PGY 2 Curriculum

~~Affective Disorders
This course covers the phenomenology, epidemiology and psychobiology of affective disorders. Treatment is reviewed from both psychotherapeutic and pharmacological perspectives.

Anxiety Disorders
This course covers the phenomenology, epidemiology and psychobiology of the anxiety disorders. Treatment approaches including psychopharmacology and psychotherapy are discussed.

Assessment and Management of Suicidal Behavior (NYSPI)
(NYSPI) An introduction to the basics of risk assessment and management of acutely and chronically suicidal patients.

Basic/Clinical Neuroscience
Using resources from the National Neuroscience Curriculum Initiative and current literature, this course reviews the structure and function of neural systems directly relevant to psychiatric disease.  Using interactive tools, residents will learn the function of key brain circuits, neurotransmitters and receptors, and their roles in major psychiatric diagnoses and treatments.  Neuroimaging modalities are also reviewed.


Basic Psychopharmacology
This course offers the junior resident an introduction to the basics of psychopharmacology, such as how to choose medications, dosing, assessment of side effects, and relevant laboratory tests. Emphasis will be placed on how to incorporate electronic resources such as Epocrates and Micromedex. Case based lectures on drug-drug interactions are included to solidify resident knowledge. It will cover Antidepressants, Antipsychotics, Medications for Substance use Disorders, and Anxiolytics. Using the American Society of Clinical Psychopharmacology slides, residents are taught in lecture format. In a workshop format, residents will also learn about treatment algorithms for major psychiatric disorders. Additionally, residents practice how to speak with patients about the medications.


Clinical Skills Verification Exam and Practice Sessions
Through observed interviews and presentations, the clinical skills verification (CSV) provides an opportunity to ensure that residents master critical skills such as establishing an effective physician-patient relationship, conducting a clinical interview and presenting a case. This course reviews the process and expectations set by the American Board of Psychiatry and Neurology for CSVs in general psychiatry.  Also, residents are given an opportunity to practice skills at making clear, concise and accurate presentations during this class.

Introduction to Child Development
Normative child development is the focus of this introductory course prior to the start of formal 3rd year rotation in child psychiatry. Physical and neurological growth, attachment, cognition, language acquisition and psychosocial maturation are discussed in the context of current and historical theories.


Forensic Psychiatry (NYSPI)
Overview of salient issues in forensic psychiatry for psychiatric residents. 

Genetics and Mental Illness (NYSPI)
This course will focus on an overview of the role of genetics in psychiatry and mental health research.

Patient Safety & Quality Improvement – Introduction to concepts
 Residents learn the foundations of patient safety initiatives, quality improvement strategies and their role as leaders in healthcare. Tools such as PDSA and A3 model will be introduced. The TEAMSTEPPS tools such as huddle, brief and debrief for effective team communication will be identified. They wll assess their own clinical practices and the culture and practices of the systems in which they work. Incorporation of the Institute of Healthcare Innovations resources will bolster knowledge base of residents. QI tools such as the fishbone and process maps will organize their approach to areas for improvement.

 

Community Care for Severe Mental Illness (NYSPI/Harlem)
These are the first in a series of lectures that cover topics related to the care of people with severe mental illness in community settings. Lectures include topics related to the concept of recovery as it applies to housing, benefits, vocational rehabilitation and systems of outpatient treatment. Residents will also learn about services for the home bound elderly. Residents will learn about forensic services such as CASES for court involved patients.


Consultation Liaison (NYSPI)
Consultation-Liaison Psychiatry deals primarily with the understanding and treatment of psychiatric problems in patients with other medical problems. The course will focus on four key topics that are important because of their acuity and generalizability: agitation, alcohol and sedative withdrawal syndromes, capacity to make decisions such as refusing treatment of release from the hospital, and psychotherapy with the medically ill. It will include a brief review of neurocognitive disorders due to medical conditions.
 

Cross-Cultural Psychiatry (NYSPI)
This is an introduction to cross cultural psychiatry. Topics covered include impact of language on evaluation and treatment, culture-specific syndromes, folk belief systems, and other issues that reflect the impact of culture on one's identity and on psychiatric illness. 

Social Determinants of Health
This course will introduce residents to the role of structural societal factors in the health of the population including health care disparities.

Geriatrics 
This course covers the pathophysiology, phenomenology, and treatment of late life neuropsychiatric disorders. The course focuses on common issues such as the diagnosis and management of memory disorders and late life depression. PGY 3 residents will present their cases from the Geriatrics rotation to highlight key aspects of psychopathology and treatment in this population.

Initial Psychiatric Interview
Each week, residents will participate in an interview of an outpatient currently receiving services at Harlem Hospital. Residents will observe each other practicing different aspects of the psychiatric interview and will observe course director interview the patient at times.  During group discussion, important techniques will be highlighted and a review of the mental status observations will help reinforce basic knowledge of these subjects.

Introduction to Psychopathology (Depression and Bipolar Disorder)
This course introduces junior residents to an overview of epidemiology, biological underpinnings, risk factors and basic neurobiology of affective disorders. Also includes a brief introduction to treatment.

Quality Improvement
During this introductory course, residents learn the foundations of Quality Improvement (QI) approaches within healthcare delivery.  They learn basic concepts critical to QI such as setting aims, establishing measures, and developing an intervention in order to change behavior and improve uptake of new evidence based practices.

Introduction to the DSM V

This course will introduce the new resident to the history of the DSM, and overview of the diagnostic categories in the DSM V, including paraphilic disorders. Case vignettes and differential diagnosis will be discussed. 

