Postgraduate Education

Ronald O. Rieder, M.D., Director, Residency Training
Lisa A. Mellman, M.D., Associate Director, Residency Training
Jules Ranz, M.D., Director, Public Psychiatry Fellowship
Mark Sorenson, M.D., Director, Columbia University Program for Creedmoor Residency Training

The Department of Postgraduate Education’s primary mission is directing the Adult Psychiatry Residency Training Program. It also sponsors a variety of fellowship programs for both M.D. and Ph.D. graduates, and Department-wide educational activities such as Grand Rounds. The New York State Psychiatric Institute has a long and distinguished record of support of psychiatric education. Its residency program is one of the oldest in the United States. These educational programs are very often conducted in conjunction with the other institutions at the Columbia Presbyterian Medical Center – Columbia University and New York Presbyterian Hospital. For example, the residency training program in adult psychiatry is jointly sponsored by all three institutions, and is headquartered on the first floor of NYSPI where the offices of the directors of the program, and the residents’ offices, are located.

Residency Program The quality of residents recruited into the program for 2001 remains superior as the Department continues to attract the top applicants nationally. First year residents (PGY I) who began in July 2001 represent diverse backgrounds, have a broad spectrum of clinical and research interests, and have demonstrated significant achievement. The department’s ability to recruit outstanding residents is a reflection of excellent faculty and residents’, educational program, resources and departmental reputation. The excellence of the residency is also evident by the notification in 2001 from the ACGME of reaccreditation without any citations for 5 years. Tireless efforts of faculty and residents on the Residency Selection Committee play an essential role in recruitment.

The variety of residency tracks offered by the Department continues to provide special areas of development within an integrated residency program. All tracks continue to recruit and graduate outstanding clinicians, teachers, and administrators. Research track residents who initiated the track in 1994 are now graduates pursuing research interests. The affiliation in 1998 between Presbyterian Hospital and Stamford Hospital resulted in the addition of a community hospital internship in medicine and psychiatry, now in its 4th year of operation, for our PGY I residents.

There are 44 psychiatry residents in the adult psychiatry program: 11 PGY I residents who will be joined by one PGY II entry resident next year, 12 PGY II, 12 PGY III, and 9 PGY IV residents. Twelve residents graduated from the Adult Psychiatry residency in June of 2001. Many of the graduates remain affiliated with the department in some capacity. Their careers continue to reflect the diversity of departmental activities and of the educational program. Four graduates entered research fellowships at NYSPI and one joined the research faculty at Washington University; three are continuing in the Child Psychiatry residency at Columbia; one is a Psychopharmacology Fellow and is in Psychoanalytic Training at Columbia; one became a Forensics Fellow at Columbia; one joined faculty at New York University and another is in practice in San Francisco. Many graduates opened part-time private practices.

During 2001 the Residency Training program continued to enjoy its state-of-the-art quarters in the new Psychiatric Institute. Our new home provides office and teaching space for residents and staff in a conveniently located education wing with easy proximity to conference rooms and teaching equipment. Each resident office is equipped with a new computer and web access.

The psychopharmacology Listserv, implemented in 1998 for residents and teaching faculty to address pharmacology questions that arise, has continued to thrive. This has been a boon to our educational process and is well utilized by residents and staff who both pose and answer questions.

A case conference on Cognitive Behavioral Therapy and a Comparative Psychotherapies course were added to the curriculum in 2001.

The PGY I year for the clinical track newly includes a three month elective experience on the Eye-6 general psychiatry service, directed by Stan Arkow, M.D. Three interns selected this rotation and join medical students and Creedmoor residents already being trained there. Research track residents rotate for three months on the Schizophrenia Research Unit, directed by Roberto Gil, M.D.

PI residents have continued to perform in an outstanding fashion nationally. On the PRITE exam, an annual national written exam in psychiatry, the resident classes performed in the 91st – 97th percentile.

PI residents continue to receive national fellowships and to be recognized nationally. The following residents received fellowships and awards in 2001: Jean Marie Bradford – APA Minority Research Training Fellowship; Susan Turner – APA/Bristol-Myers Squibb Fellowship; Joanna Steinglass – APA/Glaxo Wellcome Fellowship; Susan Stern – American Psychoanalytic Association Fellowship; Dianna Dragatsi – APIRE Research Colloquium Award; Britta Ostermeyer – National Consortium of Residents Fitzhugh Mullen Award for Resident Leadership and American Academy of Psychiatry and the Law Rappaport Fellowship; Arielle Stanford and David Sherman – APIRE Janssen Scholars Award; Serena Volpp – Trainee Consultant APA/CMHS Fellowship Program; Suzanne Yang – APA Lilly Psychiatric Research Fellowship Award, Honorable Mention. The graduating residents honored Eve Caligor, M.D. as Teacher of the Year.

