Top Psych Residencies

What do you mean by "top 5?" Are you looking for a high-powered academic center? Are you looking for a small community program? Are you looking for a program that has more of a biological focus? Are you looking for extensive psychoanalytical training? Keep in mind that psychiatry is probably the field with the most variation among the available programs.

It can be hard to know where to start looking for the "best" programs in psychiatry since there isn't (or if it is I don't know about it) a source that ranks the programs and lists the average stats for them like U.S. News does for colleges and medical schools.

A few sources that are available are the ranking of psych departments based on the amount of research money they get from NIH and the U.S.News ranking of best hospitals.

The best source for knowing what the best programs for you (after all since the real best program is the one you can learn the most in and be happy in) is to talk to residents and psychiatrists at your school. Resideny program directors often have some great suggestions about programs to investigate.

Anyway, hope this helps somewhat!

Seriously, there are no top 5 residencies in psych. If you are concerned about that, internal medicine might be a better residency for you because, obviously, there is disparity in internal medicine programs and some fellowships (cardio, GI and allergies) are harder to obtain than others (infectious disease, rheumatology, etc.) and it pays to go to Hopkins or Brigham and Women for internal medicine in order to maximize your chance of becoming a cardiologist.

But psych residencies and psych fellowships are so not competitive, I don't know why anyone would bother to come up with a top 5 list in terms of reputation, etc.? half of the psych program spots are filled by foreign medical graduates. By going to an US med school, you already have a leg up on half of the applicants out there. You also don't have working visa issues to worry about. So you get the point....

It really should be about what type of training you want and what location in the country you want to be in. The only major issue is that most psych programs out there put some emphasis on either psychopharmacology or psychotherapy, but nevertheless, teach you both. HOWEVER, there are rare programs out there that emphasize one of those two modalities of therapy AT THE EXPENSE of another. Two polar examples: Hopkins is all about psychopharm while Cambridge hospital (one of the three programs affiliated with Harvard) is mostly if not all about psychotherapy. But some people want that. It depends on you. The bottomline, it is too early for you to think about! Just try to enjoy your psych rotations when you get there. Don't you still have 2 years of basic sciences to do (not sure about that; please correct me if I am wrong)?

Top 5 in psych is so tough to pin down. There are so many good programs with so many different strengths. A lot really depends on what your career interests are and where (geographically) you are interested in going. I think one person's top 5 would differ significantly from someone else's. I would talk to your program director at you school, tell him your interests and maybe he could help you sort out top programs to interview at.

For myself personally, I was looking for strong, well-rounded programs since at that time I wasn't going to pigeon-hole myself down a career path just yet. Ultimately, I chose my program based on diversity and geographic location. Which in the end, looking back, was the best decision I could have made for myself and my family.

Programs that impressed me that I would put in my top 5 were Pittsburg, Michigan, and UNC. I'm sure people would argue with me over this. But, I would highly recommend that you put "rankings" behind you in your decision. Psychiatry is a buyer's market when it comes to residency and job placement. In a majority of cases, you are going to get good training and have no difficult finding a fellowship or a job when you're done with residency.

The number one factor when I made my rank list was geography (though I had second thoughts at first). But now, I am so happy I did.

Good luck...

Not a list of residencies but a place to start looking http://www.usnews.com/usnews/nycu/health/hosptl/rankings/specreppsyc.htm

No one commented on your question about consultation liaison (CL) psychiatry, so I will add what I know. CL psychiatry is actually a fellowship after residency. "Psychosomatic Medicine" is a new subspeciality of psychiatry, which will have its own subspecialty boards. If you are not already practicing CL psychiatry, you will have to complete a CL fellowship in order to sit for those boards.

As for the top 5 psych residencies - I can't help with that. They definitely are not in Illinois, and unlikely to be in the mid-west.

Just curious why you picked UNC as one of your top choices. I'm having a difficult time choosing between a few residencies, in particular, Univ Of texas Southwestern, UNC chapel Hill and UAB. Mostly my choices are based on ACGME status, location, reputation, and where I would like to end up. What have you heard about these programs? And, again, why was UNC on the top of your list as well--thanks

Several are certainly better than others. Several have a name brand which attracts the best and brightest, and their quality matches the brand. Others have a good name, but aspects of their program don't match the name. E.g. I know of a few forensic fellowships in Ivy League locations which are nowhere near as good as Case Western, U. Mass, U of Cincinnati or Albert Einstein. I mentioned this in another thread, but while I was at one Ivy League place, they weren't going to teach much of the psychometric testing that often goes on in forensic psychiatry.

Its hard to pin this down. For example some places get tremendous amounts of research money, have better research facilities, but the quality of the teaching in psychodynamics, psychotherapy, and general clinical experiences are not on the order of some places that do not have good research, but better clinical teaching and experiences.

Other places have top people in the field, but those people do not want to teach, or teach at all. Yeah, they might be a top researcher, but their quality of teaching is of low quality.

The typical "I'm going to go to the most competitive school" or "the most prestigious school" mentality that often exists in undergrad and medical school doesn't apply anywhere near as much for residency.

