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Beth Israel Medical Center: Psychiatry Residency and Fellowship Programs

Fellowships: Geriatric Fellowship

FELLOWSHIP IN GERIATRIC PSYCHIATRY
Mount Sinai Beth Israel

BACKGROUND
Mount Sinai Beth Israel is a 949-bed full service teaching hospital which has been serving New York City for the past century. Beth Israel has an academic affiliation which Ichan School of Medicine at Mount Sinai and is a major clinical campus for the medical students’ psychiatry rotation. Over the years, Mount Sinai Beth Israel has developed a reputation for a caring involvement with its surrounding communities, such as the East Village, Gramercy Park, Loisida and Stuyvesant Town. A commitment to the excellent clinical care of the community and research into the best methods of delivering such care are hallmarks of Mount Sinai Beth Israel, the Department of Psychiatry, and the Division of Geriatric Psychiatry.

The Division of Geriatric Psychiatry, now in its 20th year as a clinical and teaching entity, was the first Geriatric Psychiatry division in Manhattan. The Medical Center has given strong institutional support to the Division since its inception. This support has continued despite the current economic problems New York hospitals are facing.

Our extensive experience in psychiatric services for the elderly enable us to offer our fellowship candidates a comprehensive curriculum that is integrated with the rest of the department, yet preserves its independent status as a subspecialty division. Moreover, our curriculum complies with the recommendations of the Curriculum Committee of the American Association for Geriatric Psychiatry (AAGP), and we are accredited by the American Council for Graduate Education (ACGME). As a result, we are uniquely able to prepare our Fellows for the American Board of Psychiatry and Neurology’s recently approved Examination for Added Qualification in Geriatric Psychiatry. The duration of this fellowship is one year.

CURRICULUM
The foundation of our curriculum consists of the following:

  1. A comprehensive didactic curriculum
  2. Inpatient and outpatient rotations in specialized Geratric Psychiatry units
  3. A nursing home consultation-liaison experience
  4. A senior housing consultation-liaison experience
  5. Training in Neurobehavior and Movement Disorders
  6. A home-visitation program
  7. ECT elective
  8. Inpatient and outpatient research opportunities

DIDACTIC CURRICULUM
The Division’s faculty presents a weekly core lecture series, Overview of Geratric Psychiatry, to our Fellows. The course presents in a systematic way the essential data base of Geratric Psychiatry. The topics covered include:

Psychiatric Assessment of Geriatric Patients Medical Evaluation of Geriatric Patients
Functional Assessment of Geriatric Patients Psychosocial and Family Assessment of 
Physiological Changes with Aging Geriatric Patients
Cognitive Changes with Aging CNS Changes with Aging
Evaluating Competency Epidemiology of Late-life Disorders
Mood Disorders in the Elderly
Depression and Cognitive Impairment Anxiety Disorder in the Elderly
Bereavement Delusional Disorder in the Elderly
Sleep Disorders in the Elderly Neuropsychiatric Syndromes
Iatrogenic Disorders in the Elderly Psychotherapy with Older Patients
Drug and Alcohol Abuse in the Elderly Elder Abuse
Sexuality and Aging Electroconvulsive Treatment 
Neuroimaging Medicare, Medicaid & Community
Evaluation and Managment of Dementias
Behavioral Managment of Dementia

Geriatric Fellows participate in bi-monthly Geriatric Psychiatry Journal Club to perform critical reviews of evidence-based articles and reviews of the literature.  A weekly outpatient case conference is held to review new clinic patients and those that are clinically complex.  In addition, the Geriatric Fellows participate in a bi-monthly Geriatric Psychiatry Board Review Course in order to prepare for the ABPN subspecialty examination.

Geriatric Fellows also have the opportunity to attend the Mount Sinai "Intensive Update with Board Review in Geriatric & Palliative Medicine" sponsored each year by the Icahn School of Medicine and the Brookdale Department of Geriatrics & Palliative Medicine.

The department offers a full schedule of additional didactic activities in general psychiatry, including Grand Rounds, which often features topics of interest to the geriatric psychiatrist.

INPATIENT ROTATION
During this rotation, the fellows functions as the Assistant Service Chief of our 15-16 bed inpatient Geratric Psychiatry service and has direct responsibility for its day-to-day operations. The educational aims are to gain experience as an administrator, as a supervisor of junior trainees, and as a researcher on our inpatient protocols. More importantly the Fellow will come into contact with a large number of geropsychiatry inpatients and will have direct responsibility for the supervision of the care of 6 to 8 cases, and may carry a few cases themselves.

