4. Program Overview: The facilities at University Hospital seem nice but the psychiatry program itself is very average, even for midwestern standards. Generally nothing stood out about the program apart from forensics where it is strong thanks to Dr. Resnick. It is slightly more academic than MCW but not by much (and that is not saying a lot since MCW is a community program and does not have very good didactics). The department is also relatively small and has very few faculty involved in research. They mentioned that their main focus now is community psychiatry, but then I learned that they ship most of the uninsured patients to the other program, MetroHealth. That seemed contradictory, and also meant that the clinical experience here would be highly limited. Neuroscience also seemed to be far removed from the psychiatry department and appeared mainly to be the forte of the neurology department. Overall, it seemed like the program was completely dwarfed in all ways other than forensics by Cleveland Clinic locally and University of Cincinnati and Ohio State University in state.
5. Faculty: Unlike many of the other departments here, the faculty in the psychiatry department are not well-published or well-known. But the few I met on interview day seemed nice. The program director, in particular, was very warm.
6. Location & Lifestyle: It is Cleveland. It is cold and grey most of the year, and with the lake effect, also snowy. There is not much to do here either. But there are some theater and music for those who are fans of the arts.
7. Program Strengths:
- Forensic psychiatry
- Warm PD
8. Potential Weaknesses:
- Limited clinical exposure
- Average faculty and didactics
- Sub-par neuroscience training
- Very few research opportunities
- Cleveland: cold & dreary most of the year
The following response to the above post is by a current resident at the program who wishes to remain anonymous.
This post shows a few significant incorrect perceptions about our program. First, we do not "ship most of the uninsured patients" to Metro. I assume that Psychedelicious, being a residency applicant, is thinking mainly of what his experience on call and on inpatient psych will be like, and thus, what will happen when he is asked to see a patient on call and decides to admit them. Will they be admitted to UH? What you might not know is that if a patient is uninsured, the
only hospital they can be admitted to is the state hospital, Northcoast. This is true no matter which ER in the city they are seen in, including Metro's. The exception to this would be if the patient is "rated" at Metro; getting rated is something an uninsured person can do and it involves an application process. So a new presentation to the ER is not going to get admitted to Metro; they're going to get admitted to Northcoast. And to my knowledge none of the residency programs in Cleveland entail doing routine rotations there. When you see a patient in the ER, you decide whether they need to be admitted or not. If they need admission and they have insurance (any insurance, including Medicaid,) and there are beds at UH, you admit them there. If not, a citywide centralized referral service finds them a bed at another hospital. This is something Metro or Cleveland Clinic residents have to deal with just as much; if they see a patient who needs admission on call and there are no beds in their own hospital, they have to send them somewhere else.
Second, with the Medicaid expansion, anyone can apply for Medicaid solely on the basis of income, so a lot more of those poor and indigent people now have insurance.
Third, if you think seeing only the insured means "limited clinical exposure," you'd be wrong. At UH, you'll see people from all walks of life and all races, from comfortable middle-class housewives to impoverished people who sleep under a bridge. Actually, I'd be more concerned with "limited clinical exposure" at a place like Metro, where there is a strong bias toward the poor and not much in the way of experience with middle-class people.
Fourth, and I think this is reflective of your bias as a fourth-year medical student looking toward inpatient, "community psychiatry" is mainly an outpatient phenomenon. It is not contradictory of our program to emphasize community psychiatry while not having a unit where those with no insurance can be admitted. Everyone does a longitudinal clinic at a community psychiatry site starting 3rd year, where you will have your own case load of patients in the community system, many of whom are homeless and/or uninsured. If you happen to see one of your patients in clinic and decide they require admission, and they don't have insurance, you're going to have to send them to St. Vincent's Charity Hospital's city-sponsored psych ER, from which they will be admitted to Northcoast. Again, this is as true of Cleveland Clinic and Metro residents as it is of us (unless the Metro resident is seeing a patient already rated at Metro.)
Fifth, I think it's interesting that you are very focused on experience with the poor and uninsured, yet do not criticize Cleveland Clinic in this regard. I don't want unnecessarily to badmouth another institution, but it is the Cleveland Clinic, not UH, that has a reputation (in Cleveland and beyond) of avoiding at all costs taking on patients that will not be remunerative for them.
Sixth, Cleveland is not cold and grey "most of the year." True, it is cold in the winter as in any temperate climate, and the sky is overcast for days at a time roughly November through March. But winter here is only marginally colder than, say, Philadelphia or New York City, and April through October is beautiful. Also, Cleveland's restaurant scene far surpasses what is typical for a city of its size.
Seventh, there are not "very few" research opportunities. True, you will not automatically get sucked into a serious research project as you will at a select few other programs. But a scholarly project is a requirement of our residency. You can get involved in a serious research project if you want; it's just that you have to seek it out rather than having it come to you. Many residents do a literature review for their scholarly project, and many of these have been published.
Eighth, I don't think our department is that small (it's certainly larger than Metro) nor that we have "very few" faculty involved in research. This impression may be an artifact of our being spread out over several locations, an arrangement which unfortunately many psych departments across the nation are stuck with these days.