Northwell Health Fellowship in Psychosomatic Medicine
The Psychiatric Consultation- Liaison Service was established at the Long Island Jewish Medical Center in 1972 after the Long Island Jewish Hospital merged with Hillside Hospital. Hillside Hospital, which was then a free-standing psychiatric hospital adjacent to LIJ, became the Department of Psychiatry of the combined Long Island Jewish-Hillside Medical Center and provided psychiatric services to the general hospital. North Shore University Hospital also has an extensive C-L Psychiatry Staff that works together with LIJ.
The Consultation - Liaison Service consists of four CL psychiatry attendings at LIJ and seven CL psychiatry attendings at North Shore University Hospital, a geropsychiatry attending at LIJ, four CL Fellows, two PGY 2 psychiatry residents, PGY-4 psychiatry residents on elective, geriatric psychiatry fellows, medical students, PA students and secretarial staff. The Psychiatric CL Service provides both inpatient and outpatient treatment.
The inpatient service responds to requests to help diagnose and treat the emotional disorders of patients in the general hospital. These disorders include delirium, dementia, depression, anxiety disorders, adjustment disorders, somatoform disorders and others. Liaison relationships help the staff recognize and refer these disorders and assist them in their management. Educational teaching programs are provided to staff and house staff of other departments of the general hospital.
The Department of Psychiatry at Long Island Jewish Medical Center offers four one-year fellowships in C-L Psychiatry / Psychosomatic Medicine. It is one of the largest programs in the country and nationally recognized for C-L education with the Stoudemire Award. The fellowship provides broad training in C-L psychiatry in the inpatient and outpatient settings, and upon completion fellows are eligible for subspecialty certification in Psychosomatic Medicine. The fellowship program at LIJ fully endorses and reflects the goals and objectives set forth in the Academy of Psychosomatic Medicine’s standards for fellowship training. In addition to seeking to fulfill all of these goals and objectives, the fellowship at LIJ places particular emphasis on providing broad training in the inpatient, outpatient and primary care aspect of Consultation-Liaison Psychiatry.
Fellows have a manageable caseload in each area with extensive supervision by an active attending staff. A well-developed didactic program provides a combination of lectures, case conferences, journal club and clinical bedside rounds. Fellows have a major teaching responsibility with medical students as well as Zucker Hillside PGY-2 residents. Extensive liaison and specialized clinical opportunities with oncology, cardiology, ob-gyn, and other services are available. Fellows will spend half of their fellowship year at the Long Island Jewish campus, and the other half at the North Shore University Hospital. Our clinical training sites span a broad array of race, socioeconomic class, culture and languages spoken.
Applicants must have completed 4 years of a fully accredited psychiatric residency at the time of beginning their fellowship. Prior evidence of interest and commitment to C-L Psychiatry during the candidate’s residency, e.g. elective work in C-L, or post-residency employment, e.g. working in a C-L setting will be seen as strengthening a candidate’s application.
Consultation-Liaison Psychiatry Facilities
Fellowship training takes place at both Long Island Jewish Hospital and North Shore University Hospital, as well as associated facilities of the Long Island Jewish Medical Center..
The Long Island Jewish Medical Center sits on a 48-acre campus in New Hyde Park, NY and is a 610-bed, not-for-profit teaching hospital serving the greater metropolitan New York area. In 2014 the hospital opened a medical-psych unit specializing in the care of demented and delirious patients, and this unit was expanded to a total of 25 beds in early 2016.
The North Shore University Hospital located in Manhasset, NY is an award-winning 806-bed teaching hospital on the 58-acre Sandra Atlas Bass campus that delivers advanced care in all medical specialties.
Both LIJ and North Shore have extensive residency training programs with 45 approved residencies and 16 fellowships.
The Consultation-Liaison Psychiatry Service at Long Island Jewish Hospital is a division of the Department of Psychiatry at The Zucker-Hillside Hospital, a two-hundred bed inpatient psychiatric hospital which is adjacent to Long Island Jewish Hospital on the same clinical campus. The Department of Psychiatry at Hillside has a total of approximately 68 residents in years PGY 1-4 and 20 fellows in 4 different fellowship training programs – Geriatric Psychiatry, Child Psychiatry, Research and C-L Psychiatry. PGY 2 psychiatry residents rotate for 6 weeks, full-time, on the C-L service.
SITE: Long Island Jewish Medical Center (6 months)
General Medical/Surgical/Obstetrics Inpatient Service
Fellows perform consultations on general medical, surgical and Ob/Gyn patients drawn from the daily consult requests received by the C-L service. Consults are triaged by fellows and the faculty for assignment to fellows, so as to provide a broad mix of patient problems as well as interesting cases. The C-L service helps to diagnose and treat the emotional disorders of patients in the general hospital, which include delirium, dementia, depression, anxiety disorders, adjustment disorders, somatoform disorders and others.
Fellows coordinate a clinical team consisting of an attending psychiatrist, a PGY-2 psychiatry resident and at least one or two third year medical students, as well as possibly PA students or podiatry residents. Each team makes rounds daily on their patients, in addition to weekly teaching rounds with the Chief of the C-L Service.
