Let the ranking begin...

[atethesun]

Right, I think Case Western would give a more well-balanced training while Cincinnati would only provide a better training in child psych. I remember a resident telling me that 40% of all inpatient childpsych cases in US are managed at Cincinnati.
I do agree with your opinion on the buildings. University Hospital looked beautiful and their cafeteria looked amazing. The resident tourguide said she thought they have real birds inside the hall.

What about city-wise, which city do you guys think is better (more wholesome)? I hear Cincinnati has a lower crime rate than Cleveland near their respective main campuses.

Right now, I might have a major shift in my ranklist due to a recent development in my family (gotta stay closer to home) and these programs in Ohio and Illinois are within driving distance to home.

I don't know anything about Cincinnati, and I can only comment on Case Western from my interview impression - but it certainly did make a good impression. The program director was extremely helpful and seemed dedicated, as did the assistant program director. University Hospital, where you do internal medicine, is really quite a beautiful building, and must be a great place to work. Additionally, if you are interested in Child Psych, their wards are in the same complex and looked really fantastic.

The disadvantages I would think could come in if you had strong research interests. My friend interviewed their in neurology, and seemed to think they had great clinical as well as basic neuroscience research, which suggests their would be scope to get involved with this kind of thing, but it doesn't come across as being a strong point.

---

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[psychphan]

Well that doesn't make sense. U must mean in Ohio, not US.

 

[pingouin]

Well that doesn't make sense. U must mean in Ohio, not US.

No, I've heard the same stat. Apparently the combination of large number of beds, status as a quaternary care center for child psych/treatment refractory referrals, and relative short length of stay contribute to this. I don't have confirmation that the 40% is correct, but I'm positive that atethesun has correctly quoted what has been reported by UC.

 

[TexasPhysician]

No way UC hits 40% of US.

 

[classof2011]

Is anyone else having the problem program "A" #1 the rest tied for 10th? Sighhhh.

I think the more common problem (at least at my school) is 2 tying for the #1 spot and 3 through however many you have falling into place being a much less daunting experience. We have too much information at this point, knowing that you are very likely to get your first choice. Sticking to a number 1 has not proven easy....

Anyways, I just went ahead and told a program I was ranking them #1 just to relieve myself of (insanely) going back and forth between chosen one and another close 2nd.

I'd be happy at either, and nothing stays on the list that I wouldn't still be very happy to attend.

I'll post my ROL soon!

 

[psychphan]

No, I've heard the same stat. Apparently the combination of large number of beds, status as a quaternary care center for child psych/treatment refractory referrals, and relative short length of stay contribute to this. I don't have confirmation that the 40% is correct, but I'm positive that atethesun has correctly quoted what has been reported by UC.

Well I'm calling bull**** on whoever told you two this stat then. It doesn't make sense on a number of levels. Further proof that 87.2% of all statistics are made up.

 

[bestcoast]

Well I'm calling bull**** on whoever told you two this stat then. It doesn't make sense on a number of levels. Further proof that 87.2% of all statistics are made up.

I too have heard about it from one of the senior residents who will join the program as an attending next year (the one who used to play guitar with Jack White <--- just this fact alone is bumping the program up a couple spots for me ).

Although it sounds extraordinary for a single hospital to cover 40% of all inpat cases in US, it is possible if all the stays are very short and they do have a large inpat child unit (a HUGE unit with HIGH turnover = lots of patients).

 

[billypilgrim37]

I too have heard about it from one of the senior residents who will join the program as an attending next year (the one who used to play guitar with Jack White <--- just this fact alone is bumping the program up a couple spots for me ).

Although it sounds extraordinary for a single hospital to cover 40% of all inpat cases in US, it is possible if all the stays are very short and they do have a large inpat child unit (a HUGE unit with HIGH turnover = lots of patients).

They have 69 beds total with an average length of stay of 8 days. We have around 60, though our average length of stay is probably closer to 10-14 days.

So if they have 40% of the psychiatric admissions, then my program has about 25% of them.

There are probably another 20-25 beds in the area that have much shorter lengths of stay, that might be another 15%.

So basically, you're saying that Cincinnati Children's has 40% of all admissions, another 40% of them are in my current city, and the rest of the country has only 20% left, well my friends, I believe this is the definition of a bull**** claim.

 

[Leo Aquarius]

If UC sees 40%, then my name is Santa Claus and we're all related to Kevin Bacon. (Well I guess my name really could be Santa Claus, some people have that name.)

 

[HCE]

depending on how many steps you want to go, we are all related to Kevin Bacon. I'm just saying'....

