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Rotations

The internship year is divided into three four-month rotations. Interns are on rotation sites from approximately 9:00am to 12:00noon. On each rotation site, the intern works closely with attending psychologists and/or psychiatrists who provide clinical and administrative supervision. Interns provide an array of clinical services and participate in various team activities on each of the rotation sites. The majority of the rotation sites are open to all interns, who rank their preferences during the orientation period in July. The exceptions to this are outlined below.

General Track: Interns in this track choose any three rotations, excluding the Child Study Center rotation and the rotation at Kirby Forensic Psychiatric Center.

Child and Adolescent Track: Interns in this track choose three morning rotations, which must include either, the Child Inpatient Psychiatry Unit or Adolescent Inpatient Psychiatry Unit. While on this rotation, the intern will spend four mornings per week on the unit, and Fridays at the Child Study Center. During the other two rotations, the intern will spend three mornings per week on the chosen rotation. Fridays and another morning will be spent at the Child Study Center.

Cross-Cultural Track: Interns in this track must complete a rotation at the Bilingual Treatment Program Clinic. The other two rotations are of the intern’s choosing – excluding the Child Study Center and Kirby Forensic Psychiatric Center rotations.

Forensic Track: Interns in this track must complete the rotation at Kirby Forensic Psychiatric Center and the Forensic Inpatient Psychiatry Unit rotation. The third rotation is of the intern’s choosing – excluding the Child Study Center rotation.

Adolescent Inpatient Psychiatry Unit

This unit serves patients between the ages of 12 and 16 years who present with a wide range of diagnoses, including psychotic disturbances, mood disorders, burgeoning personality disorders and behavioral disorders. The intern serves as the primary clinician for 3-5 patients, provides group psychotherapy, and conducts psychological assessments. Interns work as part of a multidisciplinary team that includes psychiatry residents, social workers, activity therapists and nursing staff. There is also frequent contact between interns on this rotation and outside agencies, including schools, treatment centers and the Association for Children’s Services.

Adult Consultation-Liaison Psychiatry Service

Interns on this rotation provide an array of services to late adolescent and adult inpatients on non-psychiatric wards throughout the hospital. In conjunction with the C-L treatment team, which is comprised of psychologists, psychiatrists and nursing staff, interns assess and intervene with regard to a variety of physical and mental health issues. Services provided include consultation with other clinicians and patients’ families, psychotherapy, brief assessments, evaluation of decision-making capacity and treatment in specialty clinics such as women’s health services, oncology services and smoking cessation.

Adult Inpatient Psychiatry Unit

This is a 28-bed unit providing acute psychiatric services to individuals who present with primary Axis I diagnoses, including all subtypes of schizophrenia, schizoaffective and bipolar disorders. While on this unit, interns learn to apply various psychological interventions within the inpatient milieu treating individuals with severe mental illnesses. Interns on this rotation are supervised by both psychologists and psychiatrists, conducting individual and group psychotherapy, as well as brief psychological assessments. The intern also serves as the primary clinician for a small number of patients, working with a psychiatric resident who addresses medication management issues. This unit is the inpatient training unit for the psychiatric residency program, consequently, there are many opportunities to work with other advanced trainees in psychiatry as well as regular didactic presentations.

Bellevue/NYU Program for Survivors of Torture

This program provides comprehensive medical and mental health care to survivors of war and war trauma. Clients come from over 60 different countries, and the PSOT is committed to providing treatment that is both culturally relevant and appropriate. Interns on this rotation conduct intake interviews with potential new clients, provide individual and group psychotherapy, address crisis intervention needs, and participate in forensic evaluation of asylum cases. Supervision is conducted according to an array of theoretical orientations including psychodynamic, cognitive-behavioral and family systems.

Chemical Dependency Outpatient Clinic

This rotation provides the intern with varied experience in substance abuse assessment and treatment. Working with a population of polysubstance dependent individuals, the intern will gain experience in the psychological, social, cognitive and medical sequelae of substance abuse. Interns on this rotation conduct intake interviews, individual and group psychotherapy, case management and occasional psychological assessments. Interns will also become familiar with the multiple issues related to the treatment of mentally ill chemical abusers (MICA).

