Psychiatry & Behavioral Sciences › NuHealth - Nassau Health Care Corporation

Psychiatry & Behavioral Sciences

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Welcome

NuHealth offers a well-rounded, fully-accredited, four-year Residency Training Program in General Psychiatry that gives residents clinical experience in all areas of psychiatry so as to establish a foundation for future specialization. The educational philosophy of this program emphasizes fundamental mastery of a wide variety of diagnostic and treatment approaches, and an intellectualappreciation of the evidence supporting their use.

The residents, under the guidance and supervision of an experienced faculty, gain clinical expertise in the care and treatment of a diverse patient population. The Department is responsible for more than 3,550 inpatient admissions per year, accounting for more than 35,500 inpatient days. These figures have doubled over the last three years as the Department has expanded to 183 inpatient beds.

The interdisciplinary nature of our clinical department exposes the trainees to a wide range of theories and therapies. The Department is continuously expanding and improving, and, thus, it provides a rich academic and training environment for the residents throughout the four years of training. For example, in the past two years, the Department has added a Substance Abuse Rehabilitation Unit, an additional adult psychiatric unit, and a second Child and Adolescent Inpatient Unit. A Comprehensive Psychiatric Emergency Program (CPEP), is currently under construction. An Outpatient Child and Adolescent Program, and an Outpatient Geriatric Program are all currently under development.

The Department is affiliated with the Department of Psychiatry at SUNY Stony Brook School of Medicine, and with the North Shore-LIJ Health System, where cross-training opportunities are available. We also have an American Psychological Association accredited Clinical Psychology Internship Program.

We welcome your interest in our residency program, and we look forward to seeing you soon.

Nyapati Rao, MD, MS
Chair

Jacob Sperber, MD
Vice Chair for Education and Training

Program Description

The Department of Psychiatry and Behavioral Health Sciences at NuHealth is the most active provider of comprehensive mental health services on Long Island. It is a major community Mental health program, which provides direct clinical services and outreach programs, consultation and educational activities.

The Ambulatory Mental Health Service provides more that 8,000 service visits per year. Our 24-hour Psychiatric Emergency Department makes us a major receiving hospital on Long Island. The emergency service is supervised by two full-time and several part-time psychiatrists, as well as by several psychiatric social workers and nurses.

The professional clinical staff of the Department presently includes 22 full-time and 2 part-time psychiatrists, 9 full-time psychologists, 28 psychiatry residents, and 5 psychology interns. The Department also benefits from staffing with excellent nurses, social workers, and recreation therapists. The entire staff participates in the “360 degree” training and evaluation of our residents.

Medical and allied health profession students rotate throughout the Department, including medical students from SUNY Stony Brook, NY College of Osteopathic Medicine, and the American University of the Caribbean. After its opening in 2011, the new Hofstra University School of Medicine will also send students for rotations in the Department. Psychiatry residents play an important role in medical student education.

FIRST YEAR (PGY-1 CATEGORICAL)

This fully accredited program conforms to the requirements of the American Board of Psychiatry and Neurology for board certification in Psychiatry. The achievement of core competencies is stressed. Seven residents are enrolled in the Categorical First Year, which includes four months of Internal Medicine, two months of Neurology, and six months of Adult Inpatient Psychiatry. All training in the first year takes place at NuHealth. PGY-1 residents in Psychiatry are each assigned to one of our Adult Inpatient Treatment Teams where they receive intensive and continuously supervised clinical experience with patients hospitalized for psychiatric evaluation, treatment, and disposition.

Each resident is supervised directly by two members of the psychiatric faculty to whom she or he is assigned. During clinical rotations, the resident also comes into contact with other members of the treatment team, including fellow residents, psychiatric nurses, social workers, psychologists, recreational therapists, and medical students. Psychiatric evaluations and treatment plans are carefully coordinated at daily clinical rounds and at team meetings.

