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Official Inteview Review Thread 2011-12

Discussion in 'Psychiatry' started by splik, 10.11.11.

  1. NoNoNoNo

    NoNoNoNo

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    Thanks so much for your review. I was wondering if others get this impression, or how you got it because I definitely don't have the same one... I know a lot of it is just "feeling," but if you had any way to explain your impression or why that would be that way, that'd be great. Perhaps what type of programs it is and isn't compared to, in that sense. (Or if anyone else has input?)

    Many thanks.
  2. belle54321

    belle54321

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    I brought up this question before on this thread. I did notice that a lot of the residents from Yale end up staying there as attendings or fellows. http://psychiatry.yale.edu/education/residency/about/recentgrads.aspx

    However, I noticed the same thing at Columbia. Granted, I think a lot of people would put Columbia in a different league than Yale. I know Yale has great childs, addiction, and forensic fellowships which would explain why a lot choose to stay. When I interviewed there, one of the attendings said that Yale tends to "grow on" people ( I am assuming she was speaking about the culture there, the QoL in CT (not necessarily New Haven) and the people.) I think others have mentioned that a lot institutions also prefer to hire within since they are familiar with the residents.

    The only thing that is concerning about Yale is the C.L. I was wondering how splik came into the conclusion that Yale's C.L. is a weakness of the program. I only found out about this, because one of residents admitted this to me. He blames this on the lack of C.L. leadership. Also, the PD or aPD didn't really talk about C.L during their presentations. Looking back, I remember Longwood as one of the programs that seemed really strong in C.L. I guess it has to do with the Brigham and the aPD there is a C.L. guy.
    Last edited: 12.20.11
  3. NoNoNoNo

    NoNoNoNo

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    1. interview accomodations/food: dinner at restaurant (wine not included), great food brought in for lunch, LOTS of residents at both
    2. interview day: PD came a slidshow that included interesting personal facts about all of the residents really highlighting her approach,
    3. program overview: seems to not just have rich clients as sometimes stereotyped but also medicaid unfunded etc., multiple clinical sites including private with PER and RIC public(?I think?) and VA(shuttle), seems to be growing department, family friendly, start o/p 2nd year, 3-4 supervisors a week as outpt (dynamic, med, CBT), forensic/addiction/C/L fellowships, residents have bar nights, mostly elective 4th year, psychosocial rehab option, family institute, Wednesdays are fully didactic other than “lightning rounds,” get own office 2nd year,
    PGY1: 3internal/1 med ER/2 neuro, all residents do first 6 months med together, call is a bit confusing but ~PGY2NF (6 wks), senior residents to weekend, call ends winter PGY3 (maybe 6 teaching call after?), PGY3 is 2 call/mo of 12hr wknd shifts, many electives including torture policy etc., 30-50% on to fellowships, down to earth and fun residents
    4. faculty: one of the nicest/friendliest PDs met (came from UIC), some talked higher of other institutions (but mainly outside chicago)
    5. location, lifestyle: beautiful facilities in downtown Chicago, inpt psych units are brand new and the nicest i’ve seen with huge private rooms and midwest landscape murals and lights that change with day (behavioral activation model), don't need car
    6. benefits: 49 -> 56K (highest in chicago), 21 vacation days, 10 sick days, 6 wks maternity, conference presentation money, 165 book fund
    7. strengths: great PD, downtown chicago, lighter call than coasts?, amazing inpt unit, didactic day
    8. weaknesses: psych not necessarily treated extremely well in hospital but brought in new faculty to improve this (i.e. on C/L), cold city, bringing in some new research faculty (though some seem to be using position as stepping stone)
  4. NoNoNoNo

    NoNoNoNo

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    I would be interested in the response too. My input is that the C/L rotation is 2 months and can be done at either Yale or the VA (I think?). I heard people speak highly of the learning at the VA but that the main attending is kind of an acquired taste. At Yale, I would imagine you see A LOT at a tertiary/quat hospital with trauma center in which psychiatry is well-respected and one of the biggest departments. Also seems to be good psychopharm training overall. But I don't know any more than that.

    (I think another thing people talk about re: staying in CT is the fact that people can tend to buy homes and start families during residency that then they get used to and might not feel like moving back to a city at that point? Which is along the lines of what you alluded to.
    Also, even a lot of the med students stay for residency I was told on interview day, so I think that has to do with the place growing on you more than lack of post-residency fellowships or positions.)

    p.s. thanks for the discussions; they're helpful.
    Last edited: 12.20.11
  5. LEdaddy

    LEdaddy

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    I was intending to write exactly the same post and came here to find that you'd written it already. I can't imagine that the Yale name wouldn't be an asset, assuming you're subspecializing in any of the many areas in which they are strong.

    The weakness in C/L came up on my interview day as well. One resident told me that the program wa taking steps to improve this.

    One interesting note about Yale is that it has come up many times at other programs. I've met many residents (at least 4 of them) who went to medical school there but entered other top programs who have a deep affection for the psychiatry department at Yale and Dr. Rohrbaugh, specifically. I have never heard them have any thing but great things to say about it, other than wanting to get out of New Haven.
    Last edited: 12.20.11
  6. NoNoNoNo

    NoNoNoNo

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    1. interview accomodations/food: dinner was small (drinks not included), not very many residents at lunch either but of course this is a small program (6 residents)
    2. interview day: includes going to 2 classes, otherwise normal except for a couple slightly odd/uncomfortable questions (like how much i paid in rent when i lived a certain place)
    3. program overview: small department, accept DOs/IMGs, very family/personal feel, research class and lab requirement, start o/p 2nd year, talk about philosophy and phenomenology, 50% to fellowships, ethics elective/fellowship, medicine is definitely strong focus of hospital, PGY2s get offices, didn’t necessarily connect with other residents but that was likely just me and some were great
    PGY1: 4 months med (hard at quat care; can sub 2 peds), 2 neuro, 2 C/L (hard), 4 inpt psych b/w higher class and inner city hospitals, 1 call/wk short or shift call
    PGY2: 4 inpt, 2 addiction, 2 emergency, 2 community, 2 C/L, ~q7 call
    PGY3: adult o/p with speciality, child, and med psych
    PGY4: required administrative, research, academic, o/p rotations but also elective options (student health, sleep, women, forensic, brazil international)
    4. faculty: lifelong PD, some faculty a bit odd and talked about selves being nerdy
    5. location, lifestyle: no call 3rd (though back up and home as 3) or 4th year, on university campus (reduced fee classes), in hyde park which i was told not to walk to subway after by faculty bc unsafe, but still chicago
    6. benefits: 47->54K, 4 wks vacation, 5 days sick, 4 wks maternity, conference time
    7. strengths: call ends 2nd year, talk about aspects like philosophy etc that other programs may not, family feel
    8. weaknesses: small okay department in what feels like its hiding in intense medical world and hospital (totally subjective), cold city, bad rep on SDN?
  7. splik

    splik

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    I think it is hard to tell, but I like to see a good mix of staying on (which suggests it is a good place to work) and going elsewhere including academics, private practice, fellowships etc. It seems like everyone stays on at yale even for fellowships which aren't as good (e.. psychosomatic - there is no question of course that yale would be great for child, forensics etc) or end up working at some less desireable places. I think if you look at MGH, Columbia, NYU, Mt Sinai, Cambridge, WPIC/Pitt there seems to be a greater mix and it seems residents do very well for themselves with jobs and fellowships. I have noticed a similar pattern for Hopkins as with Yale - lots of people staying on and people going elsewhere but maybe not the best or most prestigious fellowships or working in less desireable areas. It is hard to interpret of course, but I least want to know it is possible for residents to do a variety of things wherever they choose.

    As for C/L- As I am very interested in C-L this is something that is always addressed in all my interviews wherever. This was the first interview I had where I did not interview with a C-L person. The PD did say they had lots of C-L services but they were all disparate and not well integrated but also told me they had hired someone from Hopkins to better coordinate the services and research in C-L psychiatry and that improving their 'psychological medicine' portfolio was the main development they were working on. The residents also mentioned there was a new C-L outreach service which sounded a bit like critical care outreach trying to prevent at risk patients developing full blown acute psychiatric disturbance.
  8. splik

    splik

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    1. interview accommodations/food
    liver here so did not need accom. Pre-interview dinner night before at one of the residents apartments. standard breakfast. Lunch at the Harvard Faculty Club very swish.

    2. interview day -- (e.g. schedule, interview types, unusual questions/experiences...etc. )
    start at the more humane hour of 8.30 with breakfast and talk by the PD and APD, then 2 interviews, then tour of the hospital, lunch, visit to outpatient clinic, 2 further interviews, then wrap up with the PD. I interviewed with director of Psych ER, associate chair (a psychoanalyst), the PD, and a resident. was asked questions like 'have you had any analytic training or read any classic psychoanalytic literature' and PD is known for asking personal and challenging questions but he is like a teddy bear so you don't feel uncomfortable.

