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.

Training
Overview

Fellows will have the unique opportunity to work with the Palliative and Pain Management Service, the Addiction Psychiatry Consultation Service, Stem Cell, Heart, Kidney, and Liver Transplant services and High Risk Pregnancy Clinic. A 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. A bi-weekly joint Neurology-Psychiatry Case Conference is held to discuss cases on the interface between Psychiatry and Neurology. Fellows may attend bi-weekly Complex Case meetings that bring together institution wide experts, including Legal, Bioethics, Social Services, Patient Representatives, Home Care, Administration, Office of the Medical Director, and the primary care team to coordinate the care of the most challenging patients. Fellows will also take part in Departmental Quality Improvement activities.

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 200 patients/month and each fellow usually sees one new patient daily. Afternoon rounds are conducted daily by the attendings, who see each new patient with the fellow, PGY II psychiatry resident and other trainees, including a PGY IV neurology resident and first and third year medical students.

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, and the Consultation Service at Jack D. Weiler Hospital Division, offering exposure to different patient populations, disease entities and diagnostic challenges.

In addition, each fellow spends four months on the Solid Organ Transplant Service, one month on the Pain and Palliative Care Consultation Service and the one month on the Addiction Psychiatry Service.

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.


Research Opportunities

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. Time and financial support is available to attend a national Psychosomatics focused meeting and fellows are encouraged to submit abstracts for presentation at national meetings.

Library Resources

24-hour access to on-line journals and periodicals is available to the Einstein Community through the library's website at http://library.aecom.yu.edu/.

The Montefiore Medical Library has 24-hour access to online periodicals and journals and computerized databases for literature review through the Montefiore intranet service.

Seminars

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 the teams and attendings together to discuss difficult cases, and Psychiatry Department Grand Rounds which take place every Thursday and features leading speakers from the field covering a wide range of topics.

A monthly journal club is offered to all trainees and Dr. ODowd, the Service Director, meets monthly for journal club and discussion with the Psychosomatic Medicine fellows.

Lecture Series in Psychosomatic Medicine, Pain and Palliative Care, QI and Peer Review, Addiction Psychiatry and Stem and Solid Organ Transplant are offered at different times through-out the year.

Supervision

Daily supervision occurs formally in rounds and less formally throughout the day as the primary attendings are always on site and available. Supervision is an integral part of each of the clinic activities. In addition, fellows meet twice monthly with senior staff to provide more advanced supervision.

Evaluation

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.