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Programs to Avoid

Discussion in 'Psychiatry' started by splik, Feb 6, 2012.

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  1. splik

    splik

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    Wake Forest and Harvard Longwood were nominated but I cannot find enough dirt (serious or amusing) to include them. Please let me know if this is an omission on my part. NYMC-Metropolitan and Bergen Regional Medical Center are definitely programs to avoid - the former is on probation (and you have to be really really bad to be put on probation by ACGME) and both these programs primarily/entirely offer prematches or do not take part in the match so for the purposes of this thread will not be included. This ranking is entirely arbitrary and I have gone for sensation over substance, and the visibility of programs or heinousness of their crimes has been taken into account.
    Last edited: Feb 19, 2012
  2. splik

    splik

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    I am going to start a poll based on the nominations although I maintain the right to veto the winner for #10 program to avoid.
  3. NewPsych123

    NewPsych123

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    Don't you think having Wash U on this list is a little harsh? Did you even interview there?
  4. NoNoNoNo

    NoNoNoNo

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    I think the point is...if you don't think Wash U should be on the list, you're welcome to offer evidence to the contrary from yours or others' experiences. Foster some discussion etc.

    (I hope that doesn't sound rude!)
  5. NewPsych123

    NewPsych123

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    I'm happy to offer my 2 cents about Wash U (which I think is a great place); however, when someone posts an institution in a list of "top 10 places to avoid," that is a big deal. So I'd like to hear the exact reasons why. Being in St. Louis is not a good enough reason.
  6. splik

    splik

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    maybe you should actually read the review?
  7. NewPsych123

    NewPsych123

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    Splik--I DID read your review. Frankly, I think it was a bunch of drivel written in a sensationalist manner.

    Indeed, there was a person who was asked to leave Wash U. If this, coupled with its location in St. Louis, constitutes the basis for making the top 10 list of programs to avoid, your argument is unfounded. My understanding is the administration was exceedingly patient and gave multiple chances to a resident who simply could not get his act together. To me, this speaks well of the administration. Not all places are as generous and understanding. Is Wash U a perfect place? There is no such thing as a perfect place. Wash U is very biologic, and hence not for everyone. Not everyone likes living in the Midwest, etc.
  8. pixella

    pixella

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    Um, I think that's the point.
  9. splik

    splik

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    :thumbup: medstudents these days have no sense of humor. And I did mention that WashU was a great program for certain folk but there are some people who would rather go somewhere that had a bit more of enlightened view of what psychiatry is about without the threat of being involuntarily hospitalized or beaten up or whatever this resident's allegations are. (I am not saying this happened, we don't know but there is a lawsuit so someone thought there was a case here)
  10. NewPsych123

    NewPsych123

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    1) I'm not a med student.
    2) My sense of humor is just fine; my maturity level, however, surpasses yours by light-years.
    3) Where did you get the idea that the resident was "threatened to be involuntarily hospitalized or beaten up"? Oh yeah, you probably pulled it out of your butt.
    4) If anything, I would've put a place like Emory on your list, because THAT institution is in a real state of instability since the entire Nemeroff scandal.
  11. splik

    splik

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    I'm not going to get into an argument, but all this information is in the public domain (whether true or not). I would be genuinely interested to hear about why WashU shouldn't be on this list, but so far you have just insulted me and bashed Emory. As I have said, I am sure it is a great program for some, and I believe the PD posts on here (?), but whether untrue or not these allegations are all over the internet, and they have likely scared some applicants off.
  12. Nasrudin

    Nasrudin Member

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    Really. How does one answer a charge of comparative maturity. This whole thing is like a sketch comedy routine.

    Last I checked. We're not all wearing wigs. And addressing the judge in proper ...would it please his royal majesterial judiciousness.

    Nobody seemed to mind their program being explicated as top notch by splik.

    Just defend your position.

    Boasting of superior levels of gravitas in a deliberately facetious and provocative rating scheme just makes you look worse.