    3. Program overview
    PGY1 is 3 months medicine wards, 1 month Peds OR ICU, 1 month neuro (o/p and i/p consults) 1 month behavioral neuro at McLean, 2 weeks med night float, 6 weeks elective (1x 2week 1x4 wk), 1month addiction, 1 month child or adolescent i/p, 1 month geropsych, 1 month community
    PGY-2 - 6 months i/p adult (3 months Cambridge, 3 months Whidden), 3 months partial hospitalization at Mass Mental Health Center (either CBT or DBT), 6 weeks Psych ER, 6 week C-L inpatient, plus 1/2 outpatient for longterm psychodynamic therapy etc
    PGY-3 all outpatient including o/p C-L (either psycho-oncology or HIV), o/p eropsych (e.g. memory clinic), o/p child, psychodynamic, family, group, CBT cases, med management
    PGY-4 continuity clinic and electives

    4. Faculty
    The PD Marshall Forstein is awesome! He is extremely dedicated to the program and to the training of the residents, the APD Matt Ruble is also very friendly and approachable. Did not meet chair, but he has been involved in the Nova Scotia study (epidemiological study into the social epidemiology of mood and anxiety disorders). Many psychoanalysts on faculty. Notable other faculty are Judith Herman (PTSD), Arthur Kleinman (anthropology, moral existence, global health), and Margarita Alegria (multicultural mental health)

    5. Location, lifestyle, etc.
    Cambridge is very cute with tons of stuff to do for a small place, Boston obviously has its attractions, but this is not New York, LA, SF - things close early here and there aren't as many good restaurants as those places, it is relatively expensive, it is ethnically diverse but you wont find a large Black or Hispanic population around here, rent is expensive but gets cheaper the further out from Harvard Square you get. Most residents had a car but driving in the area is a nightmare and it is not necessary to have one.

    6. Benefits
    excellent benefits - 4 week vacation, 15 days sick which can be carried over and used for conferences etc, personal days for bereavement, decent food in call rooms, unionized housestaff, $1900 education budget can be used for personal psychotherapy, ipad, books, flights etc, $700 for Step 3 USMLE/COMLEX, funding for conference attendance, good health insurance, dental plan/vision etc. lots of moonlighting opportunities from PGY-2 onwards; can audit classes at any of the Harvard schools; get benefits of being Harvard faculty; if you have to cover on call for a colleague they pay you!

    7. Program strengths
    apparently 100% residents get their top choice fellowship and land impressive jobs post-residency with almost 100% pass rate on the ABPN exams; excellent didactics; excellent training in psychodynamic therapy, with everyone getting experience in group, family, CBT, classes in IPT, and option to do DBT; strong outpatient C/L exposure especially HIV psychiatry, neuropsychiatry and psycho-oncology; supportive, friendly nurturing environment; elective time in PGY-1; lots of elective time in PGY-4; child psychiatry; emergency psychiatry; working with sick, vulnerable populations; social and cultural psychiatry research; program coordinator is very nice

    8. Potential weaknesses
    no VA, no tertiary experience (except behavioral neurology at McLean), outpatient rather than inpatient C-L, does not have the depth of research opportunities as other programs, no call for psych in PGY-1, carry fewer pts than other programs (may have as few as 1 in PGY-1!), ?too much supervision. One thing is there is enough elective time and the program is so well connected you can do research at any of the harvard affiliates or overseas, and also do clinical rotations at any of the harvard affiliates so can make up for perceived weakness (e.g. tertiary C-L if heart so desired)

    Final thoughts
    Cambridge is a magical place that provides excellent training, with possibly the best psychotherapy training during residency in the country, working with a diverse population and a supportive environment but republicans and biological psychiatrists should look elsewhere!
  9. spinnerette

    spinnerette

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    I still don't understand why UofC has such a bad rep on SDN. Based on feedbacks from other applicants whom I met over the interview trail at top-to-middle tier programs, a good number of those applicants liked UofC. Anyhoo, I'm doing my Chicago interviews in a couple weeks and I will start writing reviews at the end of Feb (hoping to get to 18 interviews if I can work out a doable schedule with my elective coordinators.....)
  10. NoNoNoNo

    NoNoNoNo

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    Gosh, thanks for posting this. Makes me remember how much I like that program and how high up on my considerations it is.

    I know you said that biological psychiatrists should look elsewhere, but do you feel you'd still leave with good psychopharm skills? They seemed to kind of tug on that "myth" during my day, which always worries me a tad.

    Also, I think the thing about 100% fellowships means that they've gotten their top choice out of the interviews that they've gotten. I'm not sure if that ends up being any different, but it could...

    Funny, I got the "wow, amazing supervision, maybe even too much?" vibe, too.
  11. atsai3

    atsai3

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    You would get fine psychopharm training at CHA.

    Match statistics are always conditional on the rank list, which is conditional on interviews received, which is conditional on interviews sought. So any such statistic (e.g., "95% of our medical students get one of their top 3 matches", "100% of our residents match to the subspecialty fellowship of their choice") only means that the student dean or program director is doing her job with regards to career mentorship. A medical school can assure that 100% of its medical students matches to their top #1 choice by steering medical students to only rank programs that are appropriately within their reach. Similarly, a program director can assure that 100% of her residents matches to their top #1 fellowship choice by steering them to apply to fellowship programs that are appropriately within their reach. This statistic is not meaningless, but it is certainly not interpreted appropriately.

    The statistic you should really be interested in is, "What percentage of residents matched to the fellowship of their choice, assuming that they applied to all the programs they wanted to apply to (assuming that these preferences are not shaped by subjective awareness of their competitiveness), assuming they got all the interviews they wanted to get, and assuming they ranked all the programs they interviewed at?"
  12. NoNoNoNo

    NoNoNoNo

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    Yeah, that's what I was trying to point out. Thanks!
  13. LEdaddy

    LEdaddy

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    Thanks for the great review, splik. Now I regret not applying there.

    As far as the fellowships are concerned, my sense from talking to other applicants on the interview trail is that Cambridge residents come from the same pool of competitive applicants that are applying to the other top programs, so I doubt these impressive fellowships results are just based on good counseling about where to apply safely.
  14. NoNoNoNo

    NoNoNoNo

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    Oh, agreed. Just talking about what that phrasing means, in general.
  15. splik

    splik

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    I think you will get good psychpharm training here because the supervision is good and the teaching is good. But the fact is they emphasise psychotherapy training unlike anywhere else- there is more psychotherapy training and you will have to see more therapy cases than at MGH/McLean or Longwood. That is because they believe it is harder to learn therapy and anyone can pick up psychpharm so they spend more time on therapy. Also, because it is a community setting you will not get the experience of the complex (and largely unevidencebased) psychpharm you would get at McLean where they see all the treatment-resistant mood disorders or psychosis, or MGH with the complex OCD patients where you will become au fait with 6th or 7th line agents for these disorders. The PD said 'you won't read the esoteric psychpharm literature here, but you will learn psychopharmacology'

    The reason I said 'biological psychiatrists look elsewhere' is because this is NOT a biological program. Now you will get great therapy training at MGH/McLean but they are a fairly biological department and culled most of their analysts years ago (though they still have John Gunderson etc). The research that happens at Cambridge is sociocultural or dynamic not biological. The grand rounds at CHA are primarily clinical or psychotherapeutic, the grand rounds at MGH or BIDMC tend to be more biological.
  16. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    1. interview accommodations/food
    No dinner, lunch w/ senior resident. Coffee in the afternoon lets you meet plenty of PGY-2s. They send a list of hotel recs.

    2. interview day -- (e.g. schedule, interview types, unusual questions/experiences...etc. )
    Roughly 8:30 to 5, interview group is small at 3 applicants per day. Conversational interviews, nothing out of the ordinary.

    3. Program overview
    See clinical rotations here: http://www.hopkinsmedicine.org/bin/m/d/CLINICAL_ROTATIONS_2011_12.pdf

    I came into the interview day nervous from rumors of malignancy, extremely intense work hours, and dismissal of psychological and social interventions in favor of biological ones but decided to give it a shot given the department’s history and reputation for great clinical care. I am glad I did, as I feel like each of the above concerns was generally mistaken!

    There is a big focus on the “perspectives” approach and an emphasis on making the residents great diagnosticians. The perspectives approach is explained in a packet sent before the interview day (“The education of psychiatrists,” Paul R McHugh and Phillip R Slavney) and basically tries to understand each patient from a disease perspective, dimensional perspective, behavior perspective, and life-story perspective. They do not embrace the biopsychosocial model because it is considered basically too vague to be useful in a clinical setting; however they do value psychological and social interventions as well as biological.

