The Mount Sinai School of Medicine

Department of Psychiatry

PSYCHIATRIC SERVICES CURRICULUM: PGY II, PGY III, PGY IV

2002-2003

Director of Residency Training:
Jack Hirschowitz, MD

Professor of Psychiatry

Curriculum Directors:

Hunter L. McQuistion, MD

Associate Clinical Professor of Psychiatry

Jorge Petit, MD

Clinical Assistant Professor of Psychiatry

PGY II CURRICULUM

Emergency Psychiatry:

a. General Introduction & Safety

b. General Assessment Guidelines, Differential and Treatment Options

c. Psychopharmacological Principles

d. Violence

e. Suicide

Law & Psychiatry:

a. Basic Law for Psychiatry - Part I

b. Basic Law for Psychiatry - Part II

c. Competence (Civil & Criminal)

d. Confidentiality/Tarasoff - Part I

e. Confidentiality/Tarasoff - Part II

f. Coercion & Engagement

Public Health & Epidemiology:

a. Demography & Urban Mental Health

c. Identification of Psychiatric Cases

d. Measurement of Health Status & Surveys and Surveillance

e. International Psychiatry & Migration Flow & Refugees

Social Psychiatry:

a. Social Class & Poverty

b. Gender, Religion & Spirituality

c. Family and Consumer Initiatives

Cultural Psychiatry:

a. Cultural Identity and Mental Health

b. Cultural Considerations in Psychiatric Illnesses

c. Cultural Formulation and Comprehensive Diagnosis

d. Cultural Framework of Psychiatric Treatment

Community & Public Services:

a. History & Social Context

b. High-risk Populations - An Overview

c. The NYC Mental Health Services System

d. Clinical Approach to Dual Diagnosis

Consultation-Liaison:

a. Depression in Medical Illness

b. Medical-psychiatric Syndromes in the Elderly

c. Delirium and Related Syndromes

d. A Data Base for Consultation-Liaison Psychiatry

e. Psychiatric Aspects of Terminal Illness

f. HIV-related Psychiatric Syndromes

Ethics:

a. Introduction

b. Autonomy and Paternalism

c. DNR & Capacity

d. Suicide/Euthanasia

PGY III CURRICULUM

Emergency Psychiatry:

a. Special Topics - Malingering, Treatment & management of substance intoxication/withdrawal & abuse/dependence, adolescents, geriatrics

b. Disaster/Critical Incident Psychiatry - Part I

c. Disaster/Critical Incident Psychiatry - Part II

Forensics - Issues and Services Module:

a. Child Abuse/Elder-care Laws

b. Psychiatric Disability/Workman's Compensation

c. Psychiatric malpractice

d. Expert Witness Testimony

e. Juvenile related issues

f. Civil Commitment (National/Local Civil Commitment Laws)

g. Patients in the Criminal Justice System: Correctional psychiatry, trans-institutionalization, diversion, community reintegration, etc.

Psychiatry and Rehabilitation: A Paradigm of Care:

a. The Biopsychosocial Model and The Continuum of Care for People with Severe Psychiatric Disorders

b. ACT/Case Management/Fayerweather

c. Alternatives to Hospitalization (day hospitals, crisis r esidences, MCT's)

d. Consumer Managed Initiatives (consumer-run housing, consumer-run drop-in center) - Part I

e. Consumer Managed Initiatives (consumer-run housing, consumer-run drop-in center) - Part II

f. Housing

g. Long-term care/institutionalization

h. Social Skills Training and Vocational Training Models

Substance Abuse Programming:

a. The natural history of chemical dependency

b. 12-step model and abstinence models

c. Other recovery/rehabilitation models: harm reduction, methadone

d. Dual Diagnosis - Part I

e. Dual Diagnosis - Part II

Integration of Mental Health, General Health and Social Service:

a. Psychiatry & Interdisciplinary Care

b. Psychiatry & Primary Care Interface

Services for High Risk Populations:

a. Severely Mentally ill

b. Mentally ill Homeless - Part I

c. Mentally ill Homeless - Part II

d. HIV/AIDS

e. Children/Adolescents

f. Geriatrics

Organization & Financing of Psychiatric Care - Reimbursement Models:

a. Managed care v. fee-for-service

b. Medicare & Medicaid

c. Entitlements: SSI/SSD and Public Assistance (recent changes)

Consultation-Liaison:

a. Psychiatric Aspects of Pain Management

b. Transplantation Psychiatry

c. Somatoform Disorders

d. Neurologic Issues in Consultation-Liaison Psychiatry

e. Sexual Dysfunction

f. Financial and Liaison Issues in Consultation-Liaison Psychiatry & Lecture Series Wrap-Up

Ethics:

a. Refusal of and Forced Treatment

b. Surrogate decision-making

c. Consultation and double agency

PGY-IV CURRICULUM

a. Clinical: six-month, 3.5 hrs/wk, mandatory community selective. Supervision: on-site, in some cases augmented by off-site faculty

b. Didactic: semi-monthly to monthly meetings, alternately discussing a case from the selective or hearing a guest presentation about a community-oriented program.

2001-2002 Lecturers:

Amy Hoffman, MD Dual Diagnosis (Journal Club)

Hunter McQuistion, MD Project Renewal/homeless services

Jim Mutton, CSW Project Renewal's Clinton Residence and RCCA model

Naomi Miller, DSW MSSM - MICA Day Treatment Program

Etta Graham, CRC Fort Washington Shelter

Michele Potash Weston United Case Management

Michele Fontaine, CRC Project Renewal's JobLinks/supported employment model

Dova Marder, MD NYC Department of Homeless Services

Sam Tsemberis, PhD Pathways to Housing

Alan Felix, MD Critical Time Intervention model

Peter Della Bella , MD YAI/developmentally disabled

Katherine Falk, MD Project for Psychiatric Outreach to the Homeless

Ralph Aquila, MD Fountain House/ transitional employment model