New York Service Corps Program Brings Young Trainees to Underserved Areas

The New York State Office of Mental Health (OMH) is paying the salaries of 14 psychiatry residents at the State University of New York (SUNY) Upstate in Syracuse as part of a unique OMH Service Corps Program. Four more trainees will be joining the corps in July.

Courtesy of Zsuzsa Meszaros, M.D.

In return, the residents are serving at a designated state hospital or psychiatric facility throughout their training and are contracted to practice at the state facility after graduation for five years (one year for every year of salary support plus one).

“The rationale is to expose residents from the beginning and throughout their training to caring for adults with serious mental illness in the OMH system,” Jay Carruthers, M.D., director of academic affiliations with OMH, told Psychiatric News. “That is a unique experience, different from the experience residents normally have in their rotations. Ultimately, we hope to encourage our Service Corps residents to embark on a career in public psychiatry in New York state.”

Szuzsa Meszaros, M.D., psychiatry training director at SUNY Upstate, said the program, which began in 2019, exposes Service Corps residents to an underserved population. “The trainees see patients with a wide variety of psychopathology, including many with serious mental illness—bipolar disorder, schizophrenia, and major depression. Many of the patients are maintained on long-acting injectable antipsychotic medications. Our Service Corps trainees have a more in-depth experience with people who are chronically ill, keeping them safe and seeing them over the long term.”

She added that the program is a win for the underserved communities of upstate New York, a region of the country that typically does not attract medical school graduates.

Making Strategic Investments in Workforce

The OMH Psychiatry Service Corps Program is an example of how some states and municipalities are seeking to expand their mental health workforce. The state of Iowa has funded the University of Iowa to train psychiatry residents in rural areas of the state, and Cleveland’s MetroHealth Hospital, the public hospital serving Medicaid beneficiaries and uninsured individuals in Ohio’s Cuyahoga County, last year opened a new psychiatric hospital and expanded its residency by 20 trainees.

OMH Chief Medical Officer Thomas Smith, M.D., said that as stewards of the largest state-operated public psychiatry system of its kind, including 22 hospitals and over 90 clinics, “the New York State OMH has long recognized the importance of strategic investments in maintaining its psychiatrist workforce.” For decades, OMH has partnered with psychiatry training programs across the state to ensure trainees gain exposure to caring for children and adults in the OMH system, paying a portion of their salaries for work in state facilities, Smith said.

The elements of the Service Corps Program are as follows:

• SUNY Upstate can recruit up to four residents into the program each year. By September, before recruitment begins, OMH indicates which OMH Psychiatric Center will host incoming Service Corps recruits. OMH sites within two hours’ driving distance of SUNY Upstate are eligible; for sites farther than an hour away, OMH will provide suitable overnight housing.

• OMH agrees to pay the residents’ salary and benefits for every year in training. SUNY Upstate assumes full responsibility for meeting all required ACGME training requirements, as it does for its other residents.

• Service Corps residents must do rotations at their host OMH psychiatric center throughout their training, including a minimum of two months a year in the first two years of residency and one day a week in the third and fourth years either on-site or via telepsychiatry.

• Upon completion of training, graduates must provide one year of service for every year of salary support plus an additional year at their host psychiatric center. They may pursue fellowship subspecialty training but are still expected to return upon graduation to fulfill their service commitment.

Getting to Spend Time With Patients

Anthony Gobbo, M.D., is a PGY-4 resident in the Service Corps Track who is completing a fellowship in child and adolescent psychiatry. He has been hosted throughout his training at Mohawk Valley Psychiatric Center (MVPC) in Utica, NY.

“I have tremendous respect and appreciation for my team at MVPC,” said Gobbo. “What stands out to me is how well so many of the patients respond in such a powerfully resilient way to positive therapeutic relationships. This reinforced how important and powerful it is to have a supportive team with you while caring for patients and how restorative that can be.”

Gerson Nunes, M.D., a PGY-2 trainee, does his OMH Service Corps training at Hutchings Psychiatric Centers in Syracuse. He especially likes working with patients with severe and persistent mental illness and the ability to establish a real therapeutic relationship.

“Working in a state facility, I actually get a chance to spend time with the patients,” he said. “I can spend an hour or an hour and a half with them, sometimes playing games with them, which really helps me connect with the patients.”

He plans to do a geriatric fellowship after training before returning to his service commitment at Hutchings. Where does he see himself in 10 years? “Ideally I would like to continue to work with OMH and also have my own outpatient clinic,” Nunes said.

Smith and Carruthers said that the first cohort of Service Corps residents are expected to enter the service phase in July 2024. Based on initial success, OMH is exploring starting up a similar downstate program in greater New York, they said.

“The OMH Psychiatric Service Corps Program allows us to engage with the residency program and the residents from day one,” Smith said. “The residents know that when they are accepted into the program, they will be linked with a particular state hospital. Through their entire training period, they will be developing a relationship with the OMH hospital, and when they complete training, they are all set to move straight into an attending psychiatry role.”

Carruthers added, “We all need to be advocating for increased residency training slots because we are all facing acute shortages in psychiatry. I think this is a novel program that tries to address this at the training level.”

Meszaros said she hopes that Service Corps trainees will remain in the state long term, beyond the service phase of their contract with OMH.

“At SUNY Upstate we want to create Centers of Excellence, staffed by our trainees, so that young medical students can come here and fall in love with working in a small rural community.” ■