Take for example my younger brother who wanted to go into art specifically for video games, tv and film. Had he gone to Cornell's art school (an Ivy League school--oh wow!), it most likely would not have trained him anywhere near as well as the school he attended (Pasadena School of Design). That specific school is specialized for his field in a manner much better than Cornell.

Now of course for my supercilious, "we like to brag about our kids, and hang out with other people who brag about their kid's accomplishments" Pasadena was an unknown, and they would've had more cred if he went to Cornell. However that's all this would've done. He was far better off going where he did, and is now a big guy in the field of designing video games.

In general I've come up with the following formula in general for residencies...
-quality of the patients: more diversity=better. This concerns race, age, sex, socioeconomic status. This will be greatly influenced by the location. E.g. if its in a specific area in NYC, you'll most likely only get patients within a few blocks of that hospital--> if that hospital for example in Harlem, you'll get a much more limited demographic of patients vs a hospital that services an entire county.
-clinical opportunities to learn: more = better. You'll want an involuntary and involuntary unit, a (P)ACT team, outpatient, day programs, emergency crisis center, case managers. The better places will also have a forensic facility, access to the court room for involuntary cases. For child psychiatry, an inpatient child facility, day program etc. Does the place have ECT? The best places may have an eating disorder clinic (those are rare).
-strange cases: while this could go in the previous 2 categories, I think it deserves a place all its own. In general, university hospitals, bigger hospitals, and hospitals cover a larger population and geographic area will present with more challenging and interesting cases. For example, don't expect a small hospital to have a CL case of someone who wants to die because he just went through a car accident where he was made a quadriplegic. Those will be reserved to larger hospitals with top of the line trauma centers.
-quality of the teaching: The best are top people in the field who actually love to teach. Though you could go to a place where the people aren't at the top, but still do great teaching. You want to avoid places with attendings who see residents as fodder to do their work and don't teach.
-research: more=better, but you have to temper this with the availability to residents. Some places have great research but will not include residents in that research, or use them to do the scutwork for the research, while they attach your name to the very end of a paper if at all. I've seen places that made residents do all the hard work, then didn't even attach the person's name to the paper.
-atmosphere of the program: avoid malignant programs where abuse of residents occurs. This occurs less in university programs due to a bigger and better GME office. There are several programs that I know of that are malignant. E.g. one program I knew of made residents work about 100 hrs a week in clear violation of ACGME guidelines. The program instilled a sense of fear in residents. It has gone there for years, and will likely continue for more.
-competitiveness: yes of course this is a factor. I do think people tend to overrate it, but the more competitive programs will mean that your colleagues probably had higher scores. While scores are not the bottom line, they do have some influence in the quality of the resident.

whopper said:

-clinical opportunities to learn: more = better. You'll want an involuntary and involuntary unit, a (P)ACT team, outpatient, day programs, emergency crisis center, case managers. The better places will also have a forensic facility, access to the court room for involuntary cases. For child psychiatry, an inpatient child facility, day program etc. Does the place have ECT? The best places may have an eating disorder clinic (those are rare).

-quality of the teaching: The best are top people in the field who actually love to teach. Though you could go to a place where the people aren't at the top, but still do great teaching. You want to avoid places with attendings who see residents as fodder to do their work and don't teach.

-atmosphere of the program: avoid malignant programs where abuse of residents occurs. This occurs less in university programs due to a bigger and better GME office. There are several programs that I know of that are malignant. E.g. one program I knew of made residents work about 100 hrs a week in clear violation of ACGME guidelines. The program instilled a sense of fear in residents. It has gone there for years, and will likely continue for more.

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I've heard these 'malignant programs' mentioned vaguely in a few threads - may I inquire into some specifics in order to be better informed of which programs to avoid? Or is that too... impolite... a question to ask?

I'd ideally love to find a residency that's heavy on the teaching and clinical variety, but does not necessarily have to be a big name or even in one of the popular big cities (I'm from NYC and am ready for a change of pace/scenery).

I know of 3 programs I feel confident were malignant. However I will not name them. Call me an intellectual coward, but since I am willing to put my name if asked on my posts (and its not hard to figure out who I am. There's only 2 fellows in my program, and I do mention which program I'm in...), this can open me to a libel suit. While I would be telling the truth, I just don't want to deal with a suit.

However, I will tell you some red flags to tell if a program is malignant.

1-The program will not let you speak to the residents to ask them what their opinion is of the program. A malignant program knows their residents aren't happy and rule by fear.

2-your interviews seemed like interrogations. I do think several good programs will give some interviewees some tough questions. That's not what I'm talking about. I'm talking about an attending literally doing some very questionable things during the interview like raise his voice in an angry and condescending manner.

3-The work schedule is something on the order of "you only have to work from 6am to 8pm 6 days a week. We only work you 80 hrs a week.)

4-Does the program have avenues that allow residents to complain without fear of retaliation? (And a better question that I do not have an answer for---how do you bring this up during the interview without looking like you are a complainer?)

5-The best source of information is people you know who've been in the program and you know you can trust their work. E.g. a friend in the program. During your interview day, the chief resident, PD and program coordinator are most likely going to try to sell you the program as if they're a salesman.