Dr. Mellman was appointed as Chair, APA Committee on Psychotherapy by Psychiatrists and to the APA Council on Quality; selected as Master Educator for the 2002 APA Annual Meeting and appointed as Program Chair, 2003 AADPRT Annual Meeting. Dr. Rieder was appointed to the ACNP Study Group on Research Training.

Psychotherapy research progressed in the PI Psychotherapy Clinic under the direction of Dr. Mellman. One-year follow-up in the outcome study of twice-weekly psychodynamic psychotherapy is completed, and data analysis is in progress. Drs. Mullen, Rieder and Glick developed a psychodynamic psychotherapy test, the first of its kind that has been administered to over 900 residents nationwide. The validity study supports its use as a measure of psychodynamic psychotherapy skills among residents.

Research Fellowship Programs
Three fellows in the fellowships directed by Postgraduate Education completed research training in 2001: Drs. Ilise Lombardo, Cheryl Corcoran and Steven Hamilton. Drs. Lombardo and Corcoran are continuing in research at Columbia. Dr. Hamilton has taken a position as Director of the Genetics Laboratory in the Department of Psychiatry at University of California, San Francisco. In July 2000 there were 15 research fellows beginning or continuing in the research training programs conducted in this department.

Of the eight in the NIMH Fellowship in Affective, Anxiety, and Related Disorders, four are focusing on anxiety disorders, one on affective disorders, one on eating disorders, one on health services research, and one on stress. Seven are in the Schizophrenia Research Fellowship. The specific areas of research of these 15 fellows vary widely and reflect exciting basic and clinical research topics, for example, imaging of brain biochemistry using PET, MRI and MRS, neuropathological investigations, animal models of schizophrenia and addiction, and epidemiological studies of perinatal or childhood exposures that might contribute to severe mental illnesses. Former fellows, now Columbia faculty, who have gone on to receive substantial research funding include Drs. Michael Liebowitz, Jack Gorman, Steven Roose, Devangere Devanand, Laszlo Papp, Franklin Schneier, Jennifer Downey, Jonathan Javitch, James Knowles, Alan Brown, Michael Devlin, Brian Fallon, Dolores Malaspina, Mitchell Nobler, Edward Nunes, Kathleen Pike, Zafar Sharif, Jeremy Coplan, Margaret Spinelli, Sarah Lisanby, Randall Marshall, Jay Gingrich, Lawrence Kegeles, Pamela Collins, Ramin Mojtabai., Ramin Parsey, Diana Martinez, Laurel Mayer, Stuart Seidman, and Blair Simpson. Other fellowship graduates have been similarly successful at other universities.

Public Psychiatry Fellowship
The Public Psychiatry Fellowship continued to attract outstanding Fellows as the premier Fellowship of its type in the country. Applicants in the past few years have come from New Jersey, Massachusetts, Rhode Island, Maryland, Washington DC, Florida, Texas, California, Oregon, Washington State and Canada. The 2002 class includes two graduates of Harvard residencies, two from PI, three from NYU, one from PW, one from Downstate and one from San Mateo County MH Center in California.

Fellows continue to work in non-traditional community settings in increasing numbers. Of the 10 Fellows in the present class, 5 are working in such settings: one at the Fort Washington Shelter CTI program, a second at Pathways to Housing (a nationally prominent program providing mobile services and permanent housing to the homeless mentally ill), a third working for the Department of Homeless Services (under the supervision of the agency’s medical director, a former Public Psychiatry Fellow, one in the St. Vincent’s Community Medicine Program and one at the Callen Lorde Health Center (for gay and lesbian adults and teens).

