Medical Student Education Program in Psychiatry

Molly Poag, MD
Director of Medical Student Education in Psychiatry
Molly.Poag@nyumc.org

Program Coordinator:
Jeffrey Sanchez
Jeffrey.Sanchez@nyumc.org

Contact Information:
1 Park Avenue 8th Floor room 8-240
New York, NY 10016
Phone: 646-754-4836
Fax: 646-754-5431

The undergraduate medical education curriculum in Psychiatry at NYU School of Medicine offers required courses, extensive electives, and extensive opportunities for medical student research. The past few years have seen extraordinary advances in the understanding of etiologies underlying psychiatric disorders and mechanisms of symptom production. We have an increasingly sophisticated appreciation for the ways in which the environment can alter both gene expression and brain structure, and the mechanisms by which emotion may impact physical health. The pre-clerkship curriculum provides all students with a basis for understanding core psychiatric illnesses as well as this rapidly unfolding area of medical science. The clinical clerkship in psychiatry teaches students how to put this knowledge into practice.

A primary mission of our undergraduate program in psychiatry is also to ensure psychiatric literacy of the next generation of physicians across all specialties. We are also committed to nurturing and facilitating the interests of those students who develop a deeper interest in the field and wish to pursue post-graduate training in psychiatry. Students can pursue myriad clinical and research topics in greater depth through a broad array of elective and research opportunities. The Department is fortunate to have world class leaders in many areas including Posttraumatic Stress Disorder, Schizophrenia, Addictions, Dementias, Brain Imaging, and numerous others. Students also have opportunities to work with national experts in the Department of Child Psychiatry in areas such as Trauma, Attention Deficit Disorders, Anxiety Disorders, Imaging and other major disorders of childhood.

Pre-Clinical Curriculum

NYU School of Medicine has recently completed an exciting forward looking reorganization of the preclinical curriculum from predominantly department based courses to multi-disciplinary organ-system based modules with associated mechanisms of disease. The Department of Psychiatry contributes to these modules in a number of ways. For example, psychiatry faculty work alongside other clinicians as preceptors in the Practice of Medicine module.

The majority of preclinical teaching in psychiatry is taught within the two month course: The Nervous System/Mechanisms of Disease and is devoted to the study of behavior and psychopathology. Class lectures, frequently using video demonstrations, cover the phenomenology, neurobiology, and taxonomy of major psychiatric disorders. Lectures on introductions to psychiatric treatments provide overviews of both psychopharmacology and psychotherapies. Augmenting the lectures are small group seminars on selected topics, and all students participate in supervised small-group sessions interviewing psychiatric patients; an exciting first exposure to patient care. In addition to making connections between lecture material and living patients, these groups help students to develop clinical interviewing skills, understand the phenomenology of psychiatric disorders, learn to take a psychiatric history and conduct a mental status examination. The small-group clinical sessions take place on the clinical inpatient units of Bellevue Hospital Center, Tisch Hospital, and the Department of Veterans Affairs New York Harbor Health Care System (the VA). Midterm and final examinations are fully integrated with the other portions of the Nervous System Module: neuroscience, neuropathology and clinical neurology.

Core Clinical Clerkship in Psychiatry

The required Psychiatry clerkship is a full-time, six-week experience in the care and treatment of psychiatric patients. Students are assigned to an inpatient service at Bellevue Hospital Center, Tisch Hospital, or the VA. Students are given the choice of working on a general adult inpatient service or on one of the specialized services of Bellevue: the forensic service, the dual diagnosis service, the adolescent service or the child service. A general adult Spanish language unit welcomes students fluent in Spanish. In addition, each student spends one afternoon a week in an outpatient clinic or other off-unit site. Under the close supervision of psychiatry faculty and house officers, students are given primary responsibility for the care of their patients. Students conduct initial psychiatric evaluations, write admission notes and treatment plans, and follow patients through to discharge. A series of case-based seminars are provided throughout the rotation covering the major clinical psychiatric disorders, substance abuse disorders and more advanced psychopharmacology. All students on the psychiatry clerkship are observed conducting diagnostic interviews by attending faculty. In addition, students learn to write comprehensive data based case reports. Examinations include a psychopharmacology clerkship exam, and the psychiatry subject examination of the National Board of Medical Examiners.

