PGY-1
During the first year, the resident gains knowledge and experience in many areas, including basic psychopathology, psychopharmacology, differential diagnosis, emergency evaluation and treatment, interviewing and case presentation, and the diagnosis and management of common medical and neurological problems, including those complicated by significant psychiatric co-morbidity.
The typical year features four blocks of medicine (three at Albany Medical Center and one at CDPC), two blocks of neurology (Albany Medical College), four blocks of inpatient psychiatry (Albany Medical College), two blocks of emergency psychiatry (CDPC Crisis Unit) and one block of consultation liaison psychiatry (Albany Medical College). There is some variability to number of blocks spent on neurology, emergency psychiatry, inpatient psychiatry and consultation liaison psychiatry as indicated in the table below.
Please note that the order of rotations is variable, and we use a 13-block schedule. Each block is four weeks.
Call: In the month of July, all PGY-1s participate in training calls prior to taking call. PGY-1 residents take weekend calls (8 a.m.-8 p.m. or 8 p.m.-8 a.m.) and have one to two golden weekends per four week block. As the year progresses, each PGY-1 takes one to two inpatient and consultation liaison call shifts. When rotating on the two blocks of medicine at Albany Medical Center, PGY-1s take medicine call. For all other rotations, they participate in the psychiatry call schedule.
| Rotation | Blocks |
|---|---|
| Medicine* | 4 blocks |
| Neurology Consults | 1-2 blocks |
| Emergency Psychiatry | 1-2 blocks |
| Inpatient Psychiatry | 3-4 blocks |
| Consultation Liaison Psychiatry | 1-2 blocks |
PGY-2
During the second year, the resident develops knowledge and experience regarding addicted patients, geriatric patients, children and adolescents, and consultation to other medical services. Skill regarding the management of psychiatric inpatients and psychiatric emergencies is further developed. The resident begins learning and doing psychotherapy with a small continuous outpatient caseload.
The typical year includes four blocks of consultation liaison psychiatry (Albany Medical College), two blocks of child and adolescent psychiatry (CDPC), one block of geriatric psychiatry (CDPC), one block of addiction psychiatry (VA), and four months of inpatient psychiatry (Albany Medical College/CDPC). During the inpatient psychiatry rotation, residents will also spend time on a forensics rotation at the county jail.
Please note that the order of rotations is variable, and we use a 13-block schedule. Each block is four weeks.
Call: PGY-2 residents participate in the call system and take weeknight calls (8 p.m.-8 a.m.) as well as some weekend calls (8 a.m.-8 p.m. or 8 p.m.-8 a.m.). Each PGY-2 also has four to five inpatient weekend calls shifts and four to five weekend consultation liaison shifts.
| Rotation | Blocks |
|---|---|
| Consultation Liaison Psychiatry | 5 blocks |
| Child and Adolescent Psychiatry | 2 blocks |
| Geriatric Psychiatry | 1 block |
| Substance Abuse (Detox and Rehab) | 1 block |
| Inpatient Psychiatry* | 4 blocks |
| Outpatient Clinic | 10-15% |
PGY-3
In the third year, the resident focuses on strengthening and expanding a variety of psychotherapy and psychopharmacotherapy skills. The resident works with individuals, couples, families, and groups, learns more about types of psychotherapy (psychodynamic, cognitive-behavioral, supportive, brief, long-term, combined psychotherapy, and medication), and manages outpatients in a variety of settings (Albany Medical Center Outpatient Psychiatry Clinic, VA Mental Health Clinic). In addition to rotation-based outpatient experience, the resident continues to develop and expand their long-term caseload (PGY-2 through PGY-4).
The year involves a split week (two days at the VA, two days at Albany Medical Center) and a dedicated day for didactics and some supervision.
Please note that the order of rotations is variable, and we use a 13-block schedule. Each block is four weeks.
Call: PGY-3 residents participate in the call system and take mostly weeknight calls (8 p.m.-8 a.m.) and a few of the weekend call shifts (on average, three shifts for the year). They also participate in the inpatient and consultation liaison weekend call shift schedule. The number of calls may vary slightly from year to year dependent on the number of residents in the PGY.
| Rotation | Blocks |
|---|---|
| Outpatient Psychiatry | 13 blocks |
| Outpatient Clinic (Long-term cases) | 15-20% |
PGY-4
In the final year, the resident develops further skill in all clinical areas, as well as teaching and supervision, and utilizes elective time to bolster knowledge and expertise in selected areas. In addition, knowledge and experience are gained in the areas of administration and leadership. The resident produces a research project/scholarly work and becomes familiar with issues pertaining to transition into practice, fellowship, etc.
The typical year features five blocks of consultation liaison psychiatry (Albany Medical Center), three blocks of inpatient psychiatry (Albany Medical Center), one block of neurology (dementia clinic, Albany Medical Center) and eating disorders clinic, and four blocks of electives. Substance abuse, movement disorders, sleep disorders, neuroradiology, toxicology, and forensic issues are some of the areas recently chosen for elective time. There is an opportunity for a resident to gain experience at a local college in the counseling center.