 

[atethesun]

They have 69 beds total with an average length of stay of 8 days. We have around 60, though our average length of stay is probably closer to 10-14 days.

So if they have 40% of the psychiatric admissions, then my program has about 25% of them.

There are probably another 20-25 beds in the area that have much shorter lengths of stay, that might be another 15%.

So basically, you're saying that Cincinnati Children's has 40% of all admissions, another 40% of them are in my current city, and the rest of the country has only 20% left, well my friends, I believe this is the definition of a bull**** claim.

I agree... Something doesn't add up....

 

[psychphan]

I too have heard about it from one of the senior residents who will join the program as an attending next year (the one who used to play guitar with Jack White <--- just this fact alone is bumping the program up a couple spots for me ).

Although it sounds extraordinary for a single hospital to cover 40% of all inpat cases in US, it is possible if all the stays are very short and they do have a large inpat child unit (a HUGE unit with HIGH turnover = lots of patients).

If the unit is 8,000 beds, runs at full capacity and has a 3 day avg length of stay.

 

[classof2011]

.

 

[splik]

I would say you are trying to escape the cold weather of the northeast!

 

[classof2011]

I would say you are trying to escape the cold weather of the northeast!

More like the Cold(er) personalities of the NorthEast. One thing I've come to know is that (for better or worse) NE programs have a very different feel to them compared to Southern programs of comparable caliber. I did not see how I could be apart of many of the more northern programs and chose not to rank most of them..

 

[splik]

glad to see someone else is going on gut feeling etc and not just 'prestige' etc although you have a great list and because they are not all north east programs a bit less competitive so am sure ranking 6 will do you fine.

In the end I decided to rank the program I thought I would be happiest at #1. And to think I had never even heard of this program in September and would not have even applied there (late) if my advisor had not suggested I should.

 

[tensin79]

Any advice would be helpful.

Have to choose between these two (distance from family is not an issue)

Westchester NYMC and Hawaii

Both are in very different places with slightly different focuses regarding psychotherapy and research.

Just wanted to see what people thought

 

[splik]

where would you prefer to live? personally I would rather live in Hawaii than westchester any day (the weather is nicer!) but there is definitely a claustrophobia associated with being trapped on a small island. not for everyone (where you would go on vacation isnt necessarily where you would want to live). If you are interested in addictions, public health, cross cultural psychiatry then Hawaii is great. If you want psychoanalysis then westchester.

 

[classof2011]

where would you prefer to live? personally I would rather live in Hawaii than westchester any day (the weather is nicer!) but there is definitely a claustrophobia associated with being trapped on a small island. not for everyone (where you would go on vacation isnt necessarily where you would want to live). If you are interested in addictions, public health, cross cultural psychiatry then Hawaii is great. If you want psychoanalysis then westchester.

Great Advice...I would also be careful with how you consider programs that may be very selective in their training approach. For example, many would be concerned that Hawaii's program may prepare you to be a beast at treating that particular population, just as many NY programs claim to do a great job at preparing residents to practice in NY. Im not suggesting that you'd be hopeless in NY if your training was in California, but sometimes this can be like trying on your girlfriends shoes; It will work at the end of the day but it might not ever feel as comfortable (for some).

As a disclaimer I know very little about either program and am just talking out of the side of my lip. One thing I do notice about my rank list, however, is the similarity in style and how training at any of them could provide me with confidence in practicing at or near the others (on my list)....

 

[MiddleRoad]

What do you all think about Cornell?

My impression:
I liked the residents, the balance of sites between PW in Manhattan and the Westchester residential hospital, the rigorous training ethos, the strong psychodynamic training, the guaranteed housing options, and the sense that it would be a great springboard for practicing in Manhattan.

I'm wondering what the reputation of the program is around the country. Would the name help for getting fellowships? Does anyone have any anecdotes, positive or negative, about the program?

 

[splik]

The cornell residents I've met have been very impressive and seemed very happy with their choice. It is probably the most shamelessly analytic program in the country (more so than Columbia or Cambridge) but they have some pretty strong neuroscience work going on so I can't imagine you wouldn't get good 'biological' training (whatever that means). The vast majority end up in New York, either for fellowships, private practice, or on the faculty of one of the major hospitals. It is quite common to have a small private practice on the side during fellowship.

The post-residency placement list is here: http://www.cornellpsychiatry.org/pdf/Post-residency_plans_2011-2012.pdf - As you can see they have no problem getting top fellowships across the country but most prefer to stay in NYC.

 

[atethesun]

....

 

[psychphan]

glad to see someone else is going on gut feeling etc and not just 'prestige' etc

I think once rank lists start being posted you will see more and more of this. I'm still interviewing, so haven't finalized a rank list yet, but I have a pretty good idea of where programs will end up on my list and I'm guessing an outsider who looks at it will definitely be confused by some of my choices.

