Away electives during residency

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notamindreader

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I had a question regarding the nature of doing away electives at other residency programs while in training. The program I matched into is open to me pursuing home and away electives during the latter half of my residency. Although this is a few years out, I was curious to know how one goes about rotating at other institutions for specialized clinics? Are residencies generally open to these types of requests? For example, I am interested in learning about the diagnosis and clinical management of sexual disorders and was hoping to spend a month at a program that has a clinic in this field. Although I am not necessarily committed yet towards specializing in this field, I think it can be of great worth to have some teaching exposure with this population prior to residency graduation. I appreciate any thoughts or suggestions. Thanks.

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Have you talked with the senior residents at your program about this already? I'm sure it all comes down to funding (someone's going to have to pay your salary for those months), licensing and liability limitations.
 
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Have you talked with the senior residents at your program about this already? I'm sure it all comes down to funding (someone's going to have to pay your salary for those months), licensing and liability limitations.
I haven't yet but that's something I'll bring up during my orientation. Thanks
 
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Have you talked with the senior residents at your program about this already? I'm sure it all comes down to funding (someone's going to have to pay your salary for those months), licensing and liability limitations.
He already said his program was open to this so presumably these are non-issues. You basically then just have to find a willing program, fill in all their paperwork and orientation stuff and get licensed etc etc It is not uncommon for residents to do away rotations. For example for some specialties like forensics it is pretty common to do an away at the top programs to get a fellowship position. Some programs might want that. There are some specialt electives like UC Davis has/had a cultural psychiatry elective and commonly had away rotators. I believe Partners inHealth accepts residents from other residency programs for global health electives etc.

Of course very few (almost no) residencies provide clinical training in sexual disorders , a few more provide training in paraphilias and you will be very limited in what you can actually learn or would be able to do in month long rotation. So you may also consider approaching other clinics etc that aren't part of a residency program to see if they are interested.

TBH I dont think it would be terribly helpful for you to do a month long rotation. I would recommend doing some reading in this area, attending a course on the topic, attending conferences, finding mentors, and looking for opportunities to get more clinical exposure to this kind of thing within your residency program. I have an interest in psychosexual disorders and I think it is pretty as a psychiatrist to develop your basic skill set in this area. After all, it's totally legit for psychiatrists to talk to all their patients about sex :) In fact a psychosexual history is going to pertinent in the majority of cases (okay not in the ER etc but you know what I mean). What you will find is that sexual dysfunction is extremely common in our patient population, and unless you ask about it you won't get to discover this. Add to that, many of our drugs will cause sexual dysfunction, it will be incumbent upon you to learn how to manage these troublesome adverse effects, and become au fait with prescribing PDE-5 inhibitors when appropriate.

If you let everyone know of your interests, you can become the go-to person for this sort of thing. you can select psychotherapy cases where there are clear sexual problems. You can rotate in the HIV clinic where sexual addiction is particularly common. You could develop a program in the urology clinic, in women's health, or the infertility clinic (the #1 cause of infertility is not having sex and these pts still rock up for IVF). You could set up a group for those with sexual difficulties. You want to distinguish yourself as a resource on human sexuality, relationship, sexual dysfunctions, diversity in sexuality (for example many people don't know what all the new and less new labels that have emerged to describe various facets of sexual and gender identity, or about non-traditional relationships, kink, working with LGBTQQIA populations etc etc.) When you have to gives talks or grand rounds, or choose a paper for journal club you can choose sexuality related topics. If you have to teach students or junior residents, you can teach on topics related to how to talk about sex with patients etc.

Rutger's has a program in human sexuality Robert Wood Johnson Medical School
The European Society for Sexual Medicine offers training in this area ESSM School of Sexual Medicine
The AASECT runs various courses and a summer institute with a different topic each year 49th Annual AASECT Conference | AASECT:: American Association of Sexuality Educators, Counselors and Therapists
NYU has a training program in human sexuality Request Rejected

This is something you should cultivate an interest early on, develop a focus in later in residency, and realize that much of your additional training and experience will come after training as in the case for so many fields or subspecialties with psychiatry.

If you are interested in paraphilias, you may wish to do electives in forensics with sex offenders, or do a fellowship with more of an emphasis on sex offender treatment/evaluation, and/or risk assessment.
 
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He already said his program was open to this so presumably these are non-issues. You basically then just have to find a willing program, fill in all their paperwork and orientation stuff and get licensed etc etc It is not uncommon for residents to do away rotations. For example for some specialties like forensics it is pretty common to do an away at the top programs to get a fellowship position. Some programs might want that. There are some specialt electives like UC Davis has/had a cultural psychiatry elective and commonly had away rotators. I believe Partners inHealth accepts residents from other residency programs for global health electives etc.

Of course very few (almost no) residencies provide clinical training in sexual disorders , a few more provide training in paraphilias and you will be very limited in what you can actually learn or would be able to do in month long rotation. So you may also consider approaching other clinics etc that aren't part of a residency program to see if they are interested.

