Benefits of choosing a community based program?

[serimeri]

I really like the feel I have gotten at some of the more community based programs as this season winds down. However, some of the ones I have remaining are university based. I was wondering what drew you guys to choose community programs over university based programs?

I'm interested in doing Forensics perhaps--not definite though and I want to be able to be in an environment where i'll have approachable attendings and good therapy training. i also want a lighter call schedule and I don't like the hierarchical system of university settings IMO.

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[wolfvgang22]

The links immediately under this thread where it says "similiar threads" is interesting. I agree with this response by second year: http://forums.studentdoctor.net/threads/community-based-program-vs-university-based-programs.228767/
Being at a community based program doesn't guarantee any of the things you want, and it won't prevent you from doing Forensics, either. There are great and not so great community based programs and great and not so great university based programs.

 

[Leo Aquarius]

The programs I can recommend are in California since that's what I know.

Excellent programs are San Mateo and UCLA-Harbor. Both are county programs. UCLA-Harbor has the added benefit of being closely connected to main campus UCLA. They both offer very approachable faculty without the hierarchy you will find at core academic programs.

You can land a forensic fellowship from either one. That's what I can recommend.

 

[splik]

Psychiatry is very much a community based specialty so it certainly makes sense to be at a community based program. If you are interested in forensics you would do well to pick a program that has some state hospital experience or at the very least exposure to jail or prison psychiatry. Forensics is probably the only competitive psychiatry fellowship and even then it is only competitive at a few places, there are still open fellowship spots this year at many places, including some good programs. Also the programs in california tend to fill pretty early regardless of whether it's a good program or not. If you have designs on a particular fellowship then it might be better to do your residency there (for example this year UCSF didn't even consider outside applicants for their fellowship and filled internally). For fellowships in other psychiatric subspecialties it is very common for people from programs no one has heard of to do fellowships at name brand places because nobody wants to do fellowships. However, most people change their mind about what they want to do when they go to residency so it is best just to choose a place where you think you will be happy and not close any doors.

Also there is a false dichotomy really, as many of these so-call "university" programs are all/mostly community based. also some of the most university based programs have innovative community psychiatry experiences (like columbia which is about as far as you can get from a community based program). The truly great programs have the best of the academic medical center and community/public psychiatry exposure. Some academic programs have a county hospital as the main training site (like NYU, UCSF and UW). The only things you miss out on are research opportunities and a more limited c/l exposure. Also, depending on the program, the psychotherapy training may not be as robust as some of the academic places (though this is not true for the programs Leo mentioned). And some community programs like cambridge health alliance and wright state (i wouldn't consider this a "university" program) are heavily psychodynamically oriented.