I do know of one specific program where several residents told me they worked over the 80 hr limit. The program director would tell the residents something to the effect of----yes you are allowed to go home at 5pm, but if you do, I'll personally think you are lazy. If you stay here after 5pm, you''re doing it on your own, and therefore you can't count it on your work hours.....They felt they had no way to complain, and several of the residents were too scared to do anything because most of them came from a country where to complain meant getting kicked out.

I can only tell you that this particular program, the PD and the overwhelming residents of that program were of one ethnicity where this type of practice is still highly prevalent in that ethnicity's culture. If of course you weren't of that ethnicity--too bad. You still had to play by those rules.

If you're looking for the top 5 programs for you, no one here can help much. There are some objective lists (NIH funding is one, but it probably doesn't relate directly to your residency experience). US News is probably a better gauge but is also kinda random. Doctor and Geek came up with a list of the numbers of MD/PhD residents in various programs (I cut and pasted it, below), which is probably a reasonable marker for which programs recruit the most serious research trainees (and is probably a pretty good marker for overall selectivity), but may not relate to the average good applicant. Further, "selective" and "best" may not be highly correlated, especially for non-research residents.

D & G's list of programs with their current number of MD-PhD's (I think the Harvard number includes Cambridge and Longwood, though presumably most are at MGH/McLean):

Harvard programs 11
Cornell 10
Columbia 9
UCLA 9
UCSF 8
Yale 8
Penn 5
Pitt 5
U of Washington 5
UCSD 5
NYU 4
Stanford 4
Wisconsin 4
Duke 3
Emory 3
Michigan 3
Mt. Sinai 3
UTSW 3
Chicago 2
UCDavis 2
WashU 2

So I looked, and "Harvard programs" does equal "MGH", as the posters above were thinking. Also, the numbers listed above are a little outdated. Among CURRENT residents (those who matched from 2006-2009), here are the number of MD/PhDs:


MGH (10)

Cornell and UCSF (9 each)

Columbia (7)

Yale (5)

UCLA (4)

Barclay said:

So I looked, and "Harvard programs" does equal "MGH", as the posters above were thinking. Also, the numbers listed above are a little outdated. Among CURRENT residents (those who matched from 2006-2009), here are the number of MD/PhDs:


MGH (10)

Cornell and UCSF (9 each)

Columbia (7)

Yale (5)

UCLA (4)

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I'm pretty certain that there's at least one MD/PhD at Longwood - curious where'd you look for this info since the Longwood website doesn't list residents' degrees and I don't think the Cambridge website lists their residents at all.

Yes, this is an excellent measure of one-up-manship. We all know that those who have PhD's all have them in pertinent fields to their speciality and will ultimately complement their future academic career. I mean, no one ever gets a PhD in Biochemistry and becomes a community psychiatrist post residency, right?

Sneezing said:

Yes, this is an excellent measure of one-up-manship. We all know that those who have PhD's all have them in pertinent fields to their speciality and will ultimately complement their future academic career. I mean, no one ever gets a PhD in Biochemistry and becomes a community psychiatrist post residency, right?

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The list was intended to be one imprecise measure of where serious researchers go for their psychiatry training. Nothing more than that.

I think everyone knows that NO program has an alumni group in which MOST people are engaged in serious, full-time, grant-supported research; most people from even the most research-oriented programs are doing predominately clinical work within 10 years of graduation.

whopper said:

I2-your interviews seemed like interrogations. I do think several good programs will give some interviewees some tough questions. That's not what I'm talking about. I'm talking about an attending literally doing some very questionable things during the interview like raise his voice in an angry and condescending manner.

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I actually laughed out loud at this, imagining an interviewer yelling at an interviewee. No offense Whopper. How unprofessional can one be?

HooahDOc said:

Which residencies are considered the "Top 5" for Psychiatry, and what are the average stats for such residencies?

(Consult-Liason is consdiered a fellowship, correct?)

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I don't know about "top 5", but I'd be willing to guess that the following 4 programs are amongst the most competitive to match into:

ucsd
ucsf
columbia
ucla

psychotrope said:

I don't know about "top 5", but I'd be willing to guess that the following 4 programs are amongst the most competitive to match into:

ucsd
ucsf
columbia
ucla

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MGH/McLean is a pretty glaring omission on that list.

psychotrope said:

I don't know about "top 5", but I'd be willing to guess that the following 4 programs are amongst the most competitive to match into:

ucsd
ucsf
columbia
ucla

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You wouldn't happen to be from California would you?

VMSmith said:

MGH/McLean is a pretty glaring omission on that list.

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Not to mention the other 5-10 programs more competitive than UCSD...

Psychiatrists like intellectual cities, so tend to go to places like New York, Boston, and San Francisco. The same is true of psychiatry residents.

The most competitive programs are MGH/McLean, Columbia, Cornell, UCSF, and (maybe) UCLA.