The inpatient service is also a teaching service for Icahn School of Medicine medical students and Mount Sinai Beth Israel Psychiatry residents. It is a multi disciplinary service with a full-time attending psychiatrist, a full time psychologist, specialized nurses, an experienced social worker, occupational therapists, and psychology graduate students. Trainees from all disciplines enhance its relaxed and collegial environment.

The Unit Chief supervises the Fellow on this rotation. Depending on the interest and needs of the Fellow, we will arrange additional supervision to focus more intensively on certain clinical issues as well as on administrative or group process issues.

During the inpatient rotation the Fellow will also see outpatients and will consult at our nursing home once or twice monthly.

OUTPATIENT ROTATION
With nearly 400 visits a month, the Geratric Psychiatry Clinic serves a large, ethnically diverse population of seniors in the New York City area. The educational goals for the Fellow’s outpatient rotation are the following: mastery of a comprehensive psychiatric evaluation of an ambulatory geriatric patient, training in psychotherapeutic and psychopharmacologic treatment of geriatric outpatients, training in leading group therapy with elderly patient living in the community. During this rotation, the Fellow will have a vivid and varied clinical experience in the diagnosis and treatment of mood, anxiety, cognitive and psychotic disorders in elderly outpatients. The fellow will gain administrative experience as part of the outpatient rotation.

The fellow will be a member of our multi disciplinary team consisting of two attending geriatric psychiatrists, four Beth Israel psychiatric residents and two geratric psychiatry social workers. The Director of the Clinic will provide supervision for the Fellows in diagnostic and treatment issues; additional supervision in group therapy issues is also available.

NURSING HOME CONSULTATION-LIAISON
Beth Israel is affiliated with the Jewish Home Lifecare, an extended care teaching facility in upper Manhattan. The Division of Geratric Psychiatry is responsible for consultations on one of the floors. The Nursing Home provides the Fellow with a variety of important educational opportunities including psychiatric consultation on the facility’s residents and liaison with their families and staff. The Fellow will also be part of a multi disciplinary team including internist with geriatric subspecialty training. The ACGME has determined that these activities are essential components of geropsychiatry training.

NEUROBEHAVIOR CENTER
A free-standing Neurobehavior Center is currently in its fourteenth year of operation at Beth Israel. The Center specializes in the diagnosis and treatment of patients with psychiatric problems secondary to neurological disorders, many of whom are elderly. Our Fellow may attend conferences and teaching rounds or set up an elective at the Neurobehavior Center Clinic.

CONSULTATION WITH GERIATRIC MEDICINE
Part of the Fellow’s training will involve consultations on medical units and at several medical clinics near the hospital including the Meltzer Clinic in a senior housing facility near First Avenue and Houston; Lincoln Square Neighborhood Center at 250 W. 65th Street, New York NY 10023;and Penn South, another senior housing facility at Eighth Avenue and 28th Street. Other settings are currently being developed. These experiences will give you the opportunity to consult with medical colleagues in a primarily medical rather than psychiatric setting. This will provide you both didactic and clinical training in doing functional assessment, observing the altered signs and symptoms of physical illness, and identifying physical illnesses and iatrogenic factors that can alter mental status and behavior.

HOME VISITS
Fellows perform house calls, evaluating home-bound geriatric patients in association with a community agency.

ECT ELECTIVE
Fellows can elect to spend 1 month gaining expertise in our active ECT program.


BENEFITS
Beth Israel Medical Center supports a generous package of benefits to its trainees and staff. The Fellowship stipend for 2015-2016 is still to be determined, but should be around $71,000. Also included are malpractice coverage, health insurance, as well as dental, optical, and hearing aid benefits. Fellows may contribute to a tax-deferred annuity through the Medical Center. Housing may also be available through the Medical Center at attractive rates.

Mount Sinai Beth Israel has an excellent full-service medical library, the Seymour J. Phillips Library. It is conveniently located on the 12th Floor of Fierman Hall.  The library at Mount Sinai is also accessible, the Levy Library at One Gustave L. Levy Place.

Finally, the Division of Geratric Psychiatry as well as the Department of Psychiatry is sincerely interested in fostering a pleasant and collegial working environment at Mount Sinai Beth Israel. The concerns of trainees are taken seriously. There are also many opportunities to socialize both within the Department and with other medical colleagues.

Those interested in the Fellowship should send a CV and two letters of reference with cover letter to:

 

Melinda Lantz, M.D.
Chief of Geratric Psychiatry, Geratric Psychiatry
Mount Sinai Beth Israel
First Avenue at 16th Street
New York, N.Y. 10003
 

Tel: (212) 420-2457
Fax: (212) 844-7659
email: mlantz@chpnet.org

 
 

©2017 Mount Sinai Beth Israel Medical Center


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