Please note that the order of rotations is variable, and we use a 13-block schedule. Each block is four weeks.
Call: PGY-4 residents participate in the call system by assisting with training calls and in supervisory/junior attending roles.
| Rotation | Blocks |
|---|---|
| Inpatient Psychiatry | 3 blocks |
| Consultation Liaison Psychiatry | 5 blocks |
| Albany Medical Center Neurology and Eating Disorders | 1 block |
| Elective | 4 blocks |
| Outpatient Clinic | 10-15% |
Didactic Curriculum
Didactic curriculum complements clinical training and provides our residents with the knowledge necessary for their growth and development as psychiatrists. PGY-1 classes are scheduled throughout the week between noon and 2 p.m. Below is a sample listing of classes:
- Basic Psychopharmacology
- Ethics
- Human Development
- Interviewing Skills
- Interviewing & Psychotherapy Techniques
- Neuroscience
- DSM & Biopsychosocial Formulation
- Research
- Diversity & Inclusion Experiential Seminar
- Psychopathology
PGY-2 classes are scheduled throughout the week between noon and 2 p.m. Below is a sample listing of classes:
- Case Conference
- Personality Disorders & Defense Mechanisms
- Interviewing Skills
- Interviewing & Psychotherapy Techniques
- Motivational Interviewing
- Group Therapy
- Experiential Process Group
- Child & Adolescent Psychiatry
- Geriatric Psychiatry
- Introduction to Cognitive Behavioral Therapy
PGY-3 classes are scheduled on Mondays. Below is a sample listing of classes:
- CBT Practicum
- Attachment Informed Interpersonal Psychotherapy
- Psychological Assessment
- History of Psychiatry
- Short Term Psychotherapy
- Family & Marital Therapy
- Forensic Psychiatry
- Psychodynamic Psychotherapy
- Public Psychiatry
- Termination
- Addiction Psychiatry
- Neuropsychiatry
Below is a sample listing of classes for PGY-4:
- Short Term Dynamic Psychotherapy
- History of Psychiatry
- Addiction Psychiatry
- Forensic Psychiatry
For all PGYs:
- Journal Club/Case Conference
- Case Conference
- Departmental Grand Rounds
- M & M
- Department Quality Improvement Meetings
- Quality Improvement Projects beginning in PGY-1
- Psychopharmacology Case Conference
- College Mental Health Case Conference (for PGY-3s and 4s participating in College MH)
Locations
PGY-1 residents spend three months on internal medicine. As required by the ACGME, they also rotate for two blocks on the neurology consult service. They also rotate through the Inpatient Psychiatry Unit (PGY-2 and PGY-4 residents may as well), where they are exposed to a spectrum of psychopathology, and begin to learn basic skills (interviewing, diagnosis, etc.). The unit has 25 beds. Residents will also spend 1-2 blocks on the consultation liaison service.
PGY-2 (and PGY-4) residents rotate through consultation liaison psychiatry, where they develop knowledge and skill regarding the interplay of medical and psychiatric conditions.
PGY-3 residents spend half of the week at the Albany Medical Center Outpatient Psychiatry Clinic, a teaching clinic with heavy emphasis on training and supervision.
PGY-4 residents rotate for one month through subspecialty neurology clinics (movement disorders, behavioral, pain management, epilepsy, general neurology) and the Comprehensive Care Center for Eating Disorders of Northeastern New York. This rotation has been designed to provide advanced training in the assessment and treatment of neurological illnesses and psychiatric illnesses co-occurring with neurological and medical conditions and offer an opportunity to work with patients with eating disorders. Many residents also choose to do an elective in one of these clinics.
The Capital District Psychiatric Center (CDPC) is a New York State Office of Mental Health facility adjacent to Albany Medical Center. Among the services offered are: 165 inpatient adult beds (intermediate to longer term); a child and adolescent service with both an outpatient clinic and day treatment program; comprehensive geriatric services offering consultation in the community in addition to an outpatient clinic and inpatient beds; a Crisis Intervention Unit (a 24-hour emergency psychiatry service); and a large community outpatient clinic (Albany County Support Center) serving the seriously and persistently mentally ill. Residents rotate through five services at CDPC. Electives are also available.
Typically, PGY-1 residents spend two blocks at the Crisis Unit, where they learn how to assess and manage psychiatric emergencies. One block is spent on the primary care medicine and consult service. This rotation provides exposure to the assessment and management of a wide variety of disease processes and medical and chronic psychosocial issues affecting the health of persons with severe and persistent mental illness.
PGY-2 residents spend two blocks on the child and adolescent service, splitting time between the outpatient clinic and the day treatment program. They also spend one block on geriatric psychiatry, where they evaluate and treat individual patients, attend family meetings, participate in milieu and group therapy, and attend nursing home and home visits. PGY-2 (or PGY-4) residents also rotate on one of the adult inpatient units for one block.