NYU, Stanford, and Longwood are not that far behind. "Most competitive" doesn't mean "best", and I don't know if it's a good thing that all of your co-residents are AOA or MDPhDs from the ivy league. It does mean that your co-residents will be wicked smart and competitive, so if that's your thing, you should shoot for one of the top ivy or UC programs.

Also, the most competitive residency programs are not necessarily in the best psychiatry departments. Hopkins, UCSD, Penn, Wash U. and Pitt all have very strong departments, but the training programs are not that
"competitive". For some people, it might mean more to them to be a big fish in a program with a top research department, and have access to the gods of psychiatry research, than to be a small fish among co-residents with astronomical step 1 scores.

wellfleet7 said:

Psychiatrists like intellectual cities, so tend to go to places like New York, Boston, and San Francisco. The same is true of psychiatry residents.

The most competitive programs are MGH/McLean, Columbia, Cornell, UCSF, and (maybe) UCLA.

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If applicants think of LA as "intellectual," boy are they in for a rude awakening...

Sophie said:

You wouldn't happen to be from California would you?

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nope, and have no interest in ever living there. That state has some serious issues with respect to the size of their state government, funding all those state pensions, etc........and honestly from the studies and forecasts I've seen in terms of where those pensions are headed(hell the state cant break those pensions and benefits), it's a real issue.....10 years from now it's going to be an even more massive issue.

but several people have told me that those three california programs are 3 of the 4 most competitive in the nation.....

My Impression from last year:
1 or 2. MGH/McLean and Columbia
3 or 4. Cornell and UCLA
5. UCSF

No offense Whopper. How unprofessional can one be?

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Mentioned this in another thread. That same guy was accused of assaulting a resident within 2 years of my interview at that program. As bad as that sounds, this guy was a teaching attending for years at that institution. I'm wondering if the then newly instituted ACGME guidelines that forced programs to develop a method for residents to complain without fear of retaliation finally made it so that he couldn't get away with his usual shannanigans which several people from that program told me happened often. Oddly enough, the PD told me he really wanted me in the program and even considered letting me in ahead of the MATCH. I didn't want to say something to the effect of "hey your fellow attending, he seems like he has intermittent explosive order, or maybe he was in a Japanese or Vietnamese prison camp for years and my Asian ethnicity reminds him of one of his torturers."

This was the one guy I thought was just so over the top it was ridiculous. In hindsight it's actually funny. Back then I was way PO'd. If I knew then what I knew now, I would've just walked out of the interview after this guy kept it up for ten minutes. I had multiple interviews, cancelled a few, and already knew I the program I wanted to go to the most wanted me there. Back then I was fearing that doing so would spread the word to other NYC programs because there are a high concentration of them in a local area.

Yes, this is an excellent measure of one-up-manship.

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Possibly. Several highly competitive institutions can fit into the bad stereotype. However several truly have better learning opportunities and are great institutions. If you have a top person in the field, and that person just happens to be a great teacher--that's the opportunity of a lifetime. Of course yes, there are some who are top people who don't teach well, or do not want to teach, and yes, some places with a name.

IHMO, if a place has more Ph.D.s they're much more likely to be a research institution. Ph.D.s in general require years of research and good skills in that area. If those areas can be further spready to psychiatry--then yes, I would think more Ph.D.s is more likely to make that place a better research institution on the surface. This of course has to be taken into the context that there's much more to a program than a simple ratio of M.D./Ph.Ds v. M.D.s (that's way too simplistic a method to look at), and that there are many factors to consider when judging a program. The number of Ph.D.s is only a factor, and a simple one at that, but it still deserves some consideration.

notdeadyet said:

If applicants think of LA as "intellectual," boy are they in for a rude awakening...

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notdeadyet said:

If applicants think of LA as "intellectual," boy are they in for a rude awakening...

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Ah, the NorCal snobbery..... almost as good as the East Coast variety!

As a CA native (central CA, nobody's favorite place) and a 7 year resident of Los Angeles, I've always found these perspectives puzzling and frustrating, particularly since I cannot recall ever experiencing the reverse (e.g. SoCal people talking trash about NorCal, or West Coast people shooting down the East Coast).

Now I'm on the East Coast for med school, and my Chief Resident asked me yesterday what programs I'm looking into (M3 right now), and I mention either staying in the area of my school or heading back to Cali, he was quick to tell me "There are NO good Psychiatry programs in California!" and said that I had to stay on the East Coast if I wanted any "real" training.

Where is all the love, people?

-

babel said:

Ah, the NorCal snobbery..... almost as good as the East Coast variety!

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Oh, I've got no illusions that the sun rises and sets on Northern California (though I know the type you mean). It's definitely not everyone's cup of tea. I just never found LA to be all that intellectually stimulating.

Being born and raised in SoCal, I personally couldn't wait to get out. LA is a fantastic place for some folks but can start to feel pretty much a wasteland for others. Some LA natives will swear that LA is intellectually a west coast Boston or New York but others find it a little too focused on form rather than function, if you catch my meaning. I'm in the latter camp.

babel said:

As a CA native (central CA, nobody's favorite place) and a 7 year resident of Los Angeles, I've always found these perspectives puzzling and frustrating, particularly since I cannot recall ever experiencing the reverse (e.g. SoCal people talking trash about NorCal, or West Coast people shooting down the East Coast).

