Psychiatry Residency

The curriculum is based on the seven areas of core competency (as described in the AOA Basic Standards for Postdoctoral Training) and the six areas of core competency in the ACGME basic standards. Our program will successfully prepare residents to achieve certification in general psychiatry from the American Osteopathic Board of Neurology and Psychiatry (AOBNP).

It is our intention that upon graduation from the psychiatry training program, physicians will be fully prepared to serve their patients and be a great asset to the profession, as well as their community. Our residents have broad-based clinical training in multiple settings. As a Psychiatry Resident, you can expect to your training to take place in a variety of different settings to capitalize your learn experience, including:

• In the emergency room
• Inpatient
• Outpatient
• Consultation-liaison
• General medical
• Pediatric settings

Residents treat geriatric and adult patients, as well as adolescents and children. Evidence-based clinical work encompasses diagnosis, psychiatric management, psychopharmacology, somatic and psychotherapeutic treatment modalities.

Primary Care

The primary care training experience for psychiatry residents will occur during four months of the PGY-1 training year. Residents will train side-by-side with osteopathic family medicine residents during their Internal Medicine Rotation. We will have a fully accredited osteopathic family medicine and osteopathic manipulative treatment (OMT) training program with dedicated primary care osteopathic physician’s members serving as faculty members. Teaching methods include bedside clinical teaching on daily rounds, lectures, seminars, clinical conferences and grand rounds. Residents attend one afternoon (five hours) of didactic seminars each week.

The psychiatry residents will learn how the principles of OMT apply to primary care medicine through both didactic and clinical experience. As part of their clinical assessment of patients, residents will be required to complete a relevant musculoskeletal examination and employ manipulative techniques for a variety of disease states where applicable. The library will have available educational materials to support the psychiatric residents. Specifically, the textbook, Somatic Dysfunction and Osteopathic Family Medicine (Nelson, K, Glonet, T., ACOPF, 2007) will be available in addition to other educational, video and internet resources. Furthermore, visiting faculty from Touro College of Osteopathic Medicine (TouroCOM) will be invited to participate in the delivery of the didactic curriculum to all residents.

It is anticipated that the psychiatry residents will be embedded within care teams, with other learners, on the inpatient medicine teaching service (MTS). For example additional PGY-1 residents, one or more supervising residents (PGY-2 or PGY-3) and full-time faculty attending supervisors. The primary care experience will ensure a breadth of experience working with adults and geriatric patients (approximately 40% of patients are over age 60), with a full range of diagnoses on the IPS at Garnet Health Medical Center. The MTS at Garnet Health Medical Center reflects patients from diverse backgrounds (ethnic and racial) and from all socioeconomic statuses. Similarly, the psychiatry residents will have opportunity to treat a full range of disorders in pediatric populations (i.e., children and adolescents) on both the inpatient pediatric service as well as in outpatient clinics.

Caseloads vary with services but are comparable with those carried by interns in the specialty area.

• Supervision occurs at the bedside, on rounds, in scheduled seminars and in departmental conference
• Lectures, conferences and grand rounds are offered on a weekly basis in the family medicine department.
• Attending faculty are always available in person or by pager for supervision.
• Evaluations will be completed for each resident and returned to the psychiatry residency program director (PD).

Neurology

The duration of neurology training for PGY-1 residents is two separate block rotations. One of the two blocks will typically consist of an inpatient neurology experience, while the other block will be spent on the neurology consult service. The neurology department consists of full-time, board- certified neurologists who have robust ambulatory practices in addition to serving as faculty attendees on the inpatient unit and consult service. Neurology faculty members work with psychiatry residents as well as family medicine residents on these services.

The patient population that residents will care for during this experience is approximately 75% Caucasian and 25% other races (majority African-American) with a male/female distribution of 40%/60% respectively. The diagnostic mix for the neurology services is roughly 50% cerebrovascular disease, 20% seizure disorders, and the remainder is comprised of a variety of other neurologic illnesses. Specifically on the stroke services approximately 60% of patients are over the age of 60.

Teaching methods include bedside clinical teaching on daily rounds, lectures, seminars, SIM training, clinical conferences, and grand rounds. Supervision of residents will occur at the bedside, on rounds and in peer review. Evaluations will be completed for each resident and returned to the psychiatry residency program director (PD).

