Residency in General Adult Psychiatry at Zucker Hillside Hospital
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. Our discoveries generate breakthroughs in our understanding of disease mechanisms, the development of novel treatments, and the delivery of higher quality care.
Each resident receives extensive training in the critical appraisal of evidence and its application to clinical care through extensive 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 and judged at a department event. 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.
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
Passion drives innovation: Learn more about the Pathways to Expertise program
The research and innovations generated by our faculty, staff and trainees advance mental health worldwide. For trainees interested in pursuing a career in academics or as a physician investigator, we offer a research track and a pathways programs to foster the development of a focused expertise.
Clinical Pathways (Clinical Scholars)
For residents that want to develop clinical expertise, they 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)
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 and includes more than 100 members that includes principal investigators, fellows, trainees, and support staff. Our research division is actively working in a wide range of areas, including:
- 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.
- 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
- Treating First Episode Psychosis - John Kane, M.D. - Watch Video
The research track welcomes psychiatry residents who have no or minimal exposure to scientific research in the past as well as those with substantial prior research experience (e.g. PhD).
Limited Prior Experience:
For those with limited experience the track offers the opportunity to develop strong foundational skills that may support future research efforts such as a subsequent research fellowship.
Substantial Prior Experience:
For more experienced candidates, the track offers development toward becoming an independent investigator with extramural funding.
Thus, the track allows residents to tailor their experience based upon their experience, interests, and goals with the time and support they need to successfully engage in both their clinical and research training.
The following criteria will be considered when selecting research track residents. Consideration of the resident’s prior experience with research will be taken into consideration and designated as limited vs. substantial.
- Track Record: Creativity of the candidate and potential to lead excellent multidisciplinary research judging by track record in some or all of the following: leadership; areas of expertise and prior training; publications and presentations.
- Research Plan: Scientific value of, potential clinical importance, and feasibility of the written multidisciplinary research plan.
- Training Plan: Quality, appropriateness, and multidisciplinary complementarity of the proposed mentors, and plan for additional didactic and other training.
- Resources: Likelihood that the department has the mentor and infrastructure to support the trainees proposed area of focus.
- Career Potential: Global assessment of the likelihood that the candidate will develop a career as an outstanding investigator who will lead multidisciplinary teams and have an important impact on health.
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: Christoph U. Correll, MD & John Kane, MD
This track provides the opportunity to gain experience expertise with designing, conducting and analyzing clinical psychopharmacological studies.
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
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
Medical 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 ambulatory, psychiatry 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
Our professional development curriculum helps to nurture and grow our humanism and professional identity – essential foundations for the future resilience and leadership of our residents.
The pedagogy for professional development is story telling. By hearing and sharing our stories, we keep our ‘aspirations’ and ‘imagination’ alive. New pathways emerge, new meanings come into focus. Throughout the academic year, we organize story telling sessions during which all residents interact over lunch with faculty and leaders who share their ‘story’. Each session explores a different career path, including research, health professions education, leadership, private practice, and subspecialty expertise.
Each resident is assigned to a faculty advisor, with whom they work over their career as a resident. Twice a year, they meet with their faculty advisor to review their individual development plans, which include setting goals for both career planning and learning. By assessing their professional development and their strengths and weaknesses on an ongoing basis, residents receive support and also learn how to monitor their own progress. The advisor also aids the resident in finding mentors and scholarship/elective opportunities within their fields of chosen interest (which, understandably, may evolve over the course of training). In addition, the advisor provides career guidance as well as advice around fellowship training options.
Weekly support group
Embedded within our residency program is a weekly resident support group, led by a senior faculty member during each of the four years. This group creates a safe, off-ward space for trainees to discuss challenges in establishing their professional identity and adjusting to their new clinical responsibilities. The groups aim to encourage identity formation, prevent burnout, and promote wellness. An adjunctive resilience curriculum helps residents develop individual skills (such as mindfulness).
Monthly class meetings
A monthly gathering for each class is led by the program director and associate program director. This time is used to discuss opportunities to improve the program and to explore the challenges residents face at work and in life. Topics include managing stress, coping with patient death or harm, and balancing one’s professional and personal life.
The training program continues a longstanding ZHH tradition of not just one, but two retreats each year. There is a half-day fall retreat, and a weekend spring retreat. Residents across training levels look forward to this protected time, as it allows for connecting with peers and attendings outside the pressures of clinical environment. Through team-building exercises, reflections, and process groups, residents focus on awareness of the self as part of both a group and a profession at large.