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Really? I've found that Californians can sometimes be a pretty obnoxious bunch regaling stories of the golden state to anyone within earshot in their new home (especially grating during that first winter). And you'll find plenty of SoCal folks up in NorCal (especially during the tech boom) in which "In L.A...." was the preface of every description of a better club/beach/restaurant/etc. (albeit rarely bookstore/coffeeshop/etc).

SF, LA, Boston, New York, Chicago, Atlanta, etc. are all acquired tastes. Any place that can inspire passionate loyalty will also inspire distaste among those that don't get it. Some don't get San Francisco. I don't get LA. Viva la difference.

notdeadyet said:

Being born and raised in SoCal, I personally couldn't wait to get out.

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As I wrote my post, I had this inkling that you were probably a SoCal native - so I respect your opinion. You know, like I can talk b*tch and moan about my family, but god help an outsider who chimes in.

notdeadyet said:

Really? I've found that Californians can sometimes be a pretty obnoxious bunch regaling stories of the golden state to anyone within earshot in their new home (especially grating during that first winter).

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Okay, so everyone can be rude & obnoxious - I'll give you that. I complain pretty loudly every time it drops below 50 deg out here on the East Coast. I just try to make it more about me i.e. "I just can't handle the cold" rather than "This place is a sh*thole" (Well, at least, I try to play nice when I'm with the natives ).

notdeadyet said:

SF, LA, Boston, New York, Chicago, Atlanta, etc. are all acquired tastes. Any place that can inspire passionate loyalty will also inspire distaste among those that don't get it. Some don't get San Francisco. I don't get LA. Viva la difference.

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And I certainly agree, to each his own..... I've met others in med school who went to the same SoCal undergrad that I did, and hated it because of the all of the superficiality as evidenced by the "bleached blondes with boob jobs & nose jobs". I know that these people were there, but they were so outside of my sphere of interests, I just really didn't notice them.

It's like trying to argue with people about various medical specialties (as I've been experiencing lately as I've begun to declare my intent to enter psychiatry) - sadly, many people are so wrapped up in what they do (or where they're from), they can't see the value in the alternatives.

-

Go Californian expatriates! :-D I grew up in LA, but went to Cal Berkeley for college and fell head-over-heels in love with NorCal. I still enjoy SoCal, since it was where I grew up, but I hope to make the Bay Area my home someday. Come on, match! Put me back in the land I love!

HeyThereJude said:

Bump for this question

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Residents at UCSF and UCLA seem happy.

-AT.

i'm at ucsf and very happy... pm me if u have specific questions

wellfleet7 said:

The most competitive programs are MGH/McLean, Columbia, Cornell, UCSF, and (maybe) UCLA. ...

NYU, Stanford, and Longwood are not that far behind.

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Where do people learn this stuff?

Cornell is competitive, but very much self-selecting. They want people who are focused on psychoanalysis/dynamics. But it's not even close to Columbia/MGH/UCSF/UCLA in terms of competition to match there.

Similarly, NYU is not that competitive. The class is huge and they want people who want to work very hard and don't mind being in a little bit of a run-down atmosphere at times (no knock on Bellevue, it's an amazing place, but it's nothing fancy). However, given that it's one of the good programs in NYC, there is a certain degree of competition of someone who'd rather by in New York than even the best program in another city.

Standford is extremely competitive. Maybe it's not as good as Columbia/MGH, but it's extremely hard to match there, partly because they have the added "California factor" that raises a barrier for non-West coasters. Recall multiple people last year got the "we're not inviting you for an interview because we have such limited interview spots and don't know if you'd come out here, but if you are serious about coming to California [lists criteria by which "serious" is defined], then let us know" e-mail from Stanford.

Longwood is not as competitive. It's a great program, don't get me wrong. But if you are a good applicant with a good interview, you can match there. You don't have to be from a top undergrad, a top med school, or have research. Excellent facilities, large faculty, especially for consult-liason. But the Harvard name elevates it more than the actual substance of the program.

And, UCLA - it's highly competitive. It's the best program in SoCal, "the best in the west," whatever you think. That's why the residents there work very hard -- they can afford to recruit 15 or whatever number of people who will smile and work very, very hard (for the first two years - years 3-4 are a cakewalk). Compared to NYU, Cornell, Longwood... UCLA has their pick of applicants.

Think about why not a single Cornell med student matched at Cornell psych last year -- because none of them ranked it first.

Consider that Longwood didn't fill their class two years ago.

Those are things that don't happen to the top top programs.

A lot of comments on these message boards, over the years, seem to simply repeating other people's views about different programs, rather than using real evidence, an insider's view, or from actually knowing the program.

So, for all you applicants, learn about the programs yourself and don't pay too much attention to what you're reading here, especially when you don't know the person writing! Trust yourself!!

Good luck

dianamd said:

Where do people learn this stuff?

Cornell is competitive, but very much self-selecting. They want people who are focused on psychoanalysis/dynamics. But it's not even close to Columbia/MGH/UCSF/UCLA in terms of competition to match there.