In addition to this clinical training component, all PGY-1 residents receive approximately eight hours per week of formal didactic instruction, which includes orientation to psychiatry, basic lectures in psychiatry, consultation liaison psychiatry conferences, seminars in psychiatry, the psychiatric interview course, and other didactic activities. Training experiences of comparable quality are provided during their Internal Medicine and Neurology rotations.

SECOND YEAR (PGY-2)

This year of training includes rotations of: three months in the Psychiatric Emergency Department, three months on the Inpatient Child & Adolescent Psychiatry Units, one-and-a-half months on the Substance Abuse Inpatient Service, one-and-a-half months on the Consultation-Liaison Psychiatry Service, and three months as an advanced resident on other Adult Inpatient Units.

The child psychiatry rotation involves work with both children and adolescents on the Child and Adolescent Inpatient Units. Opportunity is provided to observe and perform evaluations of patients for admission, participate in individual work-up, psychotherapy, and follow-up of patients, attend team meetings, and work with the child psychologists and social workers. The resident takes part in disposition planning and to have ongoing contact with families, schools, and child agencies whenever indicated. The three-month, full-time assignment to the Psychiatric Emergency Department is closely related to the experience on the inpatient service, since virtually all admissions are initially evaluated there. It provides an opportunity to view both acute and chronic patients presenting at an earlier stage in the course of their current episode of illness, frequently before any treatment has been provided. This experience hones the resident’s diagnostic abilities. The Emergency Department rotation also provides an in-depth knowledge of the community support systems needed in the comprehensive care of psychiatric patients.

Competency in ECT procedures is learned at Hillside Hospital, which is part of the North Shore-LIJ Health Care System.

The PGY-2 year, in addition to the clinical training component, is one of the core didactic years in the training program. Consequently, the residents receive over eight hours of formal basic didactic curriculum on a weekly basis throughout this year. This includes curriculum in psychopathology, psychopharmacology, child psychiatry, ethics, brief psychodynamic psychotherapy, empathic interviewing techniques, and other areas. At the end of the second year of training, the resident will have acquired sufficient mastery of the knowledge, skills, and attitudes which are required to perform more independent work and study during the third and fourth years of training.

THIRD YEAR (PGY-3)

The third year of training consists of a year-long, full-time outpatient training experience under supervision. In the outpatient service, the resident evaluates and treats a group of carefully selected patients under close supervision to gain experience in the various treatment modalities including long-term psychodynamic psychotherapy, supportive psychotherapy, brief therapy, family and couple’s therapy, group therapy, behavioral and cognitive therapy, and outpatient pharmacotherapy.

A well thought-out didactic curriculum complements the clinical experiences. This includes year-long courses in psychoanalytic theory and practice, cognitive and behavioral therapy, and courses in short-term therapy, family therapy, group dynamics, and crisis intervention.

FOURTH YEAR (PGY-4)

This final year of training is a time when the residents consolidate all of the competencies acquired during the residency. Residents engage in increasingly independent decision-making, and are involved in supervisory, administrative, scholarly, and quality assurance activities. This year prepares the residents to graduate and to become confident and knowledgeable mental health care providers.

Fourth-year residents divide their time between sub-specialty and elective rotations, and continuation of long-term treatments in the outpatient department. During their advanced consultation liaison rotation, residents expand on the competencies acquired during the PGY-2 year. The residents also work more independently, gathering relevant information and clinical details required to present their cases during consultation rounds. They follow up patients on a regular basis and provide psychiatric treatment and management when required.

The residents continue with their half-time, year-long outpatient experience, gaining understanding of long-term psychotherapy, chronic psychiatric disorders, ambulatory treatments, rehabilitation, and consultation.

Residents also participate in a two-month rotation at the Nassau County Correctional Center to learn about Outpatient Forensic Mental Health. Further training also involves a two-month geriatric psychiatry rotation at the A. Holly Patterson Skilled Nursing Facility. The residents, during this year, are also intimately involved in administrative and quality assurance activities, teaching and supervision of junior residents, elective activities, and psychiatric research. Through its collaboration with NS-LIJ, the Department is actively involved in NIMH research studies on an ongoing basis, and the residents have the opportunity to actively participate in these studies. Each senior resident completes a scholarly project for presentation at a national meeting, supported by the program.