The other five Fellows in the class work in hospital settings, all in unusual programs: Long Island Jewish Hospital (see below), Maimonides Hispanic Day Program , NY Presbyterian’s Hispanic Clinic, NY Presbyterian’s IOP Program (working on developing the program for the NYPD) and Gouverneur Hospital’s Asian Bicultural Clinic.
Over the past five years the Fellowship has noted an increasing number of applicants who want to work in primary care psychiatry. This is an area still underserved by C/L Fellowships, which continue to be mainly focused on inpatient C/L. Presently, four Fellows work in such settings: one at Long Island Jewish Hospital (jointly enrolled in their C/L Fellowship, in an ambulatory track), a second placed in the St. Vincent’s Hospital Community Medicine Program (which provides services in many community settings), a third at the Callen-Lorde Health Center (see above) and a fourth placed part-time at the NY Presbyterian ACNC network.

Of note over the past few years, there has been a significant increase in the number of psychiatrists applying to the Fellowship after having worked for several years post-residency. A common theme among applicants is having experienced the well-known dissatisfactions that can occur while working in the public sector, which include feelings of isolation, lack of professional affiliation and marginalization within their organizations. The applicants have learned that the Fellowship has had considerable documented success in helping Fellows and alumni deal with these problems. It does so by providing them with a conceptual orientation and by offering the ongoing support necessary to sustain productive careers in the public sector. In most cases, the Fellow’s field placement becomes the first year of a public sector job. Ongoing support is achieved by continued involvement in Fellowship activities after completing the one-year Fellowship, and includes individual presentations to subsequent Fellows, ongoing consultations with the faculty, group meetings and an e-mail network. The faculty believes this ongoing support to be crucial to the success of the Fellowship.

The Fellowship continues to investigate the role of the psychiatrist as medical director in public agencies. In 2001 Dr. Ranz conducted a follow-up survey of members of the AACP, assessing the changes they have experienced in the public sector over the past five years. The results of this survey will be presented at a special lecture at the Institute for Psychiatric Services October 2002.

Activities and Awards of Alumni
Paula Panzer is Chair of the Scientific Program Committee of the Institute on Psychiatric Services, Avrim Fishkind is president-elect of the American Association of Emergency Psychiatry, Jorge Petit is president-elect of the New York Chapter of the American Association of Psychiatric Administrators, Hunter McQuistion has been elected Treasurer, Tony Ng (Jorge Petit) Area II representative, and Pamela Weinberg Representative at Large of the American Association of Community Psychiatrists. Intikhab Ahmad is currently a Fellow in the APIRE/Janssen Public Policy Leadership Program. Linda Chokroverty has been chosen as a Fellow in this program for next year. Drs. Ahmad and Chokroverty are the fourth and fifth Public Psychiatry Fellowship alumnus to be appointed to the prestigious Janssen Fellowship in its first four years of operation, Stephanie LeMelle continues on the Scientific Program Committee of the APA Annual Meeting.


Creedmoor Psychiatric Center Program
The Columbia-Creedmoor Residency Education and Training Affiliation continued into its nineteenth year. There are sixteen residents in the Creedmoor Psychiatric Center Residency Program: 4 PGY–Is, 4 PGY-IIs, 4 PGY-IIIs and 4 PGY-IVs. The Columbia portion of the curriculum provides comprehensive education and training in psychodynamic psychotherapy, human development, psychopharmacology, and human sexuality, and other areas. There are extensive clinical rotations at the New York Presbyterian Hospital’s Columbia Presbyterian Campus including the Harkness-7 Adult Psychiatry Evaluation Clinic and Adult Outpatient Psychiatry Clinic, the Eye-6 Inpatient Psychiatry Service, the Comprehensive Emergency Psychiatry Program, and the Psychiatry Consultation-Liaison Service. Creedmoor PGY-I and II residents are assigned to the Psychiatric Rehabilitation and Research Unit at Creedmoor, a joint endeavor of Creedmoor and Columbia. For ten years now, Columbia 3rd year medical students have been assigned to Creedmoor’s Intensive Treatment Unit. Creedmoor faculty supervise these students at the Harkness-7 Clinic, providing continued evidence of Columbia’s confidence in Creedmoor. Some 20 Creedmoor staff hold Columbia faculty positions, and various faculty are actively involved in Columbia resident supervision as well as teaching at the Columbia University Center for Psychoanalytic Training and Research. Recent graduates have gone into fellowship training in Geriatric and Child Psychiatry at Long Island Jewish, Child Psychiatry at Dartmouth, and Consultation-Liaison Psychiatry at Downstate Medical Center and Baylor. In December 2001 the residency program received notice of continued full accreditation for five years by the ACGME. The Columbia-Creedmoor affiliation has been a major factor in achieving this welcome result.