Inpatient Psychiatry

Inpatient psychiatry will be a major component of psychiatry resident training during the PGY-1, PGY-2, and PGY-4 years of training. Inpatient training will begin with six months of block rotations in PGY-1. Garnet Health Medical Center provides inpatient psychiatry services for the Greater Hudson Valley Region in its 30-bed inpatient psychiatric unit. Psychiatry residents will serve as integral members of the care team on the inpatient psychiatry service (IPS). Each care team will consist of psychiatry attending faculty members who are board-certified/eligible psychiatrists many of whom maintain full-time inpatient loads as well as some who provide additional outpatient or consultation liaison (CL) services; there is an attending assigned to each of the inpatient care teams.

Only adult patients are treated on the IPS and approximately 25% of psychiatry inpatients are over the age of 60. The diagnostic mix on the IPS can be characterized as follows: 40% mood and anxiety disorders, 30% psychotic disorders, 10% cognitive disorders, 10% personality disorders, and 10% other psychiatric conditions.

Resident teams will typically care for an average daily caseload of five to six patients on this service. A significant portion of residents’ training and experience with Geriatric, Addiction and Forensic Psychiatry occurs during this rotation. Residents will be exposed to the various community mental health centers and other community based care organizations through discharge planning on the inpatient unit.

It is envisioned once fully operational, the PGY-4 residents will supervise the functioning of the IPS including activities of the PGY-1 and PGY-2 residents and medical students with oversight and counsel from the IPS attending. The PGY-2 resident also has opportunities for supervision of the IPS team in the absence of the PGY-4 resident. The PGY-1 is provided an opportunity to learn supervisory skills and utilize them when they assist in the supervision of medical students under the guidance of the PGY-2 and PGY-4 residents. Additionally, residents can be expected to assist in the instruction of medical students assigned to their service.

Teaching methods include bedside clinical teaching on daily rounds, working as part of an interdisciplinary team, lectures, seminars, inpatient clinical conferences, assigned readings with discussion and didactics. In addition residents attend five hours per week of formal didactics. Inpatient clinical conferences consist of weekly didactics on clinical interviewing, addiction psychiatry, CL/emergency room (ER) psychiatry and general psychiatry topics by different faculty attendees.

Supervision occurs at the bedside, on rounds and in peer review. The attending psychiatrist assigned to each inpatient team is also available throughout the day by phone. Evaluations are completed on each resident and are returned to the PD for review. In addition residents are expected to attend individual supervision for one hour per week for OGME-1 residents and two hours per week for OGME-3 residents.

Consultation Liaison (CL)

Two month rotation that occurs during the PGY-2 training year. The CL educational experience during these block rotations is taught by full-time, board-certified/eligible psychiatrists who are specifically assigned to each of the CL psychiatry teaching services.

Teaching methods include bedside clinical teaching on daily rounds, working as part of an interdisciplinary team, lectures, seminars, inpatient clinical conferences, assigned readings with discussion and didactics. In addition residents attend five hours per week of formal didactics. Inpatient clinical conferences consist of weekly didactics on clinical interviewing, addiction psychiatry, CL psychiatry and general psychiatry topics by different faculty attendings.

Supervision occurs at the bedside, on rounds and in peer review. The attending psychiatrist assigned to each CL service is also available throughout the day by phone. Evaluations are completed on each resident and are returned to the PD for review. In addition residents are expected to attend individual supervision for 1-2 hour per week.

Emergency (EM) Psychiatry

This rotation is three one-month block rotations during the PGY-2 training year which may include one or more months of night float. A full-time, board certified psychiatrist serves as the faculty attending for this rotation. During the daytime a psychiatry faculty member is assigned to each of the ER psychiatry services and during the night-time ER psychiatry rotation the attending psychiatrist on-call is immediately available by telephone to provide supervision. Furthermore, the psychiatry residents will work closely with the emergency medicine attendees who are consistently available to all residents who are assigned to ER rotations. An average daily caseload of five to ten patients is carried by residents during this rotation; during the night-time ER psychiatry service residents get a nightly average of five to ten consults.