Education/Conferences

At NUMC, your education will be enhanced by a wide range of learning experiences. From daily teaching rounds to subspecialty conferences and visiting professor lectures, formal teaching occurs multiple times each day. Your confidence will grow from the interaction and guidance you will receive from our attending physicians. During your residency you will participate in:

  • Grand Rounds. Weekly formal lectures prepared by residents provide an overview of the pathophysiology, diagnosis, and treatment of various disease processes. Clinical seminars feature many prominent speakers from outside the Medical Center.
  • Core Lecture Series. Lectures by faculty from the attending staff on both general and subspecialty internal medicine.
  • Journal Clubs. Monthly discussions of recent literature with an emphasis on critical appraisal skills.
  • Morbidity and Mortality Conferences. A formal opportunity for the residents to discuss cases each week with the program directors in a supportive learning environment.
  • Clinical-Pathological Conferences. Residents are presented with the clinical course, radiological findings, and relevant laboratory results for a particular patient. The resident then analyzes the case and presents his or her thinking process to the program in an educational format.
  • Critical Care Conferences. Residents rotating in the ICU have lectures scheduled several times a week with intensivists to review relevant topics such as EKG tutorials or ventilator management.
  • Attending Work Rounds. Attending work rounds are held by board-certified, specialist-trained faculty. These discussions focus on patients' management skills.
  • Teaching Report. Full-time faculty lead these case-based teaching sessions. All levels of residents and medical students participate in these practical discussions. Topics range from differential diagnosis, therapeutic plan, controversies, and ethical dilemmas.
  • Morning Report. A morning report audience will include medical students, residents, fellows, and general and subspecialty attendings coming together to contribute to the learning environment.

These conferences are well-attended by both faculty and house staff, which encourages the active interchange of ideas.

Research

NHCC has launched a new web-based training course through the Collaborative Institutional Training Initiative (CITI) Program. This program is widely recognized throughout the research industry for providing ethics education to all members of the research community.

The CITI Program is used by NHCC to educate researchers and key personnel involved in research with human subjects. The CITI program will replace our prior NIH online tutorial. Going forward, all new clinical research investigators and staff must complete the CITI program and submit a confirmation of completion of the program to the NHCC IRB in order to participate in research studies at NHCC. This program is offered through our affiliation with the North Shore–LIJ Health System (NSLIJHS).

Clinical research investigators and staff who have already met their education requirements through completion of the current NIH online tutorials must complete the CITI program by December 31, 2008.

All clinical researchers must complete CITI's "Basic Human Subjects" program—either for the first time or as a refresher course—by choosing the track that corresponds to their area of research:

  • Biomedical,
  • Social and Behavioral, or
  • Biomedical and Social/Behavioral.

Investigators who want their CITI training to meet requirements for more than one institution will be given the option to affiliate with another institution after logging on to the program. If the affiliated organization requires the same modules as NHCC, the investigator will only have to complete them once to get credit at both institutions.

Requirements

New Clinical Research Investigators and Staff: As of July 1, 2008, will be required to take the CITI program only.

Existing Clinical Research Investigators and Staff who have already completed the NIH Human Subject Protection Tutorials must complete the applicable CITI modules by December 31, 2008.

Procedure: Certification must be secured prior to submitting protocols for review by the Institutional Review Board (IRB).

Go to http://www.citiprogram.org.

Register. (Your participating institution is "North Shore–LIJ Health System.")
When completing the profile information, "NHCC" should be listed as the Department.
All Clinical Researchers must take the Basic Human Subjects (if they are taking the CITI program for the first time) or the Refresher Course (if they are renewing their CITI training) in the area most appropriate to their research:

  • Biomedical,
  • Behavioral, or
  • Biomedical and Behavioral.