    Yahoo tells me all the time on my way to my email about how some celebrity f'd up a runway style thingy. If It happened to be something i wore last tuesday I doubt it would upset me.
  13. mkeguy

    mkeguy

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    i read the residents blog and it really doesnt add up. with my experience with the wash u faculty and how ridiculously humble and nice they were, i am siding with the program. st louis was not a bad city. ive always lived in medium sized midwestern cities and st louis was actually very nice in comparison.
  14. NewPsych123

    NewPsych123

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    Splik--And you don't think YOU insulted ME when you said "maybe you should actually read the review?" Don't act like a jerk. You don't think that you've insulted plenty of very good programs? Please. Honestly, you post these "top 10 lists" with no rhyme or reason, except to be the center of attention. So yes, I can make some easy judgments about your maturity level, simply based on your actions.

    Also, I did not "bash" Emory. The department IS in a period of rebuilding. The people there are very nice, and I'm sure you could get a good education there. I am not going to be like you and start posting stuff like, "AVOID EMORY!!!!!" All I said was, Wash U does not deserve to be on this list any more than Emory does. For the love of God, there are WAY worse places than both of these institutions!

    Nasrudin--I don't feel superior to anyone.

    Mkeguy--Follow your gut.
  15. digitlnoize

    digitlnoize Rock God

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    Obviously all of these "Lists" need to be taken with a grain of salt.

    The only program to avoid is the ones that aren't right FOR YOU.

    While I agree that some of the places on this list or the suggested "runner up" list may not be the "best" programs, they might be the best place for some people, so we should probably refrain from making blanket statements like, "these places suck so bad no one should go here, ever."

    I'm fine with splik posting his/her opinions, and it at least makes for entertaining reading, but everyone reading this in the future should take it with a grain of salt. Do what's best for you, even if that means picking Wake Forest over Hopkins.
  16. DirtyBoots

    DirtyBoots

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    I'm an allopathic med student from the midwest who interviewed at WashU. I liked the program and will be ranking it high. I doubt that the problem with the former resident was that he had "a more enlightened view of psychiatry," and was therefore beaten up. WashU discussed that they seek to train residents in the medical model, and want residents to learn and add to the growing evidence base in psychiatry. As far as I understood from Interview day, they want residents to learn evidence based therapy modalities, and they have a healthy respect for psychodynamic psychotherapy, but they don't generally encourage long term psychoanalysis. One of the 3rd year residents is interested in deeper training in psychodynamic psychotherapy. He started a resident group that focuses on psychodynamic discussions; the group is popular and is fully supported by the administration. They encourage resident-led initiative.
    I thought the faculty and residents were smart, collaborative, and down to earth. Some of the 4th years were going on to private practice - and they were heavily recruited - and some were going on to fellowships. All of the residents I talked to felt very confident in their training and in the administration. I think the resident in question was likely an aberration - I wouldn't let the incident scare people away.
    I think the major drawback to the program is lack of fellowships - if you're considering academics these days, having the option for in-house fellowships (so you don't have to move again) is important.
  17. splik

    splik

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    perhaps people who interviewed at WashU this year and liked it would like to post a review of the program in the interview review thread?

    I have supported WashU elsewhere and even in this thread have acknowledged that "researchers, biological psychiatrists, and IMGs looking for a reputable program" "should not be deterred".
  18. splik

    splik

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    Just in case anyone needed reminding
  19. psychphan

    psychphan

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    Take with a grain of salt is an understatement. Considering from the current poll that number 10 has about a 63% chance of being Duke, Stanford, or Yale. My guess is 90% of psych applicants would kill to match into any one of those 3 programs.

    it was only a matter of time until someone was offended by these threads. The comments and reasons for inclusion on the list came off as mean spirited, even if they were satirical.
  20. splik

    splik

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    it is interesting that the two programs on the poll that really should be avoided have the fewest votes. it is the SDN bias where everyone appears to be vying for the same few programs, with 260+ step 1 scores etc.
  21. NoNoNoNo

    NoNoNoNo

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  22. whopper

    whopper Former jolly good fellow

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    Everyone wanting the programs with the highest USMLE scores and being the most "competitive" IMHO is somewhat misguided. The USMLE, though having some merit in separating the wheat from the chaff, is not an end-all-be-all indicator of what it takes to be a good doctor.

    I'd rather be at a non-namebrand place where I'd be happy and get a good education vs. a namebrand place where I wasn't happy.

