2017-2018 Psychiatry Interview Reviews / Insight

Discussion in 'Psychiatry' started by raisinbrain, Oct 3, 2017.

  1. Amygdarya

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    There is no state tax in TX and yes, you can have a higher quality there compared to the Northeast.
     
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  3. doggums

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    1. Ease of Communication:

    Via email. PC was very responsive and sent a lot of useful info about interview day.

    2. Accommodation & Food:
    No accommodations provided. Dinner was in downtown Hanover with a huge group of applicants and residents. Walked to a nearby gelato place after, which was delicious.

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences):
    Day started at 7:45AM with an overview by the PD. Snacks and coffee provided, but no breakfast. Applicants were split into two groups with one group interviewing in the morning and doing the tour in the afternoon, and vice-versa. Anywhere between 5-12 30 min interviews (more for the research and CAP people). Interviews themselves were casual and mostly just trying to see if you’d be a fit for the program and location. No unusual questions. Overall it was a very long day, not ending until around 4:30.

    4. Program Overview:
    The outline is on the website, but one thing that wasn’t addressed was call, so I’ll try to write my interpretation of what the residents were trying to explain when I asked about it. If anyone else can comment on it, please do, I left a little confused.

    PGY-1: Short call 5-6 times per month, stay till 10PM and help a PGY-2 cover the entire hospital— consults, ED, admissions, inpatient units. One Saturday 24 hour call and one Sunday day-call per month. This is where residents seemed to think they could’ve used a little more supervision. You’re covering the entire hospital and no one else is there with you. PGY-4 and attending are available via phone.

    PGY-2: VA call is overnight call from home where you just have to go in for consults and admissions, not sure how often that is. Psych call is basically overnight 1-2 times per week and 24 hour weekend call every other week.

    PGY-3 and 4. Supervisory call on weekends, holidays, probably some VA and state hospital call mixed in too, but it wasn’t very clear.

    All the residents said it was very call heavy, but they learned the most on call and feel extremely prepared for life after residency. DHMC call sounds very busy and everyone unanimously said you won’t get any sleep overnight.

    Another note: DHMC does not do involuntary admission, so anyone who needs to waits in the ED for a bed at the state hospital. Recently they had a patient waiting in the ED for 40 days.

    5. Faculty Achievements & Involvement:
    I don’t know much about achievements, but residents said DHMC faculty were all very involved and great teachers. VA faculty, maybe not so much. The psychiatry department is very well funded and has a lot of research going on. Community psychiatry sounded particularly strong.

    6. Location & Lifestyle:
    Lebanon and Hanover, NH are in the middle of nowhere. It’s extremely rural and has a small town feel that people seem to either love or hate. Obviously not being in a big city has it’s perks and cost of living is relatively low. Some of the residents said there aren’t a ton of housing options because of the area. Many people choose to live 15-20 min away from the hospital and commute in since there’s no traffic. Lots of outdoor activities and most people seem to ski (discounted ski passes are available to residents).

    7. Salary & Benefits:
    Salary (~54k) seems to be average and probably goes fairly far in the area. Residents mentioned that their health insurance was good, they got a food stipend when on call (but there is no cafeteria discount for them in general), and parking is free.

    8. Program Strengths:
    -Excellent funding for research, very strong department in general. Psychiatry is well respected.
    -Easy life outside of the hospital, cheap cost of living, no traffic, lots of local/organic food if that’s your thing
    -Dartmouth name may open doors. Residents go on to get whatever fellowships/job they want and feel very well prepared to practice independently
    -The hospital is beautiful, actually has windows, and is built like mall. Seemed like a more therapeutic environment than most places.

    9. Potential Weaknesses:
    -Call heavy (I feel like they tried to downplay this too much), questionable supervision on weekends, no night float.
    -Lack of diversity. Intern class is 100% male and mostly white (which I feel like they tried to hide by failing to update the residents on the website this year) and overall the program is white male dominated. They said they have economic diversity in their patient population, but admit that they’re all Caucasian and English speaking.
    -Dartmouth College “rape culture” was talked about by residents and a few psychology professors at the college were recently fired for sexual misconduct. I didn’t get the feeling that this extends to the medical center side of things, but it sounded like wealthy white male privilege was the theme of the surrounding area
    -Long waits in the ED for involuntary beds at the state hospital
    (+/-) Location. Definitely no nightlife, everything seemed to close by 10PM.

    10. Overall Impression:
    I loved this program. The faculty and residents all seemed incredibly intelligent and down to earth. I think the biggest factor for most people would be location, lack of diversity, and the fact that it’s a more service-oriented call heavy program (at least for the first 2 years).
     
  4. raisinbrain

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    Ease of Communication
    Interview Broker is awesome, and makes scheduling super easy. No issues with communication; little coordination required, but every interaction I had with anyone from the program was very pleasant.

    Accommodation & Food
    The program paid for a night’s stay at a local hotel – I believe psychiatry was at the Sheraton, and Med/Psych (and Medicine) was at the Marriott. Regardless, the accommodations were nice, and a shuttle to hospital was provided. Dinner options throughout the season rotate through a couple of local restaurants. We had a good resident turnout, from representation from multiple years. Lunch was provided on campus, also.

    Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences):
    I had a skewed perspective, and can talk/write more about the combined med/psych program than anything else. The med/psych applicants start the day out with the medicine applicants, starting with a light breakfast with coffee, overview of medicine with the PD and associate PD, tour, and 2-3x 15 minute interviews. Lunch was part of the internal medicine’s noon conference, which was actually quite nice to see, very collegial and interactive. After lunch, we moved over to the Psychiatry part of the day. Even the psych interviews were quite brief (15 min) except with the IM/P PD (Dr. Kijewski, who seems great). I think everyone met with Dr. Black (psych PD), and all of the combined applicants met with several IM/psych director faculty members. Ended with a quick wrap up and program interview about the combined program (somewhat an odd time to do an overview, but that’s okay), finishing around 3:45. For categorical psychiatry, I believe many of the interviews are still short/15 minutes, but the day ended at least an hour or two earlier.

    Program Overview:
    Given the nature of the interview day for med/psych, we didn’t get a great overview of the psychiatry part of the training. More info is available on their website. We didn’t hear complaints about the program or didactics or call schedule from residents; they seemed happy with it. Call is roughly 4-5x/month for PGY 1-2 and ~2x/month PGY 3-4. Longest on weekends is about 12 hours.

    Psychotherapy training can start as early as PGY2, but is generally not required until PGY 3 and 4. They do have the consecutive 12 months of outpatient psych, and residents are expected to carry 3 psychotherapy patients per week. Some opportunities to lead STEPPS groups (BPD group).

    For senioring opportunities, PGY4 includes 6 months on a combination of inpatient psych or the CL service. Also, for outpatient psych, everything at the University clinics are staffed with an attending, all the time. On the other hand, residents have a lot more autonomy at the VA, where residents staff generally once per day (unless something urgent comes up). Also on call about once per week for outpatient rotations (I believe?).

    Didactics during psychiatry months are protected time. Have a total of about 7 months inpatient psych (at least for combined), including rotations through every psych unit they have (mood disorders, psychotic disorders, geriatric psychiatry, eating disorders, and medicine-psychiatry). 2 months of CL. 1 month inpatient CAP, 1 outpatient CAP. 1 month outpatient neurology. Has a night float coverage service.

    Notes about the combined IM/P program:
    - All of internal medicine runs on a 4+1 schedule, so the +1 week houses everyone’s continuity clinic including the psych continuity clinic, a bunch of ambulatory medicine rotations, QI project, administrative time and some didactics, etc. Call varies depending on the specific service – highest requirement is the q4 call in the CVICU. In the MICU, both junior and senior residents take overnight call q4. Otherwise at UI IM wards (with 3 teaching services) there is rotating call coming out to about 4-5 nights per months. At the VA medicine wards, all teams admit daily and take call q6 nights, with a covering night float senior. IM/P residents don’t take overnight call while on medicine.
    - During medicine, lots of noon conferences, but it’s protected time, and they even hold your pagers and only highlight your pager number if it’s actually urgent. Also have convenient in-house iphone/phone/texting/paging system.
    - During inpatient psych months, have one half day per week at continuity of care clinic (possibly starting PGY2?). Of note, IM/P residents do 8 months medicine and only 4 months of psych in PGY1, so they’re still considered a junior resident during PGY2 (for call schedules, etc). For IM/P, outpatient year starts midway through PGY3, and by PGY5 there is no more (psych) call. No formal chief year for combined residents, though recently started to be able to serve as a categorical chief for psychiatry.

    Faculty Achievements & Involvement:
    Residents seemed to enjoy the faculty and the level to which the like to teach on the go. Dr. Nisly was pretty excited about running her integrative medicine clinic and was a good proponent for diversity on campus. There’s also opportunities to work in an LGBTQ clinic (their EPIC was adjusted to use not only a patient’s preferred name, but also highlights preferred pronoun and gender. I’m kinda jealous)

    Location & Lifestyle:
    Iowa City – very reasonable cost of living with a safe environment. Many residents live within walking (or biking) distance to the hospital, but can be 10-20 minutes out with plenty of space if that’s your gig. Low unemployment and great public schools. Fairly low stress. There’s nightlight available, but the whole city seems pretty integrated into the university campus, so not much escaping the undergrad / grad school scene. That said, the city is pretty literate and has some artsy stuff, too.

    Salary & Benefits:
    Salary starting at 55,400. Other benefits Benefits | Graduate Medical Education . Health insurance package details actually seem pretty awesome, with 400/person deductible and 0% (behavioral health) coinsurance for a lot of services. 6 weeks maternity/disability leave only after pregnancy; 5 days after an adoption. There's a bit of a walk (or a shuttle ride) from the parking lots.

    Program Strengths:
    - Med psych unit, even for categorical psych residents (as part of the inpatient medicine months)-
    - Structured research training in psychiatry through the research track and/or PSTP
    - Friendly residents and faculty, and others in the area (including my shuttle driver!)
    - Complementary medicine / integrative medicine clinic
    - Residents as teachers medicine elective
    - Low cost of living
    - Safe area, easy commute with little traffic

    Potential Weaknesses:
    - Still seem to be building the psychotherapy training, but reportedly improved
    - No formal chief year for combined residents, but still help organize the program (but as of recently can now do a categorical psychiatry chief year)
    - Somewhat limited breadth of research topics
    - Minimal forensics exposure
    - Limited (albeit existent) diversity
    - Less elective time and opportunities in PGY4 than some places

    Overall Impression:
    Really enjoyed this program! The residents seemed like a great group of people, everyone got along with each other and liked the faculty as well. Overall seems like very respectable training in a lovely area. The entire institution (department included) was filled with very friendly people, and the surrounding area seemed similarly friendly. With its historically biologic tilt, residents do seem to get sufficient training of the medical neuroscience / biologic psychiatry, but modern enough to seem well-rounded in overall training. Also seemed flexible in having residents get involved with research, but not pushing it if it wasn't desired (aside from a small QI project, I believe).
     
  5. Mass Effect

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    Pretty sure psychotherapy (long-term, in fact) is an ACGME requirement. How can it not be required?
     