 

[digitlnoize]

I think once rank lists start being posted you will see more and more of this. I'm still interviewing, so haven't finalized a rank list yet, but I have a pretty good idea of where programs will end up on my list and I'm guessing an outsider who looks at it will definitely be confused by some of my choices.

Agreed. Just finished my last interview, and am trying to figure out my rank list now. It's really tough, but it's starting to come together...It would definitely not make any sense to an outsider...

 

[DandelionMed]

I can't even really say my list is getting closer to coming together....

I've known for months what my number one would be, but the order for two through eight is in complete chaos. One version of the list heavily favors academic opportunities; the other version heavily favors location...

One day I think I've decided for the more academic list, the next I feel completely confident that I should just go with location...

Today is an academic opportunities day, so I suppose I can predict my final list by looking at what the every other day alternation will be on when February 22nd hits

 

[psychphan]

Well at least you know your number 1. You could just only rank that one, then you wouldnt have to worry about figuring out the rest of it.

 

[DandelionMed]

Well at least you know your number 1. You could just only rank that one, then you wouldnt have to worry about figuring out the rest of it.

Sounds a little risky....

 

[digitlnoize]

Show of hands:

Who has made (or will make) a spreadsheet to help them decide?

 

[DandelionMed]

Show of hands:

Who has made (or will make) a spreadsheet to help them decide?

To be honest, I've never felt like spreadsheets, pro and con lists, etc. actually help me.... I know what I like about X program and what I like about Y program, but tallying them up just doesn't seem to get me much further than that....

I've heard of people with complicated spreadsheets with different weightings for different factors, but I don't think I've got enough mathematical capability to make that work....

 

[classof2011]

To be honest, I've never felt like spreadsheets, pro and con lists, etc. actually help me.... I know what I like about X program and what I like about Y program, but tallying them up just doesn't seem to get me much further than that....

I've heard of people with complicated spreadsheets with different weightings for different factors, but I don't think I've got enough mathematical capability to make that work....

...and I highly doubt it made any "significant" difference in said folks experiences by doing so....

GUT reaction is all you need, the things you can put on a spread may follow if necessary but they usually arent.

Im not feeling any more confident about any choices below my numbers 3 in terms of where I'd prefer to end up. In fact, I think I'd feel no different (okay) if I were to end up at any one of them...Now my top 3? Ecstatic! and my number 1? Ready to live out the well pondered ideas that linger in this senioritic brain of mine....

 

[digitlnoize]

...and I highly doubt it made any "significant" difference in said folks experiences by doing so....

GUT reaction is all you need, the things you can put on a spread may follow if necessary but they usually arent.

Im not feeling any more confident about any choices below my numbers 3 in terms of where I'd prefer to end up. In fact, I think I'd feel no different (okay) if I were to end up at any one of them...Now my top 3? Ecstatic! and my number 1? Ready to live out the well pondered ideas that linger in this senioritic brain of mine....

I agree. I really only made one to keep track of all the family related decisions related to this decision (cost of living, crime rates, property taxes, growth, school quality, etc). Still basing the main decision on gut feeling and data gathered at the programs...but I got sick of checking CityData.com a thousand times looking for the same stuff, so I punched it all in a spreadsheet.

 

[Saluki]

I agree. I really only made one to keep track of all the family related decisions related to this decision (cost of living, crime rates, property taxes, growth, school quality, etc). Still basing the main decision on gut feeling and data gathered at the programs...but I got sick of checking CityData.com a thousand times looking for the same stuff, so I punched it all in a spreadsheet.

Things are so much simpler when all you have to consider is your happiness and that of your cat....

 

[digitlnoize]

Things are so much simpler when all you have to consider is your happiness and that of your cat....

True that. Although, I would encourage everyone who doesn't have kids/spouse to pretend that you do...because you probably will by the time you're done with residency.

What type of city do you want to live in or raise a family in? Most psychiatrists wind up practicing in the area they train in (far more than most other specialties, you can dig up the report yourself...AMA or something, don't remember).

Anyways, everyone do what's best for you...good luck figuring out what that is. I know I'll need it.

 

[classof2011]

Most psychiatrists wind up practicing in the area they train in (far more than most other specialties, you can dig up the report yourself...AMA or something, don't remember).

Its funny, even though I know this is true I still don't like to hear it. I don't want to know that residency is where I'm most likely to stay (esp since I'm in the momentum of hitting it far). Its scares me just a little.

I wonder if much of it belongs to several factors...