    A problem with the MATCH system in general is that residencies aren't anywhere close to colleges when it comes to informing applicants in what they're really about. Some organizations such as Princeton Review and Pre-Test made reviews, "real" reviews as I'd all them giving accurate descriptions of the college life and how students felt about it. There is little in this regard with residencies. Several people apply to program X not really knowing much about it other than it's an Ivy or something to that effect. Of course several of the namebrand programs are very good, though some are not and get tons of applicants for the wrong reasons, and pretty much all fellowships take in people that could've been terrible residents because the number of residents applying into fellowship is relatively low vs. the other medical fields. Some of the worst residents I've seen got into namebrand fellowships.

    As for individual doctors, some of the best doctors in America I wouldn't want to work with because they have difficult personalities and frankly aren't good teachers. One doctor I know of, for example, treats you like a second-class person if you're not of his religious and ethnic culture, and thinks of several as beneath him. I've met with and interacted with this person on a few occasions and know plenty of people who know the guy. What the guy does he's great at, he deserves his academic honors, but don't delude yourself into thinking that because he's published quite a bit makes him a good teacher. The guy is the psychiatric equivalent of Sheldon from Big Bang Theory (though not a comic book fan- if so, then maybe I'd be able to tolerate him) and it's funny on screen but not funny in real life.

    If I had a chance to work with the above guy, or my former PD from residency that was not famous but one of the best clinical docs I knew, I'd take my fomer PD every single time. But hey, if a medstudent or resident want to be with the above guy because he's famous in psychiatry, but ends up hating going to work, being condescended daily, and being put in a constant state of self doubt because this guy is always chastising you, so be it.
    Last edited: Feb 19, 2012
  23. mkeguy

    mkeguy

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    +1
  24. Nasrudin

    Nasrudin Member

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    This is the real benefit of some of Splik's provocations both good and bad. That somebody who goes to or who is familiar with the program will go to bat for it. And give a thoughtful rebuttal.

    My home program is a tiny little program on nobody's map. But if Splik blasted it capriciously I would defend it based on what I know--that the doc's are cool supportive teachers. And that the program provides invaluable service for those who wouldn't get it otherwise.

    So this is all good stuff to my mind. I'm takin notes. Even if I don't know what to do with some of the information. They could be the basis for future, more specific questions.
  25. whopper

    whopper Former jolly good fellow

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    The medical community is small enough to the degree that residents not happy in programs aren't willing to divulge the weaknesses of their program and so hell-bent on focusing on highest USMLE scores and getting into the most "competitive" program that it makes determining a good fit a hard one.

    I ended up going to the program I put in as #1 because I did my medshool rotation there and loved it. It had it's flaws that I later saw while being a resident in it, but I was happy there (at least until my last year when the PD I loved left).
  26. Bartelby

    Bartelby

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    Bingo! Hence the focus on reputation ("prestige") and paying too much attention to rumors, online or otherwise. We get a lot of useful information, but I'm sure most of us want more than the interview day packet/tour/talk and the often much less than adequate website the program prepares (for an example of an adequate website, see UWash).
  27. Nasrudin

    Nasrudin Member

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    Yeah. Good intel is difficult to come by it would seem.

    Which is why my preliminary scouting criteria is location--which is relatively infallible--and hoping for a good fit at audition rotations in my desired location.

    Beyond that. I guess just a list of alternative acceptable locations. And some weak consideration for fellowship opportunities again with a predilection for penetrating desired locations. And setting up contacts for future practice. With the whiff of any bad things as a possible deterrent. Hence my interest here.

    I don't see anything else reliable to go on. Do you?
  28. whopper

    whopper Former jolly good fellow

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    Well, we've discussed things such as find out the call schedule, the didactics, ask if the residents are happy and things to that effect.

    But beyond the things we've mentioned in other threads, there isn't much else to go on.

    A real way to gauge a program IMHO is for a program to just cite on a bullet checklist everything-schedule, call schedule, didactics, pay, opportunities for moonlighting, scores of residents, board pass rate, participation in research, and have residents on several scales measure their happiness, ability to bring up problems within the program, the program's willingness to respond, would they go to this program again if they could go back in time, etc. The data is given to ACGME, not the program, and ACGME prints the results.

