Residency Training in Psychiatry
Fellowships:
| Fellowship in Addiction Psychiatry | |
| Fellowship in Consultation/Liaison Psychiatry | |
| Fellowship in Geriatric Psychiatry |
Clinical Psychology Training Programs:
| Internship Programs | |
| Adult Externship Programs | |
| Child Externship Programs |
Fellowship in Addiction Psychiatry:
The Department of Psychiatry at Beth Israel Medical Center has a well-established Fellowship in Addiction Psychiatry. The fellowship has been in existence since 1994 and was first accredited by the ACGME in 1995. This was the first year that training programs in Addiction Psychiatry were accredited and since then the program has expanded extensively.
The Medical center has a long tradition of offering treatment for addictive disorders. Besides running one of the largest Methadone Programs in the country, the Institute of Chemical Dependency offers inpatient and ambulatory detoxification, an inpatient 28-day rehab and a wide variety of outpatient treatment options. This places the fellowship in the unique position of being able to provide an incomparable depth of experience to trainees.
Three positions are offered each year and all fellows spend four months each on a “major” and “minor” rotation.
The inpatient rotation consists of working on the 28-bed dual diagnosis unit with a multidisciplinary staff, all of whom are experienced in the addiction field. Fellows gain experience in managing complicated withdrawal states, often comorbid with severe psychiatric illness. They are also responsible for medical student supervision and assist in the education of the PGY-2 residents that rotate through the unit. The concurrent “minor” rotation consists of providing psychiatric consultation-liaison services to three inpatient medical detoxification units (75 beds), under the supervision of an attending physician.
Fellows rotate for four months on the 28-day inpatient rehab unit. While on this rotation, they operate as members of the treatment team. This includes sitting in daily rounds, participating in evaluations at admission, observing and co-leading groups and learning the use of family therapy in addiction treatment. The “minor” rotation for this trimester is Methadone Maintenance. Fellows attend clinical meetings at a MMTP and also perform evaluations. They become familiar with the day to day running of a Methadone program and learn about the unique regulations that govern this modality of treatment.
The outpatient experience is an ongoing one, as fellows carry a variety of cases throughout the year. However one four-month block is devoted to being the “staff psychiatrist” for an outpatient drug treatment program and seeing patients for consultation and ongoing care. In addition fellows co-lead a group for dual diagnosis patients with an experienced addictions counselor. Fellows also rotate through the Pain management Service during this time and engage in consultation and treatment of patients with comorbid chronic pain and addictive disorders.
The Division of Addiction Psychiatry has an active outpatient clinic and patients diagnosed with schizophrenia and addiction are followed in the Combined Psychiatric and Addictive Disorders Program. Studies on this population of patients were initially funded by the National Institute on Drug Abuse and several important papers have been published around factors in relapse and treatment retention. Research opportunities also exist with in the Division of Neuroimaging and Biological Psychiatry, and in the area of Methadone Maintenance and novel detoxification strategies.
Ample supervision is provided by Board Certified Addiction Psychiatrists, Attending Physicians and Psychologists who dedicate their time entirely to the addiction field. The fellowship program is flexible and trainees can concentrate on a particular area that matches their particular interest.
Applications are accepted beginning early fall and interviews are usually conducted October thru February. Application packages can be requested by contacting Lynette Joseph at 212.420.2836 or ljoseph@bethisraelny.org.
Fellowship in Consultation-Liaison Psychiatry (Psychosomatic Medicine)
Background
Beth Israel Medical Center is 1,368-bed full service teaching hospital,
which has been serving New York City for the past century. In addition
to the general medical-surgical units, Beth Israel boasts several specialty
inpatient units covering HIV/AIDS, Oncology, Physical Medicine/Rehab,
Cardiology, Nephrology, Intensive Care, Cardiac Surgery, and OB-Gyn. Beth
Israel has an academic affiliation with the Albert Einstein School of
Medicine and is a major clinical campus for the medical students' psychiatry
rotation. Over the years, Beth Israel has developed a reputation for a
caring involvement with its surrounding communities, such as the East
Village, Gramercy Park, Loisaida, and Stuyvesant Town. A commitment to
the excellent clinical care of the community and research into the best
methods of delivering such care are hallmarks of Beth Israel, the Department
of Psychiatry and the Division of Consultation-Liaison (C-L) Psychiatry.
The C-L division at Beth Israel had its informal beginnings in the 1960's under the leadership of Dr.Max Needelman. Dr. Joel Wallack assumed direction of the division in 1982 and established the Fellowship Training Program in 1986. Since then the program has trained over 30 fellows, many of whom have taken on leadership roles in C-L Psychiatry nation-wide. Dr. Philip Bialer, the current C-L chief and Fellowship Training Director is himself a graduate of the program.
The program has been certified by the Academy of Psychosomatic Medicine as meeting the standards of C-L Fellowship Training and has been formally approved by the hospital's Graduate Medical Education Committee. The American Board of Medical Subspecialties and the American Board of Psychiatry and Neurology have recently approved Psychosomatic Medicine as an official sub-specialty. Once ACGME has established the criteria for accreditation, we will be submitting an application. There are four full-time faculty in the division. The length of training is for 12 months beginning on July1.