1) we tend to choose (more often than other specialties) where we'd like to train by virtue of non-competitiveness, and that may lead us to make decisions based on geographical preference. Not to mention Psych may be one of the most frequently involved specialties on the female side of couples matching.

and

2) we tend to have more time off (than other specialties) and this confers to having A LIFE, which may involve starting a family and stable lifestyle that may become disadvantaged if one were to consider setting up shop elsewhere (due to schools, spousal jobs, your access to jobs, new friends).

I dont know....but my confounders are pretty strong (and/or convincing) LOL...

 

[nitemagi]

Its funny, even though I know this is true I still don't like to hear it. I don't want to know that residency is where I'm most likely to stay (esp since I'm in the momentum of hitting it far). Its scares me just a little.

I wonder if much of it belongs to several factors...

1) we tend to choose (more often than other specialties) where we'd like to train by virtue of non-competitiveness, and that may lead us to make decisions based on geographical preference. Not to mention Psych may be one of the most frequently involved specialties on the female side of couples matching.

and

2) we tend to have more time off (than other specialties) and this confers to having A LIFE, which may involve starting a family and stable lifestyle that may become disadvantaged if one were to consider setting up shop elsewhere (due to schools, spousal jobs, your access to jobs, new friends).

I dont know....but my confounders are pretty strong (and/or convincing) LOL...

Most, not all. I know plenty who have moved afterwards. In fact 6/6 of those in my med school class moved somewhere else after residency.

 

[digitlnoize]

It's from the AAMC 2008 Physician Specialty Data Report (most recent version).

Found here: https://www.aamc.org/initiatives/workforce/reports/

~55% of psychiatrists practice in the state where they trained.

~55% of child psychiatrists practice in the state where they trained.

I think the reasons are multifactorial.

1. ~55% of psychiatrists are >55yo. It may have been more common to practice where you train ~25-30 years ago.

2. ~32% of general psychiatrists are female...and I guess that means babies? So, they lay down more roots in the community and stay put. Child psych is ~45% female, btw.

3. ~30% of general psychiatrists are IMGs. Perhaps they tend to stay put due to being familiar with the culture in the area they trained, and may be more apprehensive about moving to a new part of a new country...or not.

4. My #1 reason has nothing to do with data or statistics. I think that as psychiatrists, we tend to get more ingrained in the use of community services in our daily jobs. We need these services to do our jobs (at least well) and thus become somewhat dependent on them, especially for the inpatient population. As such, it becomes much more difficult to extract yourself from the area you know.

5. I like the point about us having lives during residency. This could also contribute to our becoming more connected to our communities.

Incidentally, many of the above reasons are also going to contribute to the drastic, growing shortage of psychiatrists. Woot?

 

[notdeadyet]

Another factor is that psych is more referral based than most specialties. Because of the low entry cost, lots of folks go into the specialty with hopes of private practice after graduation. Most of that business comes from word of mouth, so it's a lot easier setting yourself up where you trained and have a reputation than picking up and moving to where you aren't known.

The number of folks going into private practice also skews towards folks staying. Inertia is at play and once you're part of a business,the thought of picking up and starting from scratch is much less appealing.

But the fact that mostq psychiatrists end up where they trained isn't a limiter. Odds are you will, but no one is going to put a gun to your head.

 

[F0nzie]

Most of that business comes from word of mouth, so it's a lot easier setting yourself up where you trained and have a reputation than picking up and moving to where you aren't known.

Even though I love the city I currently work in, I'm considering moving to another city where housing is more affordable. Unfortunately, this transition will make it considerably more difficult to start a private practice because I will not have any referrals to start out. I plan on working several part time gigs and moonlighting in various settings to increase my contacts and referrals. Too bad nobody in our profession uses social media like LinkedIn. How much longer will our profession remain stuck in the last century?

 

[Bartelby]

Even though I love the city I currently work in, I'm considering moving to another city where housing is more affordable. Unfortunately, this transition will make it considerably more difficult to start a private practice because I will not have any referrals to start out. I plan on working several part time gigs and moonlighting in various settings to increase my contacts and referrals. Too bad nobody in our profession uses social media like LinkedIn. How much longer will our profession remain stuck in the last century?

In small town Virginia I have also heard of psychiatrists stopping by with lunch to introduce themselves to local IM and family med practitioners. That lets the person briefly meet you and hopefully has them keep you in mind when a patient needs a referral. Of course it's better if the referring physician has worked with you for years but especially if you are moving into a dry market I can't imagine that doing this would hurt.

Honestly I am relieved that only 55% stay where they trained. From the way many people talked I thought it would be 8 or 9 out of 10 staying put.