    Programs always want to look good, some at the cost of giving the real story. Attending entitlement is often-times defended by a program. While attendings should be respected, several hospitals look the other way when attendings don't return beeps, address valid resident concerns that they're not teaching well enough etc. A bad attending should be given a beat-down, which is why ACGME should be putting up this data.

    By the time residents graduate, they're off to bigger and better things and don't feel like taking the time to engage in something to fix the system.
  29. Nasrudin

    Nasrudin Member

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    Noted thanks. I'll keep those handy at the interview stage or before if ascertainable. Those for me though might come into play more at the ranking stage.

    But I'll tuck those in my pocket for the interview trail.
  30. billypilgrim37

    billypilgrim37 Unstuck in Time

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    Some of this is already covered in the ACGME survey performed every year. The problem is that every time there's the least little appearance of an infraction the ACGME launches a balls-to-the-walls investigation, which really just incentivizes programs to "coach" their residents about how to answer correctly.

    For example, residents at Program X might feel like they really don't have a way to bring up their concerns with the leadership. The leadership, on the other hand, can look at their manual and say "Well, I've told you to email me or the assistant PD to set up a meeting, you can go to your chief to explain your grievances, we have anonymous electronic feedback mechanisms for every rotation, so you have plenty of ways to bring up your concerns." In practice, residents still don't feel like these mechanisms are going to lead to any real change, so they want to click "No I don't have ways to bring up my concerns," but they get coached to click "Yes, I have lots of ways to bring up my concerns." People can still buck the system and put what they want, but they also know it's only going to cause them problems in the end and result in some hour long training about how to have your concerns addressed with leadership so the program can report back to the ACGME "here is what it says in our manual, and we just had an hour long training to teach our stupid residents how to read our manual, so everything is fine" and ACGME clicks their little "address Program X's problem" checkbox and moves on. Nowhere in there did anyone become more comfortable bringing up issues with their program. Next year, not wanting to waste an hour of their life with another training, residents just click yes and move on with their lives.

    And, as other people have pointed out, plenty of residents don't want negative things published about their program, because they want others to think they're receiving good training, and they would prefer to recruit smart medical students rather than stupid medical students who will be paging them with dumb questions while they're on back-up call. Unless people thought that reporting their programs would actually lead to some sort of positive change, but nobody really believes that. Getting burned by one bureaucrocacy doesn't really inspire you to pursue help from another one.

    To be clear, since some of you know where I'm at, the above doesn't necessarily apply to my program, more other folks I've talked to.
  31. whopper

    whopper Former jolly good fellow

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    Agree. The indicators ACGME uses to rate residents isn't great either, and several of the actions they have taken to "protect" residents actually make some things worse.
  32. mkeguy

    mkeguy

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    best website i've seen has been pittsburgh. everything is laid out and theres a FAQ section. pretty comprehensive and user friendly
  33. notdeadyet

    notdeadyet Still in California Moderator

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    They do have a killer website. I was quite shocked at how many good programs have such poor websites, which could otherwise be such great recruiting tools.

    I think these again goes back to the problem of folks in medicine sometimes thinking that because they're MDs, they can do anything. I've heard many of these programs have FACULTY that's in charge of the website, and on many it shows. Bummer...
  34. mkeguy

    mkeguy

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    some faculty are probably capable. the pitt PD told me he wrote the FAQ section. i don't know if he did the website itself but its possible.

    a bigger issue is that with constantly changing ACGME requirements and therefore changing call schedules, its hard to keep all this updated. itsnot easy to have a comprehensive website that is also current and accurate
  35. digitlnoize

    digitlnoize Rock God

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  36. EddieMD

    EddieMD

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    I'll echo this response. I'm also a midwest allo student who will be ranking Wash U highly. The most important quality I looked for in a program was that gut feeling, will I fit in. Albeit difficult (and perhaps unfair) to assess in a few days, I tried hard to look for that "smoke" of malignancy in a program. I found none at Wash U, and I may have been given more insight than other applicants...