  6. splik

    splik Professional Cat at Large
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    lol the ACGME requirements are in name only. the fact that they have given initial accreditation to all these DO programs shows what a joke the whole thing is. but yeah plenty of programs dont provide any training in psychotherapy. other requirements that may be missing in prograsms include community psych, forensics, geriatrics, and emergency psychiatry. even many of the top programs dont meet the ACGME requirements.
     
  7. slappy

    slappy Neuropsychiatrist
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    That's a sweeping statement. Most top programs have GMECs and other specific review committees to oversee just this sort of thing. Not meeting requirements is a very serious affair that can get you warnings, probationary status, etc. Do you have specific examples with names you can state?
     
  8. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
    Physician Moderator Emeritus SDN Advisor

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    GMECs will ensure that we're meeting the big requirements, make sure we're monitoring resident and grad performance, program quality, and faculty development...but I'd be surprised if my DIO knows what the psych RRC requires in terms of those subject areas, and we're not required to document them in any meaningful way, so I imagine a program that couldn't find a gero program would just say "our residents saw an average of XX cases of patients over age 70 over the course of Y and Z rotations" and call it a day.

    For therapy the ACGME requirement is minimal, and subject to interpretation: "competence" in "managing and treating patients using both brief and long-term supportive, psychodynamic, and cognitive-behavioral psychotherapies". If you want to make a PD sweat, ask them how they ensure that their residents are "competent" in anything.
     
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  9. waterytart41

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    That'll go over well during interviews :laugh:
     
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  10. Stagg737

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    Same. Some of them felt like the PDs were trying to be warm and encourage me to rank them highly, but they gave statements like "I think you'd be a good fit here" or ones you stated that could be broadly applied. I only had 1 interview where I really felt like the PD was genuinely trying to recruit me, but I also felt like we had a really meaningful interview and had a legitimate connection.

    I've been using "vibe" a lot in terms of how I'm ranking programs. However, I am hesitant to just go off of that. I had an interview with a program that I did an audition rotation at and knew the PD coming into the interview day. While the actual interviews went well, I felt like the whole day gave off a completely different vibe (in a bad way) than when I rotated there and felt like I'd love to be there for residency. In general, the interview day made me feel like the hospital and program was more concerned with their own name and looking good than actually connecting with the interviewees. Everything outside the actual interviews just felt off, which was not the vibe I got on that rotation at all. So I've been hesitant to use my gut feelings with the other programs I've interviewed at...
     
  11. st2205

    st2205 Attending

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    That’s funny. When I was interviewing for medical school, I suggested that my wife come to a set of interviews I had that were in cities ~2.5 hours apart. As we were driving to the first (rural) location, she mentioned how she hoped I didn’t get in there. Anyway, during my interviews they actually had stuff planned for SOs and really sold the support system. She then said she hoped we’d go there. Contrast that with the school the next day, which was in a really bad part of town, and she ended up sitting in the car for 5 or so hours with our oldest who, at the time, was about 3 months. I’d imagine that had she not gone we may have very well ended up somewhere else. It ended up working out really well that we did for many reasons outside of that (but also including that, too).

    ETA: My wife’s experience also included a McDonald’s (though admittedly no mugging).
     
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  12. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    For what it's worth, I'll offer that several PGY1s and PGY3s were at our dinner and lunch, respectively. They seemed chummy with each other.

    As for advocacy, I remember speaking with a resident who worked with local police to decrease juvenile arrests for behavioral issues. Another resident I met regularly works with asylum-seeking clients and a faculty member at CHA to prepare psychological affidavits for the legal process. She mentioned that many other residents also chip in at some point during their training. Overall, if I asked a resident about their post-grad plans (sample size = 4ish), the answer was working within the public health system.

    I also liked how residents and faculty talked about the hospital's relationship with people who live in the area and utilize its services. Community members serve on advisory boards and, at least I'm told, are invited to take an active part in what goes on at the hospital. In contrast, for instance, my home institution has a long way to go in this respect and seems to believe town halls open to the community would just be asking for trouble.

    Haha...I like this category
     
    #111 Coupd'Cat, Nov 27, 2017
    Last edited: Nov 27, 2017
  13. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    Accommodation & Food: Pre-interview dinner at resident’s apartment with sushi take-out and drinks. Very informal. Pastries & coffee on the interview day.

    Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences): Opens with us watching a 10-minute recruitment video. Afterward, the screen rises and the PD (Dr. Julie Penzner) breezes in to deliver a rapid-fire (but very thorough) overview of the program. Around 2 interviews in the morning (with an hour of break), tour of the clinic led by a PGY3. Lunch at the faculty club with ~5 residents (tres fancy). Around 2 more interviews in the afternoon and an hour break in the afternoon. Overall, 1-2 interviews with resident and everyone interviews with the PD. Wrap up with the chair, who is retiring (in his 80s!!) and former PD Dr. Auchinchloss.

    Program Overview:

    Sites: Manhattan Payne-Whitney Clinic, Westchester Division (historic free-standing psychiatric hospital with 250 beds about 30-40 minutes north of Manhattan), Memorial Sloan-Kettering.

    PGY1 -- IM at Sloan-Kettering (11 weeks), Neuro at Sloan-Kettering (8 weeks), and EM (4-5 weeks). 6 months at Westchester division on Geri, Acute Schizophrenia, “Second Chance”, and Selective (child/adol or eating disorders) rotations. Within those 6 months, 4-5 weeks at CPEP in Manhattan and 2-3 weeks of night float.
    • Second Chance Unit: Program for people w/ psychotic disorders that past physicians have deemed “treatment refractory”. Goal of treatment on unit is to increase individual functioning through behavioral rehab via token economy system and psychopharm tuning. On discharge, residents accompany patients to housing appointments, groceries, etc. to better understand how their symptoms may interfere with ADLs outside the hospital setting.
    PGY2 -- Adult inpatient in Manhattan (~18 weeks), Personality Disorders in Westchester (~4 weeks), CPEP (~4 weeks), CL at Sloan-Kettering (12 weeks), Partial Hospital Program (~4 weeks), Elective (3-5 weeks), Night float at Manhattan (~5 weeks).

    PGY3 -- Outpatient in Manhattan w/ about 40 patients to start out with at the beginning of the year, inherited from PGY4s. Conduct evals at outpatient clinics to pick up new patients. Sounds like the majority of patients are psychopharm-related (could be wrong), others are psychodynamic, supportive, CBT, DBT, IPT, also run weekly group therapy. 4 weeks of overnight weeknight call in CPEP (split into one week chunks over entire PGY3 resident pool). About 1 weekend call (either Saturday or Sunday but not both) per month. Residents very happy with their supervision, which is mostly process note based.

    PGY4 -- Mostly elective. I think they got rid of an earlier junior attending requirement. Scholarly paper requirement.

    Vibes - The program takes pride in working hard and becoming highly competent psychiatrists. Former PD touts that Cornell’s therapy training is “the best” & “unbeatable.” Many residents graduate and choose to stay within the Cornell “family”. Or, they leave, realize the grass isn’t greener, and choose to return. The residents/faculty I met were cerebral, curious, and professional (by which I mean a mix of being attuned to propriety and Respecting the Hierarchy).

    Otherwise, not as recruitment-heavy as other programs. Residents and faculty were friendly, but seemed to be going through the motions (with a 1-2 exceptions). I guess stamina is running out. One of my interviewers yawned more times than I thought was possible in a half hour. Most of the time, I felt like I spoke a different language from the people I met (Was that supposed to be a joke just now? They seem to be chuckling. Smile politely. Keep nodding.). Also was my first experience of having all of my interviewers inquire about how my family members reacted to my decision to pursue psychiatry given my racial background. A bit confusing, since all family dynamics in our community are different. Felt like an exotic bird invited to speak about my species. That might not have been their intention.

    Faculty Achievements & Involvement:
    Many world-renowned and distinguished faculty. If you haven’t heard of Otto Kernberg before your interview day, you will have by the end of it. At least twenty times. Residents were also a fan of Richard Friedman, who writes this NYTimes column here.

    Location & Lifestyle: Located in the Upper East Side which is quieter compared to some other parts of Manhattan. Residents are guaranteed subsidized housing within a few blocks from the hospital (about $1800-$2300 for a studio/1 bedroom I believe...good views of the East River). There are also tunnels that lead from the resident apartments to the hospital, so you can avoid rain/snow/sunlight/any weather at all to your heart's content.

    Salary & Benefits: No idea what the salary is. It wasn’t mentioned, and we received no information packet about salary/benefits. Can’t find it on the website either. Assuming it’s comparable to the other NYC programs. Got the feeling that if we asked too much about call or benefits we would be quietly judged for it.

    Program Strengths:
    • Bright & hard-working co-residents.
    • Very, very strong psychotherapy training.
    • Rub elbows with prominent figures in the field.
    • Along the same lines, if your intention is to go into private practice especially in NYC, you’ll be connected to a wide network of Cornell alums & potential to pick up referrals that way.
    • Many residents seem to fast-track into Child--PGY4 said that 6/12 of residents her year did.
    Potential Weaknesses:
    • No formal VA or community psychiatry exposure, however past residents have dedicated their elective time to these pursuits (mostly PGY2 and PGY4 year). For community, possible electives include rotating through affiliated Lincoln Hospital (city hospital), a “Health Care for the Homeless” program, and making home visits with the ACT team. Otherwise, my impression was that social/cultural aspects of psychiatry wasn't something most of the faculty/residents think much about, on the whole.
    • Culture seems to be self-selecting.
    Overall Impression: Impressive training, particularly in psychotherapy. Would be happy to train here and make the most out of it, but personally would feel out-of-place 85% the time in this self-selecting environment.
     
    #112 Coupd'Cat, Nov 29, 2017
    Last edited: Nov 29, 2017
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  14. Amygdarya

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    Very nice review. I've been feeling lazy about posting reviews lately (shame on me!) but I'll just make some additions/correction to your review:

    1) Training sites: for the sake of completeness, Cornell psychiatry residents also get consults at Hospital for Special Surgery (a premier ortho hospital across the street from NYP) and can do community psychiatry at Lincoln Memorial (a mess of a city public hospital in the war zone... ahem, in South Bronx). But it's true that Cornell is not affiliated with a VA or a public hospital to do a significant part of training.

    2) Community psychiatry: AFAIK it's an ACGME requirement to have 2 months or so (?) of community psychiatry, so, as an ACGME accredited program Cornell does have 2 months or so or community psychiatry in the 4th year. Residents can do it either at a public hospital (as above) or as part of a mobile crisis unit/ACT team that Cornell has. It's true that community psychiatry is Cornell's weakness but I wouldn't say there is no exposure to community psychiatry. In addition, residents can join faculty for homeless outreach or asylum applicant evaluation.
    To fulfill ACGME forensics requirement, there is a 1 month or so rotation at Riker's (a big prison in NYC). You can also do electives at other institutions in NYC - say, do more forensics and/or community psychiatry at Bellevue if you're interested (though of course for people seriously interested in community and/or forensic psychiatry NYU would be a better residency choice to start with).