 

[F0nzie]

In small town Virginia I have also heard of psychiatrists stopping by with lunch to introduce themselves to local IM and family med practitioners.

I suggested this to my wife who is a child fellow....she felt this was too much like being a drug rep. I have mixed feelings about it. Maybe it's because the drug reps I've seen have had too much plastic surgery and they're always displaying a fake smile. However, food bribery is how drug companies get their products known. When I think about Pristiq or Saphris, I have an image of a nice steak dinner. I have not prescribed them yet though .

 

[psychphan]

1) we tend to choose (more often than other specialties) where we'd like to train by virtue of non-competitiveness, and that may lead us to make decisions based on geographical preference.

This seems to make a lot of sense to me. There are so many good residency programs in any number of geographical locations that are also relatively obtainable. I'd venture to guess that psych applicants, more so than other residency applicants, have the luxury or applying and matching to locations they find desirable to live. Its not like ortho, derm, optho, etc where you take what you can get, live there for x number of years until you complete your residency, then move to a more desirable location.

 

[psychphan]

Just finished up the interview trail, late I know. Now the real work/fun begins. I know my top 3, although Im not sure of the exact order yet. Likewise, I know which programs will be 4 and 5, but not sure what order. 6- however, many I choose to rank, now thats going to be even more difficult. Should be fun though.

 

[Leo Aquarius]

What do you guys think about Harvard Longwood as a balanced program? I thought it had something for everyone when I interviewed there, but can only base this on one day's experience. It's really strong in C/L and has good research opptys built into the curriculum. Wondering how it stacks up against places like UCLA-NPI or even UCSD. Boston is sure cold. Anybody else feel the same or think differently?

 

[MDchouette]

What do you guys think about Harvard Longwood as a balanced program? I thought it had something for everyone when I interviewed there, but can only base this on one day's experience. It's really strong in C/L and has good research opptys built into the curriculum. Wondering how it stacks up against places like UCLA-NPI or even UCSD. Boston is sure cold. Anybody else feel the same or think differently?

I sent you a PM.

 

[notdeadyet]

What do you guys think about Harvard Longwood as a balanced program? I thought it had something for everyone when I interviewed there, but can only base this on one day's experience. It's really strong in C/L and has good research opptys built into the curriculum. Wondering how it stacks up against places like UCLA-NPI or even UCSD. Boston is sure cold. Anybody else feel the same or think differently?

If you're interested in ultimately practicing on the east coast, I'd go Longwood. If your goal is to settle on the west coast, both are good programs. UCLA wins on zebras and national rep, UCSD wins on public psychiatry and veterans. Any of the three would have the potential for fine training...

 

[Saluki]

It's interesting... Maybe there are just fewer of us to begin with, but it seems like we don't have nearly as many Program X vs. Program Y threads as I remember from the med school application cycle on SDN....

Maybe I'll post one in a week or so if I don't get closer to a decision on how to rank the programs from number two on.....

 

[digitlnoize]

It's interesting... Maybe there are just fewer of us to begin with, but it seems like we don't have nearly as many Program X vs. Program Y threads as I remember from the med school application cycle on SDN....

Maybe I'll post one in a week or so if I don't get closer to a decision on how to rank the programs from number two on.....

I think it's just too early. I know that I am having difficulty with my #3/4 spot. Two programs tied right now, and not sure which to do.

Going to try and sort it out over the next couple of weeks...gulp!

 

[pingouin]

Maybe we've just learned to hide our neuroses better than them....

Novel concept, I know, but I have an in-person meeting scheduled with my advisor to review my rank list and discuss some pros/cons that might shift things up and down. I have my #1, my #2-4, #5-7... but I need to figure out orders within those groupings.

 

[Saluki]

Maybe we've just learned to hide our neuroses better than them....

Novel concept, I know, but I have an in-person meeting scheduled with my advisor to review my rank list and discuss some pros/cons that might shift things up and down. I have my #1, my #2-4, #5-7... but I need to figure out orders within those groupings.

I've met with the person at my school who meets with all the outgoing grads about matching, an adult psychiatry professor, and a child psychiatry professor about my debates on my list. All three of them gave me different advice (my family also did, though that was unsolicited), so now I'm scared to ask anyone else lest I get a tenth differing opinion

 

[classof2011]

I think it's just too early. I know that I am having difficulty with my #3/4 spot. Two programs tied right now, and not sure which to do.

Going to try and sort it out over the next couple of weeks...gulp!

I think that if they are THAT difficult to untie, it shouldn't matter where you place em. Getting a letter from either wouldn't make you feel any different on match day. That is if you have gone through what ties them (thoroughly).

Put em down and keep it moving...