Seeking Psychiatry Residency-In Need of Program Advice

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Kaza

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Hello!
I will be applying to Psychiatry Residencies this year and I need some advice on programs. As a new mom of twins, I am in need of a program that has the following components:
- About a 40 hour work week (even during intern year)
- 2 days off per week
- Chill/Relaxed work environment.
-Chill/Relaxed call schedule

I also very much want a program that has good training in both pharmacology and in psychotherapy. I am interested in Programs in the Midwest (specifically Chicago, Milwaukee), and also in the South East (North Carolina, South Carolina, Florida, etc.).

I would be deeply appreciative of any advice you could share to help with my Residency search. Many thanks!

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Hello!
I will be applying to Psychiatry Residencies this year and I need some advice on programs. As a new mom of twins, I am in need of a program that has the following components:
- About a 40 hour work week (even during intern year)
- 2 days off per week
- Chill/Relaxed work environment.
-Chill/Relaxed call schedule

I also very much want a program that has good training in both pharmacology and in psychotherapy. I am interested in Programs in the Midwest (specifically Chicago, Milwaukee), and also in the South East (North Carolina, South Carolina, Florida, etc.).

I would be deeply appreciative of any advice you could share to help with my Residency search. Many thanks!

Do you have a supportive spouse, or are you a single mom? You need to find a program in a location where you have family support or a solid child care network in place. Ideally you will be able to live fairly close to the work sites, too, to avoid long commutes. I recommend a program in as small a community as you can find (i.e., not in a huge city like Atlanta, say) simply for the lower cost of living and the ease of commuting, etc.

My program is one that most would call "chill" in all respects but in intern year only one or maybe two rotations were of the "40 hour / 8 to 5, M-F" variety - these were in outpatient clinics. On most services you will have some late or overnight shifts, and some very long days (15+ hours), and some late call (all home call, but you still go in for some part of the day or night), especially on inpatient rotations including psych - it is just part of the deal intern year everywhere from what I hear.

And you will have some weeks where you are scheduled and/or on call 7 days straight, if not 13 out of 14 days in a row. I would say the average week during intern year is a not so bad 50 t0 55 hours, ranging from a low of 35 (felt like a vacation week) to a high of around 65. I did not have any weeks that some folks report on SDN (like on medicine) of 80 hours, though.

The work weeks are manageable, but also highly variable. It isn't the hours that are so bad, it is the variability of the work schedule that I think would be a problem for someone like you. Some days I get off at 4, and some days I don't get home until after 8 pm...you need to have reliable and flexible child care or a spouse / family member with a flexible schedule taking care of your kids on those days, and with few exceptions you will have days like that on every service.

Variable, unpredictable schedules are the norm - not so much variability on the start of the work day, but at the end of the day you don't always know when you will be able to leave with any certainty; I imagine that would be very stressful for parents of young kids. Hell, I am single and I find it stressful if only because I can't make any after work plans and my evening meal options get screwed up constantly.

Find a program where you can finish patient notes from home. I have no idea if this is universally done or not, but it is one of the ways you can better control your work hours.
 
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Milwaukee is a very family friendly program from my recollection, in fact, I really liked the program but specifically ranked it lower because it felt like everyone there had kids. That said, there is definitely no program in Milwaukee or Chicago that will have 9-5 M-F training your intern year and no call ever.

While being with your children is paramount, I would consider making 1-2 years of sacrifice (most PGY3 and up years are 40 hour/weeks) to come out a competent psychiatrist. I cannot imagine an attending who has never taken in house call and think it could cause real problems with your ability to handle emergencies down the road.
 
Milwaukee is a very family friendly program from my recollection, in fact, I really liked the program but specifically ranked it lower because it felt like everyone there had kids.

Boy, this resonates with me. In med school, just about all my classmates were my age or +/- one or 2 years, and the vast majority were single and had no kids. When I hit the residency trail, the range in ages of the residents I saw on the trail, and in programs, was much greater, and more people were married with kids. It wasn't always easy to determine at different programs how many of my potential colleagues would have kids, etc., but for a single person, it is something to consider. Your co-residents figure out who has kids and who doesn't, and I find I get lots of requests to swap call schedules with people with families. I help out when I can, but it gets old...