Bellevue Hospital Comprehensive Psychiatric Emergency Program(CPEP)/On-Call:

As part of the six week clinical clerkship in Psychiatry, students take three on-call shifts in the Adult Bellevue CPEP; two are 4:00PM-11:00PM and one is a weekend day or evening call. Students also take one call in the Child CPEP which is very unique experience among medical student programs nationally. As one of the busiest psychiatric emergency services in the country, the CPEP offers an unparalleled setting for learning how to evaluate and manage acutely ill psychiatric patients. And, this on-call experience is one of the most highly rated educational experiences by the students.

Electives

Students who have satisfactorily completed the core clerkship are eligible to take one or more psychiatry electives. The number of available electives is large, and the offerings vary from year to year. Students should consult the Department of Psychiatry at 646-754-4836 or the School of Medicine websites at http://www.med.nyu.edu/registrar/elective-catalogue  for a list of currently offered electives. Electives are available in most of the clinical services of the Department including: the consultation-liaison service, the psychiatry emergency room, the forensic service and the outpatient clinics and inpatient services of the teaching hospitals. A wide array of electives in child and adolescent psychiatry are also offered separately through the Department of Child and Adolescent Psychiatry. Numerous research electives are available in clinical, basic science and translational research with luminaries in the field. Other current elective offerings include psychoanalytic medicine and psychiatric publishing with the author of the major textbook used worldwide. Specific elective descriptions are outlined below.

Comprehensive Psychiatric Emergency Program “CPEP” Elective

Prerequisites: Core Clerkship in Psychiatry

Description: This elective gives students the unique opportunity to participate in the evaluation, diagnosis and the short-term treatment planning for patients in the Bellevue Psychiatry Emergency Room. Under close supervision by the faculty and staff of this service, students gain experience in interviewing, diagnosing and managing the acutely ill psychiatric patient. The student sees a very wide range of pathology from adjustment disorders to severe psychoses and complex multisystem illnesses. Students work with attending psychiatrists, the NYU psychiatry residents, as well as the Director of the Bellevue Psychiatry Emergency Services.

Consultation-Liaison Psychiatry Elective

Prerequisites: Core Clerkship in Psychiatry

Description: For students interested in psychiatry or general medicine, this is an opportunity to combine medical and psychiatric experience by working on the medical and surgical services as psychiatric consultants. There are a wide range of clinical problems seen as this service provides psychiatric consultation for all inpatients who require evaluation and treatment while hospitalized. Students work with psychiatry residents, fellows, and attending faculty. In addition to the individual supervision, the students participate in regularly scheduled clinical case conferences, journal club, and consultation/liaison seminars.

Forensic Psychiatry Elective

Prerequisite: Core Clerkship in Psychiatry

Description: The Forensic Psychiatry Service serves male inmates (ages 16 years and older) in the New York City correctional system. The demographics of the male population served reflects that of the jails and prisons of New York City. Although the majority of the patients are from lower-income, minority groups, we frequently treat and evaluate professionals including doctors, lawyers, businessmen and clergymen. The age range is generally in the younger to middle twenties. On average, the population is generally one-half treatment cases and one-half evaluation cases. A majority of patients carry a DSM-IV Axis I psychiatric diagnosis. The most frequent diagnoses are that of Schizoaffective Disorder, Schizophrenia, Bipolar Disorder, and Depressive Disorders. Also common among the population are diagnoses of Personality Disorder and Impulse Control Disorders. The assessment of malingering is an essential component of each evaluation, and a substantial number of referrals are for evaluation and treatment of suicidal or homicidal symptoms.

