A comprehensive Addiction Psychiatry Training experience with a 1-month rotation through multiple addiction sites during the PGY2 year exposes residents to a wide array of substance abuse treatment
modalities, under the direct supervision from the addiction faculty. Residents rotate through the Montefiore Substance Abuse Treatment Program (SATP) where they observe methadone maintained patients with co-occurring psychiatric disorders.
Here, the residents are able to conduct psychiatric assessments of patients with substance use disorders, and learn about the differential diagnosis of substance induced versus primary psychiatric disorders and appropriate psychopharmacologic and psychotherapeutic treatment modalities.
Residents also rotate through the Montefiore Substance Abuse Consultation Referral Service (SACRS) where they are exposed to medically hospitalized patients with addiction problems. Here residents do evaluations of patients who may be intoxicated or have withdrawal syndromes, and learn about motivational interviewing and issues related to patients who are just beginning to become aware of addiction problems in their lives.
As part of the addiction psychiatry training, residents also rotate through the Soundview Throgs Neck MICA Treatment Program where they evaluate patients for long-term treatment, and attend and participate in group therapy interventions. During the rotation, residents have direct supervision from the addiction faculty at all sites.
The month long PGY 2 rotation in geriatric psychiatry provides residents with the opportunity to evaluate geriatric patients in a variety of settings, including the psychiatry clinic, nursing home, home care service and senior citizens residing in the community. The rotation seeks to counter misconceptions regarding the capacity of older adults to respond to treatment as well as to expand the resident's perspective on the provision of care to frail elders and their families.
Direct supervision enhances the resident's capacity to assess impaired cognition and decisional capacity as well as consider aspects of diagnosis and treatment of particular relevance to the geriatric patient. Residents become familiar with care sites and mental health services typically used by older adults including home care services and nursing homes.
Residents are introduced to the "functional approach" to geriatric care that aims to restore or maintain the older adult's optimal possible level of independence and well being. They also become familiar with geriatric team care in which clinicians from an array of disciplines provide services that at times overlap but should always compliment. Residents accompany geriatric psychiatry fellows and faculty on house calls, consultations in the community and to nursing homes. They also participate in weekly case conferences, journal clubs and research seminars held jointly by the Divisions of Geriatric Psychiatry and Geriatric Medicine.
Finally, a 2 month rotation in child and adolescent psychiatry completes the PGY 2 year of training. During this rotation, residents are able to evaluate and treat an adolescent on an inpatient adolescent service at New York City Children’s Center, Bronx Campus
and evaluate a child or adolescent in the outpatient clinic at Montefiore Medical Center. While on rotation, the resident attends all unit-based rounds,
conferences, treatment team meetings and therapeutic groups on the services on which they rotate. Residents also evaluate children and adolescents in the Children's Hospital at Montefiore (CHAM) Pediatric Emergency Room and, with the BCT (Behavioral Care Team), on the inpatient general and specialty pediatric units. All patient experiences are under the supervision of senior faculty from the Division of Child/Adolescent Psychiatry.
The residents' training experience is further enriched by their collegial interactions with Fellowship trainees in the Division of Child/Adolescent Psychiatry, including attendance at classes and conferences with first year fellows.
This rotation provides a unique opportunity to learn about child development and psychopathology for both the adult resident who will continue with advanced training in child/adolescent psychiatry as well as enriching the experience of those residents who will continue with adult work. This rotation complements the academic experience of the course on Infancy and Preschool Development and Psychopathology that is part of the PGY II adult curriculum.