Teaching methods include bedside clinical teaching on daily rounds, working as part of an interdisciplinary team, lectures, seminars, inpatient clinical conferences, assigned readings with discussion and didactics. In addition residents attend five hours per week of formal didactics.

Supervision occurs at the bedside, on rounds and in peer review. Faculty is also available 24/7 for consultation by telephone. Evaluations are completed on each resident and are returned to the PD for review. In addition residents are expected to attend individual supervision for one hour per week.

Outpatient Psychiatry

Outpatient psychiatry consists of twelve months of block rotations during the PGY-3 training year as well as approximately 40% of the residents’ educational experiences during the PGY-4 training year. The outpatient psychiatry experience includes both experiences in a suburban office-based setting as well as experiences in community health settings.

The outpatient psychiatry clinic where residents will have regular clinics and maintain a panel of continuity patients is fully staffed with full-time psychiatrists, full-time clinical psychologists, as well as full-time social workers. There is always an attending psychiatrist available to supervise residents on each day there is a resident-run clinic. The clinic population consists of lower, middle and upper socioeconomic classes and is about 50% female and male respectively; 70% Caucasian, 15% Hispanic, and 15% other races. Patients range in age from young adult through geriatric with the majority between the ages of 20 and 55. Primary clinical diagnoses for the ambulatory clinic include: approximately 60% depressed and/or anxious, 20% psychotic, 10% personality disorders, and 10% substance abuse with many patients experiencing one or more comorbidities. Residents will spend the majority of their time engaging in combined medication management and brief supportive psychotherapy. They also maintain a panel of at least six long-term psychodynamic psychotherapy and cognitive behavior therapy patients. Additional experiences are available for group psychotherapy.

An average daily outpatient caseload would consist of 7-10 patients scheduled for combined medication management and brief supportive psychotherapy, one to two patients per week for individual psychotherapy; a weekly group psychotherapy session may also be present.

In addition to the office-based clinic described above, residents will also hold clinic sessions at the Outpatient Child & Adolescent Psychiatry Clinic where patients are between the ages of 12 and 17 and approximately 65% of the patients seen are female and 35% are male. The diagnostic complexion of the patient panel at this clinic is as follows: 40% mood and anxiety disorders, 20% ADHD and related disorders, 10% learning disorders, 10% psychotic disorders and 20% other psychiatric conditions. Educational experiences in this clinic will typically consist of one or more medication clinics wherein patients are also seen for brief psychotherapy. Residents work closely with parents, families or guardians of patients.

Residents will hold clinic sessions at the Family Program for Alcohol and Substance Abuse. Patients are mostly adults. Approximately 58% of the patients are male and 42% are female; Caucasian 87%, African American 7%, other 6%. Patients with alcohol as primary substance 37%, drugs as primary substance (including prescription/over the counter meds) 63%; (42% of 267 total patients report no secondary substances); Co-existing psychiatric disorder reported 61%. Age range of patient served: 13yrs through early 70s. Education experiences in this clinic will typically consists of group therapy sessions and individual treatments. Residents will work in collaboration with CASAC workers and with the oversight of the psychiatric attendee.

All residents have required individual supervision twice weekly and additional supervision for group therapy. Residents are also supervised by the assigned attending psychiatrist for the clinic that day before the patient leaves the clinic. Additional supervision is available on an as-needed basis.

A significant portion of residents’ training and experience with geriatric, child and adolescent, addiction, and forensic psychiatry occurs during this rotation and may include clinics held at other area ambulatory clinics.

Residents spend, on average, five hours weekly in seminars and didactics; faculty are always available for consultations; caseloads are carefully monitored by the PD and controlled for both breadth and variety of experience.

Geriatric Psychiatry

During PGY-2 residents will spend one- 4 week will rotation at the Mid-Hudson Forensic Psychiatric Center (MHFPC). While at MHFPC residents will work with Geriatric patients and perform psychiatric evaluations in nursing homes affiliated with Garnet Health Medical Center. Residents will provide consultation liaison services at Middletown Park Manor Rehabilitation and Health Care Center and Highland Rehabilitation and Nursing Center. Duties will comprise of: psychiatric evaluations on behaviorally disturbed long term care patients, psychopharmacological management of these patients, consultation and liaison to physical rehabilitation, Hospice patients in the nursing home; follow up in the hospital should hospitalization be necessary, cross consultation and case discussion with primary care.

