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Passion drives innovation: Learn more about the Pathways to Expertise program

Northwell has long been recognized for its pioneering research. Through our basic, translational, and clinical research conducted at the Feinstein Institute for Medical Research, a nationally recognized research center with more than 1,500 clinicians, scientists and staff, we discover new knowledge. This inquiry generates breakthroughs in our understanding of disease mechanisms, the development of novel treatments, and the delivery of higher quality care.

We take our mission to discover and innovate very seriously. Each resident receives extensive training in the critical appraisal of evidence and its application to clinical care through didactics, regular journal clubs, and supervision. In addition, R2s attend a two day, NIH sponsored intensive training in clinical research design and methods. R2s also work in small groups with a faculty mentor to design a proposed research project which is then presented at a department event. R3s learn and apply modern quality improvement methodologies to a practice gap and present their findings to hospital leaders. Each R4 completes a scholarship project, including submission of a paper. Finally, all residents are encouraged to use elective time during their R2, R3, and R4 years to participate in faculty sponsored research. All of these activities combined ensure that the core curriculum provides ample opportunity for residents to develop as scholars.

In addition to the core curriculum, we offer three optional ways to develop expertise: discovery pathways, clinical pathways, and the resident research track.

Faculty and residents discussing a pathways project - Adult Psychiatry Residency program at Zucker Hillside Hospital
Faculty and residents discussing a pathways project

Discovery Pathways

Click here to learn more about our Discovery Pathways

One of the residency program’s primary missions is to graduate emerging leaders. We believe the key to developing leaders is helping residents identify where ‘the passion of their heart overlaps with a need in the world.’ The program helps residents discover ‘their calling’ through advising, support group, mentoring, critical reflection, and other activities.

But this is not enough. The program believes that a resident’s passion or calling, once identified, must also be nurtured into expertise. This requires a plan.

The Pathways to Discovery program (Pathways) is designed to train and support residents who want to develop a focused expertise during residency. Pathways accomplishes this mission by providing mentorship and protected elective time over PGY-2, 3 and 4 years for residents to design and implement a scholarly innovation project and participate in other relevant training experiences. A Discovery Scholar’s pathway has the following components:

  • Individually tailored to each resident’s chosen interest or focus
  • Frequent and ongoing mentorship
  • Dedicated block (typically 4 weeks of protected time during the PGY-2 year) to develop a proposed research or innovation project. This includes a literature search, interview of relevant experts, identification of a gap/need, and development of a proposed study or innovation
  • Completion of the research or innovation project (typically with protected time during the R3 and R4 year)
  • Participation in additional training, as necessary, to acquire skills relevant to the project
  • Dissemination: presentation of the project at a regional or national meeting and publication

Pathways are optional. Any resident may opt in. A pathway can be organized around any theme relevant to psychiatry. Currently, we have residents in pathways with a scholarly focus on medical education, perinatal psychiatry, medical humanities, and healthcare delivery transformation. Recent projects include:

  • Patient Safety
  • Collaborative Care
  • Perinatal Psychopharmacology
  • Training Residents as Teachers
  • Advancing Competency Assessment with Smart Phone Technology
  • Alternative Payment Methodologies for Ambulatory Psychiatry
  • Using Fiction to Teach Biopsychosocial Formulation

Clinical Pathways (Clinical Scholars)

Residents who want to develop clinical expertise can use their ample elective time during the R2, R3, and R4 years to create their own clinical track. Examples include residents who focus their elective time on a specific treatment modality such as psychodynamic psychotherapy (with additional coursework at a psychoanalytic institute), specific patient population (such as geriatric, perinatal women, college-aged, or child and adolescent), or a specific disorder (such as addiction, early psychosis, OCD, or bipolar).

Resident Research Track (Research Scholars)

Download our brochure for the Resident Research Track Program

The Resident Research Track is an intensive pathway designed to train and support residents interested in dedicating the majority of their professional efforts to research. The purpose of the track is to train future leaders in basic, clinical-translational, and implementation research that will have a significant impact on mental health.

This track is supported by the Department of Psychiatry and its Division of Research. Residents apply to the track during their intern year. Accepted residents receive protected time during their second, third, and fourth years to develop and implement a program of research.

The track includes didactics in research methods and statistics, a supportive environment, mentoring, and access to faculty who provide expertise and guidance in research design, measurement, study coordination, data management, biostatistical analysis, publishing and presenting research, and manuscript and grant writing. Graduates of the research track are positioned to pursue a career as a physician investigator.