My point: to the OP, you probably want a program with as many friendly flexible childless singleton colleagues like me, and not necessarily a program where everyone has kids (and thus you will never be able to find someone to swap call schedules with). Of course it could cut the other way, I guess - in a program where most residents have children, maybe there is more cooperation.
 
Pardon me for the poor appreciation of audience, but this is about the most millennial conversation I have seen in a while. Before everyone politely or not politely points out how insane hours and torture are not necessary to become a fine and competent physician, looking towards training with the eye on making it easy is not a recommended strategy. I get it, having twins isn’t easy and it does change one’s priorities, but you are working towards being a physician as well as a parent. This will take hard work, and if you succeed in avoiding hard work, you will be short changed. Now there will be some life style oriented students who will take this personally enough to argue how untrue this is, but it will remain more true than not true. I know a lot of senior educators with insane amounts of experience in post graduate medical education who agree with this. No one would expect you to seek out a parent unfriendly form of training, or purposely look for an extra tough work situation just to prove you have the right stuff. Just be careful to keep perceived work load in perspective, because if this is the majority of your criteria, you will be missing some of the better programs. There are some so so programs that are very light. There are some very work intensive programs that are not very good, but there really are not any excellent programs that are very light. I hope you find the right balance, but don’t get more than a couple of standard deviations away from center or strange outcomes are likely.
 
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I'm a soon-to-be intern with a baby, and I am not especially looking forward to trading in my laid back M4 schedule for grueling hours of internship, so I'm not going to lecture you about the wisdom of seeking out the cushiest residency possible. That being said, I think you'll find that 40-hour work weeks for the first two years don't exist anywhere, so I would recommend recalibrating your expectations as to what a "chill/relaxed" schedule looks like.

Check out University of South Dakota. Very light call schedule (due in part to a social work-led triage system that seems to cut down substantially on scut work for residents), but solid training nonetheless. I think they said hours averaged out to about 45 hours per week over the course of the program.
 
Milwaukee is a very family friendly program from my recollection, in fact, I really liked the program but specifically ranked it lower because it felt like everyone there had kids. That said, there is definitely no program in Milwaukee or Chicago that will have 9-5 M-F training your intern year and no call ever.

While being with your children is paramount, I would consider making 1-2 years of sacrifice (most PGY3 and up years are 40 hour/weeks) to come out a competent psychiatrist. I cannot imagine an attending who has never taken in house call and think it could cause real problems with your ability to handle emergencies down the road.

That said, there are some programs agreed to be more "Cushy" than others in WI/IL/MI/Midwest (no, I'm not going to name them for obvious reasons). Problem is, I'm not super thrilled with what I've seen from their residents' level of preparedness.

You don't go to residency to learn to do things right as a physician/psychiatrist. You go to residency to learn how to handle yourself when things go wrong. You only get that through high-volume experience.
 
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Check out University of South Dakota. Very light call schedule (due in part to a social work-led triage system that seems to cut down substantially on scut work for residents), but solid training nonetheless. I think they said hours averaged out to about 45 hours per week over the course of the program.

Not sure where you heard this about USD, but based on what I've heard, this is not true. I know two residents there right now and they complain that MY schedule is light in comparison to theirs.

As for the original poster, you will never find a program to meet those requirements in intern year. Because half of intern year is off-service and there's no program that has IM interns working 40 hours a week. No, after your off-service months, it's certainly possible to find programs that only require about 40ish hours a week, but again, you will never, ever find one that will always give you 2 days off every week. You might find one that gives you two days off most weeks, but it won't be every week. It's just not possible because Saturdays and Sundays have to be covered.
 
You don't go to residency to learn to do things right as a physician/psychiatrist. You go to residency to learn how to handle yourself when things go wrong. You only get that through high-volume experience.
First you should learn how to avoid doing things wrong and to handle those problems. THEN you should learn how to go beyond that. Aiming to just learn to handle problems is a low bar to set and keeps one very reactionary as a physician.