Inpatient Psychiatry Sub-Internship Elective

Prerequisites: Core Clerkship in Psychiatry

Description: Students gain increased supervised responsibility for patients with severe psychopathology, and deepen their facility with psychiatric diagnosis, psychotherapeutics, and learn the evaluation and management of psychiatric inpatients with a broad range of psychiatric disturbances. The subinternship experience takes place on any one of our psychiatric inpatient units at one of our major teaching hospitals (Bellevue, the VA and NYU Langone Medical Center).

Psychiatric Education & Publication Elective

Prerequisites: Core Clerkship in Psychiatry Interview with Preceptor

Description: For students interested in academic psychiatry, writing or publishing, this elective offers the opportunity to further develop cognitive skills in clinical psychiatry and behavioral sciences as well as the opportunity to participate in the preparation of standard textbooks in the field: The Comprehensive Textbook of Psychiatry and Synopsis of Psychiatry. The student's experience will be augmented by individual tutorials held weekly.

Psychoanalytic Medicine Elective

Prerequisites: Any One Core Clerkship

Description: The faculty of the NYU Psychoanalytic Institute, in the Department of Psychiatry at New York University School of Medicine, offers an elective in Psychoanalytic Medicine. This elective provides the students with the opportunity to learn about psychoanalysis as a clinical field of practice, to become familiar with the psychoanalytic point of view, and to understand the relationship of psychoanalysis to general psychiatry and to medicine in general. The elective aims to introduce students to the basic principles of modern psychoanalytic theory and practice, and demonstrate their applicability in a variety of psychiatric settings and treatment of modalities. It is hoped that students will acquire a greater appreciation and understanding of the usefulness of psychodynamic listening, interviewing and formulation.

Addiction Medicine Elective

Prerequisite: Core Clerkship in Psychiatry

Description: This elective offers the student the unique opportunity to evaluate and treat patients with both substance abuse and psychiatric disorders on the Dual Diagnosis Training Unit, a 27-bed inpatient psychiatric unit at Bellevue Hospital Center. While our patients most frequently use alcohol, cocaine, heroin and cannabis, we also treat patients who use phencyclidine (PCP), hallucinogens, inhalants, methamphetamine and drugs like MDMA (ecstasy), ketamine and GHB. Prescription drug abuse is also common. The majority of patients suffer from psychotic and/or mood disorders, as well as severe personality disorders. The student learns about psychopathology, behavior modification techniques, group therapy techniques, motivational interviewing and psychopharmacology specifically designed for this patient population. The student assumes direct responsibility for the diagnosis and management of her or his patients under the close supervision of attending physicians who are also faculty members of the Division of Alcoholism and Drug Abuse. Each student is required to lead a weekly patient group. In the past, students have run group activities like relapse prevention, rum and relationships, poetry group, medical consequences of addictions and life stories. The experience is augmented by individual tutorials, case conferences and division-wide grand rounds. For students who have completed a core clerkship in psychiatry, this elective is offered at the level of a subinternship.

*Neuropsychiatry/Behavioral Neurology Elective

Prerequisites: Core Clinical Neurological Sciences and Psychiatry clerkships
*Also a Clinical Neurological Sciences elective

Description: The student will rotate through several different clinics that offer clinical and supervisory experience in areas of neuropsychiatry. These will include, but not be limited to, the epilepsy clinic, the behavioral neurology clinic and the adult ADHD clinic. In addition, the elective student will spend time in the psychiatric emergency room of Bellevue Hospital, will attend regularly scheduled neurology and psychiatry lectures and may arrange to observe neuropsychological testing, including WADA testing.

Reproductive Psychiatry

Prerequisite(s): 4th year medical student. Recommendation from the director of Medical Student Education.

Description: During the clerkship students will develop a greater understanding of the mental health needs of women with reproductive-related psychiatric disorders. The elective is particularly useful for students pursuing careers in psychiatry, obstetrics and gynecology, or pediatrics. The elective is conducted primarily at Bellevue Hospital Center but students may also have the opportunity to see patients at NYU. There is a weekly journal club and students will also be assigned key articles to read.