PGY 1

We have 24 general psychiatry residents in our program. We typically take 6 residents for the PG 1 year. All six residents are selected through the NRMP. The typical first year schedule includes a) four months of Internal Medicine at University Hospital, b) two months of Neurology at the Northport Veterans' Administration Medical Center, c) four months of inpatient psychiatry at University Hospital and d) two months of Emergency Psychiatry at University Hospital.

The emphasis in the first year is upon rapid acquisition of the clinical skills that are necessary to successfully complete residency training in psychiatry. Thus, the PG 1 resident receives training in medicine and neurology that is designed to make him/her comfortable in making med/surgical diagnoses and beginning treatment of the kinds of medical conditions that he/she will encounter as a psychiatrist in a large tertiary care medical center. In addition, the resident has the opportunity to familiarize himself/herself with the range of psychiatric conditions treated on the inpatient service and the emergency service.

The typical work week is about sixty hours long. The Psychiatry Department utilizes a Night Float system of coverage to ensure that residents have adequate time to rest following intensive On Call responsibilities. Overnight call in Medicine and Neurology has tended not to be as taxing as that in Psychiatry.

The PGY 1 resident is expected to attend didactic sessions while on the inpatient psychiatry service. There are special orientation seminars during the summer.

PGY 2

There are typically six PGY 2 residents. On occasion, a seventh resident is offered a position. The typical PGY 2 schedule consists of three months of inpatient psychiatry at University Hospital, two months of inpatient psychiatry at the Northport VAMC, two months of inpatient Child Psychiatry, two months of Emergency Psychiatry, one month of Substance Abuse Psychiatry, and one month of Geriatric Psychiatry.

The clinical program is designed to allow residents to achieve necessary levels of competence in emergency assessment and treatment of psychiatric patients, crisis intervention, community resource referral, inpatient assessment and treatment, with special emphasis on psychopharmacologic treatments and electroconvulsive therapy. By the end of the second year, the resident will have had intensive and extensive clinical exposure to a broad range of psychiatric conditions and acute psychiatric treatments. Although the resident will feel most comfortable in addressing acute psychiatric problems in adults, by the end of the year there will also be a level of comfort with clinical issues in child, geriatric and substance abuse psychiatry.

For the resident who knows that he/she will be pursuing further training in Child and Adolescent Psychiatry following the PGY 3 year, two months of Consultation-Liaison Psychiatry is substituted for Child Psychiatry during the PGY 2 year.

On call, overnight coverage continues throughout the PG 2 year and utilizes a Night Float System. The typical workweek is about sixty hours long.

PGY 3

There are six PGY 3 residents. The focus of the third year is on outpatient psychiatry. Residents participate in what is essentially an office-based practice in the Outpatient Clinic, which is part of the University Hospital complex. There are also opportunities for outpatient experiences at the University Counseling Center during the third year. In terms of technical skills, the third year provides the resident to become adept at the diagnostic and treatment planning assessment of ambulatory patients with psychiatric conditions (both simple and complex) and acquiring psychotherapy skills (psychodynamic, cognitive-behavioral, supportive, short-term, family and group). Special emphasis is given to consideration of combining psychotherapy with pharmacologic treatment. Each new PGY 3 resident "inherits" a practice of about 50-60 patients. During the year, the resident learns to manage a largecaseload comprised of active and relatively inactive patients as well as to incorporate new patients into his/her practice or to refer new patients elsewhere after an initial assessment. The applicability of these skills to the practice of psychiatry following residency training is obvious.

The didactic experience in the third year reflects the change in clinical focus and offers a curriculum that is psychotherapy-focused.

PGY 4

There are typically four or six PGY 4 residents. Two residents are chosen to be Chief Residents, based upon clinical and academic performance during the first three years of training. The Chief Resident fulfills a variety of administrative and teaching duties, and serves as a liaison between the departmental faculty and the house staff.

During the fourth year, residents serve as consultants to the medical and surgical services in the hospital. This experience meets the ACGME requirement for Consultation Liaison psychiatry. The C/L service at Stony Brook is a busy and active service with about 500 new consultations per year and 150 patient visits per month.