Similarly, NYU is not that competitive. The class is huge and they want people who want to work very hard and don't mind being in a little bit of a run-down atmosphere at times (no knock on Bellevue, it's an amazing place, but it's nothing fancy). However, given that it's one of the good programs in NYC, there is a certain degree of competition of someone who'd rather by in New York than even the best program in another city.

Standford is extremely competitive. Maybe it's not as good as Columbia/MGH, but it's extremely hard to match there, partly because they have the added "California factor" that raises a barrier for non-West coasters. Recall multiple people last year got the "we're not inviting you for an interview because we have such limited interview spots and don't know if you'd come out here, but if you are serious about coming to California [lists criteria by which "serious" is defined], then let us know" e-mail from Stanford.

Longwood is not as competitive. It's a great program, don't get me wrong. But if you are a good applicant with a good interview, you can match there. You don't have to be from a top undergrad, a top med school, or have research. Excellent facilities, large faculty, especially for consult-liason. But the Harvard name elevates it more than the actual substance of the program.

And, UCLA - it's highly competitive. It's the best program in SoCal, "the best in the west," whatever you think. That's why the residents there work very hard -- they can afford to recruit 15 or whatever number of people who will smile and work very, very hard (for the first two years - years 3-4 are a cakewalk). Compared to NYU, Cornell, Longwood... UCLA has their pick of applicants.

Think about why not a single Cornell med student matched at Cornell psych last year -- because none of them ranked it first.

Consider that Longwood didn't fill their class two years ago.

Those are things that don't happen to the top top programs.

A lot of comments on these message boards, over the years, seem to simply repeating other people's views about different programs, rather than using real evidence, an insider's view, or from actually knowing the program.

So, for all you applicants, learn about the programs yourself and don't pay too much attention to what you're reading here, especially when you don't know the person writing! Trust yourself!!

Good luck

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I love this post just because it shows that no one can state with any certainty what is and what isn't the most competitive/prestigious/"top" whatever residency. People on SDN seem to state these things like they're facts with no supporting evidence. And they state all sorts of other "facts" with an n of 1 about all sorts of aspects of the application process. We all see things in the application process that coincide with our view of how the world should be, not how it necessarily is.

So anyway, big note, if you're worrying because the sdn people don't give nods to your place or imply that you're screwed because you didn't go to a top 25 program (which apparently everyone at sdn went to based on the posts here), don't. No one poster here has any collective view of how the whole psychiatry world goes.

I intentially didn't apply to any of these programs talked about here. I couldn't imagine living in any of these places.

I also have a hard time agreeing that they are superior to other programs like Iowa, Wash U, Mayo, Cleveland Clinic, Case Western, Vanderbilt, U washington, U Cincinatti, and some of the programs in Texas or further in the SE that all have sizeable research programs.

There is more than the wretchedness of the NE and California...

Sneezing said:

I intentially didn't apply to any of these programs talked about here. I couldn't imagine living in any of these places.

I also have a hard time agreeing that they are superior to other programs like Iowa, Wash U, Mayo, Cleveland Clinic, Case Western, Vanderbilt, U washington, U Cincinatti, and some of the programs in Texas or further in the SE that all have sizeable research programs.

There is more than the wretchedness of the NE and California...

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From what I've seen, the SDN psych board has a very decidedly NE bias. This Caly thing is new but actually promising because a year or two ago, no program east of Pennsylvania was mentioned as being worth looking at. Maybe we'll make it to Nebraska this year.

Sneezing said:

I intentially didn't apply to any of these programs talked about here. I couldn't imagine living in any of these places.

I also have a hard time agreeing that they are superior to other programs like Iowa, Wash U, Mayo, Cleveland Clinic, Case Western, Vanderbilt, U washington, U Cincinatti, and some of the programs in Texas or further in the SE that all have sizeable research programs.

There is more than the wretchedness of the NE and California...

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Doctor Bagel said:

From what I've seen, the SDN psych board has a very decidedly NE bias. This Caly thing is new but actually promising because a year or two ago, no program east of Pennsylvania was mentioned as being worth looking at. Maybe we'll make it to Nebraska this year.

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Hey, I'm actually going to be posting a review of Creighton/Nebraska sometime today... the program really impressed my wife .

DianaMD's comments are what I'm talking about when I say that sometimes the name can be overrated.

Like I said before--my brother could've gone to an Ivy League art school. He went to the best art school for him (Pasadena School of Design) which got him to the exact job he wanted-which was to work at Disney in a high position. I'm sure hardly anyone ever heard of that school, but its name within the field for people who actually know it far exceeds that of Cornell or Yale for the type of art he does (video games, movies and animation).

It's not psychiatry, but it delivers the point. There's more to selecting a place than just the name or the "competitiveness". Competitiveness in real terms is simply how many people got accepted over the people rejected--nothing more than that. Several people seem to equate it with other things such as the quality of the teaching, the quality of the graduates etc. There are some valid correlations with the above, but its too simplistic a way to look at it.