It is highly recommended that Clinical Researchers also take the modules on Good Clinical Practice and ICH and the Responsible Conduct of Research. Both modules are optional for now but may be required in the future.

One of the key benefits of this program is that course completion is transferable between member institutions with brief updates required each year. As a result, if you have transferred to NHCC from another CITI institution and/or you are considering transferring to or collaborating with a CITI institution, you will already have met the majority of your human subject protection educational requirements by completing this course.

In addition, CME/CEU credits are available through the University of Miami for completion of the Human Subjects Protection Basic Course and for the Human Subjects Protection Refresher Course.

Questions regarding your requirements should be addressed to:

Sandy Maliszewski, Acting IRB Administrator, 516-572-4754, smalisze@numc.edu
Christine Deiker, Academic Affairs, 516-572-5881, cdeiker@numc.edu

Technical issues should be addressed to:
citisupport@med.miami.edu, 305-243-7970

Thank you for your cooperation. We look forward to continuing to work with you in the advancement of human subject research.

The minimum passing aggregate score for the quizzes is 80%. If you want to improve your score on a quiz, you may repeat any quiz in which you did not score 100% correct.

Print or download a Course Completion Report as evidence that you have met your institutional requirements. A copy will be sent to your administrator. You may return to the course site in the future to obtain a copy of the completion report.

CITI Fact Sheet

The CITI program consists of online tutorials with online exams and is offered through the University of Miami. It was developed by experts in the IRB community and focuses on different aspects of bioethics and human subjects research. There is a basic course for the protection of human subjects in either biomedical or social/behavioral research. Choose the basic course that best describes your research. The courses have some content overlap. Students should ask for guidance from their departments about which course to take. The CITI training is designed, updated, and maintained by a number of nationally known IRB professionals. Modules are housed at the University of Miami. The Basic CITI training takes approximately 4 to 6 hours to complete, usually far less if the material is not completely unfamiliar. This training does not need to be completed in one sitting. However, we suggest that you start and finish a quiz without taking a break. The modules are completed in succession. Topic-specific modules are each followed by a short quiz. You may repeat a quiz to improve your score. CITI is user-friendly and available 24 hours a day all year round.

The Collaborative Institutional Training Initiative (CITI) modules include:

  • Biomedical Focus
  • Social and Behavioral Focus
  • Refresher Courses
  • Good Clinical Practice Course
  • Health Information Privacy and Security Course (HIPS)
  • Laboratory Animal Welfare Courses for investigators and IACUC Members
  • Responsible Conduct of Research (RCR)

Registration for CITI

CITI can be accessed at www.citiprogram.org. Closely follow the instructions for registration. Remember your username and password for future access to the CITI program. If you are having problems with the CITI site or course, contact the CITI Office at citisupport@med.miami.edu or at 305-243-7970.

Training

CITI training is required of all faculty, staff, and students who are engaged in the design, conduct, or reporting of research at NUMC that involves human subjects. All personnel listed as investigators on the protocol must submit CITI certification.

Proof of completion of CITI training must be provided at the time of protocol submission.

Renewal of CITI Certification

CITI training must be renewed every two years through a refresher set of modules available through the CITI website at http://www.citiprogram.org.

Contact Us

Andrea Vazquez, PsyD
Program Coordinator
Telephone: (516) 572-5034
Facsimile: (516) 572-3210
Email: avazquez@numc.edu

Other Important Information

The various divisions of the Department offer clinical sites for a number of affiliated training programs. These include:

  • Introduction to Clinical Medicine and to Neurology for first-year medical students.
  • Clinical clerkships and fourth-year electives in psychiatry for SUNY Stony Brook, American University of the Caribbean, and NYCOM medical students.
  • Similar experiences for students from other medical schools.
  • Clinical psychology externships for undergraduate and graduate trainees.
  • Clinical training placement for psychiatric social work students.
  • Training programs for physician assistants and nursing students.