    I had the unique opportunity to interview during the annual resident/faculty dinner at the PD's house. There I got to see first hand how all the residents interacted with the faculty and each other.Myself and the rest of the applicants were immediately unrecognized (showing that everyone already knew each other), and were made to feel welcome and recruited. I saw exactly what I would expect from a program that claims to provide a "resident first" education model. The PD cooked for some 50+ people and I saw everyone laughing and telling jokes over free alcohol.

    This is in contrast to three other programs I interviewed at that hinted, or even wreaked, of malignant smoke. I tend to give everyone the benefit of the doubt, and I recognize I may have caught them on a bad day, but that's how this crap-shoot of judging programs/applicants goes. I couldn't be happier with the top three programs on my list, so here's hoping!
  37. InBoston

    InBoston

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    Right, the USMLE has piss poor relevance to being a psychiatrist, besides knowing terminology which all shrinks should know
  38. splik

    splik

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    I am really sad to put this one on the list. Many people already avoided Upstate because of Syracuse and all the snow, but it was a gem of a program with a committed program director, one of the most innovative psychotherapy curricula, a medical humanities track, and the opportunity to do an MPA at the Maxwell School. But it has fallen from grace and the rumor mill has it that morale has been very low and there are some deeply unhappy residents. The medical school is unstable and is currently on probation by the LCME which could potentially threaten the residency programs. Further, the Chair was fired for ‘political’ reasons that aren’t quite clear, and the repercussions aren’t either. I hope they sort themselves out but for 2012 they are one to avoid.
  39. splik

    splik

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    The internal medicine program was outed as a malignant program last year. A hostile work environment, fear of retaliation, breaking the ACGME work hour rule, favoritism, Gujarati residents having access to the non-Gujarati residents’ files and discussing them with the PD were all highlighted to ACGME! After the allegations were leaked last year the PD was removed from internal medicine but kept on as Med/Psych PD! He has now been removed but residents speak about the culture of misery and intimidation for those not in cahoots with the administration and this is not something limited to internal medicine. A Toxic institution in the true sense of the word.
  40. splik

    splik

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    Ahh... Yale that bastion of elitism and smuggery, desperately trying to rebrand itself as diverse and global for the 21st century. Despite allowing FMGs who run from the exceptional to the everyday into their program, the upper echelons are still dominated by old white men. Yale claims they oversample FMGs because they want diversity and have a truly global outlook, but instead they specialize in peddling the flawed psychopathological models of the west to the unsuspecting rest. Some really outrageous ‘global mental health’ research goes on here. This is psychiatric imperialism at its worst. Yale gets an honorable mention for the most ridiculous reason... they managed to land themselves a gun-toting libertarian nutjob who pulled out a gun on a woman who rejected his advances and then not only lost his licence but is now in prison! He cited living in New Haven (the 4th most dangerous city in the US) as the reason for being in possession of a firearm...



    *obviously yale is a great program blah blah they are not like #1 and #2 I just think the story of the resident in prison is funny!
  41. digitlnoize

    digitlnoize Rock God

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    SUNY: I interviewed at SUNY-Upstate this year. Posted a review about it in the review thread. I thought it was an ok program (not great), but not for me. I hated the town, even in "nice" weather. PD's interview is very strange and oddly personal (I think he tries to push buttons to get a reaction, which he did out of the girl ahead of me...she was FUMING mad "those questions were TOO personal!"), but everyone was very nice. It seemed like a friendly, but not ideal place to work. Certainly not really for me. Debated whether to rank it or not, and decided not to, especially after all the drama this year.

    ETSU: I worked with a guy who did his adult psych training at ETSU, then left and went somewhere else for fellowship.

    He highly recommended the institution he did fellowship at, but had nothing good to say about ETSU. He said it was "fine" but not great. I think he was being nice.