Forensic & Addiction Psychiatry

During PGY-2- residents will spend one- 4 week rotation each in Forensic and Addiction at the Mid-Hudson Forensic Psychiatric Center (MHFPC). At MHFPC residents will work with forensic and addiction patients admitted with psychiatric diagnosis and treat them for acute adjustment reaction & psychosocial dysfunction, depressive neuroses, neuroses except depressive, disorders of personality & impulse control, organic disturbances & mental retardation,  psychoses, behavioral & developmental disorders, other mental disorder diagnoses, Alcohol/drug abuse or dependence, left AMA, Alcohol/drug abuse or dependence w rehabilitation therapy, Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC, Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC.

Garnet Health Medical Center - Behavioral Health Services

Garnet Health Medical Center is located in the Hudson Valley Region of New York State in Middletown; about an hour from New York City. Garnet Health Medical Center’s BHS features multi-site services including:

• Psychiatric “Access Center” in the Emergency Department
• Inpatient Behavioral Health Unit
• Garnet Health Medical Center Counseling Service - an outpatient location for mental health counseling and medication management.
• Garnet Health Medical Center Family Program - an outpatient location for alcohol and substance abuse treatment

Both outpatient sites are within two miles of the hospital. The Access Center is a locked portion of the ED and features five interview rooms. The BHU is a locked unit with 30 private patient rooms and facilities for activity therapy, restraint/seclusion, and an outdoor courtyard.

Garnet Health Medical Center’s General Psychiatric Residency Program serves to provide residents with comprehensive structured cognitive and clinical education that will enable them to become competent, proficient and professional psychiatrists. Residents completing the program will be competent in each of the seven Core Competencies of the AOA and the six Core Competencies of the ACGME. Additionally, they will be able to treat patients with individual psychotherapy, psychodynamic psychotherapy, family, group and cognitive-behavioral therapy, brief therapy and crisis intervention, psychopharmacology, and other somatic treatment modalities. Residents will also develop the skills to treat patients with alcoholism and drug addiction, with or without comorbid psychiatric diagnoses.

They will have basic competency to treat patients with any of the major psychiatric disorders, to develop and critique case formulations and make appropriate treatment plans, to respond appropriately to acute psychiatric emergencies, including acute psychosis and suicidal or homicidal ideation and behavior, and to distinguish medical and neurological problems from psychiatric disorders. They will understand legal procedures related to mental health care and how osteopathic manipulative therapies can be utilized to promote patient well-being. Patients of various ages, ethnicities, races, and socioeconomic groups will be encountered by residents in settings throughout the hospital system.

To become a “mind healer,” residents will develop critical thinking skills. Critical thinking will be emphasized as students review scientific literature, and through the consideration of theoretical, ideological, and ethical issues in psychiatry.

Mid-Hudson Forensic Psychiatric Center

Mid-Hudson Forensic Psychiatric Center (MHFPC) is a secure adult psychiatric center that provides a comprehensive program of evaluation, treatment, and rehabilitation for patients admitted by court order. These admissions are consequent to judicial findings of "incompetent to stand trial" or "not responsible by reason of mental disease or defect". Resident rotations will include core and elective rotations in: Forensics, Addiction, and Geriatric Psychiatry.

Rockland Psychiatric Center

Residents will complete core and elective rotations at Rockland Psychiatric Center which provides treatment, rehabilitation, and support to adults 18 and older with serious mental illness. Rotations will include a community health core rotation. RPC has services at multiple levels of care, including hospital-based care, ambulatory clinic care, Assertive Community Treatment (ACT) teams, clubhouses, transitional and other residences, and family care residences. RPCs hospital-based services include focused treatment units for deaf adults, geriatrics, co-occurring substance disorders, and research.

RPCs main campus and hospital-based services are located in Orangeburg, NY, 17 miles north of Manhattan. RPC is affiliated with New York University and has a close relationship with the Nathan Kline Institute (NKI), one of the two OMH research centers in New York State. NKI is located on the same campus with RPC, and RPCs research unit is co-run with NKI and housed within NKI.