Several of the institutions mentioned such as Harvard certainly are great institutions for psychiatry. It certainly is filled with top people in the field, and from Doc Samson's experience was a great teaching institution. However if someone wants to base it all on the name, IMHO they're taking a risk of going to a place where psychiatry department may not match the overall name-brand of the institution. Several institutions are at the top even without being part of a name-brand institution such as U Mass for forensic psychiatry, and in fact far exceed institutions that are in places with more prestigious names. I've also seen some programs at name-brand institutions where I thought their program was actually even on the order of below average.

In NYC-Albert Einstein's program for forensic psychiatry had the best rep among the fellows I've seen from that area. Friends of mine in the NYC urged I go there over the other NYC programs. Take into consideration that Columbia and NYU are also in the same city and also have a forensics program. Merrill Rotter won the best teacher award this year at AAPL, and he's the PD at Albert Einstein. At least for forensics, it's that "placing it all on the name" that could blind someone to a better opportunity such as Albert Einstein.

dianamd said:

Where do people learn this stuff?

Cornell is competitive, but very much self-selecting. They want people who are focused on psychoanalysis/dynamics. But it's not even close to Columbia/MGH/UCSF/UCLA in terms of competition to match there.

Similarly, NYU is not that competitive. The class is huge and they want people who want to work very hard and don't mind being in a little bit of a run-down atmosphere at times (no knock on Bellevue, it's an amazing place, but it's nothing fancy). However, given that it's one of the good programs in NYC, there is a certain degree of competition of someone who'd rather by in New York than even the best program in another city.

Standford is extremely competitive. Maybe it's not as good as Columbia/MGH, but it's extremely hard to match there, partly because they have the added "California factor" that raises a barrier for non-West coasters. Recall multiple people last year got the "we're not inviting you for an interview because we have such limited interview spots and don't know if you'd come out here, but if you are serious about coming to California [lists criteria by which "serious" is defined], then let us know" e-mail from Stanford.

Longwood is not as competitive. It's a great program, don't get me wrong. But if you are a good applicant with a good interview, you can match there. You don't have to be from a top undergrad, a top med school, or have research. Excellent facilities, large faculty, especially for consult-liason. But the Harvard name elevates it more than the actual substance of the program.

And, UCLA - it's highly competitive. It's the best program in SoCal, "the best in the west," whatever you think. That's why the residents there work very hard -- they can afford to recruit 15 or whatever number of people who will smile and work very, very hard (for the first two years - years 3-4 are a cakewalk). Compared to NYU, Cornell, Longwood... UCLA has their pick of applicants.

Think about why not a single Cornell med student matched at Cornell psych last year -- because none of them ranked it first.

Consider that Longwood didn't fill their class two years ago.

Those are things that don't happen to the top top programs.

A lot of comments on these message boards, over the years, seem to simply repeating other people's views about different programs, rather than using real evidence, an insider's view, or from actually knowing the program.

So, for all you applicants, learn about the programs yourself and don't pay too much attention to what you're reading here, especially when you don't know the person writing! Trust yourself!!

Good luck

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Hmm. I agree with your last 3 paragraphs (including "good luck") as well as your assertions that Stanford and UCLA are competitive residency programs, but I'm confident that all of your other comments are either completely wrong or are significantly misleading.

To indicate that I'm not consistently churlish, I do agree with this one (though, to be fair, s/he is referring to the same post but is just more tactful):

Doctor Bagel said:

I love this post just because it shows that no one can state with any certainty what is and what isn't the most competitive/prestigious/"top" whatever residency. People on SDN seem to state these things like they're facts with no supporting evidence. And they state all sorts of other "facts" with an n of 1 about all sorts of aspects of the application process. We all see things in the application process that coincide with our view of how the world should be, not how it necessarily is.

So anyway, big note, if you're worrying because the sdn people don't give nods to your place or imply that you're screwed because you didn't go to a top 25 program (which apparently everyone at sdn went to based on the posts here), don't. No one poster here has any collective view of how the whole psychiatry world goes.

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Dianamd, with comments like that, you must be at Columbia!

One thing I disliked about Columbia and Cornell was how much they badmouthed each other, when (in reality) the residents were all the same Ivy League/AOA types, and the (very psychodynamically oriented) training seemed almost identical in most ways. And they both had this annoying fixed delusion that their training is somehow superior to those of us who don’t train in Manhattan. The Columbia people might have been a little more science-oriented, and the Cornell people a little more humanities-oriented, but all in all, they seemed to get similar training, and similar jobs out of residency.

I know a current Columbia resident whose first choice was Cornell, and a friend of mine at Cornell ranked it below Columbia. And a former attending of mine ranked NYU ahead of both of them. There’s no question that MGH, Columbia and Cornell, Longwood, NYU, and two or three of the California programs are intensely competitive. If you end up at any one of these, you’ll get spectacular training, be surrounded by accomplished residents, and go on to a career doing very similar things to the people at the other top places.

In fact, if I remember correctly, didn’t Columbia’s PD train at Cornell, and Cornell’s PD at Columbia?