Training Program
The training consists of several year-long activities:
1. Clinical and service activities
2. Liaison activities
3. Didactics and supervision
4. Teaching and supervision of residents and medical students
5. Administrative duties
6. Research
| Inpatient and outpatient consultations | |
The consultation service at Beth Israel is a busy one with an average of 100 consultation requests per month. The fellows are assigned 3-5 consults per week. Over the course of the year, they see a wide range of patients with varying diagnoses from all services in the medical center; the fellows are often assigned the more complicated cases. Daily work rounds, led by C-L attendings, are held with the fellows and residents during which all cases seen the day before are presented and discussed. In addition, Chief-of-Service rounds are held weekly. The fellows meet individually with Dr. Bialer weekly for supervision and review of their inpatient consults. Daily ad-hoc supervision is also available from all of the C-L attendings. Fellows also see patients in the Krueger Clinic for the Treatment of Immunological Disorders for 3- 5 hours per week to gain knowledge and experience working with people with HIV/AIDS. In addition, the Fellows attend the Primary Care Clinic at PAAC one morning per week for 6 months precepting medical residents on their interactions with their patients. Emphasis is placed on interviewing skills and obtaining psychosocial information from their patients. |
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| Liaison Activities | |
| The liaison experience is tailored to meet the fellows' specific interests. Past fellows have focused on HIV, Oncology, Physical Medicine/Rehab, Nephrology, Cardiology, and OB-GYN units. In addition, there are two weekly liaison ombudsman-type case conferences. These rounds are organized by the fellows in conjunction with the unit staff and are attended by medical house staff, C-L residents and fellows, and medical students. Coping and personality styles, psychosocial histories, managing difficult patients, and counter-transference issues are examples of topics explored in the conferences. Fellows will also have an opportunity to lead these case conferences. | |
| Didactics and Supervision | |
The full-time faculty supervises all clinical work and liaison activities. In addition there is a 22 week-long course on C-L psychiatry. Local experts in this field are invited as guest lecturers for this course to complement our own faculty. The areas covered in this course include: Introduction to Psychosomatic Medicine: History and Overview |
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| Teaching and Supervision of Residents and Medical Students | |
| Fellows serve as the primary supervisor for a rotating psychiatry resident for at least 6 months of the year. In addition, the fellows have an opportunity to supervise Family Medicine residents who rotate through C-L as part of their training. The third year psychiatry clerkship for Einstein medical students is primarily based on the inpatient psych units. However, the students attend C-L rounds weekly and one of our liaison conferences, In addition, the fellows spend one hour per week with the students going to see interesting cases on the service. Ad-hoc lectures for med-surg staff on topics such as Delirium or Depression is arranged during the course of the year. | |
| Administrative Duties | |
| The fellows will have a minimum of two months experience coordinating the consult service under supervision. This will involve triaging of consultation requests being called in, assigning them to residents and staff, and maintaining the patient log and database. Fellows will also learn about the financial aspects of the C-L service and about billing for consultations. This will include learning proper diagnostic and CPT code documentation, as well as the process of working with Medicare, Medicaid, and other third party payers. | |
| Research | |
Fellows attend a weekly C-L research meeting during which current projects are discussed and new projects developed. Although not a requirement of the training, the fellows are encouraged to develop their own project or focused literature review. Alternatively, they can participate in ongoing projects within the division. Past and current projects include “Missed Cases of Delirium in the General Hospital”, “Drug-drug Interactions in Patients with HIV/AIDS”, “The Presence of APOE in Patients Diagnosed with Delirium”, and “The Psychosocial Impact of Lipodystrophy on Women with HIV/AIDS”. Fellows are encouraged to write up their findings for publication and/or presentation at scientific meetings. |
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| Benefits | |
Beth Israel Medical Center supports a generous package of benefits to its trainees and staff. The Fellowship stipend is paid at the PGY5 level for New York City, which is approximately $55,000. Also included are malpractice coverage, health insurance, as well as dental, optical, and hearing aid benefits. Fellows may contribute to a tax-deferred annuity through the Medical center. Housing may also be available through the Medical Center at attractive rates. Beth Israel has an excellent full-service medical library, the Seymour J. Phillips Library. It is conveniently located on the 12th floor of Fierman Hall. Finally, the Division of Consultation-Liaison Psychiatry as well as the Department of Psychiatry at Beth Israel is sincerely interested in fostering a pleasant and collegial working environment. The concerns of trainees are taken seriously. There are many opportunities to socialize within the department and with other medical colleagues. |
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For an application and/or other inquiries, please contact:
Philip A. Bialer, MD
Chief, Consultation-Liaison Psychiatry
Beth Israel Medical Center
First Ave. and 16th St., Fierman 509
New York, NY 10003
Phone: 212-420-4352
Email: pbialer@bethisraelny.org