The research track is situated within our research division which includes more than 100 staff members (including principal investigators, fellows, trainees, and support staff). Our research division is actively working in a wide range of areas, including:

  • Genetics
  • Neuroimaging
  • Neuropsychology
  • Neuromodulatory techniques (e.g. ECT, TMS)
  • Animal models
  • Clinical trials
  • Health services/implementation research

This unique combination of expertise in clinical services and research provides an excellent opportunity for mentoring and nurturing a motivated resident’s growth toward a career as a physician-investigator.

Highlights

  • 12 weeks to 16 weeks of dedicated time for research during 2nd year of training
  • 50 percent clinical time and 50 percent research time during third year of training
  • Up to 90 percent dedicated research time during 4th year of training
  • Individually tailored methodology courses, including online courses, dependent on resident’s interests
  • Regular meetings with a mentor
  • Monthly work in progress sessions with the faculty director
  • Integration of the resident into a community of highly accomplished researchers with a wide range of interests
  • Statistical consultation team
  • Opportunity to present at national meetings and attend a three day course co-sponsored by the American Society of Clinical Psychopharmacology (ASCP)
  • Strong support and mentorship to participate in early career research activities with external institutions (i.e., APA Early Career Research Colloquium, ASCP New Investigator Award Program…)
  • Embedded within a research oriented hospital with a large volume of patient visits that facilitates recruitment for various types of research
Graphic of young adults sitting and standing in a park. Only their shadows can be seen.
Treating first episode psychosis

Psychiatrist John Kane, M.D., discusses treating first episode psychosis using coordinated specialty care.

Mentorship and sub-tracks

Mentorship is crucial for the development of a career as a physician-investigator. In addition to a primary mentor, most residents require a network of mentors to enhance their growth. The Faculty Lead guides each resident in developing the best possible mentorship network.

Examples of the current areas of study include the following:

Clinical study/psychopharmacology track

Principal investigator/mentor: Kristina M. Deligiannidis, MD
This track provides residents the opportunity to gain experience in understanding the pathophysiology, clinical presentation and treatment of depressive and anxiety disorders that occur during the peripartum period.

Recent or current examples of projects:

  • Double blind randomized control study of aripiprazole vs. risperidone in first episode psychosis
  • Double blind randomized placebo control study of pramipexole for cognitive symptoms in bipolar disorder
  • Effectiveness of ketamine vs. methohexital as anesthetic agent in ECT of major depression

Human analytic genetics track

Principal investigator/mentor: Todd Lencz, PhD
This track is for residents who are interested in human genetics, bioinformatics, and its increasing impact on how we understand the biology, diagnosis and treatment of mental illnesses.

Recent or current examples of projects:

  • CYP2D6 polymorphisms and effects on metabolism of risperidone
  • GWAS to explore links between predictors of general intelligence and the predictors of psychotic illness
  • MHC gene variants and relationship to schizophrenia in the Ashkenazi population

Neuroimaging track

Principal investigators/mentors: Anil Malhotra, MD
This track facilitates conducting and analysis of neuroimaging studies with techniques such as structural MRI, fMRI, DTI/DSI. Many projects in this lab are affiliated with other research areas, such as genetics (imaging genomics), or clinical trials (pharmacologic neuroimaging).

Recent or current examples of projects:

  • The effect of omega-3 fatty acids on the white matter integrity
  • The correlates between the corticostriatal functional connectivity and the duration of untreated psychosis
  • Antipsychotic medication effects on resting state functional connectivity in healthy controls
  • The effect of ECT and on the human brain: resting state fMRI study
  • The effect of clozapine in schizophrenia: a longitudinal neuroimaging study.
  • Multimodal imaging of executive and reward networks across the psychotic spectrum in adolescents

Neuropsychology research track

Principal investigator/mentor: Pam DeRosse, PhD & Phil Watson, PhD
This track will offer training in various aspects of neuropsychological measurement in mental disorders and how they interact with other research domains (imaging, genetics, etc).

Recent or current examples of projects:

  • The training effect in measuring cognitive performance
  • Neuropsychological characterization of the prodromal population
  • Multisite collaboration and analysis of the COGENT database

Animal research track

Principal investigator/mentor: Eric Chang, PhD & Jeremy Koppel, MD
This track is for residents interested in basic science research and animal models of mental illness. This research is conducted closely with other teams in the Feinstein Institute.