Outpatient Perinatal Experience
Fellows rotate in the Zucker Perinatal Psychiatry Clinic one full day per week over a three month period. During that time, they gain experience doing new patient intakes, follow-ups, and attending academic sessions (including journal articles and case presentations). They participate in multidisciplinary team meetings and have extensive discussions on appropriate psychopharmacological treatment for these patients.
6 South rotation
Fellows are embedded within the unique environment of a medical psychiatry unit, offering ‘on-scene’ acute psychiatric interventions and management of complex patient care. In addition to following the most interesting and challenging cases, they serve as a liaison in team rounds and collaborate with other staff members including the unit psychologist, case managers, social workers, and primary and specialty teams. Fellows will gain confidence and leadership skills by resolving dilemmas involving prolonged length of stay, readmission rates, care coordination, and disposition planning. Finally, fellows would have the opportunity to conduct individual or group psychotherapy on the unit, addressing common concerns pertaining to medical/surgical treatment, guiding patients through crises and strengthening the alliance between the staff and the patient.
The fellows spend three months coordinating the consult service under the supervision of the attendings. This involves triaging of consultation requests being called in, assigning them to residents and staff, and working closely with the program assistant who maintains the patient log and database. During this time fellows will be in charge of choosing topics and cases for journal club and case conference, as well as inviting expert discussants if relevant. Fellows learn about the financial aspects of the C-L service and about billing for consultations, and clinical information systems. They are integral members of the selection committee for new fellows.
Additional Electives / Liaison Experience
Each fellow is encouraged to develop a primary liaison experience according to his/her particular interest and the available opportunities within the medical center. OB/GYN, Neurology, the Intensive Care Unit, and Physical Medicine Rehabilitation are liaison assignments that have or can readily be used. Fellows establish an active presence on their liaison floor by attending ward work rounds with nursing staff and social service, and providing formal or informal consultations freely to the service. Close linkage with the service social worker is especially encouraged on several of the services. Fellows are also encouraged to develop informal liaison linkages with other services in the hospital, arising out of their experiences doing consults on particular units or connections with staff.
SITE: North Shore University Medical Center (6 months)
Palliative Care rotation
The Palliative Care experience is a 2-week rotation during which the fellow joins the palliative care consultation service under direct attending supervision. Typical reasons for palliative care consultation include defining goals of care, prognostication, clarifying advanced directives (ie DNR, DNI, MOLST forms), providing symptomatic management (pain, dyspnea, constipation, etc), and identifying hospice-appropriate patients. The fellow assists in holding family meetings, attends didactics and morning report and serves as an integral part of the palliative care team. The palliative care team is very invested in teaching, and attendings have typically been very skilled in tailoring their teaching style to the needs of the rotating psychiatry fellow.
C-L Psychiatry Fellow Lecture Series (Wednesday — 9-10AM)
Fellows attend the weekly comprehensive didactic C-L course known as the Fellows Lecture Series (see appendix).
Grand Rounds (Wednesday — 11AM-Noon)
The Department of Psychiatry at The Zucker Hillside Hospital organizes a grand rounds, which is a weekly presentation on Wednesdays at Hillside Auditorium.
Journal Club (Wednesday — Noon-1PM)
It is held twice a month and organized by one of the Fellows. An interesting C-L psychiatry topic is chosen; it may include review of current literature or presentation by a guest speaker or one of the house staff/attending. Lunch is provided.
Weekly Clinical Case Conference (Thursday — 10AM-11:15AM)
The C-L Clinical Case-Conference is held every Thursday. It involves the presentation of an interesting clinical case selected from the in-patient C-L service. After the presentation, the patient is interviewed by one of the attendings, followed by an open discussion. At the close of the academic year, each fellow will make a special presentation, addressing in depth a topic of interest to the fellow.
The Schwartz Center Rounds are unique, multidisciplinary quarterly sessions in which hospital staff explore the emotional side of caregiving. A national program with sites across the country, Schwartz Center Rounds are funded by the Kenneth B. Schwartz Center, a Boston-based nonprofit dedicated to advancing compassionate health care. In a typical rounds session, a panel of caregivers presents a patient case that brought up interesting and important psychosocial issues. Hospital staff members then share their own thoughts and feelings related to the topic.
