The Psychosomatic Medicine Service at Montefiore Medical Center is an active training site for psychiatry residents, medical students and for neurology and family medicine residents who are interested in psychosomatic medicine. Opportunities for teaching and clinical research are widely available and the collegial atmosphere of the service allows for mentoring.
Fellows will have the unique opportunity to work with the Palliative and Pain Management Service, the Substance Abuse Consultation Service, Stem Cell, Heart, Kidney and Liver Transplant services and High Risk Pregnancy. Clinical Case Conference is conducted weekly at which trainees present difficult cases to a panel of attendings with a wide range of experience and interests.
Weekly Ombudsman rounds (Medicine-Psychiatry conferences) on the inpatient floors of the Department of Medicine and the opportunity to help diagnose and treat psychiatric problems in super-specialized services including bariatric surgery, cardiac transplant and the epilepsy EEG-TV 24 hour monitoring unit make this fellowship one of a kind.
Each fellow spends the majority of his/her time on the Montefiore Consultation Service. We see approximately 100 patients/month and each fellow usually sees one new patient daily. Afternoon rounds are conducted daily by the attendings that see each new patient with the fellow and PGY II psychiatry resident.
For most of the year a PGY IV neurology resident and a third year student Einstein are also part of the team, following their own patients.
Half a day to a full day per week may be spent at other sites, including the Stem Cell Transplant Clinic, a High Risk Pregnancy Clinic, Pain Clinic, and the Consultation Service at Jack D. Weiler Hospital Division, which offers exposure to a different patient population.
In addition, each fellow spends four months on the Solid Organ Transplant Service, one month in the Pain and Palliative Care Consultation Service and the one month in the Addiction Psychiatry Service. Fellows have the option of participating in an interdisciplinary weekly Bioethics Seminar.
If a fellow has a particular clinical or research interest, every effort will be made to accommodate that interest. There is no night or weekend call obligation.
There is no formal research requirement as it is difficult to develop and carry out a research project during a one-year fellowship. However, fellows are encouraged to develop projects and prepare case reports or studies based on the patients seen. They are also encouraged to take an active role in the teaching of junior trainees. Time and financial support is available to attend a national Psychosomatics focused meeting.
The D. Samuel Gottesman Library at the Albert Einstein College of Medicine has a substantial collection of in house journals and texts.
24-hour access to on-line journals and periodicals is also available to the Einstein Community through its website at http://library.aecom.yu.edu/.
Montefiore Medical Center has the full service on-site Montefiore Medical Library as well as 24-hour access to online periodicals and journals through the Montefiore intranet service.
In addition, Patient records, including lab data and imaging are available on the computer, simplifying the gathering of a patient database. Old charts are also available via the computer. There is a hospital library with full access to books and journals via loan systems and access to computerized databases for literature review is available.
In addition to daily rounds with the attendings, formal teaching activities include a weekly reading seminar on Mondays, focused on chapters from the major texts in the fields, a Clinical Case Conference on Tuesdays which brings all the teams and attendings together to discuss difficult cases, and Psychiatry Department Grand Rounds which take place every Thursday and covers a wide range of topics and features leading speakers from the field.
Dr. Nicolson offers a monthly journal club open to all trainees and Dr. O’Dowd offers a monthly journal club for the Psychosomatic Medicine fellows.
Lecture Series in Psychosomatic Medicine, Pain and Palliative Care, Substance Abuse, QI and Peer Review and Oral Board Preparation are offered at times through-out the year.
Daily supervision occurs formally in rounds and less formally throughout the day as the primary attendings are always on site and available. Supervision is arranged for each of the clinic activities. In addition, fellows meet twice monthly with the senior staff to provide more advanced supervision.
As an essential part of the training program, timely and clear feedback provides residents with a personalized guide for fully developing their clinical skills.
In a collegial atmosphere, supervisors complete computerized evaluations toward the end of each rotation, quarterly and at six-month intervals.
Residents also provide feedback to supervisors and course instructors and evaluate the clinical rotations. Additionally, residents participate in our annual curriculum review. Our Training Committee meets biannually to review the progress of all trainees and feedback based on this biannual review and written evaluations are given to trainees twice per year by our Directors of Training.