RPC has thirteen outpatient clinics in the seven counties of our catchment area, two ACT teams, a Mobile Mental Health Team in Sullivan County, and operates 11 residential programs in four counties. RPC is a member of the Hudson Valley Cares Coalition and Community Health Care Cooperative.

Applications are accepted for positions in a currently AOA accredited four-year program, which includes a categorical psychiatry internship followed by three years of post-internship training.

All applications to our residency program are accepted through the Electronic Residency Application Service (ERAS): www.aamc.org/eras. This includes the following:

• Curriculum Vitae
• Personal Statement
• Dean’s Letter
• Official Medical School Transcript
• Three Letters of Recommendation
• Comlex scores, Part 1 and Part II, USMLE, Part 1 and Part II. We look for competitive scores without any unexplained failures.

Applicant Interviews

Interview days are scheduled on Thursdays from October to January. Program administration will contact all applicants accepted for interviews. You will be asked to complete a form indicating your areas of interest in Psychiatry, in order to try to have you meet with faculty members who have expertise in your particular areas of interest. Interviews this year will be conducted virtually via Zoom.

Terms of employment, including current year salary levels, benefits, duty hours, moonlighting policy, etc., may be found in our Prospective Applicant Packet

Download Applicant Packet

How many openings do you have for the academic year? 

We anticipate accepting between 4 residents in the upcoming match.

Do I need to submit my application electronically?

All applications for 1st year positions must submitted through ERAS (www.aamc.org/ERAS).

How many letters of recommendation do you require?

A minimum of three letters is required to have your application considered complete.

Do you accept applications outside the Match system? 

No, all of our 1st year positions will be filled through the National Residency Matching Program “NRMP”.

Is there a cut-off date for graduation from medical school?  

No. We consider each application on an individual basis. However, length of time away from clinical practice is considered important.

The ERAS application asks me to include a personal statement. What type of information should I include and how long should it be? 

The personal statement should be about 500 words in length. Tell us a little bit about yourself:  your interests, experiences and aspirations. It would also be helpful to describe your reasons, both professional and personal, for choosing the field of psychiatry.

If there additional information that I should include in my application beyond what is required by ERAS?

If you are a part of a couples match please indicate this in your application, including name and specialty of the other person.

Is there a deadline for submitting applications?

ERAS allows applicants to begin applying to programs on September 15, 2019. We begin reviewing applications in September and begin conducting interviews in early October. We have no formal deadline for the submission of applications, but when our available interview slots have been filled, we no longer read applications. This includes applications that arrived early but were incomplete.

Do you sponsor visas? 

Currently, Garnet Health Medical Center is not sponsoring visas for any incoming residents.

Do you offer externships or observerships? 

Yes, we do offer observerships. 

Do you have openings for 2nd year residents? 

Occasionally, we have openings for more one or two residents for the 2nd year of training. Please contact us for more information.

How do I apply for a 2nd year position? 

Applications for these positions must be submitted directly to us. Applications for PGY2 positions should not be submitted through the ERAS system.

Do you have openings for residents beyond the second year? 

Occasionally, we have openings for more advanced positions. Please contact us for more information.

Testimonial from Dr. Eric Jarmon class of ’19 - 
Garnet Health Doctors Consultation Liaison Attending - Psychiatry

"Being a psychiatry resident at Garnet Health Medical Center was a terrific experience. From internship until the last day of senior year, I felt like I was an integral part of the program. Through the support of the program director and faculty, I learned to develop my own identity as a professional psychiatrist, while having multiple opportunity to lecture, participate in projects, and to network with seasoned professionals both locally and beyond. The foundation a psychiatry residency at Garnet Health Medical Center created for me has served me well in fellowship and professionally."

Testimonial from Eneida Miranda, DO - 
Dr. Eneida Miranda is a child and adolescent psychiatry fellow at the LIJ/Zucker School of Medicine at Hofstra Northwell Health.

“My time at Garnet Health Medical Center was life changing! Not only did I meet amazing people but I also received extraordinary training that has helped me excel in my fellowship program. My residency training equipped me with the ability to weather challenges in any setting. I am proud to have completed my residency training at Garnet Health Medical Center and would recommend this program to anyone looking for a diverse clinical experience in psychiatry”.