Diagnosis and Pharmacology Inpatient Case Conference
This is a weekly case-based discussion course designed to build on the basic knowledge of psychopharmacology gained through the Basic Psychopharmacology and Disorder-specific classes. Resident case presentations serve as springboards for teaching the evidence base and practical knowledge required for actively managing psychopharmacology patients.


Electroconvulsive Therapy (ECT)
This course deals with the theory, technique, and  common indications and contraindications for ECT.

Ethics in Psychiatry (NYSPI/Harlem)
This course deals with the general principles of psychiatric ethics and professional behavior.

 

Evidence Based Medicine
In this series of seminars residents learn to critically review the literature, conduct focused literature searches and develop skills in practice-based learning.


Introduction to Leadership and Management in Systems of Care
Junior residents will be oriented to community systems for addressing the needs of the severely mentally ill. This series of lectures will focus on fiscal and administrative systems and on the role of the psychiatrist in these systems.


Legal Issues in Psychiatry
This course provides an overview of legal issues as they relate to the practice of psychiatry. Included are discussions of civil commitment (including outpatient commitment), informed consent, decision-making competence, and the duty to protect potential victims of patients' violence. Principles underlying the evolution of the legal framework for psychiatric practice are emphasized.

Resource Management
According to the Accreditation Council for Graduate Medical Education (ACGME), residents must “Practice cost-effective health care and resource allocation that does not compromise quality of care.”  This course is aimed to develop the knowledge, skills and attitudes critical to providing high-value, cost-effective care within psychiatry.

Research Methods and Designing a Research Study
Topics to be discussed include how to identify a topic, how to frame a research question, identifying the study/control populations, determining when/if IRB approval is necessary.


Neuropsychological and Achievement Testing Introductory Course
Aspects of assessment of intelligence and cognitive functioning are discussed with attention paid to profiles of neuropsychological functioning in various psychiatric disorders. Residents will learn basics tools used in assessment and will learn how to read and interpret neuropsychological and achievement testing reports.


Patient Experience
This course focuses on the hospital wide quality improvement initiative to improve patient experience. It is hands on, interactive. It emphasizes practical considerations for improving patient experience in department of psychiatry.  

Prescribing Workshop (NYSPI)
Using videos of expert psychiatrists talking with their patients about initiating medication treatments, this course will provide a practicum in talking with patients about mechanism of action, side effects, risks, benefits and alternatives of psychopharmacological treatment.


Psychotherapy Seminar Series
This year long course will include the following sections (some descriptions are above):

Overview of Psychotherapies
Supportive Psychotherapy
Ego Function Assessment
Thoughts, Feelings & Behaviors
Principles of Learning and Behaviorism & Clinical Applications
Group Therapy and Dynamics
Psychotherapeutic Interventions for Patients with Substance Use Disorders
Psychotherapeutic Interventions for Patients with Psychotic Disorders
Psychotherapeutic Interventions for Patients with Depression & Suicidal Ideation
Psychotherapeutic Interventions for Patients with Anxiety & PTSD
Assessment & Psychotherapeutic Interventions for Patients with Trauma History
Long Term Psychodynamic Case Presentation Course


Selected descriptions:
Supportive Psychotherapy, Introduction and Formulation
The objective of this weekly seminar is to develop conceptual understanding and practical skills for beginning psychotherapists. The emphasis will be on supportive therapy approaches, cognitive behavioral approaches,
psychodynamic approaches, but the seminar discussions will not be limited to them. The target goals of the seminar will be learning how to apply psychotherapy concepts and skills to all of your clinical encounters. The seminar will also promote and cultivate a professional psychotherapeutic attitude including: curiosity, empathy, compassion, honesty, authenticity, tolerance of ambiguity and conflict, and receptivity to the patient’s uniqueness and your attendant countertransference feelings.

Learning & Behavior Theory & Application to Clinical Work
This course will introduce residents to learning theory and practical strategies such as use of rewards and behavior plans in providing effective interventions for their patients in acute care services.

Cognitive Behavioral Therapy (CBT) for Anxiety and Mood Disorders
This course provides a foundation in theoretical principles and clinical skills of cognitive behavioral therapy.

 

Schizophrenia and Related Disorders (NYSPI/Harlem)
Dimensions of schizophrenia are reviewed in this course: symptomatology, diagnosis, and treatment. It will include overview of prognosis and the subjective experience, as well as the history and development of psychotic disorder classification. In addition, epidemiological and etiological studies, forensic and family studies, and the various treatment approaches are discussed. Particular attention is paid to current biological theories of both disease process and treatment.

Sleep Physiology and Sleep Disorders
This course provides an overview of basic sleep physiology for junior residents including circadian rhythms, stages of sleep and neuroscience of sleep and wakefulness. Diagnosis and treatment of sleep disorders such as insomnia and narcolepsy are discussed in an interactive format.

Statistics
The purpose of this course is to provide a basic introduction to the statistical approaches that are commonly used in clinical and epidemiological research. The emphasis is on understanding which tests should be used to answer typical questions (e.g., a randomized clinical trial), rather than on the mechanics of how to do the calculations for those tests.

Substance Abuse
This course provides an overview of the major types of addiction, patterns of intoxication and withdrawal, and an introduction to treatment. This will include but not limited to Alcohol, Opioids, Stimulants, Psychedelic drugs, Sedative/hypnotics, Marijuana, Tobacco, Adolescent Substance use Disorders. Residents will present topics

Teaching Medical Students
Provides residents with an introduction to teaching Columbia medical students psychiatry while rotating through the inpatient units and outpatient units at Harlem Hospital.

Urgent Psychiatry
This course provides an introduction to the important skills for managing psychiatric emergencies and crisis situations. It includes an introduction to decision making regarding the pharmacologic management of acutely agitated patients. This course also includes assessment and management of suicidal behavior.