Would appreciate any thoughts on my program choices now that I am done with interviewing!
My interests: Academic medicine, child psychiatry, medically complicated patients with psychiatric illnesses/integrated care/CL
First of all congrats on interviewing at all these great programs. I am certain that any one of these programs will give you great opportunities. I also had an interest in C/L and medical aspects of psychiatry so can speak to that. I don't really know that much about child psychiatry.
It sounds like you liked UW the most, then Longwood, then Hopkins, then Yale. It sounds like location is very important to you and that has influenced this order. UW is the #1 place far and away for IntegratTED (rather than integrative*) care, and in particular has rolled out the collaborative care model across the country, and now in the developing world. The entire department's primary research focus is on health services research and the clinical services at the UW are around this sort of model. The C/L requirements of 5-6months are more than any other program (includes all the different hospitals, and outpatient consultation), and many residents elect more. Outpatient C/L includes psycho-oncology, HIV, women's health, maternal infant care, pain, cardiology, family medicine, diabetes, general medicine, epilepsy, geriatric medicine, internal medicine, international medicine clinic etc. There is also the fairly unique opportunity to do child C/L as a psychiatry resident if that is your thing. There is a specific integrated care pathway for residents interested in carving out a career in this sort of thing, as well as a research and teaching scholar's pathways for those interested in academics. It is also the only one of the programs mentioned about that will let you have a month of elective time for academic pursuits in intern year (and nothing to stop you making a vacation of it). You are also allowed a MINIMUM of 1 week educational leave a year (I actually have 4 weeks educational leave in addition to vacation as a PGY-2).
The schedule isn't night float heavy (there are 2-3 weeks in PGY-1 year, and 6 weeks in PGY-2). This is less than at Longwood I think or about the same. Also night float is MUCH better than non-nightfloat and you can split it up however you like - i.e. do a week at a time, or three weeks at a time, and have a say in when you would like to do it. From PGY-2 nightfloat is HOME CALL and 40% of the time you dont get called in. sometimes you don't even get paged. at all.
Partly because it is the only residency in town and for 5 states there is the largest array of elective opportunities beginning PGY-3 of any of these programs.
It is true that many residents are outdoorsy and like climbing, camping, kayaking, doing triathalons etc but there are also more indoor creatures and those who just like to get fat at the many great restaurants, drink craft cocktails at the bars, watch random movies (SIFF is the largest film festival in north america), go to the theatre, enjoy the parks, explore the bookstores, lounge around drinking coffee etc.
I think Longwood is a great program and has an excellent C/L service and training though it is less than at UW and only at BWH. I like David Gitlin who runs the C/L service there. Boston is also a great city. I think they do work harder than the UW residents. I think your concern about competition for resources is baseless - there is NO competition between residents at different programs, they are mostly their own entity. Also the faculty, busy as they are are very happy to meet with you and discuss research opportunities etc. At least this was my experience and I wasn't even a Longwood resident. They do have less elective time than other programs, and the PGY-3 year is not all outpatient and has consults, geriatrics etc built in, and there is something to be said to having a full-immersion consults experience which they don't have.
I personally think that Hopkins offers the best clinical training in the country for psychiatry and offers the widest array of basic training including eating disorders, pain, neuropsychiatry, paraphilias as part of the standard training of psychiatrists. I think you will find your concerns baseless about the training not translating elsewhere, on the contrary you get an excellent training that is well respected everywhere. I put them last on my rank list however because 1) it's in Baltimore; 2) they work REALLY HARD; 3) they are very inflexible in their training model, with only 6months of elective time; 4) they have too much of a bio-behavioral model. It is true that psychodynamic therapy is de-emphasized, but in reality NO program is going to train you to be truly competent as a psychotherapist as part of the core curriculum and you will have to elect further training if this is what you want to do. The other criticism I have heard is they pander to the rich and despite admitting patients from the deprived surrounding area the level of care they offer is not uniform, which is to say those who can't pay don't get as good care which can be uncomfortable when you have all these patients in the same setting.
I think Yale is a wonderful program and they have made all sorts of changes to make themselves more attractive to residents as they had historically struggled to get the caliber of residents they wanted (such as increasing the pay, cutting call, sponsoring H1 visas). C/L psychiatry is weak here for an academic department, and although they are working on this with Paul Desan who was recruited a few years ago, it is marginalized within the department. Like you say for many people, myself included, New Haven negates many of the positives on offer, and is why they had a hard time getting the residents one might associated with a 'big name' like Yale. There a few better places to launch an academic career (if by this you mean research) however give the deep bench, ridiculous amount of federal and private funding trickling through, and large number of researchers here.
*integrative care is about homoeopathy/acupuncture etc!