Psychiatry Rotation for Neurology Residents

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Faculty Supervisors:

  • Dr. Sara Nash (Director of Psychiatric Consultation-Liaison Service) and the consultation-liaison division faculty

PGY-4 rotation

Description: 

The psychiatry rotation for senior [PGY-4] neurology residents is a four week in-patient experience on the psychiatry consultation-liaison service. The rotation exposes neurology residents to the principles of psychiatric evaluation and diagnosis, interviewing techniques, psychotherapy, pharmacotherapy, and a systems-based approach to patient care and disposition. The clinical material represents a full range of psychopathology and psychiatric illness, including depression and bipolar disease, delirium, dementia, anxiety disorders, affective disorders, schizophrenia, catatonia, addiction, suicidality, somatoform disorders, and personality disorders, among others.

During the rotation the neurology resident is an active participant on a multidisciplinary team that includes an attending psychiatrist, a Consultation-Liaison psychiatry fellow, psychiatry residents, medical students, and social workers. Residents work under the direct supervision of psychiatry faculty as they interview and assess patients, and make diagnostic formulations and treatment recommendations. Team rounds, a formal didactic curriculum, and an assigned reading list provide further opportunities for learning, and for applying the psychiatric literature and guidelines to clinical practice.

Location: 

Milstein Hospital Building

Feedback & Evaluations: 

Verbal feedback is provided to neurology residents on their interviewing technique, psychiatric formulation, and management approach by the faculty after patient encounters at the end of the rotation. Written evaluations will be supplied via Medhub at the end of the rotation.

Overall Goals & Objectives:

The American Board of Psychiatry and Neurology [ABPN] requires its adult neurology diplomates to be knowledgeable about psychiatric disorders and their treatment.Residents must learn: 

  1. The psychological aspects of the patient-physician relationship and the importance of personal, social, and cultural factors in disease processes and their clinical expression; and,
  2.  The principles of psychopathology, psychiatric diagnosis, and therapy and the indications for and complications of drugs used in psychiatry.  

Specific goals and objectives:

Medical knowledge

By the end of the psychiatry rotation, neurology residents will have:

  1. Acquired knowledge of the common and important psychiatric conditions, including depression and bipolar disease, delirium, dementia, anxiety disorders, affective disorders, schizophrenia and catatonia, addiction, suicidality, somatoform disorders and personality disorders, among others, in preparation for the psychiatric portion of ABPN board certifying exam for adult neurology.
  2. Become familiar with the diagnostic criteria for major psychiatric disorders.
  3. Developed insight into the epidemiology, pathophysiology and pharmacology of common psychiatric disorders.
  4. Become familiar with the pharmacology of psychoactive medications.

Patient care

By the end of the psychiatry rotation, neurology residents will demonstrate:

  1. The ability to perform a mental status exam and diagnostic interview in patients with psychiatric disease.
  2. The ability to assess suicidality and homicidality.
  3. Familiarity with the diagnostic framework in psychiatry.
  4. An awareness of the psychosocial dynamic in the evaluation of patients with psychiatric illness. 
  5. The ability to develop a multidimensional therapeutic approach to psychiatric illness, comprising pharmacotherapy and psychotherapy.
  6. An awareness of the assessment of competence and informed consent in patients with psychiatric illness.

Interpersonal and communication skills

By the end of the psychiatry rotation, neurology residents will demonstrate:

  1. Effective communication skills with psychiatric patients and their families 
  2. An awareness of counter-transference in the psychiatric encounter. 
  3. Effective communication skills with members of the health care team.

Professionalism

By the end of the psychiatry rotation, neurology residents will demonstrate: 

  1. The personal and professional attitudes of integrity, respect, and empathy in providing care to patients with psychiatric illness.
  2. A commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to the needs and vulnerabilities of patients with psychiatric illness.

Systems-based practice

By the end of the psychiatry rotation, neurology residents will demonstrate: 

  1. The ability to participate in the management of patients hospitalized with psychiatric illness as part of a multidisciplinary treatment team.
  2. Familiarity with the hospital-based and community resources and agencies involved in the care of patients with psychiatric illness.
  3. The ability to advocate for psychiatric patients within social and financial constraints.’
  4. Compliance with institutional and ethical guidelines [i.e., confidentiality of medical information] in the care of patients with psychiatric disease.

Practice-based learning and improvement

By the end of the psychiatry rotation, neurology residents will demonstrate:

  1. The application of knowledge gained from the didactic sessions, teaching conferences and the psychiatric literature to the care of hospitalized patients with psychiatric illness.
  2. Willingness to reflect on the impact of psychiatric intervention in the patients under their care.

Evaluation: 

Performance written evaluations are provided by the psychiatry attending who receive the resident’s presentations using the electronic Medhub system. Verbal feedback is provided at the end of the rotation by supervising faculty.

Suggested Reading/Reference Material:

  • Albers, Lawrence J. Handbook of Psychiatric Drugs, 2008.
  • Hales R, Yudofsky S, Roberts L. The American Psychiatric Publishing Textbook of Psychiatry 6th edition, 2014
  • Tomb, David A. Psychiatry for the House Officer, 7th Edition, 2007.
  • Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM5). American Psychiatric Press, 2013.
  • Nussbaum A. The Pocket Guide to the DSM-5 Diagnostic Exam, 2013.

Updated 7/21/25