    One advantage of the Hopkins program is the ability to work on multiple inpatient specialty units. Residents get to see pathology in rapid-fire succession in these settings and are overseen by experts in that subspecialty. It was also emphasized that all faculty, whether research or clinical, must attend on the wards at Hopkins (meaning you get to work with the big names in research as well).

    First year is all done at Bayview and the medicine training is more intense than most comparable schools (including 1.5 mo ICU time). The following years are at the main Hopkins Hospital.

    Basically the big advantage of Hopkins is supposed to be getting to see many examples of each type of pathology with true expert guidance. It is also the #1 US News Psychiatry department this year and the #1 US News Hospital 21 years running, and if I am remembering correctly Hopkins Psychiatry was the first academic psychiatry department in the US.

    4. Faculty
    It’s Hopkins, lots of big name researchers and clinicians.

    5. Location, lifestyle, etc.
    The part of Baltimore that I saw seemed sketchy. Lots of homeless people, trash and dirt on the streets, plenty of people randomly spitting on the streets and sidewalks, and smog hanging in the sky. There were also people who looked like young professionals walking about, so it looked like a mix of prosperous businesses and a poor populace. Apparently there are many really nice neighborhoods around Baltimore though, and discussing safety with several residents leads me to believe that if you use common sense, stick to the right parts of the city, and avoid high-crime areas at night you should not run into any problems. The residents seemed to really like Baltimore, talking about the bars, the harbor, biking, outdoors activities, shopping, etc. So while I can’t personally vouch for Baltimore being a great place to live the residents seemed quite happy with it.

    The work hours are tough, especially first year and somewhat in second year, but they don’t seem too out of line with other hardworking programs like Duke or Longwood. Also if you end up staying until 8 or 9 at night apparently so does your attending—they can’t just excuse themselves after rounds.

    6. Benefits
    http://www.hopkinsmedicine.org/bin/w/m/BENEFITS_RESIDENTS_fromTS_5_13_11.pdf

    7. Program strengths
    Excellent exposure to a range of pathology with good supervision on specialty units, great reputation, residents seemed happy with their training.

    8. Potential weaknesses
    Baltimore has a reputation for being a dangerous and poor city, the work hours (though not anomalous) are relatively long, some may not like a full 6 mo medicine including 1.5 mo ICU.
  17. atsai3

    atsai3

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    MGH and Hopkins are tied for #1 this year.
    http://health.usnews.com/best-hospitals/rankings/psychiatry

    Interestingly, on its web site Man's Greatest Hospital touts itself as being the #1 in psychiatry for 16 years running.
    http://www.massgeneral.org/psychiatry/about/newsarticle.aspx?id=2893

    Not that this stuff really matters to people at the level of a resident.
  18. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    Nor to those of us who didn't apply at either school and are just posting anonymously for others. :D
  19. MiddleRoad

    MiddleRoad

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    1. interview accommodations / food
    Took train up from New York and did not rent a car while I was there thanks to the great public transportation. The program provided an extensive list of hotels in Boston with Harvard residency applicant discounts. Typical (decent) sandwiches and cookies served for lunches, pastries and coffee for breakfast. Dinner with residents at hip, high-end restaurant near MGH with delicious food and wine.

    2. interview day -- (e.g. schedule, interview types, unusual questions/experiences...etc. )
    "interview dayS" is more appropriate because it is a two-day affair.

    Day 1 -- starts mercifully late at 10:30 at McLean (need a little extra time to figure out the best way to Belmont if you don't have a car, they provide directions). I recommend the commuter train which stops within walking distance. The day begins with an introduction by one of the chiefs and another senior resident in a conference room. After their brief intros, they asked for any questions from the applicants.
    Lunch was then served in the same conference room and the PD and two APDs joined all of the applicants in the room.
    After lunch, the PD does a thorough presentation about the structure of the curriculum extemporaneously, with a few items chimed in by the APDs. They stress their mantra "never worry alone" to convey that the residents are well-supported and supervised during their training. There were three interviews after lunch. One was with one of the APDs and the others were with faculty members. The interviews were of the typical variety, trying to get to know you, what are your interests, what questions do you have, etc. Once the interviews were done, there was a tour of the McLean campus. After finishing the tour, everybody found their way to the hotel next to MGH for a dinner at a trendy restaurant/bar there called "The Clink" (because the hotel was built out of an old jail). Food began with charcuterie and cheeses and then a prix fixe menu was provided for everyone to choose from. Many residents, mostly PGY 2-4 attended the dinner. One of my interviewers clued me in that as casual as the dinner might have seemed to be aware that it was an extension of the interview. While this is typically the case at most interview days, I think the resident input from the dinner at MGH is more actively considered in the selection process than at some other programs. The night ended and it was time to get to bed to be ready for round 2 the next day.

    Day 2 -- begins at 7:45 am at MGH. Pastries and fruit were served in an old, artifact-filled conference room in the historic hospital building. The PD came in to speak with us once again. Afterwards, another chief resident led us on a tour of MGH. First, the historical, original building with the Ether Dome, where they have ground rounds. Then the modern MGH complex, including the psych ER and the outpatient offices where residents see their patients.
    3 more interviews followed, with faculty and one with the PD. She asked a few questions to get to know you better (hobbies, how you cope with stress, etc.), but nothing unusual or pointed in her approach to interviewing. The faculty interviewers seemed to be selected to match the interests of the applicants and included some of the leading experts (both in research and clinical areas at either MGH or McLean). After the interviews, there was a final lunch during which more residents came to meet, eat and answer any lingering questions we had.

    3. Program overview
    There is a pretty good summary of the specifics of each of the four years on the website. I'll just make a few general comments about the more unique aspects of the program. The most salient characteristic is the split time between MGH and McLean. MGH gives you the clinical experience of a major tertiary urban hospital, while McLean offers the experience of an entirely psych focused institution in a bucolic, multi-building campus. The patients at McLean come from around the country and the world. They are typically insured and/or rich. There are buildings devoted to different pathologies/conditions including one of the few inpatient OCD units. There is a lot of research going on at both McLean and, obviously, at MGH as well. Residents choose to see their longterm psychotherapy patients at one of the two sites (there are advantages and disadvantages to each.)
    Research is generally encouraged in the program, but not required. There is a research track with protected time for those who want to pursue it. There is also a psychotherapy-oriented track, which allows those who are interested to get more supervision and time in their schedule for training. The sense is that there are tons of opportunities for residents to pursue whatever interest they might have because there is probably somebody working within that area of interest in the institution. The residents do have a fairly demanding clinical schedule, so the most difficult thing is juggling all of these potential responsibilities, especially when your time is divided between two different clinical sites that are not close to one another.
    One note about intern year: Medicine is done either on the wards at MGH or at Newton-Wellesley, a community hospital. Residents can indicate which of the sites they'd prefer, though the majority end up at Newton-Wellesley.

    4. Faculty
    There is a very large faculty between the two institutions. Lots of cutting edge research (PD mentioned 100 million dollars a year in grants). An impressive group.

    5. Location, lifestyle, etc.
    Boston has a lot going on. Arguably an easier place to live then NYC, but lacks the cultural variety and scope of NY (or is that just my New York bias shining through). Lots of smart people around, plenty to do, nasty winter weather. I think many who read this have probably spent more time in the city than I have, so I'll leave it here. Point is that the residents seemed to be satisfied with what the city had to offer. They conveyed that it is a psychiatrist-friendly town, full of shrinks everywhere, yet there always is room for more graduates from their program to either get jobs as attendings or open up successful private practices (or both).

    6. Benefits
    Good benefits that match the salary, vacation etc. of the sister Harvard programs, as far as I can remember...

    7. Program strengths
    Strong clinical experience at both MGH and McClean. McLean is unique (the environment, the variety of patients, the unique quality of the treatment units), perhaps most like the Westchester hospital at Cornell or Sheppard Pratt in Maryland (?). Endless opportunities for research (and protection for this if you are so inclined). Very solid training in psychotherapy with extensive supervision and an association with the psychoanalytic centers in Boston. Does seem like one can get a very balanced education there. A few of the research-oriented residents suggested that they specifically chose the program because they knew that they would leave with a solid clinical foundation if they trained there. Overall, the residents seemed friendly, approachable, congenial with each other, and happy with the faculty. Great fellowship placement. PD rattled off a list of where former graduates had gone recently around the country, many of whom left residency to go right into leadership positions at other programs. PD has been there for many years and seems to be involved and program seems to evolve (recently added new track).

