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
😛) 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
😀
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
😛 (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.