    By the way, I'd like to dispel a common misconception about Cornell in general: despite the fact that it's a fancy-shmancy private hospital in the fancy-shmancy Upper East Side, the hospital sees patients of all walks of life, from homeless to Saudi princes, literally. You'll see plenty of homeless and otherwise disadvantaged folks in CPEP, on the inpatient unit, on C-L.

    3) Rotations/call: PGY-1 is organized in two 6-months blocks: 6 months on service and 6 months off service; residents are split into 2 groups and switch in the middle of the year. There are 2 weeks of night float in each 6-months block (IM night float is part of NYP-Cornell IM weeks). IM and neuro are actually about 50/50 at NYP-Cornell/MSK (a premier cancer center); EM is all at NYP-Cornell. On IM and neuro you'll have 1-2 "long calls" a week (working till 8 pm, doing evening admissions) and will have 1 day off a week. IM is pretty hard/miserable; neuro may or may not be hard depending on patient load on service. Neither is right out malignant though (just really busy with very sick complicated patients), and psychiatry interns are treated just like any other intern on service.
    On CPEP you'll work five 12-hour (actually up to 13-hour if you count signout) shifts a week with free 2-day weekends. There are 2 weekend night CPEP shifts in the on service 6-months block.
    In Westchester you'll have 1-2 "long calls" a week, no nights or weekends. You'll get quite a bit of Clozaril experience on the Second Chance Unit. Residents are brought to Westchester by shuttle by 9-ish am and are taken back to the city at 5 pm, so nobody stays at work after 5 pm expect for people on "long call" who get a personal town car to the city when they're done.
    I don't have details of EM call/weekends.
    4 weeks of vacation (every year).

    Most of C-L in PGY-2 is actually done at NYP-Cornell (11-12 weeks, also covering infrequent consults from HSS at that time); only 2 weeks are done at MSK (I've heard different opinions regarding the value of C-L at MSK: on the one hand, residents say that they see enough cancer-related issues at NYP without having to go to a dedicated cancer center; on the other hand, they appreciate the different settings/culture/attendings including the founder of psycho-oncology Dr. Breitbart). C-L is typically 8/9-5 (or whenever you finish your work) five days a week. After 5 pm consults are covered by CPEP team, and weekends are covered by an attending on call.
    CPEP schedule in PGY-2 is the same as in PGY-1 except there are 2 weekend night CPEP shifts in the whole year.
    PHP is 9-5 five days a week, no call.
    Westchester schedule in PGY-2 is the same as PGY-1.
    Inpatient in Manhattan is 8-5 (or whenever you finish your work) five days a week, 1-2 "long calls" a week, one weekend shift every other week covering the whole unit with an on call attending.

    PGY-3 is all outpatient five days a week. Regarding call, there is about 1 weekend day CPEP shift/month, 4 CPEP weekend night shifts/year and 4-5 weeks of CPEP nights/year.

    There is a jeopardy system with covering PGY-2s, 3s and PGY-4 backup. No call in PGY-4 other than backup (if that ever happens).

    4) Didactics: PGY-1 off service you'll go to the didactics of the corresponding service. On psychiatry you'll have protected 1/2 day/week of mostly strong didactics + weekly generally very good Grand Rounds attracting psychiatrists from all over the city, weekly "lunch and learn" on Fridays for residents for "softer" topics, monthly M&M with residents presenting cases and invited faculty discussing them, other random talks by invited speakers, case discussions (residents presenting, invited faculty interviewing the patient and discussing the case), service-specific didactics (on C-L, inpatient, Westchester).

    5) Supervision: a lot of it, and high quality. Aside from on service attendings, you'll get an off service supervisor to discuss your cases for 1 hour/week in PGY-2. For different psychotherapies and psychopharm a PGY-3 mentioned 7 hours/week which is, admittedly... a lot. You can get pretty much as much supervision (particularly in psychotherapy) as you can handle. Depending on your preference, this can be both an advantage and a disadvantage.

    6) Scholarly paper requirement: it can be on pretty much any psychiatry related topic of your interest, doesn't have to be research. Scholarly activity including publishing/presenting is highly encouraged though not required; most residents end up publishing something.

    7) The vibe: I strongly agree with cerebral/intellectually curious. Granted, I'm very biased but I'm sorry you didn't seem to like "the vibes" otherwise. Most of the faculty are genuinely good people, though some of them can be intimidating. I think some of this stems from the psychoanalytic tradition (which is strong at Cornell) to not reveal much of yourself including your emotions, which extends from patients to trainees to colleagues. However, younger attendings, especially the ones at CPEP are actually very cool and very very human.
    Almost all of the residents are great people, in my experience. I guess they may be the kind of people that require time to get to know them, but it's totally worth it getting to know them. I don't know if I'm making sense. And, like I said, I'm quite biased here.
    You must also be right about the self-selecting culture; after all, there is a reason many Cornell psychiatry residency graduates stay in the department or return after a short stint/fellowship elsewhere.

    Re the question about parent's reaction: I don't know if they ask everyone that, or if it's because I'm also a (different species of a) rare bird in a way, but I got asked this question by the PD as well. I didn't take offense in it though, probably because it sounded unbiased to me, ie the PD actually didn't know about the attitude to psychiatry where I come from (hint: it's a very very bad attitude). I felt like the question was more about my personality and my relationship with my parents (independent but respectful - which, I assume, is the right answer :p) rather than some kind of negative stereotyping of my native culture. Of note, this was probably the most "psychodynamic" question I was asked at Cornell :D

    8) Big names: with Cornell's reputation of the evil ivory tower of psychoanalysis, I just have to start with analysts. Otto Kernberg, of course, who eons ago introduced the notion of borderline personality organization/borderline personality disorder and has been researching the disorder and developing psychotherapies for it since then. Dr. Auchincloss is a renowned psychoanalyst herself; she's the author of "The Psychoanalytic Model of the Mind", a highly readable book on the four major psychoanalytic theories (kind of like "Psychoanalytic theories for somewhat educated dummies"). Then there is George Makari, the author of "Revolution in the mind", a well written contemporary look at the history of psychoanalysis. Other big names: Dr. Lorde in autism, Dr. Barnhill in C-L, Dr. Breitbart, like I said, the founder of psycho-oncology, Dr. Michels in all things psychodynamic :p (also an author of a very good - though very psychodynamic, so not to everyone's liking - book "The Psychiatric Interview in Clinical Practice"), Dr. Attia in eating disorders, Dr. Alexopoulos in geri. Dr. Mary Jeanne Kreek who first developed methadone maintenance therapy. Dr. Vivian Pender, the UN advisor on mental health and human rightds activist (particularly in the areas of violence against women and trafficking). Dr. Richard Friedman, like you said, writes thought provoking articles on things related to psychiatry in the NY Times; he directs the psychopharmacology clinic where he supervises residents and leads "biological psychiatry" didactics; a highly intelligent person beloved by residents who get a lot of face time with him. In fact, residents get a lot of face time with almost all the "big names" I mentioned (except for Mary Jeanne Kreek who's effectively retired and Drs. Lorde and Attia, unless you take the corresponding rotations), including - gasp! - Otto Kernberg himself. Most of them are very approachable in person.

    9) Salary and benefits: yeah, to be honest it was weird they didn't include this information in the information packet. From what I hear, salary/benefits are indeed typical of NYC programs (except for Columbia which pays more in PGY-1&2 and *significantly more* in PGY-3&4; I also believe Washington Heights is cheaper than Upper East Side). I'll try to find out the specifics and will post if I do.

    10) I'll add to your strengths:

    - Good ECT exposure, possibility of getting ECT certified in residency if interested, rTMS exposure available.

    - You may not have guessed it (with the psychoanalytic vibe and all) but the program/department/affiliated hospitals are actually very LGBT-friendly (to whom it may concern).

    - The PD is awesome and stands up for her residents.

    - While residents are expected to work hard, they're supported and treated well by faculty (eg., in CPEP - the busiest/hardest setting of the psychiatry services - attendings would buy nice take out lunches/dinners for their residents with their own money and occasionally let residents go right after signout and stay behind to finish their notes).

    - For me personally the intellectually stimulating atmosphere is one of the biggest strengths of the program; residents are not just learning the trade of psychiatry here (which, make no mistake, they do - psychotherapy training has already been lauded, but "biological psychiatry" training is strong as well) but are broadening their intellectual horizons, so to speak. This may not be for everyone but is highly valuable to some people. Like you said, this place is pretty self-selecting.

    11) And in addition to your potential weaknesses:

    - A limited number of in house fellowships: geri (quite strong, I hear), CAP in conjunction with Columbia (interested residents can fast track and are just about guaranteed a spot), psychooncology between MSK and NYP-Cornell (no general C-L fellowship at Cornell, interested Cornell graduates go to Columbia C-L fellowship), forensic in conjunction with Columbia (I have no idea about this fellowship at all).

    - Relatively weak addictions despite the glorious history of methadone maintenance development :( Though the current head of addiction psychiatry (trained at Cornell residency and NYU addictions fellowship, one of those boomerangs) is very active in improving the service and training opportunities for psychiatry residents and others.

    - For people set on a research career, this is not a research powerhouse. Not like the neighboring Columbia and the burgeoningly neuroscientific MtSinai (main campus) anyway. To be sure, there is some really good research going on and the vice-chair of research is very interested in bringing more research to Cornell. However, there are not that many labs/PIs to choose from and no "real" research track (one resident in each class is given research time at what seems like the expense of breadth and diversity of clinical training, and there is no established research track funding like R25 etc).

    12) The chairman of 25 years is retiring this year. What's next for the department? Cornell psychiatry is "too big to fail", especially with long-time members of the department in other leadership positions, but I'm curious who's going to be the next chair and where (s)he'll (try to) take the department.
     
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  15. splik

    splik Professional Cat at Large
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    FYI, just want to point out that breitbart is definitely not the founder of psycho-oncology, the field predates his birth, and MSKCC (which is probably the birthplace of american psycho-oncology) had a psychiatry service in some form from the 1950s. there is no minimum ACGME requirement for community or forensic psychiatry, they merely state "experience" in those areas is a requirement.

    a new chair is definitely a good thing. 25 years is too long for someone to actually be chair, they have probably been doing nothing for the past 15yrs at least. it's just a power grab when people stay on that long. a new chair usually means the medical school will give money for start up costs for whatever strategic plan the new person has. i suppose its possible the new person might try to kill of all the analysts as has happened elsewhere but it seems unlikely the faculty would vote for such a person.in which case they may not be able to appoint a chair at all until they all die off naturally. (i'm not kidding).
     
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  17. Amygdarya

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    Thanks for the clarification.
    Well, let’s say Breitbart is a prominent figure in psycho-oncology.
    And Cornell does have community and forensic psych rotations regardless (even if they’re not a priority for the program).

    By the way, Cornell is certainly not the only one underappreciating community and forensic psych; Brown is another example of sticking community and forensic psych rotations into the 4th year as an afterthought.
    Ha.
    I know of a non-Psychiatry department at a different medical school that has been chairless for over 2 years, so I know that chairlessness can happen for various reasons. In that case the reasons are financial though.
     
