Cincinnati Children’s / University of Cincinnati
Triple Board
(anonymous)
Ease of Communication
Easy, no issues. Responsive over email.
Accommodation & Food
They put up all the applicants in an excellent hotel in downtown Cinci (to the point where I felt a bit silly and underdressed when I showed up in my casual attire from the drive in). Keep in mind that city/garage parking is not included in their hotel fee, and I had forgotten how pricy downtown parking could be. All meals provided were good (including dinner with residents the night before). We were given coupons for the hotel snack shop for breakfast (not extensive), and had second breakfast with the residents on peds day.
Interview Day (Schedule, Type of Interview, Unusual Questions, Experiences):
Day 1 was with Peds. Every morning residents go to morning report in a big classroom-style room, and in the back was a wall length table with bagels, coffee, oatmeal, etc. All the applicants introduced ourselves. Next we had a meeting with the department Chair, who asked questions in group interview thing; that was a bit awkward, but we realized she was asking us each one pointed question about our resume so that she could tie in her answer to a particular talking point about the program. We met as a group with the PD and associate PD for peds; both seemed great and chill (they actually apologized for having someone from the institution talking about hospital rankings and endowments during morning report). Next were various interviews (30 min x 2 faculty and 1 with a chief resident). No unusual questions – pretty relaxed and trying to gauge fit and learn about the program and the city. A tour of the children’s hospital was mixed in here, too. Lunch with residents, but we skipped the noon didactics. Day ended early.
Day 2 was for the psychiatry and child psychiatry aspect of triple board. The day was not combined with a categorical psychiatry interview day, so I cannot speak to the specifics of that day. The day started with a shuttle from the hotel to campus, and the coordinator (who is amazingly helpful and sweet) brought us to each of our group meetings and individual interviews. The first meeting was with the division director for child psychiatry; it was a somewhat interview-esque meeting as well, but much more laid back than the peds version, and it actually made the rest of the meeting much more relevant to the particular interests of us as applicants. We had 4 x 30 minute interviews with the psychiatry and triple board staff (TB PD, CAP PD, psych PD, and TB co-director) followed by a tour, and lunch with many of the TB residents. We ended with a trip to College Hill, the child psych hospital, which is beautiful and new - something to do with the large fundraising capabilities from Cincinnati Children’s. There we met with another TB co-assistant training director. Again the day ended early, leaving us plenty of time to explore the city and have time for afternoon travel.
Program Overview:
Got more overview of the combined training, but I’ll try to talk more to the categorical psychiatry training. The psychiatry PD (Dr. Evans) seemed very down to earth and supportive of his residents. Also a strong supporter of child psych, since he pointed out that a lot of places don’t have good exposure to normal and abnormal development, which is often hugely helpful to know even for our adult patients.
Psychiatry:
PGY1: psych months: 3 months inpatient, 1 month addiction (VA), 3 months CL. Off service: 2 months internal medicine (can trade 1 for pediatrics), 1 month family med, 1 month neurology, 1 month emergency med.
PGY2: all psych months: 4 months inpatient, 2.5 months psych emergency, 2.5 months CL, 1 month geripsych, 9 months integrated insight-oriented outpatient psychotherapy 1-2hrs/week gradually (1-2 patients by the spring, in the Resident Psychotherapy Clinic – self pay, private practice model).
PGY3: lots of outpatient work. Sites include Central Clinic (middle of main campus, older building), VA, and UC student services. Residents have an office during their outpatient psychiatry year; decorate as you wish. Also includes a weekly process group.
PGY4: Requirements include a short forensics experience, but I believe the remainder is all electives. Seemed flexible as long as the experience would be valuable and educational.
Psychotherapy – starts earlier than some, with 9 months of long term insight-oriented psychotherapy starting in PGY2. The formal therapy training is mostly in psychodynamic psychotherapy and CBT, with some parent-child interaction therapy. You can get extra supervision in other areas, with a smattering of other things found in didactics. I forgot to ask about DBT, but I didn’t see it mentioned. The city also has a psychoanalytic institute.