Child Inpatient Psychiatry Unit

This unit treats children between the ages of 4 and 11 years, providing psychiatric evaluation, psychological assessment and treatment services related to developmental and psychiatric disorders. This unit also has an autistic classroom for children in this age range. Interns on this rotation conduct assessments, provide psychotherapy and serve as the primary clinician for a small number of patients. There are also frequent opportunities for school consultation as well as interaction with family members.

Comprehensive Psychiatric Emergency Program

The Comprehensive Psychiatric Emergency Program (CPEP) is the gateway into the inpatient services at Bellevue Hospital Center, evaluating over 700 patients each month. CPEP utilizes a prevention-oriented service model, designed to increase the variety of services available to the community that includes a Mobile Crisis Outreach, a 72-hour Interim Crisis Unit and crisis residence services. Interns on this rotation are responsible for conducting diagnostic evaluations, performing mental status examinations and formulating appropriate disposition plans. This rotation provides experience in in-depth rapid psychiatric assessment, differential diagnosis, crisis management and psychopharmacology.

Dual Diagnosis Inpatient Psychiatry Unit

This is a 27-bed unit that serves patients who present with mental illness as well as substance abuse disorders. Interns on this unit serve as the primary clinician for a small number of patients and provide both individual and group psychotherapy. In addition, interns gain exposure to an array of treatment interventions, ranging from spiritually-oriented treatments, such as AA, to purely behavioral interventions such as the token economy, holistic approaches such as yoga and meditation, and the principles of motivational enhancement therapy, relapse prevention strategies, and familial interventions.

Forensic Inpatient Psychiatry Unit

This is a 68-bed unit that provides acute psychiatric care to individuals who have been charged with a criminal act. Patients on this unit may be pre-arraignment, awaiting trial or post-conviction. The mental illnesses treated may be pre-existing, or may develop during the course of incarceration. Interns on this rotation conduct intake interviews and provide individual and group psychotherapy services. Psychological assessments are frequently performed, combining cognitive, neuropsychological, structured interview, self-report and projective personality measures. Interns on this rotation also have the opportunity to observe evaluations of competency to stand trial.

Forensic Psychiatry Clinic for the Criminal and Supreme Courts

This clinic is housed in New York City’s Criminal Court Building, which is located near the Brooklyn Bridge. The clinic provides mental health evaluations for adult and adolescent defendants, in consultation with the court system and the Department of Probation. Evaluations are essentially of two types: either focused on general questions related to mental status, diagnosis and prognosis; or concerned with a defendant’s “fitness to proceed” within the criminal legal process. Under supervision, interns on this rotation have the opportunity to conduct the former type of evaluations, and in some circumstances they may participate in and observe the “fitness” evaluations.

HIV Service

This rotation provides interns with exposure to the myriad psychological issues encountered by individuals who are infected with the HIV virus, their caregivers, and others who are affected by HIV/AIDS. Interns provide an array of individual, family, couples and group psychotherapy services, working as part of a collaborative team of psychiatrists, physicians, nurses, social workers and substance abuse specialists. Treatment is provided to both inpatients and outpatients, and the individuals treated vary widely with regard to age, gender, socio-economic background, sexual orientation and degree of physical health.

Inpatient Rehabilitation Medicine

This unit provides comprehensive care to individuals who present with an array of conditions including spinal cord injuries, cerebrovascular accident (stroke), dementia, traumatic orthopedic fractures and neurodegenerative diseases such as multiple sclerosis. Interns on this rotation provide focused neuropsychological assessments and short-term psychotherapeutic treatment. Premorbid psychopathology, if present, is also assessed and treated as it impacts recovery and rehabilitation. This rotation also offers considerable interaction with the multidisciplinary treatment team, comprised of physicians, physical and occupational therapists, speech pathologists, art therapists, social workers and psychiatrists.

Neuropsychology Consultation Service

Interns on this rotation gain experience in neuropsychological assessment techniques, working with a wide array of both psychiatric and non-psychiatric inpatients and outpatients. Intensive supervision emphasizes both normative and qualitative interpretation of standard neuropsychological instruments, with particular focus on the integration of neuropsychological results with pertinent psychodiagnostic findings. Interns also participate in a weekly case conference, and there is the opportunity for a one month ‘sub-rotation’ on the Neurology inpatient unit, during which the intern serves as consultant, and gains exposure to neuroimaging techniques.