  18. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    Great review. I appreciate that it shows a different perspective for future readers. If some of the residents I met had been half as enthusiastic and thorough in their answers perhaps I would have left w/ a different impression!

    Right--I'd like to think that was their intention. What steered it toward cringe-worthy territory for me was the context of "I've heard that many people who are X think like this...how has that influenced your family's reaction" etc. etc. Semantics, I guess. I'm not offended either way. However, I did pause and mull over in what ways culture & psychiatry might be discussed at this particular program. Will it be an environment where people talk about cultural competency or about cultural humility? That sort of thing...
     
    #116 Coupd'Cat, Nov 30, 2017
    Last edited: Nov 30, 2017
  19. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    I believe someone said Cornell had 3 chairs over the past 80 years lol.

    Hm I imagine quick turnover could also be worrying & indicative of a toxic environment. Guess there is a sweet spot somewhere.
     
  20. splik

    splik Professional Cat at Large
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    Not really. quick turnover at the chair level usually means that they have been rapidly promoted to a more senior position (e.g. dean, vice chancellor, CEO etc). chairs are the ones who can create the toxic environment lol. i suppose the other reason in psych for abrupt departures is because of ties to pharma that either lead them to quit or be pushed (e.g. nemeroff, schatzberg etc.) It's usually more of a red flag when other places hire these people (e.g. miami)

    the oft quoted (and arbitrary figure) is 10 year lifeline for a chair of department before they become a waste of space. people run out of steam, get comfortable, and there is only so much one can achieve during one's tenure.

    All this said, at the resident level, it really does not make much difference whether or not there is a chair and who they are. except maybe really small programs where the chair is the program director in which case they are definitely just a placeholder. you cant possibly do both jobs.
     
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  21. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    I suspected as much! Yet we're still paraded in front of them and vise versa on interview days. Perhaps it's just a nicety.
    On the other hand, I suppose residents feel some downstream effects of which faculty members are recruited by the chair & where the budget flows--no? Unless it all moves on a glacial timescale
     
  22. splik

    splik Professional Cat at Large
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    I would say that who the program coordinator(s) is/are will probably make more of a difference of your training experience than any single faculty member. I dont think anything the chair or did or did not do made any discernible difference to my residency experience.
     
  23. Prolonged_QT

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    Stony Brook SOM – Stony Brook, NY


    1. Ease of Communication: PC is a very sweet, responsive, and efficient woman.

    2a. Accommodation: They give two options for nearby hotels at a fixed rate under $150. Hotels provide free shuttle service to the hospital.

    2b. Food: Had to put food in a separate section because it was EXCELLENT for all the meals they offered. The pre-interview dinner was a 7-course meal (!) at a nearby Hibachi restaurant, alcohol included. Resident:applicant ratio ~2:3, interns and PGY2s only. Interview breakfast was an excellent continental spread, and lunch was delicious Italian. Lunch also well-attended by residents.

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences): 8:30AM – 3PM. Three half-hour interviews, one with the PD, and 2 with other faculty. No weird questions. All interviews were pleasant and conversational. They had all read my application. Everyone asked “why Stony Brook?” Other applicants were from the NY area, a few from Long Island itself.

    Lunch was followed by a tour of the inpatient and outpatient facilities. The OPD is very pretty, with spacious offices. It’s in a separate building from the hospital that you need to drive to. Stony Brook Hospital is nice. Ditto for CPEP.

    4. Program Overview: Small program with 5-7 residents/year. The program used to see itself as a quaint community program. The new chair, who was recruited from Columbia in 2012, is trying to change that with a more academically rigorous vision for the program. The department is building several new research facilities.

    PD emphasized that faculty were very approachable, and the chair himself gets to know residents personally by coming to most journal clubs. Many residents were involved in research and said they had the time and support to do this.

    Program is structured in a standard way, PGY1 and 2 are inpatient, 3 and 4 are outpatient. Psychotherapy didactics/supervision don’t start until 2nd year. PD emphasized that the CPEP is very busy. It’s the only one in Suffolk County, with a catchment area of 1 million people, so they see a very diverse population from VIP wealthy Hamptonites to homeless chronically psychotic folks from the middle of the island.

    Residents talked about strong ECT exposure, and several were pursuing certification. Training at university, VA, and state hospitals also provides broad exposure. Senior residents felt very prepared to practice psychiatry.

    Residents were kind, happy, enthusiastic, cohesive, and down to earth.

    PD was upfront and transparent. He did not oversell the program. He directly stated that while this is not the best program in the world, it’s a very solid one and they are prepared to be flexible so you could make the most of it.

    5. Faculty Achievements & Involvement: They don’t have a lot of people doing research but the ones that are doing it are doing it well. Main research areas are psychiatric epidemiology, neuroimaging, and ECT. Faculty responsible for this research are good quality and approachable.


    6. Location & Lifestyle: Perhaps the biggest weakness is location. It’s on Long Island in a very suburban, quiet area. Car is 100% required. Cost of living is high considering location – prices are NYC level. ~$2000 for a 1 bedroom. There are some cute towns and beaches nearby with standard suburban/rural activities – pumpkin picking, boutique shopping, hiking, sailing.

    Lifestyle of the program was reasonable. Residents and interns were happy and not overworked. Several residents reported that the PD made near-immediate changes based on feedback regarding certain rigorous rotations. Several residents had children during residency and no one seemed to think it was a big deal. Residents didn’t balk at being asked lifestyle-related questions.

    7. Salary & Benefits:

    PGY-1 = $60,852
    PGY-2 = $64,735
    PGY-3 = $68,285
    PGY-4 = $71,837

    Stipends for conferences. 4 weeks vacation, 5 weeks during intern year (if you count unstructured “research week” as vacation). BYO housing.

    8. Program Strengths:
    - Small, intimate program with highly approachable faculty
    - Department seems to have money and is excited to support research
    - Busy CPEP with diverse exposure to psychopathology
    - Training at state, VA, and university hospitals
    - Residents are down to earth, seem happy and not overworked
    - PD is a straight shooter, responsive to resident feedback


    9. Potential Weaknesses:
    - +/- location
    - cost of living is high, especially considering location
    - because of the above, and enduring reputation as kind of a “blah” program, I think they have trouble attracting high quality faculty for didactics. This may be changing.


    10. Overall Impression: You will get solid training and be treated like a human. The program is flexible enough (and motivated) to support research interests and career development. You need to be OK with living on Long Island.
     
    #121 Prolonged_QT, Nov 30, 2017
    Last edited: Dec 1, 2017
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  24. When is graduation again?

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    Vanderbilt
    1. Ease of Communication:

    Via email. The program coordinator was very responsive.

    2. Accommodation & Food:

    No accommodation provided. Dinner was at a restaurant called Cabana. Morning breakfast was fruit, yogurt, and pastries. Lunch was from Panera.

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences):

    Started with a powerpoint presentation from Dr. Cowan, PD, and Dr. Skikic, aPD. There were then 7 interviews (4-30 minute interviews and 2-15 minute interviews and one other "interview). The last "interview" was specific to me and one of the other people of color. They had me see the leader for the Office of Inclusion and Health Equity, which was complete B.S. She was a nice lady, but I fail to see why the only people who went to see her were people of color, when diversity/inclusion should be a thing everyone is exposed to. She had to ask us what type of resident applicants we were and none of the residents at lunch even knew who she was. Also because of this, I left 2 HOURS after the first applicants to leave and almost 1 hour after everyone else. It felt like I had detention or something. My day ended peak rush hour and I still had to drive over the mountain in fog, rain, and darkness to reach my next destination. I've seen a lot of strange and uncomfortable attempts at talking about race this interview season, but this takes the cake for infuriating... my profile picture was my face at the end of the day.

    4. Program Overview:

    Pretty Average. Things to point out include:
    -1 month with the mental health cooperative in PGY2
    -1/2 day of elective time in PGY3
    -Most of PGY4 is elective, except a 1/2 day of forensics per week for 2 months.
    Call includes a 5-6 weeks of nightfloat PGY2 and a combination of short call (5-9 pm weekdays) and long call (9am-9pm weekdays)
    -Moonlighting starting PGY3. Though residents I spoke with didn't seem to do that.

    5. Faculty Achievements & Involvement:
    They seem pretty well achieved. I heard great things about their psychosis research and street psychiatry. Residents and faculty touted their collegiality.

    6. Location & Lifestyle:
    Salary starts at 54k. COL has been rising in Nashville, but it still seems affordable on the resident salary. A few residents bought houses. Nashville is sizeable Southern city, with an overabundance (read: too much) of country music.

    7. Salary & Benefits:

    Pretty standard

    8. Program Strengths:

    -Psychosis research
    -Street Psychiatry elective (from what I gathered, it is like an ACT team, but focuses only on the homeless. Though of my interviewers didn't really seem to know what an ACT team is, so make of that what you will.)
    -All of the training sites are in the same area and within a few minutes walk of each other.
    -You can create any elective you want as long as you find a faculty advisor or someone that the program trusts to educate. One resident started an art therapy rotation. Another carved out a niche in ethics.
    -Friendly faculty
    -Residents get fellowships at prestigious places

    9. Potential Weaknesses:

    -Very few community psychiatry offerings. I've heard that this is the Chair's primary focus now, but could still be some time.
    -Not the most flexible program
    -Psychotherapy, if that's your thing
    -Country Music

    10. Overall Impression:

    This is a pretty standard program that doesn't really stand out, to be honest. The faculty seem nice and the residents as well, but otherwise I feel like they're skating on the strength and name of their medical school and undergrad campus. This program doesn't really seem to have an identity or mission. The theme of the day was: if you go here, you'll become a great clinician and get to live in Nashville.
     
    #122 When is graduation again?, Dec 1, 2017
    Last edited: Dec 1, 2017
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  25. clausewitz2

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    This was 100% my impression of them when I interviewed two years ago. Glad to see they haven't really changed. I also got told by residents there that since Vandy is a private hospital, there are definite attempts to steer more indigent folks across town to whichever hospital Meharry has their inpatient unit at. Just another little bit of grossness from a program with an odd vibe.
     
  26. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    :yeahright: dang.
     
  27. Evidence Based

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    @coupd’cat had a wonderful review in page two of this thread and really nailed a lot of the aspects of the program I saw. I’ll chime in with additional thoughts and things that particularly struck me

    2. Accommodation & Food: Just wanted to re-emphasize that there was a really strong turnout by residents at both the pre-interview dinner and the interview lunch. Applicants were actually outnumbered by residents at lunch the day of the interview. This is definitely somewhat due to the size of the program (18-20 residents per class!), but also speaks to the degree to which the residents love Yale.

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences): PD Dr. Rohrbaugh and aPD for education Dr. Ross traded off in the morning. Gave an overview of the program that focused less on nuts and bolts (their program website is very thorough) and more on program vision, which I found super helpful. 4 interviews, ranging from 30-45 minutes. I was matched with faculty who very closely aligned with my interests, and all of whom had clearly read my application closely and had made extensive notes on the things they wanted to talk about. Some of the most enjoyable interviews of the cycle for me.

    Interviews finished by lunch, which I SUPER appreciate. Also appreciated the talk by the PD at the end of the day on Match integrity. Stated they would under no circumstances initiate contact with us, and that we should feel welcome to contact them with questions but doing so would not impact ranking.