TBH I dont think it would be terribly helpful for you to do a month long rotation. I would recommend doing some reading in this area, attending a course on the topic, attending conferences, finding mentors, and looking for opportunities to get more clinical exposure to this kind of thing within your residency program. I have an interest in psychosexual disorders and I think it is pretty as a psychiatrist to develop your basic skill set in this area. After all, it's totally legit for psychiatrists to talk to all their patients about sex :) In fact a psychosexual history is going to pertinent in the majority of cases (okay not in the ER etc but you know what I mean). What you will find is that sexual dysfunction is extremely common in our patient population, and unless you ask about it you won't get to discover this. Add to that, many of our drugs will cause sexual dysfunction, it will be incumbent upon you to learn how to manage these troublesome adverse effects, and become au fait with prescribing PDE-5 inhibitors when appropriate.

If you let everyone know of your interests, you can become the go-to person for this sort of thing. you can select psychotherapy cases where there are clear sexual problems. You can rotate in the HIV clinic where sexual addiction is particularly common. You could develop a program in the urology clinic, in women's health, or the infertility clinic (the #1 cause of infertility is not having sex and these pts still rock up for IVF). You could set up a group for those with sexual difficulties. You want to distinguish yourself as a resource on human sexuality, relationship, sexual dysfunctions, diversity in sexuality (for example many people don't know what all the new and less new labels that have emerged to describe various facets of sexual and gender identity, or about non-traditional relationships, kink, working with LGBTQQIA populations etc etc.) When you have to gives talks or grand rounds, or choose a paper for journal club you can choose sexuality related topics. If you have to teach students or junior residents, you can teach on topics related to how to talk about sex with patients etc.

Rutger's has a program in human sexuality Robert Wood Johnson Medical School
The European Society for Sexual Medicine offers training in this area ESSM School of Sexual Medicine
The AASECT runs various courses and a summer institute with a different topic each year 49th Annual AASECT Conference | AASECT:: American Association of Sexuality Educators, Counselors and Therapists
NYU has a training program in human sexuality Request Rejected

This is something you should cultivate an interest early on, develop a focus in later in residency, and realize that much of your additional training and experience will come after training as in the case for so many fields or subspecialties with psychiatry.

If you are interested in paraphilias, you may wish to do electives in forensics with sex offenders, or do a fellowship with more of an emphasis on sex offender treatment/evaluation, and/or risk assessment.

Splik, thank you so much. Your thoughtful reply is welcomed wholeheartedly and I will use much of this information to further my exposure in this area. I attended a forensics conference several years back, and without a doubt, the most interesting lectures I attended were on paraphilias. Perhaps it was due to the taboo nature of the topics discussed, but I developed a genuine reading curiosity in this area that I was hoping to correlate with clinical exposure. Your point is well received about the 1 month rotation in sexual disorders perhaps not being an ideal setup, but certainly could be appropriate for other areas of interest.
 
TBH I dont think it would be terribly helpful for you to do a month long rotation.
While the other suggestions you posted sound like a great addition, I disagree that a dedicated 1 month election wouldn't be helpful. It allows you to be immersed in the topic for a length of time (without having to worry about some other rotation you're actually on) and be in direct contact with at least relative experts in the field. It helps provide the base upon which you can build up this interest while on other rotations.

In fact a psychosexual history is going to pertinent in the majority of cases
Is there evidence that this is actually true? Pertinent for a majority is hard to believe.
 
Splik, thank you so much. Your thoughtful reply is welcomed wholeheartedly and I will use much of this information to further my exposure in this area. I attended a forensics conference several years back, and without a doubt, the most interesting lectures I attended were on paraphilias. Perhaps it was due to the taboo nature of the topics discussed, but I developed a genuine reading curiosity in this area that I was hoping to correlate with clinical exposure. Your point is well received about the 1 month rotation in sexual disorders perhaps not being an ideal setup, but certainly could be appropriate for other areas of interest.
well I think a 1 month rotation for paraphilias/sex offenders would be very reasonable. you could learn about the use of GnRH analogs, penile plethysmography, covert sensitization etc. Hopkins has a program like this that the residents rotate through. There are a number of programs not part of a residency that may be happy to have residents come and check it out.. If the state you are in has an SVP statute then there should be opportunities within the state.
 
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He already said his program was open to this so presumably these are non-issues. You basically then just have to find a willing program, fill in all their paperwork and orientation stuff and get licensed etc etc It is not uncommon for residents to do away rotations. For example for some specialties like forensics it is pretty common to do an away at the top programs to get a fellowship position.

I'm actually a senior resident looking into doing away rotations, and have looked into out of state. I think the hardest part is just the red-tape/licensing, which can take up to 4-6 months from my limited research. I'm not sure it is worth it as well, but it is definitly doable if your program allows for it...

But if you're in a large state like Texas or Cali, I would highly advise trying to stay in state and doing an elective..but understandably if you're located in a more rural area.....
 
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I'm actually a senior resident looking into doing away rotations, and have looked into out of state. I think the hardest part is just the red-tape/licensing, which can take up to 4-6 months from my limited research. I'm not sure it is worth it as well, but it is definitly doable if your program allows for it...

But if you're in a large state like Texas or Cali, I would highly advise trying to stay in state and doing an elective..but understandably if you're located in a more rural area.....
Good to know, thank you. I'll certainly keep that in mind when I begin to pin down places where I might seek further training in residency.
 
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