Recent or current examples of projects:

  • Development of immunotherapy and effects of antipsychotics in mouse models of Alzheimer’s disease
  • Behavior analysis of schizophrenia gene knock-in mice models
  • CLARITY: a technique that allows the nervous system to become transparent, which facilitates the mapping of neural tracks and brain pathology

Women’s behavioral health track

Principal investigator/mentor: Kristina M. Deligiannidis, MD
This track provides residents the opportunity to gain experience in understanding the pathophysiology, clinical presentation and treatment of depressive and anxiety disorders that occur during peripartum period.

Recent or current examples of projects:

  • Neuroendocrine and neuroimaging endophenotypes in postpartum depression
  • Perinatal psychiatry genetics consortium
  • Double-blind placebo controlled study evaluating efficacy, safety and pharmacokinetics of SAGE-547 (allopregnanolone) injection in the treatment of postpartum depression
  • Peripartum pitocin administration and postpartum mood and anxiety disorders
  • Gender differences in psychotic depression and treatment response
  • Gender differences in suicide risk factors in individuals with mood disorders
  • Antidepressant use in pregnancy

Bioelectronic medicine in neuropsychiatric disorders (BioMend)

Principal investigator/mentor: Miklos Argyelan, MD & George Petrides, MD
This track focuses on novel research aimed at understanding the efficacy and the mechanism of action of neuromodulatory treatment strategies including ECT, TMS, tDCS and DBS. Participants have the opportunity to gain expertise in the administration of many of these treatment modalities as well as develop research projects in these areas. Current projects include:

  • Clozapine and ECT in treatment resistant schizophrenia
  • Neuroimaging biomarkers of response to TMS
  • Using tDCS to ameliorate cognitive side effects of ECT
  • Connectivity and ECT response

Implementation research track

Principal Investigator: John Kane, MD
This track will facilitate the development of research at the level of systems of care to bridge the gap between best practice and actual practice. Research projects in this area focus on leveraging health systems data, optimizing the interventions of clinical services, or using technology to reduce the morbidity and mortality derived from mental health in the population.

Recent or current examples of projects:

  • Recovery After an Initial Schizophrenia Episode (RAISE) -- an NIMH research project on the trajectory and prognosis of schizophrenia treatment in the earliest stages of illness in order to reduce long term disability
  • Improve Care and Reduce Cost (ICRC) – a large study interested in improvement of disease management via technology (e.g. cell phones, computerized pills) in schizophrenia to reduce overall morbidity and health care cost
  • Social media and pathways to care: a study aimed at understanding pathways to care and predictors of relapse in first episode psychosis by examining the patterns of Google searches using machine learning algorithms
  • Early Treatment Program (ETP): a clinical service for the treatment of the early phase of psychosis that participates in the “On Track New York” program and that provides state of the art treatment for young individuals suffering psychosis; also collects research-quality clinical data to better understand the treatment and course of early stage psychosis in a “real-world” setting

Health professions education research track

Principal Investigator: John Q. Young, MD, MPP, PhD
This track supports the development of programs of research that advance knowledge in health professions education. Research in this area focuses on improving learning, assessment, professional identity development, and well-being within the framework of competency-based education. Recent or current projects include:

  • Using Cognitive Load Theory to improve patient handoffs
  • The development and validation of Entrustable Professional Activities for psychiatry
  • Competency-based assessment of performing a medication management visit
  • Aligning resident education with hospital patient safety efforts
  • Improving the quality of patient handoffs within the ambulatorpsychiatry setting

These are examples of tracks and provide a broad overview of research activities in the department. They do not encompass the entire research endeavors of the department or include all of the principal investigators.

Overall program requirements

  • Submit an application, including an initial statement of interest that addresses track record, proposal research plan, possible mentors, and proposed training plan
  • Meet regularly with their mentor and as needed with the faculty director of the RRTP.
  • Complete relevant methods and biostatistics coursework
  • Develop and implement a program of research in close collaboration with your mentor.
  • Participate in works in progress sessions with the faculty director
  • Attend weekly research seminars. This is either journal club discussion or a research presentation by visiting scholars
  • Update plan with progress report in the spring of the PGY-2 and PGY-3 Year
  • Attend national/international meetings and present your work at least one time at such a meeting