    Scutwork reviews of ETSU (in many fields) are also not very kind. I think they need an overhaul.
  42. splik

    splik

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    Stanford is sometimes referred to as the Harvard of the west. It boasts one of the most prestigious and recognizable brand names in the world with an excellent medical school and one of the world’s leading psychiatry departments. With leaders in both biological psychiatry and psychotherapy on the faculty they could potentially have one of the best residency programs in the country. But Stanford doesn’t even rank and it has failed to fill in living memory. There are fewer didactics here than most other cali programs, and fewer still in psychotherapy. The training is out there but you have to find it. Diverse patient experience is not on the cards, and Stanford shuts out poor people from its clinic (shame on you). Which I suppose is fine as Stanford residents go on to have private practices where they do what? Shut poor people out from their clinics. There are some unhappy customers here, with some applicants told not to come here and at least one resident apparently transferring out this year. Stanford is rotten to the core with drug money, but hopefully the new Chair will clean up the department and put her (non-pharma) money where her mouth is with regards to education.
  43. splik

    splik

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    We say BOO to BU! Yes I am still sour you rejected me even though you were my penultimate choice! You don’t get to reject me because I reject you! In fact we all do! That is why you did not fill last year. Or is it because you treat your residents poorly? Or is it because the residents tell applicants not to come to your program?


    *I have not been able to get a straight answer out of anyone about what is so bad about this program but I was advised to 'not bother' applying here, and it appears residents grumble but don't seem willing to divulge what the problems are here. Please let us know.
  44. cleareyedguy

    cleareyedguy Junior Member

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    I haven't heard much about BU, but if they're so bad, how did they even come up with 3 people to participate in the 2011 MindGames (~Jeopardy) competition. And then win the whole thing over dozens of other teams, including--presumably--teams from "Better" places.

    One of those teams was Pittsburgh, which also made the finals, and would presumably be primed for the biologically-oriented PRITE like questions.

    But then, how did NYPH/Cornell finish second, if all they learn is psychodynamics?

    http://psychnews.psychiatryonline.org/newsArticle.aspx?articleid=108529
  45. billypilgrim37

    billypilgrim37 Unstuck in Time

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    While just getting to the MindGames competition means the BU folks were wicked smaht, my friends who saw the match last year said the problem was that Pitt and Cornell kept buzzing in and missing things (just like in Jeopardy, you lose points). The BU folks didn't answer many questions right, but they actually just didn't buzz in and miss many either.

    Again, you don't get into the MindGames and get to rub elbows w/ Glen Gabbard unless you' did really well, so your point is still 100% valid, but I thought that was pretty interesting. I've taken the online test, and I would dispute that it's heavily biological, which is a good thing. I think Gabbard has enough of a hand in the whole thing to make sure it's more balanced.
  46. whopper

    whopper Former jolly good fellow

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    Maybe those boys and girls at P & C are suffering from TBI-induced-disinhibition?

    (Yes I'm joking).
  47. billypilgrim37

    billypilgrim37 Unstuck in Time

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    That's certainly the best theory I have heard!
  48. curiositykat

    curiositykat

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    Medical Student
    The APA announced the 2012 Mindgames finalists (NYP/Cornell, NYP/Columbia, and UT/Houston), and I was wondering how people around the country prepare for the screening test (if they prepare at all).
  49. AchooSneeze

    AchooSneeze

    Joined:
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    Resident [Any Field]
    Speaking from my own experience as a resident, and my ex-wife's experience as a resident in psychiatry, it can be hard to discern a malignant or hostile program during an interview day.

    Her PD in psych makes a great first impression, but just ask him to back a resident up on something, and his true colors show.

    Also, as time goes by, the dirt of a program comes out. Some programs which seem friendly are full of political strife and sensitive egos. Most likely, most people will be fine at a given program. And it's true that residents seem reluctant to highlight the negative aspects of a program. Think about your time as a medical student. Now, couldn't you tell numerous stories about your institution that are terrible and unfair, compared to when you first started? But who would you tell these stories too, if you wanted a shot at getting a position at that institution.

    On the west side of the US, where there may be only one psychiatry residency per state, not many will spill the beans in an interview day.
  50. Cinnameg

    Cinnameg "the psych machine"

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    I did a really great away rotation in Denver. Great city, and the program didn't seem to have any red flags. The big problem in Denver seems to be the state's mental health care system: lots of inpatient unit closures, very little public welfare net to pay for medications for uninsured outpatients, etc. The psychiatric emergency attending I worked with told me that when patients are discharged, unless they have insurance there are very few services for them, so aftercare planning is discouraging. But none of that is at all the fault of the residency training program.
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