    4. Program Overview: Great overview by Coupd’Cat and thorough website, so I won’t belabor nuts and bolts.
    Special sauce:
    -Training “leaders in 21st Century Psychiatry.” This was the first phrase the PD used to describe the training philosophy. To this end, they expect residents to develop “broad knowledge in psychiatry with an area of narrow but deep expertise.” They don’t care what kind of leader you are (chair, program director, basic science researcher, health policy guru, advocate), and are happy to support people in making names of themselves.
    -Pertaining to the above, residents get protected time to pursue this “narrow but deep” expertise. 1 month in PGY-1, and 3 months (?!) of protected time in PGY-2. Only clinical responsibilities are call which is ~q11, otherwise free to pursue interests, whether those be medical education, research, health policy, curriculum development, etc.
    -Really strong exposure to community and public psychiatry. Connecticut Mental Health Center (CMHC) is a joint venture between the state of CT and Yale, and seems to be an example of what community mental health was supposed to be (but that has never really existed in most places). Residents spend time in inpatient and outpatient clinics here, and it has a ton of research and health policy work embedded in it. Super impressed by this.
    -Possibly due to its ties to CMHC, surprisingly strong commitments to advocacy and the social determinants of health. Program is rolling out a “Social Justice and Health Equity Curriculum” for all tis residents.
    -West Haven VA seems particularly strong/academic. Houses program evaluation for VA psychosocial rehab and other psychiatric service research for the entire country. Great addiction exposure, no surprise there.
    -Didactics seem particularly well thought out. aPD Dr. Ross is clearly passionate about education, and tailors education to residents as “adult learners.” Minimum lecture, lots of flipped classroom style learning.
    -Much larger than other programs I’ve been two. 18 PGY-1s, 20 PGY-2s.

    Other notes:
    -Child was surprisingly weak. Fellowship seems excellent, but it seems like the fellows take up clinical slots that the residents can’t use. Residents can’t rotate on young child unit, and PGY-4s have only one inpatient child elective in house. That being said, you can fast track and Yale has excellent placements in child for both 3s and 4s. Lower child exposure is probably more of a weakness for people who want good child exposure but don’t plan on pursuing fellowship.
    -Didn't hear much about psychotherapy training. I have no doubt it’s solid, but was certainly not emphasized by PDs.

    5. Faculty Achievements & Involvement: It’s Yale

    6. Location & Lifestyle: I would describe my impression of New Haven as “wow, this is better than I expected!” Really good food, affordable CoL. That being said, still a city with a lot of poverty and some crime. Not sure if it’s worse than other comparable cities. Residents told us they never felt unsafe walking alone at night. Many lived either downtown or in East Rock (nicer more quiet appearing area in the northern area of the city, lots of two family houses).

    8. Program Strengths:
    -Excellent public psychiatry exposure. CMHC is a gem
    -Yale name brings tons of resources, money. Residents take advantage of this.
    -If you have an interest in being a leader in a certain area, and have at least some idea of what that area is, this place will make you a star. Tons of support and protected time to develop a “narrow but deep” expertise.
    -Larger program size means residents are more protected from sickness, maternity/paternity leave, etc.
    -Great salary/CoL ratio
    -Residents are a really fun bunch

    9. Potential Weaknesses:
    -Child experience isn’t amazing if you want to be competent without doing a fellowship
    -Having entire PGY-3 outpatient clinic within one institution is somewhat limiting, especially if you don’t get your first choice.
    -New Haven isn’t New York or Boston (obviously +/-). Definitely livable and cheap, but with perhaps slightly higher safety concerns than other programs.
    -Freedom would be more difficult if you’re totally undifferentiated or don’t have a particular non-subspecialty interest within the field.

    10. Overall Impression: Yale is a wonderful program, especially if you’re interested in becoming a leader or expert in a given area while not sacrificing excellent training. Would be less of a fit for someone who plans on being a full-time clinician, although you certainly get excellent clinical training.
     
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  28. deepsouthpsych

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    Thanks to everyone who has posted reviews so far! Adding the ones I've been on the past month. Most of these are from notes I took on interview day.

    Duke
    Easy to communicate with via e-mail. Sign-up for interview slot with an online app. No issues there. Discounts were offered for hotel. Pre-interview dinner had a great resident turn-out with a mix of years from PGY1-PGY4. Residents were a nice, cohesive, friendly group but definitely meet more quirky/bench research-oriented people than at other programs so far. No one seemed burned-out, impression that they have had a good experience with the program. Interview day started at 8am with breakfast. Overview of department from chair Dr. Rynn who came Duke from Colombia. She clearly loves the program and is excited about her role in working to build the department. Focus on the research mission and emphasized the research collaboration that occurs between departments. 3x30-minute interviews and 2x15-20 minute interviews. LOVED the faculty with whom I interviewed. Easy to speak with and asked some of the most thoughtful questions about my application in addition to the normal why psych/why Duke. I enjoyed speaking with the faculty more than I enjoyed speaking with the residents honestly. Tour was super strange. Duke only has 1 in-patient unit and then the VA in-patient unit so it takes like 10 minutes to walk over and see those places. Our tour guide then walked us through some gardens, the undergrad campus, and the famous (and beautiful) chapel. A lot of reflective pauses with no explanation. I felt like they were trying to mask the fact that a "psych" related tour only had two places of interest on the entire Duke campus.

    Program has typical structure with PGY1/2 inpatient and PGY-3 outpatient. PGY-1: 1 month of medicine on the Duke med/psych ward which seems useful, 1 month at the VA, and 2 months general medicine at Duke Regional Hospital which is apparently more bread and butter than the Duke University hospital. Psych consists of the duke in-patient unit (only here as a PGY-1!), VA (in-patient and out-patient) and Psych emergency center. PGY-2: All in-patient done at Center Regional Hospital (NC state hospital). Emergency, C/L, and outpatient done at Duke/VA. Continuity clinic which is 1/2 day at the Duke Outpt Clinic starts. PGY-3: Outpatient. Residents spoke very highly of psychotherapy training and the ability to gain experience in psychodynamics and CBT. Have an awesome, intensive family studies program that all residents participate in. Complete 1 month of output neurology. PGY-4: Electives. Can push off community and the pgy-3 neurology month until PGY-4 if you choose. Every year has protected didactic time on Tuesday afternoon. Paid well for COL in the Raleigh-Durham area. Benefits are fairly standard, neither the best nor worst.

    Overall, Duke was ok. This is the place I would go if I wanted a predominantly research focused career. I feel as if the clinical training is secondary in importance to the research mission of the university. Despite that fact, I do think the residents have a great clinical training experience and they have no issues pursuing fellowships or finding jobs immediately after residency. PGY-4s definitely felt as if they were ready to become attendings and only pursued fellowships because they were interested, NOT because they felt like they needed supplemental training before graduating. The family studies training aspect was a major plus for me but didn't outweigh the odd vibe I got at times.

    UTSW
    Communication via e-mail. Easy to schedule, no issues. Pre-interview dinner was at an italian place with 6 applicants and 3 residents (a PGY-2, 3, and 4). Residents are incredibly friendly, bright, and LOVE their program. This program had a wonderful, warm, welcoming vibe that started at the dinner and carried out through-out the day. Did not meet as many residents here as I have at other programs, but from the residents we came across as we toured in the afternoon, felt this was more a function of people being busy/spread out across a large campus rather than trying to "hide" residents or residents being worked to death. Interview day started at 8am with an overview with Dr. Brenner (PD). Followed by 3x30 minute interviews. All very laid back, conversational. No odd questions. Dr. Brenner is wonderful to speak with. Tour after lunch, they show you Zale, Parkland, and the PES. Parkland is new and beautiful. Every building is technically on the same campus but the campus itself is HUGE (everything is bigger in Texas?).

    Program has typical structure w/ PGY1/2 in-patient, PGY-3 out-patient with some time for electives and PGY-4 elective. Good exposure to a range of populations (socioeconomic, ethnic, illness severity) and settings (private, public, VA, community, forensic). Services are BUSY and as one of my interviewers told me, at Parkland "you can look for zebras and find them". PGY-1: Can do 1 month of in-pt pediatrics out of 4 medicine months done at Parkland. 2 months of neuro, several possible options. 1 month addictions, 1 month community, 2 months in-patient psych at the VA. Early exposure to psychotherapy through didactics and what sounds like a focus on CBT on in-pt at the VA? PGY2-PGY4: More detailed, concise information on their website. I don't recall the specific details of call but there were no complaints about feeling overwhelmed/unsupported. No one appeared burned out. Protected didactics on Tuesday afternoons. Appears to be good balance between psychopharm/psychotherapy and many residents take advantage of various elective opportunities in different therapy modalities to gain more experience/competence in specific therapies of interest. Electives in family and DBT are popular. Was also impressed how resident driven this program is. Residents have a voice and clearly help make decisions. Residents are encouraged to take on leadership roles in helping to make changes when there are complaints/concerns. Got the impression that if you want to do it, you can either find it or create the opportunity at this program.

    Overall, loved the energy, size, and range of opportunities at this program. Dallas seems like a cool city. Residents paid well and are able to live comfortably. Healthcare benefits more expensive than at other programs, but Texas has no state tax. Otherwise, benefits are standard. Also of note- very family friendly. Several (male and female) residents mentioned having babies and feeling supported by department and co-residents in taking needed time off.

    Vanderbilt
    A couple others have already put in detailed reviews. My thoughts- I liked the size of the program. Dr. Skikic is aPD and was wonderful to talk to. She seems very interested in helping residents and the program grow. 15 minute interviews were a bit off-putting and didn't feel like enough time. Great resident turn-out to the dinner and lunch with a variety of years 1s-4s. Seemed like a friendly, cohesive group. Several remarked on how everyone starting as interns on psychiatry helped to bring the group together. They have 88+ psych beds and are typically at 85%+ capacity, so they see lots of patients. I worry most about diversity of patient population although everyone I asked thought they saw a good range of patients in terms of socioeconomic status. Ethnic diversity reported to be reflective of the Nashville area- majority white with african-american and hispanic populations making up the rest. They do report a wide cachement area that includes parts of NC, GA, and MS as Vanderbilt may be closest hospital if you live close to the border in one of those states. If you're interested in child, they have a child fast-track option and accept 3 residents a year into this track. Residents noted the main benefit intern year being able to substitute 1 month of pediatrics for in-patient VA medicine. You also have the option of substituting 1 month of pediatric neurology for neuro and 1 month of pediatric ED for the ER month. Otherwise, the track is nice because you're already accepted into the fellowship and don't have to use ERAS/interview/rank etc. ever again. As far as the child side- they have a very strong presence in education-based psychiatry and have mental health clinics integrated into approximately 30 public elementary and middle schools in the Nashville area. As someone interested in this particular niche, I could see Vanderbilt as a place that would be both very supportive and very helpful in terms of resources and networking to build a career in this particular area. Child fellowship may be stronger than the general adult program??? Nashville is a fun city with lots going on. Will need a car as with any other major southern city. Pay seems appropriate for COL, several residents mentioned buying houses.
     