WEDNESDAY – 9:00 am – 10:00 am
2nd Floor Conference Room
Joel Finklestein Building
|September 2nd||Neuropsychiatry II: Frontal Lobe||Dr. Christopher Burke|
|September 9th||Oncology||Dr. David Straker|
|September 16th||Neuropsychiatry IV : Stroke / Stimulants||Dr. Christopher Burke|
|September 23rd||No Lecture||Yom Kippur|
|September 30th||Cancer||Dr. Saira Hussain|
|October 7th||Depression in the Medically III||Dr. Dave Straker|
|October 14th||TBA||Dr. Howard Linder|
|October 21st||Problem Solving Therapy||Dr. Jessy Warner Cohen|
|October 28th||Eating Disorders||Dr. Roslaind Hoffman|
|November 4th||TBA||Dr. David Straker|
|November 11th||No Lecture||APM|
|November 18th||Psychiatric Aspects of Women's Health||Dr. Rosalind Hoffman|
|November 25th||No Lecture||Thanksgiving|
|December 2nd||TBA||Dr. David Straker|
|December 9th||Paraneoplastic Syndrome||TBD|
|December 23rd||No Lecture||Holiday Week|
|December 30th||No Lecture||Holiday Week|
|January 6th||Factitious Disorders and Malingering||Dr. David Straker|
|January 13th||Delirium in MICU||Dr. Mike Krysko|
|January 20th||Psycho- Oncology||Dr. Saira Hussain|
|January 27th||Gastric Bypass||TBD|
|February 3rd||Systemic Lupus Erythematosus (SLE)||Dr. Adele Veksman|
|February 10th||Endocrine||Dr. Howard Linder|
|February 17th||Review of Basic CBT Strategy||Dr. Warner Cohen|
|February 24th||Transplant||Dr. Howard Linder|
|March 2nd||Greif and Bereavement||Dr. Joe Weiner|
|March 9th||End of Life Issues||Dr. Joe Weiner|
|March 16th||Alcohol||Dr. Adele Veksman|
|March 23rd||Opiates and Pain||Dr. Brian Keefe|
|March 30th||Steroids||Dr. Brian Keefe|
|April 6th||Sickle Cell Disease||Dr. Helen Khaysman|
|April 13th||Motivational Interviewing||Dr. Warner Cohen|
|April 20th||Dementia||Dr. Adi Virmani|
|April 27th||Synthetic Marijuana/Designer Drugs||TBD|
|May 4th||HIV Psychiatry||Dr. Rosalind Hoffman|
|May 11th||ECT in the General Hospital||Dr. Sohag Sangahani|
|May 18th||Liver Failure||TBD|
|May 25th||Renal Failure||TBD|
Fellows supervise their PGY 2 residents during their C-L rotation. This supervisory experience is itself supervised by a staff psychiatrist. Fellows are responsible for the medical students rotating on C-L Psychiatry. Each fellow spends 1-2 hours per week teaching the medical student on his/her team, critiques their write-ups and performance and provides a series of lectures to the medical students.
Fellows can and are encouraged to give lectures or talks on their liaison services to non-psychiatric house staff, nurses, etc., e.g. psychiatric issues in the Emergency Room, or psychiatric problems in OB/GYN.
Fellows also present in-depth reviews of clinical problems at case conference for the C-L staff and resident.
Fellows are encouraged to have a research experience during their fellowship year. This can entail:
1) Having primary responsibility for developing and conducting a research project during the year.
2) Sharing responsibility for developing and conducting a research project with a staff person who has initiated the project and has primary responsibility for it.
3) Becoming an active participant in an ongoing project through gathering data, helping interpret it, or being involved in the write-up.
Fellows have in recent years participated as co-investigators in the following research: The impact of delirium on length of stay in the general hospital, psychosocial responses of Emergency Medicine Residents to one month rotation in the Emergency Room, the use of screening instruments to identify psychiatric co-morbidity in medical patients, and the use of advance directives by medical residents.
Fellows have also authored clinical reports on individual cases that have been published in the literature or presented at the annual Academy of Psychosomatic Medicine conference.
Every fellow receives one competency-based evaluation per rotation completed by the CL team. Fellows also formally meet at least twice a year with the program director to discuss evaluations and the continued evolution of their clinical, academic and professional skills. 360 evaluations are also incorporated into each fellow’s assessment as well as two observed inpatient consultation-liaison interviews. It is expected that each fellow complete at least one academic project (case presentation, research, etc).
Twenty paid days per calendar year are granted after approval from the program director as well as eight paid legal holidays.
Permission for moonlighting is granted at the discretion of the training director. Moonlighting must not interfere with the training responsibilities of the house staff or the number of hours worked for programs in New York State and must be in compliance with Part 405.4 of the New York State Health Code.
No calls are required from the fellows.
Salary and Benefits
The program offers a comprehensive package that includes a competitive salary as well as medical, dental and vision insurance coverage. Malpractice coverage is also provided. For more information on current pay scales, benefits, contracts, and other residency information, click here.
Long Island Jewish Medical Center
Christopher Alexander Burke, MBBS
- Chief of Division of Psychiatry - Consultation-Liaison Psychiatry, Long Island Jewish Medical Center
- Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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North Shore University Hospital
Howard David Linder, MD
- Associate Chairman - Psychiatry of Psychiatry - Consultation-Liaison Psychiatry, Long Island Jewish Medical Center
- Chief of Division of Psychiatry - Consultation -Liaison Psychiatry, North Shore University Hospital
- Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Click here for application.
Christopher A. Burke, MD, FAPM
Head of Division, Consultation Psychiatry
Director of Psychosomatic Medicine Fellowship
Long Island Jewish Medical Center
New Hyde Park, New York 11040
Phone (718) 470-7653