    8. Potential weaknesses
    No VA. Some residents complained about the split service between McLean and MGH, where the travel time for didactics or other required activities was burdensome (there is no shuttle between the two hospitals!). Heard that some of the research mentors use the residents to get projects done, write papers for them, etc. rather than support independent research projects (not sure of the truth of this because they certainly didn't seem to have any shortage of residents who were conducting impressive research). Heard some rumblings from applicants of possible malignant underside, but, if this is true, they did an amazing job of hiding it because there were definitely quite a few residents who actively expressed their love for the program. General vibe is a little more formal, buttoned-up than some other programs (especially vs California). Like all of the equivalently competitive programs in the Northeast (and West Coast), the residents work hard, especially in the first two years. Some residents indicated that the PD and administration were not always fast in response to resident feedback (though they did suggest they feel supported).
  20. splik

    splik

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    It is true that faculty will often use residents to do their donkey work on projects or you may be more of an assistant than a junior colleague but this happens elsewhere, and no one is forced to do a project they don't want. You would do the donkey work on a research project rather than carve out your own because 1) you get the opportunity to work with top names in the field 2) it is easier than making your own project from scratch 3) it is an easy way to get your name on publications. At all of the Harvard programs you will find faculty are very receptive to meeting with you and try and get you involved in research however they are often extremely busy and not everyone will be able to give you the mentorship or time to develop as a researcher. (Although not in the NIH rankings, MGH and McLean together got over $50million in NIH grants this year making them #2 or #3 just behind WPIC and possibly Yale)

    This is a formal program, not just compared to cali programs but also compared to Longwood and Cambridge there is a very different atmosphere. Personally I think the MGH atmosphere is smug, but that is my opinion.

    There is no malignant underside but you will spend 3 years working very hard, there are some huge egos, there is a fair amount of internal politics you get at a large department with so many egos under one roof, and this is not a warm and fuzzy program. The residents at MGH/McLean are extremely intelligent, ambitious, motivated, and driven, and not particularly warm and fuzzy themselves and if this describes you, you will probably do well there. Not everyone is enamoured with the atmosphere but you have to be willing to put up with it knowing that you are getting excellent clinical training and many doors will open for you having gone here.
  21. LEdaddy

    LEdaddy

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    Great additional info! Thanks for adding your thoughts. Have you spent time working or training at MGH?

    I think you got it right about the lower score on the warm and fuzzy meter. I have, however, met many recent graduates and current residents who were very friendly and eager to talk about there experiences there (not unlike residents from some of the warm and fuzzier places). Still, there's no denying the formality that pervades the institution.
  22. Suedehead

    Suedehead

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    The Perspectives is where it's AT!
  23. DandelionMed

    DandelionMed

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    1. interview accommodations / food
    Duke sent a list of recommended hotels. I stayed at the Brookwood, which is literally across the street from the building where you meet up in the morning. There was a dinner at a nice Italian restaurant in Brightleaf the night of the interviews rather than the night before.
    2. interview day -- (e.g. schedule, interview types, unusual questions/experiences...etc. )
    The interview day was busy. After an orientation with the program director, there was an interspersing of three or four interviews with tours and observations of residents at work. Some of the applicants went to the VA; others to the consult service; other to child psychiatry didactics and others to observe the video monitoring of psychotherapy depending on their interests. I think you typically got to observe three different sessions, but it might have depended on how many interviews you had.
    3. Program overview
    The program structure seemed pretty standard. The residents at lunch were mainly upper levels and were unsure of what the first year off service rotations now consisted of, but it seems like there was some choice of family medicine, medicine and pediatrics. All of the residents acknowledged that they worked hard- one mentioned 75-80 on psychiatry rotations first year, but most seemed happy in spite of that.
    4. Faculty
    The faculty seems large. The department chairman was impressive and seemed aproachable. Lots of research going on and apparenty very open to resident participation. The program director seems wonderful-very kind, enthusiastic, interested in helping both residents and applicants reach their goals.
    5. Location, lifestyle, etc.
    I didn't see much of Durham when I was there, but like a lot of Southern cities, it seems like things are more spread out. Fairly inexpensive to live even close to the medical center.
    6. Benefits
    Good benefits, as far as I can remember...
    7. Program strengths
    Strong clinical experiences with lots of research opportunities. Excellent program director. Residents felt that every career door was open coming from Duke. Residents do a lot of observed psychotherapy- individual observed via video feed and family therapy through a one way mirror. Although this could be intimidating at first, it seems like great psychotherapy training. Great consult experience, with close ties between psychiatry and medicine because of the med-psych program.
    8. Potential weaknesses
    High work hours, which could be a strength or a weakness depending on your stage of life.
  24. splik

    splik

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    I don't think the perspectives approach is any better than the biopsychosocial model. It's just another way of conceptualising patients problems that lends itself particularly the a behaviorist paradigm. The main problem with the biopsychosocial model is that it was never meant to be used in psychiatry and it is not particularly holistic or integrative to think about 'biological', 'psychological' and 'social' aspects of the problem and management - in fact I can think of nothing more fragmented and counter-intuitive. The Meyerian psychobiological approach is too fluid and dynamic, whilst the Neo-Kraeplinian approach reifies diagnoses that have been increasingly shown not to be valid in external reality. The psychodynamic approach is largely unfalsifiable, especially the psychoanalytic conceptualisations which can be very tenuous and speculative at best, and fantastical at worst. Behavioral approaches are too reductionistic and ignore the internal word. Cognitive approaches are again reductionistic and mechanistic. Biological approaches don't help us understand the nature of mental disorder. I am inclined to sympathise with social constructivist, social realist and nihilistic approaches but they are not all that helpful in guiding treatment and management when things are outside your control.

    I guess the fun bit of psychiatry is we dont have a unified model of psychopathology so draw on one of range of different approaches that might best explain the person in front of us.
  25. Suedehead

    Suedehead

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    Great post. and fun topic. I dig the Perspectives mostly because it forces us to clarify method. when done right, should mitigate the shooting into the wind approach.

    To keep this in the spirit of the thread, though, I'll say that I'm very attracted to programs that are openly addressing issues of general theory. Most programs (and graduates) accept the biopsychosocial model as given and dismiss the discussion.

    Makes Hopkins sound very interesting.
  26. splik

    splik

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    The programs that seem to discuss this sort of thing in addition to Hopkins are Mt Sinai (they teach perspectives and phenomenology), Harbor-UCLA (teaches phenomenology), Yale and Duke seem to consider different approaches to psychopathology in their didactics. So there are at least a few programs out there that critically engage in this. I cringe when I hear programs talk about having a 'biopsychosocial' approach. Tufts has Nassir Ghaemi so I would imagine they discuss this sort of thing.

    I think all psychiatry residents should read Manic-Depressive Insanity and Paranoia (Kraepelin), Dementia Praecox: or the group of schizophrenias (Bleuler) and at least fliick through the relatively impenetrable General Psychopathology (Jaspers) to at least understand the history of the philosophical development of psychiatry. Madness and Civilization (Foucault), The Myth of Mental Illness (Szasz), Steps to an ecology of mind (Bateson), and The interpersonal theory of psychiatry (Sullivan) give an overview of the social constructivist, nihilistic, and social realist perspectives on mental illness. The Divided Self (Laing) and The Discovery of Being (May) are short reads giving an existential approach and of course Yalom has written his great tomb on existential psychotherapy but I haven't read that (yet).

    I also really like this article by Ken Kendler on explanatory models for psychiatric illness which I think all psych applicants and residents should read.
  27. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Moderator Emeritus SDN Advisor

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    At the risk of being thought pedantic...it's TOME.

    Dr. Yalom is still quite alive, though I suppose if he wished to write his tomb in advance, it would be acceptable...
  28. DandelionMed

    DandelionMed

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    1. interview accommodations / food
    Discounted rate available at the Dahlmann Campus Inn, which was a very nice hotel within walking distance of the medical center. Dinner the night before at a nice restaurant- good breakfast and lunch in a conference room off the cafeteria.
    2. interview day -- (e.g. schedule, interview types, unusual questions/experiences...etc. )
    The interview day was pretty standard: welcome with the program director, interviews interspersed between tours and then at the end closing statements by the chair. I had two interviews with faculty members, two with residents, and then one with the program director. One of the best parts of the interview days is that you are taken to all three main training sites including the inpatient psychiatry ward at the university hospital, the VA, and the area where residents see outpatients.
    3. Program overview
    During intern year, the four months of psychiatry are divided between the university hospital and the VA. As an intern, there is also one month of addictions and one month of consult liaison, both at the VA. There is one month of required emergency medicine, plus the standard medicine and neurology. It looks like people interested in child psych can substitute in one month of pediatrics and one month of pediatric emergency medicine.
    During second year, there are three months of emergency psychiatry; otherwise the rotations in the last three years seem fairly standard. The residents all have their own offices, which are quite spacious in the outpatient building. The program also offers a series of six month intensive psychotherapy mentorships in CBT, DBT, IPT and couples and family therapy.
    4. Faculty
    The faculty all seemed friendly and enthusiastic about the program and about teaching. The program director seems dedicated to helping residents reach their individual career goals.
    5. Location, lifestyle, etc.
    Ann Arbor isn't huge, but because of the medical center and the huge undergraduate university, it seemed to have almost anything you could want. Residents seem happy and cohesive.
    6. Benefits
    Good benefits, as far as I can remember...
    7. Program strengths
    Strong clinical experiences with lots of research opportunities. Enthusiastic program director. Residents felt that every career door was open coming from Michigan; good success in placing residents in good fellowships. Places emphasis on psychotherapy training.
    Beautiful facilities- the outpatient building is gorgeous, the university inpatient unit looks great, and even the psychiatry unit at the VA was really nice.
    8. Potential weaknesses
    Child psychiatry unit apparently is not as nice and did not move with the rest of the services to the new Women's and Children's hospital.
  29. DandelionMed