Pain Management Service

The Bellevue Pain Management Service treats patients who present with a variety of chronic pain syndromes including end-stage cancer, neuropathy, back pain and pain secondary to trauma. Clinical responsibilities of interns on this rotation include consultation, evaluation and both individual and group psychotherapeutic treatment. Psychotherapy is primarily time-limited, and consists of an integration of psychoanalytic/psychodynamic, cognitive, behavioral, and experiential approaches. Interns also receive training in stress reduction, relaxation, meditation and guided imagery techniques. Treatment also includes the evaluation and treatment of comorbid personality and psychiatric disorders, as well as screening for substance abuse in patients who are receiving opioid treatment.

Pediatric Hematology/Oncology Service

This service provides medical and psychological treatment to children (and their families) who are afflicted with cancer and related blood disorders. Interns on this rotation provide consultative, evaluative and psychotherapeutic services to patients and their families in both a hematology/oncology day treatment setting as well as the inpatient setting for patients who are admitted to the pediatric unit of Tisch Hospital. There are also opportunities to design and implement cognitive-behavioral interventions, and the intern will gain experience in crisis intervention, school re-entry skills. Interns on this rotation can also work with adults and/or bilingually (Spanish/English), if interested.

Pediatric Psychiatry Unit

Interns on this rotation provide psychological consultation-liaison services to outpatients between the ages of 2 and 22 years. This comprehensive mental health clinic serves specialty areas including Adolescent Medicine, Asthma, Dermatology, Gynecology and Neurology. Emphasis is on the evaluation and diagnosis of psychiatric problems and psychological reactions to medical illness, and interns perform intake assessments, mental status examinations, and varied consultative services to physicians, families and schools. There are also opportunities for psychological assessment of preschoolers, children and adolescents.

Recovery Clinic

The recovery clinic is a day treatment program for mentally ill chemically abusing (MICA) individuals. It is structured as a modified therapeutic community (TC) that patients attend for approximately 12-18 months. The majority of patients in this clinic present with co-occurring major mental illnesses as well as polysubstance abuse/dependence, and enter the clinic in varying stages of drug abstinence and psychiatric stability. Interns on this rotation are active members of the multidisciplinary treatment team and will conduct extensive intake assessments as well as individual and group psychotherapy. Psychological assessments and case management responsibilities are also incorporated into this rotation.

Traumatic Brain Injury Unit

The TBI Unit at Bellevue is a 22-bed adult inpatient unit providing acute rehabilitation services to individuals who have experienced cerebral trauma secondary to motor vehicle accidents, falls, assaults or degenerative/organic brain injuries. Interns on this rotation work as part of a multidisciplinary team of physiatrists, psychologists, neuropsychologists, speech pathologists, physical and occupational therapists, vocational and educational counselors, social workers and rehabilitation nurses. Services provided include evaluation and assessment, individual and group psychotherapy, cognitive remediation and family support.

Track-Specific Rotations

Bilingual Treatment Program Clinic

The BTP Clinic is a specialized, outpatient mental health clinic that is tailored to the specific psychological, psychiatric, and psychosocial needs of the Hispanic community. Its mission is to provide culturally relevant and competent services to the Hispanic population. Interns on this rotation will work with a wide range of Hispanic patients, conducting intakes and initial evaluations, individual and group psychotherapy, as well as family/couples therapy as conceptualized within a culturally competent framework. The intern will also perform occasional psychological assessments, utilizing instruments and measures that are culturally-sensitive.

Child Study Center Rotation

This rotation, required of interns in the Child and Adolescent Track, is tailored to each intern’s needs and will involve intake evaluations and psychotherapeutic treatment in one or more of the following services: ADHD, Anxiety and Mood Disorders, Tourette’s, Early Childhood and/or the Institute for Learning and Academic Achievement. Interns will also participate in various treatment team activities, and will gain experience in school observations, consultation and outreach. There will also be numerous opportunities to observe treatment and to conduct co-therapy with senior clinicians.

Kirby Forensic Psychiatric Center Rotation

Next: Outpatient Caseload