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  29. SmallBird

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    Nice review. I'd offer one reflection as a recent grad - most people who graduate still do go into full-time clinical work, myself included. However, I've been really happy with how I've been able to leverage the richness of my training experience to much more quickly get into exciting leadership and teaching roles at my new institution. I'm sure that there many ways people are able to do this well but frequently when I'm receiving positive reinforcement for a specific contribution around clinical leadership or education, its something I learned at Yale.
     
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  30. valid username

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    I am originally from Nashville. I have good friends who still live there and a few alumni friends.

    Even though I am an IMG, I was strongly encouraged to apply at Vanderbilt (read that with head tilted toward ceiling for best effect). I couldn't bring myself to do it. The thought of spending the next four years as their token non-traditional, non-WASP gave me a pathological feeling. Considering those down-and-out feelings would be reinforced by country music in the grocery store prevented me from parting with another $26.

    @whenisgraduationagain, I hope you remember and follow your instincts described here come rank day. Even though I have many friends and lots of family there, that is not enough to overcome that atmosphere.
     
  31. When is graduation again?

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    I honestly felt bad posting my review because I didn't want to bash the program, especially since everyone at the program seemed so nice. But I feel a lot better knowing that other people have had similar experiences/ feelings about the program/area. I can see it being a great program for some people, but I don't think it's for me either.
     
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  32. splik

    splik Professional Cat at Large
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    well at least they're trying (even if it sounds like they don't wtf they're doing). many institutions could not care less about this sort of thing. it sounds like they are least trying to make a concerted effort. these diversity initiatives are often epic fails even at institutions in more progressive and diverse regions of the country. i know for a fact that the psych dept has gone above and beyond in supporting their foreign residents in the past, for example. there are many reasons not to regard the program highly (it's not a particularly well regarded program) but I really do think they have been making a concerted effort to recruit and support a diverse workforce. though it does sound like your interview experience was comically bad!
     
  33. valid username

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    I am sure their intentions are good. You are right, Their efforts are commendable. I am sure in another five years the improvement will be significant. I know I'm biased because I grew up there. I am too aware of and sensitive to the kinds of judgement anyone outside the wasp-box will experience there. To be fair, the institution has its work cut out for them. I don't envy the task a bit--they cannot control the opinions of their patients.

    And if anyone from the program is here reading: if you must keep these applicants longer consider giving them an option to come in early. Driving thru rural TN at night can be unsettling. The applicant should have the option of leaving at the same time as other applicants.

    Kudos to Vandy for tackling this issue.
     
  34. Salpingo

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    This was my experience from the outside as a resident. There was an outline of general expectations, required classes, and awareness of "competency," as well as unceasing requests for endless feedback forms, but nothing specific, like set number of procedures for the surgical specialties. Basically, formalized instruction not to be a racist, sexist, incompetent jerk. Then there seemed to be periods of profound panic coming from the residency office for a few months during some accreditation period, and we would be told to log XXXX number of XXXX type of patient for XXXX period of time. I assume those logs are out there somewhere, placed strategically into piles to create a makeshift on-call room required by our governing body.

    Actually looking at the forensic requirements in the ACGME guidelines, all you have to do is "include experience evaluating patients’ potential to harm themselves or others, appropriateness for commitment, decisional capacity, disability, and competency." No specifics beyond that, including amount or length of work. This could literally be a part of any psychiatric rotation.

    For what its worth, Jimmie Holland is still active at MSKCC, although probably less so at Cornell. While I don't know if there can be a single founder for any specialty, she's pretty close. In fact, with respect to establishing, organizing and legitimizing a field, she might be right up there with Freud, creating several societies, journals and the seminal textbooks. Yes, before she started the psychiatry service at MSKCC in the 70's, there was research and psychosocial care provided to cancer patients in the US (mostly by RNs and SWs), but there's a world of difference between disparate groups with shared research subjects, and a sub-specialty. Of course, that's based on my reading of the psycho-oncology history (which she wrote, because someone's gotta do it).

    That being said, I don't think going to any particular residency will give you special access to her or any of the prominent people listed above. Your best bet is always to join and become active in the society or conference of whatever you're interested in, whether personality disorder, psycho-oncology or whatever. Which is my half-baked way of staying on-topic with this thread.
     
    #132 Salpingo, Dec 2, 2017
    Last edited: Dec 2, 2017
  35. Amygdarya

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    Well, Cornell does have cultural psychiatry didactics, its patient population is as diverse as it can be (hello, NYC!), and cultural aspects of patient's experiences are discussed on rounds and case presentations if relevant. In addition to this, there is a "kosher unit" in Westchester that specializes in treatment of observant Jewish people (a student elective on the unit is actually called "Cultural psychiatry" and focuses on the cultural aspects of patients experiences and treatment). I don't know if it's any less "culturally focused" than NYU's Spanish-speaking and Mandarin (or is it Cantonese?)-speaking units.
    Haha, oh no, it's 3 chairs in 40 years, not 80 years :D
    And, by the way, the current/retiring chair is a neuroscientist, not a psychoanalyst. So it's not like Cornell psychiatry is all psychoanalysis all the time; in fact, it's a large and very diverse department.

    A couple of things I'd like to add about Cornell psychiatry:
    1) The residents are happy here, and they are quite tight both within and between classes. There is plenty of intra- and interclass interaction built into the program.
    2) Something you can't glean from an interview day and is never discussed in program overviews is other mental health professionals and support stuff; both of which, I believe, can make a difference in your training experience. At Cornell, there is a mutually respectful collaboration between psychiatrists, psychologists and social workers. Most if not all non-psychodynamic therapies (CBT and DBT for sure) are taught and supervised by psychologists. Social workers do wonders both arranging dispo at CPEP and on the inpatient unit and doing group and individual therapy on PHP. Patient are treated well by support staff including mental health assistants and security guards. I've heard patients compare their positive experiences at Cornell's CPEP/inpatient unit with their prior experiences at some other hospitals in NYC (which will remain unnamed), and I was horrified by their stories. I know that the way patients are treated is going to affect my morale in residency, so I'm looking for a place where they're treated well.
    Actually, I know for a fact that the "big names" I mentioned for Cornell (aside from the exceptions I mentioned) are actively involved in teaching residents, both in didactics and on the wards/in clinic. I don't know whether it makes much difference in the big scheme of things though. Won't hurt I guess.
     
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  36. deepsouthpsych

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    Communication via e-mail. No issues with scheduling. Some hotel discounts. Cheaper to stay outside of the city in North Charleston, but more of a drive into campus in the morning. Pre-Interview dinner was well attended by residents. Significant others were invited to attend as well. Residents seemed happy, laid-back. They enjoy the program and living in the Charleston area. A lot of talk about how much free time they had. Stated that the busiest/most stressful service is night float and they expect that to become more chill with the hiring of a few more mid-level providers to help with the workload. I was actually a bit put off by how much they emphasized the chillness/amount of free time. While I don't want to spend my whole life at work, I do want to see and do as much as I can during residency. Interview day started at 8am. Overview of program by Dr. Kantor (PD) and one of the chief residents. Dr. Kantor is very warm and clearly loves the residents/program. He does not interview everyone and I wish I'd had an opportunity to speak more with him my interview day. Overview is followed by 3x30 minute interviews. Some people had their last interview in the afternoon after the tour. This was another weird tour where instead of emphasizing you get to train at a place with 90+ psych beds and a range of units (acute adult, general adult, child/adol, addictions, VA, PHP, neuromodulation suite) we spent more time looking at the cafeteria and the gym. Again- off-putting in terms of making me question if residents are really working enough to become excellent clinicians.

    Program organized into PGY1/2- in-patient, PGY-3 out-pt, PGY-4 electives. PGY-1: Medicine- 4mo w/ in-pt VA, in-pt MUSC, Out-pt VA (very chill), 1mo EM MUSC. You can substitute 1mo peds for in-pt VA. Psych- 3 mo at MUSC (child, acute, general), 2 mo VA, 2 mo Night Float. Night float has eliminated call when on psych rotations. Night float is apparently the busiest and most challenging rotation. PGY-2: Rotate through C/L, ED, In-pt (general, addictions, geri, acute) and out-pt addictions. You also start a continuity clinic at the VA. PGY-3: Out-patient. This is when psychotherapy training really kicks into gear. PGY-4: Electives

    Overall, I wish I had liked this program more than I did walking away. Great size, lots of beds with what came across as a diverse patient population. Very strong in neuromodulation and addictions. Charleston is a fun, beautiful city and I would enjoy living there. Pay may not go as far as some other southern cities given slightly higher cost of living but all residents were living comfortably, able to buy a house if they wanted to. This program does pay for Step 3 which is a nice benefit. Otherwise benefits standard. Biggest concerns- enough training in psychotherapy? Do residents enjoy learning and caring for patients? Are they motivated to work hard and get all they can out of residency? Or are they just doing the bare minimum required and then going home to enjoy living in Charleston?
     
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  37. MiddleRoad

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    This is a highly important aspect of a residency that I think applicants often don't think about when evaluating programs. Having excellent non-MD clinicians on the treatment teams not only makes the work of a resident less stressful, it also provides increased breadth of training and informal/formal supervision from non-MD clinicians who often have more direct experience working in the system than many psychiatrists. As an attending, you will want to have good relationships with SW's, psychologists, and other members of the team. It helps to know about their expertise and get experience in collaborating with them as a resident.

    Unrelated, it's nice to see multiple people commenting on individual programs. The difference in perspectives and dialog is helpful.
     
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  38. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    I also like to hearing that many members of the non-physician staff have chosen to stay for years or decades, for two reasons: 1) I try to use it as a proxy for the work atmosphere and measure of mutual respect on interdisciplinary teams and 2) The nurses, SWs, OTs, etc. on our inpatient unit during my 3rd year clerkship had loads more experiential knowledge about the floor than most of the residents put together & I know I'll be learning from them too wherever I am next year.

    Agreed. Come on, lurkers. Don't be shy. Join the party.:nod:
     
    #136 Coupd'Cat, Dec 3, 2017
    Last edited: Dec 3, 2017
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  39. tellme_areyoufree

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    Northwestern University, Chicago IL

    1. Ease of Communication:

    Standard email communications, got a reminder email with details about pre-interview dinner and interview day. PC was great to talk to.

    2. Accommodation & Food:

    Chicago can be an expensive place to visit, but you can find a few cheap airbnb spots around.
    The interview pre-dinner was a fun meet and greet with residents at a bowling/bocce place. Food was great and a lot of residents came, easy conversation and some people bowled.

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences):

    The interview day was pretty laid back. PD gave a great overview - she clearly loves her program and her residents. She made a point both to talk about 50% of their residents coming from top schools, but also that multiple residents came from disadvantaged backgrounds - "first in their family" etc. Personally I really appreciated that she did this.
    Easy conversations with all the faculty. The residents were friendly and forthcoming. Great tour. Interviews were very laid back, no weird questions. Both PD and APD were great to talk to.


