Psychiatrists in training at New York State Psychiatric Institute (PI) are in the enviable position of working with experts at the top of the field, including experts who conduct research with patients in a wide variety of diagnostic categories, affording residents the opportunity to work with a broad range of patients. One way in which they are able to take advantage of the Department of Psychiatry’s outstanding faculty is through their work at the Psychiatric Institute Residents’ Clinic (PIRC), a service that provides teaching opportunities in psychopharmacology and various psychotherapies for residents in their 2nd, 3rd or 4th year of training.
The treatment of outpatients has of course been an integral part of the residency training program for many years, and for the past four years this part of the residents training took place at Columbia University Medical Center. On July 1st, the Clinic moved to PI, where it provides free services not only to patients who have completed research studies at the Institute, but individuals referred by staff at the Medical Center’s outpatient service line, 212-305-6001, and direct referrals from Columbia-affiliated physicians all over the Medical Center.
Dr. Eileen Kavanagh, a graduate of the residency program and director of PIRC, has been collaborating with research coordinators and principal investigators to facilitate referrals from the research clinics for follow up care with residents. For researchers like John Markowitz, MD, this is good news: “As a clinical researcher, I know the difficulty we face in referring patients who have not responded or only partially responded to study treatments and follow-up treatments, and it is wonderful to have a clinic of talented young psychiatrists to refer to.”
One major change has been that Dr. Kavanagh has combined various sub-clinics under one umbrella “with one electronic medical record, one person overseeing [residents’] caseloads and the diversity of the caseload.” As providing valuable learning opportunities is at the crux of the Clinic’s mission, cases will be screened carefully by Dr. Kavanagh to ensure a rich and diverse caseload. In this endeavor, Dr. Kavanagh will work closely with Drs. Maria Oquendo, Deborah Cabaniss and Melissa Arbuckle to fulfill residents training needs.
“We will track the clinical work both case-by-case and resident-caseload by resident-caseload,” said Dr. Kavanagh. “It is clearly a great learning opportunity to have a resident see a patient who needs a medication that they don’t normally prescribe. At the same time, if the residents all have a certain type of patient in their case load, at some point in the year we might stop taking such cases.”
Since the Clinic began operating at PI, Dr. Kavanagh notes, psychotherapy is in great demand as a treatment. Right now, however, she would like more “true psychopharmacology cases.” These cases involve “patients already in stable therapy with an outside provider” – which will introduce residents to working with clients who have multiple providers (i.e., those patients in a split treatment) – or cases that only require medication management once a month if not more frequently. There is also value in working with stable cases, added Dr. Kavanagh, where residents, for example, may explore the longterm effects of lithium in a patient who has been stable on the same medication for 20 years. “This type of case is very interesting for the trainee.”
Researchers who would like to refer subjects to PIRC should complete an internal referral form which Dr. Kavanagh can provide. Write to her at ek2155@columbia.edu or kavanagh@pi.cpmc. columbia.edu. Other patients, including employees, should contact the Medical Center’s outpatient referral line at (212) 305-6001. Columbia-affiliated clinicians who want to refer a patient can contact Dr. Kavanagh directly via e-mail or by calling 212-543-5549.
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