Triple board specific: 3 residents/year. Starts with full immersion in pediatrics, then bounces back and forth more in the later years. All very friendly. Spend a lot of time with their peds or psych co residents. Skip psych PGY1 lectures, but join up as PGY2 with specific things, and follow through outpatient year.
PGY1: 11 months peds (5 months wards, 1 each of NICU, nursery, outpatient neuro, ED, outpatient peds, and advocacy). 1 month inpatient child psych for exposure (choose from child/latency, neurodevelopmental disorders, or adolescent). ½ day per week of peds continuity clinic
PGY2: Start with 7 months adult inpatient psychiatry (3 inpatient general, 2 adult psych emergency, 1 addiction, 1 adult CL), 1 month of child CL. Finish with 4 more months of pediatrics (NICU, outpatient adolescent med, 1 month inpatient (GI or Heme/Onc), and peds ED. Again ½ day per week peds continuity clinic.
PGY3: 11 months adult psychiatry – including 9 months adult outpatient psych clinic. 1 month adult inpatient, 1 adult neuro. I was a bit confused by this schedule, but the 9 months is of normal clinics. Residents also have a minimum of 12 months of continuity with their own patients in adult outpatient psychotherapy with supervision – some residents carried these patients on going into PGY4 as well, but this was not common after going back to peds. Outpatient offices are at Central Clinic. Continue ½ day per week peds continuity clinic..
PGY4: 4 months of child psychiatry – 2 months are inpatient (fill in gaps of either child/latency, neurodevelopmental, or adolescent from PGY1 year), 1 partial hospital, 1 of ED/adolescent chemical dependency split rotation. Then back to 8 months of pediatrics, with 1 PICU, 1 month as a senior on child acute care, 2 months senioring on wards, and 4 months subspecialty electives/selectives. Roughest transition of the residency is from outpatient psych 8 months to the PICU and then 3 more months of peds, but they do this to get you re-acquainted with peds before taking boards. Clinics change somewhat – main peds continuity clinic ½ day every other week, and a subspecialty clinic ½ day every other week. In the spring, start outpatient child psychotherapy – offices transition to the College Hill campus for PGY4-5 while on child psych. Again, decorate as you wish. In addition, four ½ days of outpatient bipolar disorder clinic.
PGY5: continue fully with outpatient child and adolescent psychiatry. Comprised of psychopharm clinics, outpatient psychotherapy patients, a psychotherapy consultation clinic, and rotations on child forensics and school consultation. Additional electives, create as you desire. Psychotherapy patients here are now indirectly supervised. Additional clinics include ½ day every other week of pediatrics continuity, and ½ day every other week of subspecialty pediatrics. Currently have 1 chief resident, but current 4’s want to split the chief year. CAP didactics seem to be plenty – Tuesdays noon-3, and Fri 10-1pm, with grand rounds monthly.
Pediatrics comments:
1 month of developmental and behavioral pediatrics clinic. Plenty of NICU experience (they highlighted their acute care and ED training a lot during the tour), 1 month newborn nursery. 1 month private practice pediatrics. Have a goal of decreasing length of inpatient hospital stays (resulting in only the super sick kids getting and staying admitted). Interns said they usually average around 60 hrs/week, though sometimes more.
Call: where are my notes on this?! I recall it seemed reasonable.
For peds: senior electives have 4-5 jeopardies and random shifts per month. Senior selectives (GI and heme/onc) still have q4-5 call. PICU also has q4-5 call, and a fellow is always in house. Everything else is shift work.
Facilities:
Cincinnati Children’s is amazing. All pediatrics work rooms in the hospital had windows, and the lounge has windows and couches, and is shared with a work room attached. I presume psych CL offices are similar. The hospital has a 2 minute call-back rule for pages, and even well renowned attendings will be responsive and friendly. Lots of awesome attendings who are supportive but will push you to come up with a plan. Plenty of fellows, but they’ll let residents get involved in procedures and things, too. Hospital planning to build a new critical care tower on campus. #3 in peds NIH funding, 92,000+ ED visits/yr.
Central Clinic – on campus, PGY3-4 have individual offices, furnished by the residents. Older building, but has individual rooms for support staff as well.