Humanities in Psychiatry
Engaging with fiction is believed by medical educators to enhance humanistic and professional qualities. It allows us the unique opportunity to tread in the footsteps of a character outside our realm of everyday experience, enhancing our capacity for empathy – a necessary ingredient in professional development. The study of fiction also forces us to confront ethical and moral gray areas that arise in the content, and in this way can promote self-reflection. Our residency program offers several opportunities for this type of learning, including:
- Integration of humanities into the curriculum: In their first year formulation workshop, residents practice the art of biopsychosocial formulation with fictional characters in addition to their patients. Interns read two short stories and watch one film; through the rich and evocative narratives, they glean a new perspective on the human condition that cannot be found in a clinical case history. Short stories and films are also used as teaching tools in the second year communications curriculum as skills like motivational interviewing, shared decision-making, and cultural formulation are developed.
- Book Club: All residents are invited to participate in a monthly book club discussion, which takes place on a Wednesday evening under the direction of two attendings. Dinner is included, and food choice reflects the setting and culture of the novel being discussed (i.e., Indian food was served during a discussion of The Lowland by Jhumpa Lahiri). There is no standardized reading list; book choice is based on member interest.
- Movie Night: All residents are also invited to our monthly movies nights. We start by watching the chosen movie while enjoying dinner, and follow up with a thoughtful discussion, led by senior residents and faculty. Movie choice is again based on member interest.
- Humanities elective experience: Residents have the opportunity to take an year elective in which they read works of classic and contemporary literature in the study of advanced psychotherapy topics. Through reflective writing prompts based on the texts, they examine closely their own counter-transferential reactions to patients, and in this way, become more self-aware practitioners.
Reflective writing has been shown to improve empathic patient interactions, professional identity, and clinical reasoning. At least three times a year throughout residency, trainees participate in a faculty-led reflective writing exercise. Topics for reflection range from exploration of one’s ‘calling’ to psychiatry to an examination of an adverse patient outcome to the appropriate use of humor in the clinical setting. We aim to create reflective prompts and ensuing discussions that can lead to self-awareness, and we encourage residents to share their reflections with their faculty advisors in the ongoing process of creating a career development plan.
In addition to participating in the many different activities sponsored by the School of Medicine’s Osler Society, all residents are also invited to contribute works of fiction, non-fiction, reflective pieces, and works of art to the Hofstra Northwell School of Medicine’s art and literary journal, Narrateur: Reflections on Caring. Narrateur is a celebration of the humanistic values of medicine, and the incredible importance of the patients who come to us for help. Reflecting on those special moments that bond caregivers with patients is one of the ways that we learn about ourselves, remember why we chose the field of medicine, and continue to build a sense of satisfaction in our work. You can see past volumes by clicking here.
Advanced subspecialty training
Hofstra Northwell offers advanced training in a variety of psychiatric subspecialties.
Zucker Hillside Hospital training programs:
The Division of Addictive Treatment Services at Zucker Hillside Hospital offers a one-year ACGME-accredited fellowship in addiction psychiatry. Trainees acquire the knowledge, skills and judgment to provide quality clinical care as well as an understanding of the etiology and course of addictive disease.
The child and adolescent psychiatry fellowship program at Long Island Jewish Medical Center trains psychiatrists to understand; relate to, and treat the complex emotional, behavioral and developmental needs of children and teens. The United States is facing a shortage of child and adolescent psychiatrists. As of 2013, there were only 8,300 to treat more than 15 million children and teens in need of the special expertise of child and adolescent psychiatrists. The faculty and staff at Zucker Hillside are committed to addressing this shortfall through the development of exceptional clinicians in this field.
The geriatric psychiatry fellowship training program at Zucker Hillside Hospital, part of Northwell Health, offers psychiatrists the expertise in the diagnosis and treatment of neuropsychiatric disorders in late life. The program is one of the first and largest geriatric psychiatry programs in the United States.
Zucker Hillside Hospital, part of Northwell Health, offers a one-year fellowship program in psychosomatic medicine in the Department of Psychiatry. The program is one of the largest in the country and has been recognized nationally and internationally for excellence in consultation-liaison education, including winning the Alan Stoudemire Award for Innovation and Excellence in psychosomatic medicine education.