    DandelionMed

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    1. Interview accomodations/food
    The program mails out a list of recommended hotels with prices and distance from the medical center noted, which was really helpful. I stayed at the Silver Cloud Inn and highly recommend it- nice, close to the medical center, and within walking distance of a little shopping center with restaurants, Starbucks, etc. There was a dinner the night before at a really nice Vietnamese restaurant.
    2. Interview Day
    The interview day began with an introduction by the program director at the main medical center. Then there was a shuttle to Harborview (the county hospital) where there were a few faculty interviews including one with the program director, as well as an interview with a resident or fellow. Lunch was actually the noon conference, so you get to see a bit of the program in action as one of the residents presents a case and topic followed by discussion. In the afternoon, there was a tour of Harborview Medical Center and then a tour of Seattle Children's for the applicants interested in child (basically all the applicants minus one:p )
    3. Program Overview
    The structure of the program is pretty standard, but the program has several different tracks that you can become involved in. Except for the research track, these are less formal but allow you to focus more on career development in areas of interest (teaching, consult liaison psychiatry, etc.) I also think that this program and Pitt were the only two I interviewed at that allowed you to do all four months of primary care in pediatrics.
    4. Faculty
    Large group, seems very friendly and committed to teaching. Lots of research going on in a variety of areas. Everyone gives rave reviews of Dr.Cowley- both the residents in the program and interestingly even faculty members at other programs!:)
    5. Location/Lifestyle
    Seattle is incredible. It's hard to imagine a better place to live for four years, unless rain really troubles you. Good mix of big city attractions and great outdoors activities.
    Residents seem really happy with the work-life balance. During your first two years, you have a mix of night float and weekend shift calls, while in the last two years, you only have a few weekend shift calls.
    6. Benefits
    Seemed standard, though I can't say that I paid much attention.
    7. Program Strengths
    Excellent clinical training. Varied clinical sites- UWMC, VA, and Harborview allows you to see everything. Great research opportunities. Beautiful location. Opportunity to do rotations in underserved areas in the WWAMI region (Alaska, Montana, etc.) Large and well respected children's hospital. Great reputation, especially for C/L psychiatry.
    8. Program Weaknesses
    Seattle is a tad expensive. Most of the children's hospital was beautiful, but portions looked run down. I think we came through in the midst of renovations though. Otherwise, the program is "practically perfect in every way.":love:
  30. DandelionMed

    DandelionMed

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    I also really liked the fact that University of Washington's packet of information included information on where recent graduates are now... It's great to get a sense of what sorts of things the residents do after finishing up....
    Last edited: 01.02.12
  31. DandelionMed

    DandelionMed

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    1. Interview accomodations/food
    I stayed the night before at the Grove Hotel in downtown Boise, which was recommended by the program. This works out really well, because the place where you eat breakfast in the morning is literally across the street. Instead of a dinner, there's a breakfast with the chief resident at Goldy's Bistro, which has the best breakfast I've encountered so far in life.
    2. Interview Day
    At least on my interview day, I was the only applicant there. The day is pretty short- interviews with the program director, assistant program director and one faculty member broken up by a nice lunch with residents and faculty. At the end of the day, the program coordinator actually drives you back to the hotel where you first started. Overall, the interview day was wonderful. The only downside is that since the breakfast is only with the chief resident and the lunch includes faculty, you don't really get a chance to ask questions without someone involved in the selection process present (I think this is actually somewhat inevitable given the small size of the program). I pressed forward with my questions and concerns anyway:p, but it was a tad intimidating.
    3. Program Overview
    The program involves two years in Seattle followed by two years in Boise. During your time in Seattle, you get most of your core rotations taken care of: medicine or pediatrics, neurology, inpatient psych along with addictions, consult liaison, child psych emergency psych, etc. The time in Boise is primarily oupatient, though the program allows residents to tailor electives to their specific interests. Unlike the main track residents, the Boise track residents do not have call during the third and fourth years.
    There is also an option to still fast track into child by doing a year and a half in Seattle followed by a year and a half in Boise. This seems a little crazy to me, but it is an option...
    4. Faculty
    During the first two years, you have all the faculty and resources of the main program. During the second two years, it seems like there is a small group of enthusiastic core faculty supplemented by a variety of psychiatrists in the community that are interested in teaching. Several residents had sought out community psychiatrists focused on areas of interest and developed rotations with them.
    5. Location/Lifestyle
    Seattle is wonderful, and Boise is as well. Boise has about 200,000 people and is right near the mountains. There is skiing at Bogus Basin about twenty minutes away, and it seemed like every resident had a season pass. Sun Valley, the big ski resort area, isn't far away either. In the warmer months, there's lots of biking, hiking, etc.
    It also has an orchestra, hosts a yearly jazz festival, etc. for the more culturally inclined among us:)
    6. Benefits
    Seemed standard...
    7. Program Strengths
    Interesting program that allows you to get the advantages of the big academic medical center followed by work in a more underserved area at a smaller, more intimate program. The program director seemed really sweet and seemed dedicated to building the program. During the third and fourth year, there are a lot of opportunities to develop your own rotations and work in a variety of clinical settings. All of the residents seemed intellectually curious and extremely self motivated. Most seemed to be outdoorsy and had at least partially been drawn to the program because of the location. It was a really warm and friendly group that seemed to be very cohesive.
    8. Program Weaknesses
    As discussed in previous threads, I think the big unknown here is the prestige coming from this program versus the main program. A couple of the past residents had gone on to fellowships at UW (I think in addictions and geriatrics), but it's difficult to tell how the residents would fare applying for fellowships at other institutions or if there were more applicants from the various UW tracks than could be accomodated in one of the fellowship programs.
  32. DandelionMed

    DandelionMed

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    1. Interview accomodations/food
    I stayed at the Bentley Hotel, which is a five minute walk from the medical center. There were some light breakfast items available the day of the interview, and there was a fabulous buffet lunch at the faculty club at Cornell.
    2. Interview Day
    The structure was pretty standard with interviews interspersed with tours and talks. The overview of the program first thing in the morning was actually given by one of the fourth year residents, though later in the day the PD also went over some more specifics about the program. It was great to hear about the structure of the program and the experience from someone who had actually been through the process. I had two interviews with faculty members in addition to the program director, who was very warm and personable. There was also a meeting with the department chairman, who seemed very approachable and interested in the applicants.
    There was also a meeting with the director of the psychopharmacology teaching. I may not be remembering it completely accurately, but I think it works like this: In addition to more formal didactics, each resident picks a patient that illustrates a particularly teaching topic in psychopharmacology (treatment resistant depression, perinatal psychiatry, etc.) Then the residents present about the patients and about pharmacologic options and strategy with a discussion afterwards.
    3. Program Overview
    There are six months of medicine and neurology during the first year with no option to substitute pediatrics. The residents do psychiatry at both Cornell's Manhattan campus and the Westchester campus. There is a car that takes residents back and forth from the Westchester campus. The Westchester campus includes some unique opportunities like a personality disorders unit, eating disorders unit, and a second chance unit for patients with severe and persistent mental illness.
    In the third and fourth years, there are opportunities for electives doing consult liaison at Sloan Kettering and in the oupatient setting working in the Payne Whitney Women's Program for women with reproductive related mental health concerns.
    You spend half of your fourth year working in a leadership role at the Payne Whitney Clinic, which may be the reason that it appears that there is less elective time. But for that time you have several options like consults, inpatient service,and emergency room. This seems like a great way to further your teaching skills and ease the transition out of residency.
    4. Faculty
    Large faculty with diverse interests including both psychodynamics and psychopharmacology.
    5. Location/Lifestyle
    Living in NYC would be quite the transition, but the program offers subsidized housing for residents within walking distance of the medical center. The apartment we saw during the applicant party (pizza, appetizers, etc. at a resident's apartment after the interviews) was really nice albeit small.
    6.Benefits
    Subsidized housing, car to take you back and forth from Westchester units; otherwise fairly standard.
    7. Program Strengths
    Excellent clinical training in both psychopharmacology and psychodynamics. This program does have more of a psychodynamic bent, but I actually was really impressed with the psychopharmacology training. The didactics seemed really well structured, and you have the opportunity to focus on advanced psychopharmacology through the second chance unit, the women's clinic, and through serving as the consultant for therapy patients.
    The residents were all friendly, kind and enthusiastic. It seemed intellectual while still being welcoming. The residents' intellectual interests seemed diverse- a few interested in hard core bench work, a few more in clinical research, several in psychotherapy, and then a few in a variety of more humanities related areas. The history of psychiatry program is incredible- I think there is one resident in a more formal track, but the archives, faculty resources, etc. would be open to any resident who was interested.
    8. Program Weaknesses
    Cornell is not quite as much of a research powerhouse as Columbia, MGH, Pitt, and it does not have a formal research track. However, they seem very open to resident research including giving protected time during the upper level years. There also appears to be some interesting research at Cornell; for instance, the PD was discussing work there using neuroimaging techniques to look at the effects of psychotherapy. Additionally, if residents can't find the particular research area they're interested in at Cornell, they can do research at any of the NYC institutions.
    9. Additional Thoughts:
    Cornell shares a child psychiatry fellowship with Columbia. I'm actually inclined to think that this is a strength, as you get the best opportunities from both programs and some new colleagues in your PGY-4 year.
  33. DandelionMed