I think it's pretty clear that what speak of on SDN is the reputation of residency programs. Most of us interviewed at 8-10, we have friends at 4-5, and we went to 1. We talk to faculty who had these same experiences, and we develop some sort of understanding of what programs are about.

Reputations are like DSM diagnoses. They are somewhat reliable, and only somewhat valid.

To say that reputations don't matter is basically a contradiction in terms. If reputations didn't matter, they would never exist in the first place. They do matter, because there are some people who think they matter.

There are vast numbers of asterisks attached with any of the broad generalizations we make on here.

It's probably true that training at a second tier program (top 25) (as judged by this subjective notion of competitiveness we've put together) can result in becoming just as good a clinician, and even just as good a researcher, as those training at some of these top programs (top 5).

But the fact remains, if you want to wind up at SuperProgramX, you have to be judged by SuperProgramX to be better than a lot of your peers based on whatever weak or strong proxies available. Because getting selected by SuperProgramX is de facto a stamp that you beat out a lot of people for the slot, it becomes inherently valuable if for that reason only. The people who were selected as the best at one point in time become the faculty of the next generation, and the cycle continues. Your peers at SuperProgramX were also judged as being better than other people based on those same weak or strong proxies, and so your resident class is filled with other people who can probably teach you something.

Just because it's not valuable to you doesn't mean it's not valuable. My God, they play soccer in some countries, and I could care less, but I'm not going to say the World Cup is stupid.

A lot of people want to be in New York, Boston, and San Francisco. The slots there are inherently valuable because of that, and it's pretty unlikely that having all of these people who value being better than other people results in a lot of mediocrity.

We all went to medical school. We're already selected to be a bunch of narcissists who have variously learned to thrive with and suppress our inflated opinions of ourselves.

You're good enough, and gosh darn it, people like you. And you don't have to hate on Cornell (or the people who care about being at a place like Cornell) for those things to be true!

billypilgrim37 said:

...You're good enough, and gosh darn it, people like you. And you don't have to hate on Cornell (or the people who care about being at a place like Cornell) for those things to be true!

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And just look at what became of the (midwestern, btw) guy who coined that little catch phrase...

billypilgrim37 said:

A lot of people want to be in New York, Boston, and San Francisco. The slots there are inherently valuable because of that, and it's pretty unlikely that having all of these people who value being better than other people results in a lot of mediocrity.

We all went to medical school. We're already selected to be a bunch of narcissists who have variously learned to thrive with and suppress our inflated opinions of ourselves.

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You don't think that specifically selecting for narcissism can result in a certain TYPE of mediocrity? (Albeit a particularly non self-aware mediocrity?) Generally, just being a narcissist in a popular location does not guarantee a great deal, and anyway, a person's entire residency application is based ONLY on their medical school performance, NOT by and large on their aptitude for research or their likelihood of making a great contribution to the field, since medical school performance does not measure those things. Hence, mediocrity (i.e. being no better than "ordinary") is always a possibility, no matter how many people apply.

nancysinatra said:

You don't think that specifically selecting for narcissism can result in a certain TYPE of mediocrity?

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No.

The narcissism is a constant here. We were all a bunch of medical students in the most self-centered, free-market, pro-self esteem nation on the planet who decided to pursue a specialty generally maligned by our peers which involves seeing the darkest stories of humanity splattered all over triage sheets.

They're still narcissists at Iowa and Mayo (perfectly wonderful programs, of course). It's just that very few people at these places had to beat out people who would rather have wound up at MGH. You can say that medical school performance doesn't measure X, Y, and Z, but that's so painfully obvious I don't know why we'd bother talking about it.

Listen, I'm not at the most prestigious program. I picked a place that I thought could train me to be a great clinician with all the resources I wanted to pursue a research career in a town where I wouldn't have to live in a closet. But I don't have to comfort myself that somehow I'm better than folks that recognized that there are very special psychiatric communities in some of the bigger cities, and there are a lot of very talented people that want to be a part of those communities, and winding up at those places required somehow showing that you were more deserving of that position than some other people who wanted to be there.

So if all that doesn't matter to you, great! It apparently didn't matter enough to me to make me rank some other programs higher than the program where I'm at now, which I am extremely happy with. Being happy with where you are and with your own priorities does not require that you belittle others who have different ones than you do. You don't have to pretend that the names 'Harvard' and 'Columbia' don't matter, because to some people they matter a lot, and to some people they only matter a little, but they all still matter, if only evidenced by the fact that these populist "names don't matter" threads pop up every few months and drag on with people like me ranting ad infinitum.

I apologize for bumping a week old thread, but I kept up with this on my iphone while traveling and had some thoughts then. You know, no one is saying that reputation doesn't matter in certain circumstances and that people are bad for caring about that in a residency. However, no one seems to be able to state with any accuracy what programs have a better reputation outside of maybe the top 2 or 3 since we're all influenced by regional and personal biases. This was evidenced by the person above who mentioned all Cali programs in listing the most difficult ones to get into. And the programs Sneezing mentioned are reputable programs that can get you tons of research exposure and an academic career, but no one mentions them in these lists because they're not in the NE or California.