For the OP, I have to agree with many others here. It might be ideal to explore taking some year(s) off before residency. It's hard enough to find ANY program that really trains well in psychopharm AND therapy. Trying to find one that does that and has low workload is unrealistic. I'd figure out what you're willing to sacrifice and for how long. Think of it less as "what can't I have," and more like "what can't I have right now." Though it may sound horrible to med students (and residents), we're lifelong learners. You're not going to get it all in residency.
 
Some residencies allow for 1/2 time for moms in situations like this. That being said, it complicates things greatly, and may complicate your match ranking. Aside from this, I'd look at USC-Palmetto in Columbia, SC. Milwaukee is a good choice too.

I'd strongly consider going somewhere near family (who could help out on call nights) or bringing a family member with you to residency. I knew someone who brought their Dad to residency with them to take care of their kids while they were at work.
 
Hello!
I will be applying to Psychiatry Residencies this year and I need some advice on programs. As a new mom of twins, I am in need of a program that has the following components:
- About a 40 hour work week (even during intern year)
Um... I want to be snarky about this, but I just can't even... Good luck in finding a program with strong support systems and such though, they are out there.
 
First you should learn how to avoid doing things wrong and to handle those problems. THEN you should learn how to go beyond that. Aiming to just learn to handle problems is a low bar to set and keeps one very reactionary as a physician.

my point is that if you don't have the volume, you only ever learn how to handle the former, and have no idea how insufficient you are at the latter. What we do "on paper" isn't that hard.
 
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You should check out IU. I know intern year 6 mos of medicine is tough but I was told by someone in leadership that they had been flexible in the past with a resident who worked one month on and one month off for family. Just an idea!
 
Do you have a supportive spouse, or are you a single mom? You need to find a program in a location where you have family support or a solid child care network in place. Ideally you will be able to live fairly close to the work sites, too, to avoid long commutes. I recommend a program in as small a community as you can find (i.e., not in a huge city like Atlanta, say) simply for the lower cost of living and the ease of commuting, etc.

My program is one that most would call "chill" in all respects but in intern year only one or maybe two rotations were of the "40 hour / 8 to 5, M-F" variety - these were in outpatient clinics. On most services you will have some late or overnight shifts, and some very long days (15+ hours), and some late call (all home call, but you still go in for some part of the day or night), especially on inpatient rotations including psych - it is just part of the deal intern year everywhere from what I hear.

And you will have some weeks where you are scheduled and/or on call 7 days straight, if not 13 out of 14 days in a row. I would say the average week during intern year is a not so bad 50 t0 55 hours, ranging from a low of 35 (felt like a vacation week) to a high of around 65. I did not have any weeks that some folks report on SDN (like on medicine) of 80 hours, though.

The work weeks are manageable, but also highly variable. It isn't the hours that are so bad, it is the variability of the work schedule that I think would be a problem for someone like you. Some days I get off at 4, and some days I don't get home until after 8 pm...you need to have reliable and flexible child care or a spouse / family member with a flexible schedule taking care of your kids on those days, and with few exceptions you will have days like that on every service.

Variable, unpredictable schedules are the norm - not so much variability on the start of the work day, but at the end of the day you don't always know when you will be able to leave with any certainty; I imagine that would be very stressful for parents of young kids. Hell, I am single and I find it stressful if only because I can't make any after work plans and my evening meal options get screwed up constantly.

Find a program where you can finish patient notes from home. I have no idea if this is universally done or not, but it is one of the ways you can better control your work hours.
Thank you for the information! I am a single mom, but your program sounds wonderful. Where do you go?
 
Not jumping into the bigger debate here about the merits of being busy versus not being busy. I agree with the idea that it's probably impossible to get super strong training in psychopharm and psychotherapy all within 40 hours a week. Still just a new grad, but I'd say quality instruction and varied clinical experiences are more important than just being busy.

Anyway, on top of programs already listed, maybe check out University of Oklahoma-Tulsa. It might have changed, but they used to not have inhouse overnight call aside from off-service rotations. It also didn't seem like the average days were too long.
 
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