    DandelionMed

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    1. Interview Accomodations/Food
    I think I stayed at New Haven Hotel. Nice hotel, just steps away from the interview building and within walking distance of the restaurant from the night before.
    Yale took us out to a nice Japanese restaurant the night before and then a nice Southwestern restaurant the day of the interview for lunch.
    2. Interview Day
    The day begins with a group meeting with the PD and assistant PD where they go over the program. The rest of the morning is then sent in four interviews with some breaks interspersed. Lunch is with the residents. Then there is a tour of the facilities b a the chief residents, a group meeting with the research director, and a group wrap up meeting with the PD. After this there was also an optional meeting for those interested in child psychiatry.
    3. Program Overview
    The program does six months of internal medicine and two months of neurology. The medicine months can be done either at St.Raphael's, a lower key more community based option, or Yale. The most unique part of the curriculum is the three month selective in PGY-2 that you can spend working on almost any academic area of interest. This really gives you a jump start to continue that academic project during your third and fourth years. Your third year gives 20% time for that project, and the fourth year is all elective to allow you tailor the year to your career development needs.
    There are also formal research tracks for both adult and child that need to be applied to separately.
    4. Faculty
    Large, diverse group with lots of research going on.
    5. Location/Lifestyle
    I had heard a lot of people down on New Haven, so I wasn't sure what to expect. I actually was pleasantly surprised. Because of the big academic medical center, there are restaurants and cultural activities galore. The neighborhoods did seem a little patchy where a really nice area with BMWs parked outside was a block away from an area that looked pretty run down.
    The residents work hard but seem to still have a lot of time to explore outside interests. A lot of the residents actually seem to hang out together as well.
    6. Benefits
    Seemed standard to me.
    7. Program strengths
    Excellent clinical and research training. Great child and adolescent training through the Child Study Center, as well as research opportunities there. Protected time for academic activities even if not part of the defined research track. Program really emphasizes developing leaders.
    The residents all seemed really happy, and every one of them seemed genuinely nice. Like one would expect, it's a very academic group where almost every resident seems to have some particular academic niche already carved out. It's difficult to say whether that's something the residents came in with or whether that was developed through the selective time. There were a fair number of bench scientists, but also residents working on cross cultural psychiatry issues, etc.
    8. Program weaknesses
    Most people that I've me on the interview trail have been planning to do child fellowship at the institution where they did residency, and Yale seems like it might be the one place where that could be difficult. The fellowship doesn't actually have room to accomodate all the residents from Yale interested in child psychiatry, and apparently the program also likes to bring in residents from different programs at the fellowship level rather than simply have residents from the one residency (one resident mentioned that several have come from Columbia, MGH, etc.) This probably does make for a more interesting training experience if you can get in, and I'm sure that the residents that can't be accomodated do fine in finding other fellowship slots. But it's not quite the almost sure thing that you find at a lot of programs.
    Last edited: 01.03.12
  34. atsai3

    atsai3

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    The reason is because the Yale child fellowship is more prestigious (however vaguely defined) than the Yale general adult psychiatry residency. Kind of like how going to Cleveland Clinic for cards is much more well regarded than going to Cleveland Clinic for internal medicine residency.
  35. belle54321

    belle54321

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    For some reasons, from reading previous years' reviews, Yale is always one of those programs that seems to get a lot of scrutiny. Although rankings are dubious and controversial, but I think in most applicants' mind, we all have a prestige ranking. Yale seems to be a solid program with good balance of trainings and a mix of training sites. It has tons of research opportunities. The value of the Yale brand seems to come from its medical school more than the Yale New Haven Hospital. It seems most people would say that it is a notch below Columbia, MGH, Cornell, WPIC, UCSF, and a few other programs. Between sandwiched between NY and Boston doesn't help with its recruitment. There is also some concerns regarding the opportunities for its residents once they graduate. Nevertheless, I would be more than happy to match there.
  36. NoNoNoNo

    NoNoNoNo

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    One thing I thought was interesting and seems to counter some concerns about Yale grads having opportunities is Yale gives a list of all the departments at which Yale residency grads are chairs, saying that "no other residency training program in the country has produced more current chairs of departments of psychiatry at major academic medical centers than Yale."
  37. DandelionMed

    DandelionMed

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    1. Interview Accomodations/Food
    I stayed at the University of Utah guesthouse. It's really close to the main medical center, and right near the Trax (Salt Lake City's light rail system that you can take to downtown). There was a discounted rate for applicants. I think the University Park Marriot is just across the street from the Neuropsychiatric Institute, but it's more expensive. There was a dinner the night before with the residents at Squatters Brew and Pub (See, there is alcohol in Utah:laugh: )
    2. Interview Day
    The day began with an overview of the program by two senior residents. This was followed by a meeting with the chairman who seemed very down to earth and friendly. Then there were interviews with a mix of faculty and residents, including interviews with both the program director and the assistant program director. Everyone was incredibly nice, and the interviews were low pressure. At lunch there was a lunch with the residents followed by a tour of the training sites (VA, the neuropsychiatric institute, etc.) Finally, there were interviews with child faculty for those interested in child psychiatry.
    3. Program Overview
    The first year includes two months inpatient medicine at University of Utah, one month inpatient medicine at the VA, and one month outpatient at VA. You can also substitute in one month of ER or pediatrics, but I'm not 100% sure which month it substitutes for. The rest of the structure of the program is pretty standard. The program is fairly small with six residents per year. The department actually has some impressive research going on, but there isn't as much variety of options as at some larger programs. The residents seemed like an interesting mix- there are some residents who probably could have gotten into a very competitive program on the East or West Coast and were drawn by the friendliness and the outdoor activities and then a bunch from the Mountain West.
    4. Faculty
    Slightly smaller group, but seemed devoted to teaching.
    5. Location/Lifestyle
    Salt Lake City is gorgeous!!! At least in the winter, I don't think I've ever been someplace more beautiful. The residents seem like an outdoorsy group. A lot of them go skiing on the weekends, and there are also a fair number of bikers, long distance runners, etc. in the group.
    University Neuropsychiatric Institute is brand new and beautiful. Every patient's room has a wonderful view of the mountains. Almost every room is private with the exception of a couple rooms for patients who would especially benefit from having a roomate. There is a gated area out back, and when I interviewed children from the child psychiatry ward were actually sledding out there.
    The residents all seemed genuinely happy and nice. The group seemed really cohesive. I think there is call throughout all four years, but it still seems like residents have plenty of time to enjoy the city.
    6. Benefits
    Seemed standard...
    7. Program strengths
    Great clinical training with very invested faculty. Child psychiatry and addictions are particular areas of strength. Opportunities to do work with adolescent addiction issue through Odyssey House, which draws children from several states including Nevada. Hospital has a huge catchment area and sees a wide variety of patients. UNI (University Neuropsychiatric Institute) would be a beautiful place to train. Both the program director and associate program director seem great. Salt Lake City is wonderful, especially for those who love the outdoors.
    8. Program weaknesses
    Seems like not as strong of an academic reputation as some other programs out West.
    9.Other Thoughts
    Research opportunities are there, but program generally seems more clinically focused.
  38. DandelionMed

    DandelionMed

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    Me too:D Seriously, though, I think the opportunities for residents all depends on what you want to do. If you want to start a cash only private practice in imaginary wealthy suburb X, I think the Yale name might actually carry one further. Regardless of whether the prestige is mainly associated with the undergrad and medical school most people outside of medicine will not know that.

