a 4 month rotation on the inpatient psychiatry unit, PGY 1 residents will experience a multidisciplinary treatment team model, where they are either the assigned primary therapist for acutely hospitalized patients, or the medical back-up for psychology trainees and medical students. The large multicultural community served ensures a rich immersion in severe psychopathology of all major syndromes with culturally sensitive evaluation, case formulation and treatment planning.

Residents are provided close and supportive supervision as they develop new skills and competence in psychopharmacology, individual, group and family therapy. The long-term inpatient setting at Bronx Psychiatric Center, provides a rare opportunity for PGY 2 residents to intimately observe the course of mental illness over an extended time period, not only from day to day but also from month to month.

Here, our residents learn much more than stabilization and discharge; they are provided with the opportunity to delve into a psychodynamic exploration of their patients' mental experiences and psychiatric illnesses. In addition, and of paramount importance, they also begin to learn how to examine and better understand their own reactions to their patient's illnesses and life stories. This unique experience becomes the incubator for deeper and more sophisticated ways of thinking about psychiatric issues.

This unique, intensive training experience, while also utilizing milieu, family and psychopharmacological approaches, offers the opportunity to learn a multiplicity of state of the art clinical interventions, in an environment that greatly enriches the training experience beyond that of the acute care inpatient units currently used by most residency programs.

The PGY 2 two-month rotation on the Psychosomatic Medicine Service, offers unique opportunities to gain expertise in Psychosomatic Medicine. Residents will learn how to evaluate and manage psychiatric aspects of medical illness while providing liaison and consultation to the medical/surgical services in our large university hospital.

Residents are supervised by attending psychiatrists with multiple subspecialty boards including psychosomatic medicine, forensics, geriatrics, substance abuse and pain medicine. Weekly Ombudsman rounds on the inpatient services of the Department of Medicine and the opportunity to diagnose and treat psychiatric problems in super-specialized services such as bariatric surgery, cardiac transplant, pain and palliative care, and the epilepsy EEG-TV 24 hour monitoring unit make this rotation one of a kind.

On this Service, the residents are assigned to a team, each made up of an attending, a fellow, 1-2 residents, and a medical student. Each team conducts clinical teaching rounds daily. All consults seen by trainees are also evaluated by the attending and discussed in rounds. Patient interviews are observed and critiqued, histories and clinical findings are presented, management plans developed and the medical literature reviewed. Each team sees an average of 2-4 new consults per day. A clinical case conference, in which trainees present difficult cases to a panel of attendings, is conducted weekly.