The Samuel Stratton VA Medical Center, a major teaching hospital, is located adjacent to Albany Medical Center. It has 156 beds, along with extensive outpatient services in all areas. Residents rotate through three services at the VA. Electives are also available.
In PGY-1, two blocks are spent on the acute inpatient unit (15 beds) whose primary mission is to evaluate and treat the acute phase of serious and chronic mental disorders.
PGY-2 residents spend one block with the Chemical Dependency Rehabilitation Program (CDRP). There, they participate in a variety of activities, including group therapy, treatment planning, inpatient detoxification evaluations and follow-up, and psychiatric evaluation of chemically dependent patients.
PGY-3 residents rotate throughout the year for half of the week at the Mental Health Clinic. The clinic provides varied treatment modalities for veterans and their families, using a multidisciplinary model. Residents see patients in individual treatment and participate in one group.
Research Initiatives
2020
Lukowitsky, M., Vosatka, K, Emmond, J., Biaggi, N., Balkoski, V. (June, 2020) Adverse Childhood Experiences as a Moderator of the Working Alliance Outcome Relationship. Society for Psychotherapy Research Annual Meeting.
Lukowitsky, M. & Balkoski, V. (June, 2020) Adverse Childhood Experiences and intra- and interpersonal problems: The mediating role of attachment style. Paper presented at the annual meeting of the Society for Interpersonal Theory and Research.
Lukowitsky, M., Bromley, N., Balkoski, V. & Gallagher, P. (June, 2019). The role of empathy and personality in predicting trainee attitudes towards patients. Paper presented at the biannual meeting for the Association for Research in Personality. Grand Rapids, MI.
Vosatka, K. & Lukowitsky, M.R. (June, 2020). Motivation to change is associated with psychopathology in treatment seeking adults. Poster presented at the Society For Psychotherapy Research Annual Meeting. Amherst, MA.
Hurley, M. & Lukowitsky, M.R. (2020). Dispositional mindfulness and adverse childhood experiences moderation on treatment outcomes. Poster. American Psychiatric Association Annual Meeting. Philadelphia, PA.
Mosharif, N. & Lukowitsky, M.R. (2020) The University of Rhode Island Change Assessment can be used to predict treatment attendance in psychiatric outpatients. Poster. American Psychiatric Association Annual Meeting. Philadelphia, PA.
Brown, J.M. Lukowitsky, M.R., Sharma, T., Zhou, H., Balkoski, V., Winseman, J (2019). Associations between adverse childhood experiences and pain. Poster presented at IPS: The Mental Health Service Conference. New York, NY.
Moorjani, P., Lukowitsky, M.R., Sharma, T., Zhou, H., Balkoski, V., Winseman, J (2019). The role adult attachment style in mediating the relationship between adverse childhood experiences and adult interpersonal problems. Poster presented at IPS: The Mental Health Service Conference. New York, NY.
Huynh T, Marella A, Lukowitsky M, Winseman J, Balkoski V. The association between adverse childhood experiences and suicide risk using self-report and clinician rating scales. Poster accepted for presentation at the American Psychiatric Association Annual Meeting, Philadelphia, PA (2020).
York TRM, Winseman J, Lukowitsky M, Balkoski V. ‘Who’ What? The Implementation of the World Health Organization Disability Assessment Schedule (WHODAS) in the Outpatient Psychiatry Setting. Poster accepted for presentation at the American Psychiatric Association Annual Meeting, Philadelphia, PA (2020).
2020
Lukowitsky M, Winseman J, Feld E, Kam S, Balkoski V (2020). Patients’ perceptions of their clinicians: Effects of race, culture and cultural competency on the working alliance. Academic Psychiatry (Under Review).
Mason HRC, Winseman J, Ayala EE (2019). Admissions isn’t Access: First Generation College Graduates in Medical School (Book Chapter). In Press.
Mason, H. R. C., Winseman, J., Marcellon, R., Huamantla, M., Ruiz, C., & Ayala, E. E. (2019). First-generation wellness in the United States: A cross-sectional snapshot, Journal of Best Practices in Health Professions Diversity, 11(2), 96-106.
Lukowitsky M, Winseman J, Balkoski V (2018). Contemporary Interpersonal Theory: A Clinically Informed Model of Personality. European Journal of Personality, 32:563-564.
- Correlation of glucocorticoid-related measures with symptoms and treatment response in depression
- Risk factors associated with psychiatric symptoms and treatment outcome
- Evaluating change in attitudes and beliefs about substance use and the efficacy of screening, brief intervention and referral to treatment (SBIRT) training
- How does culture affect the therapeutic alliance? Patients' perspectives on their therapists' cultural background and cultural competencies
- Clinician self-knowledge study (UAlbany, UMASS Amherst)
- Delirium Project
- Assessing dangerousness on Inpatient Psychiatry Unit using BROSSET
- Evaluation of Med to Bed Program on inpatient psychiatry
- Med Education Group
- Using a patient-clinician match intervention to optimize primary care referrals to mental health care