College Hill – pediatric psychiatry campus, with both inpatient and outpatient facilities. Plenty of space and staff for programming. Fairly new, gorgeous campus. They’re planning to renovate to expand the number of rooms to increase the percentage of single rooms (but not increase the total number of beds). After they do this, they plan to move the only remaining child psych floor out of the main medical hospital (where the more medically sick kids were, so they’re not entirely sure yet how they’re going to handle this change in flow, since it seems to silo the practices a bit more).
VA: typical VA.
Location & Lifestyle:
Cincinnati. Children’s hospital and UC right in the middle of the city, in Avondale, one of the lower/lowest income zip codes in the city. Provides good access to care. Don’t have to be too far from the hospitals in order to live decently. Lots of peds and psych residents live on the East Side of town where it’s a bit more gentrified but hip and up and coming, around Hyde Park or Oakley. Others life on the west side of town, where you get more space for your dollar. Plenty of residents have dogs. A reasonable number of residents had children, at least to the point where it didn’t seem to be a big deal, but plenty were single as well. I’ll say that the PL1 residents in particular were a very tight and very active bunch. They have a group text and do things like trivia twice per week, and some other recurring activities. Obviously not everyone attends every event, but it was really clear they enjoyed their time together both during and after work.
Salary & Benefits:
Time off: 20 days vacation per year – usually taken in 1-2 week blocks (particularly while on peds). At least for the pediatrics residency, this includes holidays (no extra days after the 4 weeks). Most residents have gotten the requested days off, and often do a week over the holidays without a problem. Seemed more flexible on the psychiatry side. On PGY2 during night float weeks (4 total? I believe this is the emergency psych rotation), work 5 days on, 5 days off – so many people use that as extra vacation. Maternity leave / medical leave up to 12 weeks. The paid part of paternity leave is 4 days, though I believe you could use vacation time for more. Their psych/UCMC contract better outlines that FMLA provides up to 12 weeks unpaid leave for things including birth or adoption of a child.
Other:
- Salary just a hair below median, but awesome cost of living in the city. 52,585? -62,225 (for peds/TB, but it looks like psych my start at 55k since it’s through UCMC).
- shared insurance cost
- parking not an issue, but costs $10/pay period while on peds. Psych has free parking.
- Cab vouchers for post call.
- other benefits around the city (tickets, etc)
- call nights $5 meal allowance.
- EAP
- For pediatrics, weekdays the residents are fed an awesome breakfast for morning report (bagels, oatmeal, coffee, etc) and a hot lunch (great) every week day. Breakfast extras stay in the resident lounge all day (for night call people, etc).
- Moonlighting can start PGY2/PL2
- Educational fund exists, amount depending on filling out evals ($200-1200+/yr)
Program Strengths:
Amazing amount of research infrastructure and projects going on at Children’s
Exposure to complex and rare conditions while maintaining exposure to ‘bread and butter’ pathology and training
Inpatient child and partial hospitalization programs
Extensive child psychiatry electives (strengths in school consultation, child forensics, etc)
Cost of living
Great amount of mental health resources embedded within local school districts
Fellowships: CAP, addiction psych, addiction med, forensics, geriatrics
Potential Weaknesses:
Interesting transition with PICU senior month immediately following outpatient adult psych
+/- big city resources
No early exposure to integrated mental health clinics (for TB folks)
Overall Impression:
The triple board program in particular has many strengths, one of which is that it didn’t feel weak in any core components. Since Cinci Children’s has so many combined programs (TB, family/psych, med/peds, peds/neuro), everyone stressed that the combined residents fit in well and are treated exactly the same. More lingering pediatrics in PGY4 than I’ve seen at other places, but it leads to perhaps delayed time spent as a senior on peds rotations, but it’s nice that it’s right before taking peds boards. The PGY5 curriculum seemed great, not just generic CAP. Good exposure to partial hospitalization programs. Definitely a strong pediatrics program with amazing resources, clinicians. Really, really loved this program – feels like home. A good amount of diversity in the city. Plus, the parks are true parks, with trees, hiking trails, plenty of green space.