    4. Program Overview:

    The website can describe better than I can. Curriculum: Department of Psychiatry and Behavioral Sciences: Feinberg School of Medicine: Northwestern University
    Sounds like didactics are refined with resident input, and are a full day on Wed - gives residents an opportunity to see each other and bond. The first 6 months are your IM/Neuro/ED months, so everybody starts Psych stuff at the same time.
    Multiple residents talked about moonlighting in PGY3.

    5. Faculty Achievements & Involvement:

    Great faculty, as you would expect from a place like Northwestern. Regarding resident achievements - PD made a point of saying that multiple residents take leadership roles, get involved in national organizations, present research, etc - and the program considers this a major priority.

    6. Location & Lifestyle:

    Chicago is a great city. I lived there before medical school, and it is a fantastic place to live. Not cheap per se, but not as expensive as many other major cities. A city of neighborhoods - with a very diverse population.
    Northwestern is downtown, making it very easily accessible by public transit.


    7. Salary & Benefits:
    PGY1 high 50s, PGY4 mid 60s.
    Stipend: McGaw Medical Center of Northwestern University: Feinberg School of Medicine: Northwestern University

    8. Program Strengths:
    I fell in love with this place. I'm pretty sure this will be my number 1. So I may be biased/hyped, so take what you will from that.
    I'll start with the city. You can't beat Chicago, in my opinion. The Second City will always be first in my heart.
    The first group of residents I really felt completely comfortable with. Nobody I didn't like.
    Well established program with a very respectable name
    The PD is all-in on supporting residents.
    The Chair was very nice, very approachable. Told some great stories about patient interactions.
    Everybody (including Chair, PD, APD) were very "down to earth."
    Salary is highest for psych residencies in Chicago.
    Beautiful hospital.
    Research opportunities.

    9. Potential Weaknesses:
    Honestly not seeing a lot that I consider weaknesses. It does seem like you'll work pretty hard intern year, which isn't a weakness to me but might be a negative if you want a more cush residency.

    10. Overall Impression:

    I hate to admit this, but I hoped I wouldn't like Northwestern... I didn't want to get my hopes up. But I'm seriously thinking they'll be my #1. My hopes are up, for better or worse.
     
  40. molecularmimicry

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    Northwestern also moved way up my list after my interview. Ain't the PD a treat? I thought I'd add my stream of consciousness impressions as well. I must admit the call schedule is a bit fuzzy (I didn't write it down right away), so it may not be 100% accurate.

    PGY1: medicine call q6 and 55-80hrs/week, neurology is 40-55 hrs/week; from mid PGY1-mid PGY2, short call (5-8PM) once/week on psych and weekend call (12 hrs) 3x/month; 1 golden wknd/month while on psych. From midPGY2-midPGY3, 12 hr call every few (2?) weeks; from PGY3 on, call 1x/mo; external moonlighting starting PGY3 (North Shore); shuttles q30 mins to go to VA; residents love Dr. Anzia; program mission is to produce leaders in psychiatry; intern class started with 4 married/engaged couples and 4 single; by PGY3, 3 of the 4 singles had serious SOs; very family friendly program (baby board); PD is universally loved by residents and supportive of residents no matter their interests (in psych or otherwise)
     
  41. tellme_areyoufree

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    "A treat" is a great way to describe Dr. Anzia.
     
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  42. Salpingo

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    All really great points. As I mentioned in another thread, Cornell has that small liberal arts college intimacy/claustrophobia feel where you really get firsthand experience with the professor (as opposed to TA). The flip-side of that is that it gets cast as an elitist, homogenous institution, not helped by the snooty psychoanalyst stereotype. And while there are moments that might be true, if thats your perspective when you walk in, that's what you're going to be focused on (which may have explained why the first reviewer felt like "an exotic animal"). But its great to get perspective beyond the stereotype, to see its a place where SWs/PhDs/RNs/behavioral techs/security and MDs are all working together on a first name and familiar basis, the complete opposite of elitism (particularly compared to other institutions where MDs are indifferent to anyone without the same two letters attached to their name). Its definitely a line of questioning I would urge every applicant to ask (how are the nurses and mental health staff? Do employees take pride coming to work? Are there interdisciplinary rounds or supervision?)

    As for the big name comment, you're right, and I didn't mean to diminish the experience at Cornell. I'm mostly trying to make the point that even if you don't go to the residency, you can still connect with the prominent people in the field in a meaningful way, something I didn't truly appreciate until after I got out of the residency bubble.
     
    #140 Salpingo, Dec 3, 2017
    Last edited: Dec 3, 2017
  43. Evidence Based

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    Thanks for this perspective! That makes a lot of sense. So helpful to hear from grads double checking our opinions of programs.

    We know y'all are there- come hang out with us! We're nice I promise, and let's help future applicants the way past ones helped us.
     
  44. Evidence Based

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    @Coupd'Cat has seemingly had my schedule just shifted ahead of me, so I'll direct people to their excellent review on the first page for program specifics. Focusing on things that stuck out to me/people have had questions about:

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences):
    As others have mentioned, Dr. Forstein (the PD) and Dr. Frank (the aPD) are wonderful. Great interviews with both of them. Dr. Forstein has a reputation for being more “analytic” in his interviews, which one could potentially find off putting, but I really enjoyed it. The interview wasn’t intrusive, just a deep conversation about how I came to be here, past experiences that have influences me, what things are important in my career, etc etc.

    Other thing to mention is that interviews here are long. Three of mine were an hour, and one was a half hour. However, I loved this- really felt like my interviewers got to know me really well, and I’d definitely prefer this to brief interviews that seem more superficial. Very conversational overall, and I enjoyed talking to everyone.

    4. Program Overview: Won’t try to match above reviews on specifics. One early review said that CHA “used to be” a public hospital, but got taken over by Harvard. It actually still is a public system, although now that it has grown beyond Cambridge its governance is a little more unclear. However, they were clear at my interview day that CHA is the last public healthcare system in Massachusetts that actually serves the public.

    I also found the facilities to be better than expected. I mean, this place wasn’t built yesterday, but the inpatient unit was on par or better than other units I’d seen, and the clinic we saw appeared well laid out..

    Which brings us to SPECIAL SAUCE
    -Public and community psychiatry. It’s almost a cliché at this point, but CHA is basically unmatched if you want great community exposure in an academic setting. They are deeply committed to serving their community, and provide top notch care to a largely poor and marginalized population. This meshes with their commitment to psychotherapy in a cool way, with them finding ways to get their patients into high quality therapy (including dynamic therapy) with MDs through research studies and resident clinics (The PD said they’re the only institution to provide psychodynamic therapy to Medicaid patients on a large scale that he’s aware of).
    -Commitment to Social Justice and Health Equity: I fell in love with this program because of this. One of the residents said to me “advocacy and policy is part of the water here,” and it really shows. CHA has a long tradition of activism, and all the residents and faculty are passionate about this. It can take the form of health disparities/health equity research, working with police to improve responses to people in mental health crisis, advocating for refugees and asylum seekers, and more. But really, it just seems like it’s part of basically everything they do.
    -Respect for department within the health system: Psychiatry is the largest department, and makes up 45% (?!) of the clinical personnel. They have a pretty unique ACO arrangement, and because of that have really prioritized psychiatry and primary care.
    -Collegial atmosphere: We were instructed to call everyone (including the PD) by their first names. Quote from one of the residents: “If you don’t like being hugged, don’t come here.”
    -Therapy training and psychodynamics: CHA has a deep history of strong draining in the psychodynamic tradition, and the therapy training here is superb. (I also heard residents say that they almost had too much supervision). It sounds like psychodynamic formulations are really foundational to how people think about patients here; however, the therapeutic modality varies based on the patient in front of you.
    -Strong addictions training, especially in outpatient setting
    -Dedicated training in teaching and supervision. PGY-4s supervise the PGY-3s in some of the clinics, and get dedicated supervision time to hone their teaching skills.

    6. Location & Lifestyle:
    Cambridge and the surrounding areas are expensive but awesome (I’m biased though). For those not from the area, Cambridge is right across the river from Boston proper (think Brooklyn in NYC, Oakland in SF), but is an independent city. Served by public transit (subway and bus). 1 BR will probably run you 1600-1800 at the minimum, although it’s definitely cheaper to get a larger apartment and get roommates. Driving here isn’t the best (so just don’t do it). Most residents get by with public transit, walking, biking. You get free cab vouchers if you have to go to any far away site.

    7. Salary & Benefits: Really excellent. Residents are unionized through CIR. Hospital pays 90% of insurance costs, 100% of dental, vision, and disability. Moonlighting is available in house through paid backup call, which pays very generously. The PD explicitly talked about designing the call system (overnight q 14 days PGY-2&3) so that residents would have time to take paid backup call and supplement their incomes to make up for CoL in the area if they want.

    8. Program Strengths:
    -Community and public psychiatry
    -Deep felt commitment to social justice and health equity, tradition of activism
    -Good combination of community hospital feel with HMS resources.
    -Very collegial atmosphere
    -Reasonable workload, opportunities to get more experience (and money) through moonlighting
    -Strong therapy training
    -Strong addiction exposure (both clinical and research)

    9. Potential Weaknesses:
    -Less tertiary care exposure, would be less good if you want to see a lot of crazy inpatient C/L (although outpatient C/L and integrated care is awesome here)
    -No VA
    -No bench science research (I don’t care, but others might)

    10. Overall Impression:
    Will probably end up ranking CHA #1. Is a great fit for what I want (community psych, addictions, advocacy), and its weaknesses (ex. no bench research, less tertiary care exposure) are not things I care a ton about. Just felt at home here, hopefully they’ll feel the same about me!
     
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  45. digitallion

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    All Cornell residents got a raise back in November. This is the current NYP graduate staff salary:

    PGY 1: $69,271
    PGY 2: $72,625
    PGY 3: $78,578
    PGY 4: $80,786
     
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  46. Amygdarya

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    Nice! Thank you for your response.
     
  47. Coupd'Cat

    Coupd'Cat Caught in Life's Washcycle

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    I think that was my review--apologies for the misleading wording. In writing that CHA was "taken over", I meant that they became affiliated w/ Harvard Medical School. Still very much a public hospital.

    :clap::luck:
     
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  48. Wonton Soup

    Wonton Soup II me plz?

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    Oregon Health & Science University hasn't made it on the list so I decided to add my contribution. I typed this in a hurry, so sorry for typos. Anyone else can chime in where I left gaps.

    1. Ease of Communication: No problems, Confirmed interview date through ERAS.

    2. Accommodation & Food: No hotel accommodations. Stayed at AirBNB closeby. Preinterview dinner/social at Punch bowl social.

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences): 8 a - 3 pm. begin with resident slideshow on program. Half of group gets split up int morning tours/afternoon interviews and morning interviews/afternoon tours. 4 30-minute interviews; including 1 with PD and APD. 1-1 interviews, questions overall were pretty straightforward. One interview grilled behavioral questions during the majority of the interview. Lunch w/ residents; fantastic indian food.