    For a hard core academic career, going to Columbia or Pitt could be an advantage, but the hard core research places are probably going to care far more about your publication record than the reputation difference between Yale and UCSF. And I don't really see Yale residents having trouble getting into C/L or addictions fellowships at good places if they want to try someplace else after residency.

    The child fellowship thing is a little stickier in my mind. Having to move is a hassle, and it can also be harder to fast track into another institution. Also, if you go from Yale residency to a less prestigious fellowship, it seems like it will be obvious to others that you weren't able to stay at Yale for fellowship.

    All that being said, the other side of the coin is that coming from Yale residency you're still going to be at an advantage applying for Yale's child fellowship, and if it's an incredible enough program that people from MGH and Columbia are leaving to go there, then maybe that's the way to go....

    Oh well- the match gods will sort all of this out for us....
  39. NoNoNoNo

    NoNoNoNo

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    I really love this post. Really.
  40. splik

    splik

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    1. interview accommodations/food
    No accommodation provided. Dinner with residents at a nice gastrotavern. unfortunately program doesn't pay for booze :(. Breakfast was ?donuts no fruit. Lunch was the most disappointing of the interview trail - some sandwiches, salad etc. and only one resident (who admittedly was very nice) turned up.

    2. interview day -- (e.g. schedule, interview types, unusual questions/experiences...etc. )
    Day begins with intro by PD Dr Cowley and then 3 interviews, then a trip to the VA for another interview, then to Harborview (county hospital) for lunch and a tour of the facilities. Then back to UWMC for more interviews (everyone else seemed to go off to Children's so can only assume they thought I really hate child psych!) for 2 more interviews and then a group meeting with the Chair Dr Veith. I enjoyed meeting all my interviewers who tended to be quite candid about the strengths and weaknesses of the program. For example was told 'this is a workhorse program for the first two years' and 'if you want good training in psychodynamics/analytic therapy you will have to get it elsewhere' and 'cohesion is affected by people coming and going and you can go through residency without ever having a conversation with some people if they are not in your class'. Harborview is the nicest county hospital I have seen, it looks more like an art gallery with some fantastic art and breathtaking views of Seattle. The psych wards are a bit shabbier, more like the county hospitals I have come to know and love.

    3. Program overview
    PGY-1: 4 months of medicine OR peds (can do 50:50 or 100% peds), 2months neuro (can do peds neuro or o/p neuro in 2nd year), 6 months inpatient psychiatry (2x 3months including 3 weeks nightfloat). PGY-2 4 months consult-liaison psychiatry (2x 2months), 4 months inpatient psych, 1 month emergency psychiatry, 5 weeks night float, 2 month selectives, 1/2 day continuity clinic with 1 brief analytic case and 1 supportive case; PGY-3 all outpatient including child/adolescent, geriatric, addiction, and various options, plus CBT; PGY-4 all elective except for 1/2 day continuity clinic and 1/2 days o/p consultation-liaison in primary care.

    4. Faculty
    PD Dr Cowley is highly regarded by the faculty and residents, and in fact nationally. She is very experienced and really tries to nurture interests of residents and is very responsive to concerns. Chair Dr Veith seemed nice. They have some big names in the fields of consultation-liaison psychiatry and health services research and also psychiatric epidemiology.

    5. Location, lifestyle, etc.
    Seattle is a beautiful city, and even though it is grey season I still saw blue skies, and amazing sun rises and sunsets with stunning views of the city. There are lots of great bars and restaurants, a major international film festival and a number of art house cinemas, good music venues, a small theatre scene, lots of outdoor activities. It is quite mild, not the most diverse city (mostly white with a smattering of asians and then a bit of everything else), and everyone seemed a bit pale - clearly in need of more sunshine! Seattle is a bit on the pricey side, but much cheaper than Boston, SF, NYC. Residents quoted about $1000-1300/month for 1-2 bedroom apartment. There is a bus system and monorail but you definitely need a car because of the VA and the buses are not as frequent as say in NYC.

    6. Benefits
    Pay is similar to UC programs, but a lot less than many East Coast programs, only 3 weeks vacation, $250 education fund, but there are funds for residents to go abroad, present at conferences etc, 1 week conference leave, usual health benefits. Parking is ridiculously expensive at UW and Harboview. Residents mentioned 'not being allowed' to moolight, but I asked about this and although there is no inhouse moonlighting residents do disability evalutions and can fly to Spokane for the weekend and make lots of money doing that if they wish.

    7. Program strengths
    Strong consultation-liaison psychiatry, collaborative care, geriatric psychiatry, women's health, health services research, psychiatric epidemiology, exposure to underserved populations, rural mental health, telepsychiatry. Opportunities to get strong training in CBT, DBT, IPT, motivational interviewing, Cognitive Processing Therapy and hypnosis. Strong psychotherapy supervision. Opportunities to join informal 'tracks' such as addictions, psychiatry in the medical setting, teaching, clinical research, cross-cultural. Harborview provides excellent exposure to really sick patients. Dr Cowley is probably the biggest strength.

    8. Potential weaknesses
    Did not appear to be cohesion between different classes but within classes there was good camaraderie; UWMC does not have strong general adult inpatient or outpatient mental health services; not strong on basic neuroscience; psychodynamic/psychoanalytic training is weak but improving; too much inpatient general adult psychiatry for my liking; there seem like there are great opportunities but most of it is optional (you could probably get away with seeing 3 psychotherapy cases your whole residency if you wanted or not have much addiction experience if wanted)

    Final thoughts: This is an amazing program in an amazing city if you are interested in consultation-liaison psychiatry, geriatric psychiatry, health services research or working with urban/rural underserved population. However if you would rather talk about erotic transference than the stages of change, would rather practice ivory tower psychiatry away from your medical colleagues, or prefer a small cush program look elsewhere.
  41. splik

    splik

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    1. interview accommodations/food
    No accommodation provided. Dinner before at a restaurant with residents, everything was deep fried! Usual breakfast goodies and lunch was a wrap. Cookies at the end of the day.

    2. interview day -- (e.g. schedule, interview types, unusual questions/experiences...etc. )
    Day started with breakfast then the usual slide presentation by the PD who seemed very tired and bored of her own slides at this end of interview season. Then there was a talk with the new chair. Then I interviewed with the PD and associate PD, the child and adolescent fellowship director, and 2 other faculty. The interview with the PD was a bit strange, and everyone seemed interested in 'why Emory' (this is the first place that asked why so I assume they are really trying to gauge if people want to go there). I have absolutely no interest in child in fact I would rather gouge my eyes out so it was a bit excruitiating pretending to be interested in child with the interview, and this was also the only interview where I did not interview with anyone who matched my particular interests (even though they asked!)



    In the PM we had a tour of Grady and lunch with the interns and then a talk with Dr McDonald the Vice Chair for Education (former PD). This was followed by a tour of Atlanta and a wrap up with the chief resident.

    3. Program overview

    First year at Grady 4 months of medicine, 2 neuro, psychiatry crisis, inpatient, psych ER. 2nd year mainly at VA and Emory with inpatient, elective time geropsych, 4months C-L, 1month child. Also see 2+ psychodynamic cases. PGY-3 12 months outpatient including psychopharm, psychodynamic cases, child, CBT, group therapy elective etc. PGY-4 entirely elective with o/p continuity clinic.

    4. Faculty
    PD was probably the least warm and fuzzy I have met on the interview trail and came across as preoccupied and distant. New and inexperienced, she did not seem to know how some things worked, but apparently is supportive of residents when it matters. New Chair appointed after 3 years when Nemeroff left. Recruited from the sinking ship that was Cedars-Sinai, he is relatively charismatic but lacks the research credentials of Nemeroff or most of the chairs at other places I interviewed at. Vice Chair of Education seemed very cool and invested in the program. Associate PD is an analyst - heard good things about him and had an interesting conversation with him. There are a number of analysts of the faculty (e.g. Dr Levy) as well as some major players in biological psychiatry e.g. Kerry Ressler, Helen Mayberg etc.