    4. Program Overview: Schedule: PGY1: Rotate btwn psyc + off-service rotatations q3months. 6 mo psych : 3 mo inpt (unity) +3 mo VA 6 mo off service: 1 mo outpt primary care, 1 mo ER, 2 mo inpt medicine, 2 mo neuro.
    PGY2 13 wks psych conuslts + 13 wks nigh float (split in 3-4 wk blocks) +13 wks psych ER/Inpt VA + 13 wks Forensic+geriatric. Begin OHSU outpt clinics.
    PGY3: 6 mo community block. 6 mo addiction + outpt consult block (addicitons clinic + cosultation clinic). Continue outpt clinics (child/adolescen, outpt va).
    PGY4: VA outpt continuity clinic, OHSU outpt continuity clinic electives

    5. Faculty Achievements & Involvement: omitting

    6. Location & Lifestyle: Portland overall is a great city to be in with beautiful scenic trails and outdoor opportunities galore. The cityscape is changing as Nike and Intel have expanded and there's been a significant influx of people from out-of-state. This has caused an increase in rent prices inevitably. That being said, Portland is still significantly cheaper to live than seattle or los angeles. Unfortunately the downtown area has also undergone some changes too, with a significant increase in homeless occupying the streets.

    7. Salary & Benefits: PGY 1 55K, PGY2 57k, PGY 3 60k, PG4 62k. Resident wellness group. 4 built-in half days off for 'wellness', 3 wks vaca + 3 wks sick leave.

    8. Program Strengths: Focus on diversity and inclusion: refugee clinics (human translators!), clinics for pts w/ disabilities. Didactics on gender identity, clinic care for african american pts, among others. Diversity focused grand rounds. Portland is a fantastic city.

    9. Potential Weaknesses: Inpt medicine seems to be a weakness and is VA-based; mostly see bread+butter medicine. Inpt child not a part of core curriculum. Per resident, matching into C&A fellowship may be difficult even for internal grads. Overall reputation and resources not up to par with other west coast programs: Stanford, UCLA, etc.

    10. Overall Impression: Great program with distinct focus on community psych and intercultural psychiatry. Lots of focus on resident wellness and esidents seem vey well treated oveall. Off service inpt medicine seems to be a weakness. However, there are integrative care clinics for psych in the primary care setting. Residnets and graduates tend to stay in PDX, and it seems that people who stay here really do so out of love for the city. One interviewer had suggested the program has previously gone through some transitions in leadership and now are poised to be on the rise as they continue expanding their resources. Greatly liked the program but have concerns on ability to be as competitive for fellowships as more established academic programs.
     
    #146 Wonton Soup, Dec 6, 2017
    Last edited: Dec 7, 2017
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  49. syvian.

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    UC Irvine, UC Davis or UC Riverside anyone?
    Doesn't have to be super detailed! Just general impressions and what stood out the most! Please!
     
  50. Evidence Based

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    My sources tell me the review gods are more likely to smile on your request if you post reviews of your own!
     
  51. raisinbrain

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    UPMC - University of Pittsburgh Medical Center
    (Triple Board - also w/ Children's Hospital of Pittsburgh)

    1. Ease of Communication
    No concerns! Communication started out through ERAS, and transitioned to email as the interview week approached.

    2. Accommodation & Food
    Lovely accommodation suggested near downtown and ‘the strip’, with a bit of university discount, and shuttles provided to and from the pre-interview dinner as well as the interview day itself. Others did quite well with airbnb near the hospital as well.

    3. Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences):
    Prior to interview day, we were sent a link to several orientation videos about the program, city, residents, interview day, etc. These do an excellent job giving an overview of the program and the day, so I won’t stress as much about it here. Everyone had 6 x 30 minute interviews, including with the program director (Dr. Travis is excellent!), though combined program (family med/psych and triple board) applicants had (‘only’) 5 psych interviews on day two, and met up together for the psychiatry resident’s lunch (low key meet and greet).

    For triple board specific: day 1 was integrated with the pediatrics residency applicants, I believe 20 total. The day concluded with a meeting with the department chair who seemed kinda geeky but in a good way, and definitely dedicated. Day 2 was all with the combined programs (TB on its own, and FM/psych on their own), starting with an overview from the PD and then a tour of WPIC. The psych PD is frequently seen taking very thorough notes during his interviews, so don’t be alarmed if this is the case. He is definitely interested in learning why you need to do one of the combined programs compared to general psych training.

    4. Program Overview:
    Good outline on their website. PGY1 is 3 blocks inpatient family medicine, 2 x 2 week blocks of night float, total of 2 blocks neuro, 1 block medical care of psychiatric patient (neat), 3 of psych ER, and 3 months substance and/or anxiety. Switched from gen medicine to family medicine a few years ago; the program seems to like it. Thursday afternoon didactics.

    PGY2 is a lot of inpatient and CL months, including 1 block each of child and geriatrics (all in WPIC). Still have half day didactics. Some long term psychodynamic cases start PGY2, as well as interpersonal therapy training.

    PGY3 is outpatient stuff, long term psychotherapy, etc. Get CBT training. Other types of training more in electives, or sought out opportunities. No call in 3rd year.

    PGY4 has elective time with tons and tons of opportunities.

    Special tracks available for child and adolescent psych, AACE track (their version of a clinician educator, essentially anyone who would want to end up in academics could benefit), a CORE track for community medicine, some global health opportunities, advanced psychotherapy training, and a research track.

    TB track curriculum is definitely different from categorical training. All but 2 months of PGY1 are spent with pediatrics, primarily on inpatient units (where residents definitely work a lot, but really enjoy what they do and seemed surprisingly happy at work). 2 months at the “DEC” which is like WPIC’s psych walk in center/acute care type thing. PGY2 starts with another 6 months of pediatrics (as senior residents on floor teams), then switches over to adult psychiatry, starting with inpatient units. PGY3 starts back in peds for a few blocks with electives – again switching back to 6 months of outpatient adult psychiatry. Somewhere in there they mix in the required 12 months of continuity patients for psychotherapy as well. PGY4 has a few more peds electives and ED time (ED time was big here). Then the last 1.5ish years are spent with child and adolescent psychiatry, both inpatient units, and then outpatient as per usual, including long term therapy patients. PGY4 also starts a specific TB continuity clinic, which is sweet. Website has a surprisingly helpful timeline of the psychotherapy didactics for TB residents.

    5. Faculty Achievements & Involvement:
    I’m sure there are many. I’m bad at describing this section. So much going on, from clinical niches to both clinical and basic science research. All seemed very willing to have residents get involved. There is a massive number of psychiatry faculty, so I’m sure there’s something for everyone’s interests.

    6. Location & Lifestyle:
    Pittsburgh! Initially I wasn’t so sure about the area, but it grew on me quite quickly. It’s lovely to drive into downtown at night when the city is all lit up. It’s definitely a city of neighborhoods, each with its own distinct vibe. There are a couple of neighborhoods where residents tend to collect/live/hang out, with some being very near the hospitals. The cost of living is very reasonable for a city of its size. While there are cute neighborhoods in places, it may be hard to find a place with a yard within the Pittsburgh proper area between the rivers. The psych residents seemed like they were busy but all still had lives outside of medicine as well. Can’t fully say the same about the pediatrics residents, at least during intern year. For example, several residents agreed that having kids while training at Children’s (esp. for TB residents) would be quite challenging, and less common.

    7. Salary & Benefits:
    Salary is pretty standard, starting at 56,000. Benefits found in a little booklet they give out – but it’s at home and I’m out on the trail, sorry. Seemed reasonable. Someone mentioned a program to help residents buy houses, but I can’t find any info on it.

    8. Program Strengths:
    Great exposure to clinical psychiatry – WPIC is massive with lots of specialized services and units (thus specialized teams of nurses, SW, etc)
    Amazing breadth of psychiatric research opportunities
    Extensive elective opportunities, or can ‘create your own adventure’ particularly in PGY4
    Can fast track into child psych
    Top notch training
    Down to earth residents and faculty
    Get ECT training
    In house fellowships: geriatrics, child, forensics, psychosomatic, addictions
    Location?

    9. Potential Weaknesses:
    Location? City feel (difficult to have a lawn without a significant commute)
    Perhaps less extensive required psychotherapy exposure (on the flip side, can tailor your training to your interests)
    Possible EMR hassles (If I recall correctly, inpatient and outpatient services on different systems, Cerner vs Epic? maybe this was for peds?)
    Harder to fit in meaningful research experiences if doing any of the combined programs
    I don't recall talking much about forensics, but they have a fellowship so it must be there somewhere

    10. Overall Impression:
    I absolutely loved this program. Just so much going on that I'm sure I would find a really fun clinical and research angle with lots of faculty mentorship (if that's your jam). TB residents were a great group, easy to get along with, and felt at home. From the psychiatry angle, it was hard to find a meaningful weakness for me. From the pediatrics side of training, residents definitely work hard (more hours than the other children's hospitals I've visited so far, but they clearly pile it on PGY1-heavy), but all seemed very happy while at work, and felt very well prepared by the final year of training.

    (also, do people think reviews for the combined tracks are out of place here? I can put them in the combined tracks section, but I get the sense that literally nobody posts over there, and hopefully at least some of this can be relevant).
     
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  52. clausewitz2

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    Yes, the note-taking also struck me as excessive when I interviewed but I have come to understand that this is just how he approaches essentially every meeting!


    So the switch from doing internal medicine months across the street at UPMC's crown jewel hospitals came for a couple reasons. One was that our residents ended up violating duty hours a lot and this was actually taken seriously. The second is that we would end up seeing and medically managing a lot of zebras which are fascinating and all but sort of irrelevant to the medical issues that will face the majority of patients a psychiatrist is going to see. St. Margaret's (the family medicine-run hospital we do medicine months at now) is much more bread and butter COPD/CHF/etc. It does have a rehab floor that you will cover, however, so I ended up seeing quite a lot of neuro cases (MS, AIDP, post-stroke, that sort of thing). Also apparently St. Margaret's is very highly regarded in the FM world for rigorous training, though thankfully we do not cover their ICU. There is a geriatric service that you spend a month on that I found exceptionally helpful to do prior to geri psych.

    I should note that despite it being a family medicine residency-run place, you are not going to see OB or pediatric cases at St. Margaret's. Those folks go elsewhere and indeed the FM residents do their training in those fields elsewhere. It really is basically general adult medicine wards.



    It is actually not that hard to find a place with a yard, even in Pittsburgh proper, but your options expand dramatically if you are willing to go literally 500 feet beyond the boundaries of the city qua city. The East End in particular has many options. Sure, you will not find a place in Oakland right by the hospital, but is is sort of a student ghetto infested with undergraduates and not the kind of place you want to live if you do not like people doing keg stands on your lawn at 3 AM or vomiting on your porch. PM me if you want more info about where makes sense to live if you want a house/kids


    Unfortunately the EMR split is true of the psych side as well, with Cerner on inpatient services and Epic...well, we are transitioning to Epic for outpatient services, slowly but surely. There are still some functions being served by a terrible homebrewed system for outpatient clinics but they are serious about banishing this from use within 12 months and indeed since I have been here its role has shrunk dramatically.

    The standard forensics exposure for us is court evaluations. Rotations in the Allegheny County jail can be arranged but we do not go there as a matter of course because it is run by the Other Pittsburgh Psych Residency.

    Again, feel free to PM me with questions that you fear might ID you, original author!
     
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