    5. Location, lifestyle, etc.

    Atlanta is a great city in a lot of ways and is relatively cheap. Apparently rental for a 1br is about $700 and several residents have bought houses or condos whilst in residency. Southern sprawl so you need to drive everywhere and the city is pretty segregated. Program is fairly formal apparently more like Northeast programs

    6. Benefits
    only 3 weeks vacation, 1 week professional leave and a educational stipend (?between $200-1000); moonlighting within program; usual insurance pay reasonable considering cost of living in Atlanta

    7. Program strengths
    very strong in HPA axis aspects of psychiatry, psychopharmacology, mood disorders, PTSD, biological basis of fear and anxiety, DBS, strong psychoanalytic training with option to start analytic training (affiliated with psychoanalytic institute); They are keen to get people involved in research if you are interested there are tons of opportunities; faculty very accessible; Grady is amazing in terms of volume and extreme pathology; opportunities to work with urban underserved including homeless outreach; can work with CDC, school of public health, Carter Foundation, get involved in policy work too. One of the most diverse patient populations and experience at university, VA, and county settings. Building links with Liberia and Ethiopia

    8. Potential weaknesses
    resident-dependent program; ?not financially flush (was told funding was an issue for international electives and another applicant was told they ‘could not afford’ to sponsor her visa? It is also possible PD is just not sure- she seemed to be unclear how medicare funding of residencies worked); new PD and new chair; department still suffering from departure of Nemeroff; difficulties going from lots of autonomy as an intern to less as a PGY-2; one resident suggested o/p child here summed up everything wrong with American child psychiatry (i.e. overmedicalization and medication of bad parenting etc); CBT (residents seemed to have a caricature of what this is); nightfloat all 4 years.


    Final thoughts: Emory is an excellent program for those who work hard, want a truly diverse clinical experience, want to work with the underserved, get top notch psychodynamic and psychopharm training and are interested in research in mood disorder, anxiety and/or trauma. Cognitive behavior therapists and those looking to sleep through residency should look elsewhere!
  42. classof2011

    classof2011

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    Im glad I'm not the only one who noticed the PD was the exact-opposite of warm and fuzzy (although not mean)...Her energy seemed low and unmotivated to sell the program.I do wonder if she inherited the position in some strange attempt to move up the academic chain or if she is just uncertain of how a program director can be perceived as the energy of a program (to some)...regardless, I dont see her in the position for long term...No offense to her, she just doesn't give off "come here! this is why we are great! Look at all we can do!"...more like "yeah this is it, thats that, contact me if you have anymore Qs, I probably wont wanna talk with you though LOL"

    However, the residents made up for whatever seems to be missing in her. I also agree with the fact Emory presents itself similar to a NE program.
  43. SmallBird

    SmallBird

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    Whilst I got the exact same impression of the PD during her presentation, on the tour of Atlanta, where she was our guide (not sure if this is always the case), she warmed up considerably, and it was fun chatting to her. But certainly, not as openly energetic as other PD's!
  44. classof2011

    classof2011

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    As I look back I have to agree with this one. She did reveal her quirkiness on the tour. I appreciated that. The residents warned us how she'd come off though before she warmed up.
  45. NoNoNoNo

    NoNoNoNo

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    I'll just add a couple things:
    -I think the fact that it's the only two day interview shows kind of how split the two sites (and potentially difficult travel between them is). That's a plus and a minus as far as two very different and complementary types of training, but also spread with commute etc.
    -Many people remark that the PD's speech (pacing, emphasis, etc.) on the first day is a bit odd, however you might interpret that. I'm sure some people love it.
    -Big emphasis on being "rigorous" as their key word (similar to the "marine corps" key phrase I heard at Cornell)
    -Very aware of their ranking as a top place
    -May be a PGY1 transferring out (due to some difficulties with the program itself and them not being handled with compassion) currently that the program avoided answering questions about when someone was asking
    -Agreed about hearing the malignant underside
    -Less public exposure but definitely building the community exposures with someone who came from CHA
    -Medicine very intense if at MGH
    -Faculty are non-tenure-track, which is good and bad if you stay on. Not everyone has to publish or perish to get title, but you also can't get tenure and secure your spot/flexibility of research (and your appt is based on clinical income)
    -Lots of guaranteed time abroad. Your elective time is paid (you don't have to secure money for it unlike other schools like maybe yale?, columbia?, etc.) so you have more true flexibility (though not more TIME) to go abroad or do random things
    -Their other mantra is "we have yet to see it all" so the doctors all wear short white coats if they trained there
    -lots of great and unique specialty uniques, partial programs, etc.
    -60% of residents stay on
    -Developing new tracks (though say they don't want to call them tracks because certain other schools do) in things like research, psychotherapy, etc.
  46. NoNoNoNo

    NoNoNoNo

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    Some things I'll add:

    -They give out a list of applicant contact before the day with listings of those with LGBTQ or cultural diversity interests
    -Dinner was small and with interns, who seemed quite tired
    -All interviewers seemed very friendly, helpful, engaging, etc.
    -The 3rd year outpatient is at Langley Porter, the private component of the three sites
    -The hospitals must have the best, most beautiful views out of anywhere in the country!
    -Some food provided
    -$660~ housing stipend per month
    -Removing funding for short call this year
    -SFGH has recently downsized its units (7 to 2?) and had a lot of older attendings leave to be replaced by younger ones (which is good and bad) due to financial constraints
    -Residents write "fun/quirky/interesting but maybe not academic" bios that are neat to read
    -Can't get a good sense of how much residents have to run around (e.g. for supervision? didactics? etc.)
    -Inner Sunset, where most residents live is in a very foggy area with little sunshine
    -Call is mix of night float (2-3 weeks each year) and 12 and 24 hour shifts (2 weekends per month PGY2 and 1/mo PGY3) with some short call
    -Faculty very responsive to addressing applicant's questions/interests/concerns/etc
    -SFGH seems uniquely interesting, fun, public, intelligent, deconstructionist, um, and great though tough. Its motto is "as real as it gets."
    -Attendings may have to see outpt patients for medical etc. reasons??? unlike some other programs (some residents at such programs will claim that requirement can really affect both flexibility/scheduling and patient-provider dynamics)
    -The housing market really does seem quite difficult
    -Very strongly agree about the strengths in LGBTQ and cultural opportunities, which seem unparalleled.
    -Even PGY3 year, some residents spoke of "getting patients piled on"
    -The PGY1 "six months of med" is actually 2 of wards, 1 outpt med, 1 ED, 1 outpt neuro, 1 inpt neuro
    -Residents speak very highly of memory and aging neuro rotation
    -Program is a good mix of good training and good reputation but still being a bit more laid back (personality wise)
    Last edited: 02.07.12
  47. splik

    splik

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    What does 'malignant' mean in this context? It is not a warm and fuzzy program, they don't attract (with a few exceptions) warm and fuzzy people, there is a lot of internal politics, they do have a few egomaniacs on the faculty, it is extremely hierarchical, and the residents work extremely hard for the first 3 years (and I am not sure whether didactics are pager free cos they kept answering them during didactics) BUT I don't think it's a toxic program. It certainly was not a contender for the programs to avoid list. However if you don't cream your pants everytime you think about MGH/McLean, aren't endeared to wearing a short white coat, would rather not spend 6 months doing brutal medicine, would rather have a more nurturing environment, and wouldn't sell your own grandmother for a Veritas-embossed diploma then there are other programs out there with equal or better training.
  48. NoNoNoNo

    NoNoNoNo

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    1. interview accomodations/food: nearby hotel, standard
    2. interview day: interviews after lunch, which is difficult
    3. program overview: 8 sites (va, wom's, children, free standing, etc.), 5 hrs supervision per week year third year, PGY4 with 4 mo electives (if do 2 mo forensic pay for license) and 2 mo community, residents friendly, can treat RISD art school patients, see Caucasian/African American/Portugese/Hispanic patients, biggest department in med school, aiming to integrate with neurology neurosurgery etc., new public health school, "biopsychosocial" approach, seemed Lgbtq friendly
    4. faculty: seemed more impressive in some ways than resident pool (probably totally personal, but seemed more a place I would like to work than train)
    5. location, lifestyle: call is much lighter than other programs with HEAVY night float months second year (x2 but 1 is lighter) but rest of call is rare and only 12 hour shifts or home pager call, familly friendly
    6. benefits: money for conferences even if not presenting, excellent moonlighting opportunities and time to do so (someone even doubled salary)
    7. strengths: 8 sites, lots of partial programs(existential, post-partum substance abuse, sexual etc.), cute and manageable city though things to do, flexibility
    8. weaknesses: 8 sites, 1s and 2s do lectures together (which residents say they like for cohesion) but makes the didactics seem repetitive or ineffective, seemed very woman heavy in terms of residents (may have been just my day or impression but also may have to do with lots of child and women's health exposure?), need car but no traffic
  49. NoNoNoNo

    NoNoNoNo

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    I guess mainly those things you talk about, but also regarding this resident trying to switch out as well as needing to operate on little sleep and "have thick skin" to train there...

    Maybe I'm confusing terms or something but I think I meant the things you described....
  50. NoNoNoNo

    NoNoNoNo

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    Does anyone else have any Penn reviews? That'd be much appreciated...

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