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I've now interviewed at all of my top 5 programs, and I've decided where to put #4 and #5 with fair certainty. But I keep going back and forth between my top 3. I was hoping that somebody might be able to impart some wisdom or tell me something that I haven't considered.
Aside from getting a strong balanced general clinical training with mostly biological psychiatry but also good enough therapy training so that I'm comfortable using it when necessary (#1 priority), my main priorities are:
2. A strong academic program with substantial research opportunity in biological/medical psychiatry, particularly in either genomics or neuroimaging/connectomics
3. Good fellowship placement - I'll choose a subspecialty when I have more experience, but I'm interested in psychosomatics, forensics, pain, and sleep.
4. Strong overall reputation among both psychiatrists and laypeople, for two reasons: (a) I'm a part-time freelance writer and I'd like to write for the lay public in the future... I'm imagining that people are more likely to read a book written by a person with a "name-brand" institutional affiliation. (b) Down the road, I'd like to spend some time practicing in South Asia and the Middle East, and name-brands like "Mayo" and "Harvard" are valued highly there.
My "top 3" choices are WashU, Mayo, and HSS. I know that a lot of people may think that those three programs may be in different "tiers" and have a lot of major differences, but they all meet my main requirements very effectively:
WashU:
(1) They place a lot of emphasis on balanced training. They're known as one of the top biological/medical psychiatry programs around, but they also start some level of therapy training in PGY1, which matures a bit in PGY2 and becomes a firm requirement in PGY3 (at least 6 therapy patients at any given time, with at least 2 in each of the three main evidence-based therapies). There is a very broad range of faculty with expertise in practically everything. They pride themselves in teaching "cutting edge" psychiatry.
Downside: no protected didactic time, and didactics are daily 1-hour sessions rather than weekly full-afternoon sessions. But all that means is that we have to work a bit harder, which is probably a good thing if it translates to better training.
(2) Academics are definitely a priority here. They have a huge neuroscience department and everybody is required to do at least 4 months of research. For those of us who are academically inclined, we can do an entire 8-month research block in PGY4 plus a 2-month elective in PGY2. They also require 4 months of "supervisor/teacher" rotations in PGY4.
(3) They have most fellowships, but the sleep fellowship at WashU is mostly neuro-based (although they've taken psych people in the past). At the moment, I think sleep is one of my top choices, but I can't imagine that going to WashU would close that door.
(4) Everybody in the medical world knows that WashU is a great place, but I'm not sure if the name will help much for my writing career or my international career. On the other hand, being with the "department of neuroscience" (which is multidisciplinary at WashU) would probably make up for that.
(location): St. Louis is slightly more desirable than the other two options - my family is within a 5-hour drive and I grew up in St. Louis. But this is only a marginal improvement over the other locations.
Mayo:
(1) They're known for the "Mayo model" of education and care, which may mostly be a brand thing, but seems to resonate with the attendings there. Teaching is really a priority for everybody in every situation. And they may have a reputation for being a bit light on the therapy exposure, but the new PD is being very aggressive about increasing therapy training in both formal and informal capacities. Their faculty research list isn't as extensive or "cutting-edge" as WashU, but each individual faculty member was quite impressive.
Downside: somewhat limited range of pathology, but that might not be as big of a deal considering my subspecialties of interest (psychosomatics and pain is particularly strong there because of the weird things that they get in the medical arena, sleep is particularly strong there because they actually have a psych-oriented sleep program, and forensics is reasonably strong because of the local prison).
(2) Academics are big here, but research isn't required like it is at WashU. Education is simply a part of the culture here, which is great... but I can't say the same about research (unlike WashU, where research is everywhere). In the end, I think those factors all balance out.
(3) The fellowship opportunities here are fully in line with what I'm interested in, especially sleep and psychosomatics.
(4) Everybody everywhere has high opinions of Mayo, but psychiatry may be the one exception to that.
(location): Rochester is probably the least desirable location, but one upside is that it's within about 5 hours from my family.
HSS:
(1) They may be based at a VA, but most of the residents place a lot of value on the diversity of clinical experience that they get from working at various different sites around the Harvard network and elsewhere. Also, they have a full day of protected didactic time, which seems to be unparalleled. And the patient load is fairly light, which allows for more time to read up on the literature about each patient's condition. The VA faculty weren't as impressive as the Harvard faculty (the faculty come from both institutions), but Harvard has a huge faculty. And the marriage of HMS and VA means access to massive resources in terms of research funding, faculty, exposure, etc.
Downside: there'll be a restricted patient population at the VA, but I think that the rotations at community hospitals and BWH might make up for that.
(2) Academics may not be huge at the VA, but they encourage us to do research throughout the Harvard network. The PD put me in touch with a high-profile professor at BWH whose research interests align well with mine (and who seems to be open to having me work with her), so I think that the HMS ties might make up for the VA aspect here.
(3) HSS graduates seem to match well at fellowships throughout the Harvard network and elsewhere in the Ivy League
(4) SDN seems to be pretty ambivalent about HSS's reputation, but I'm not sure how well that carries throughout the psychiatry community. Honestly, I think that SDN comments may have lowered my opinion of HSS despite the fact that I liked the program overall. But I guess if they get fellowships at MGH, that must mean that MGH faculty are happy with the residents when they rotate there...
(location): Boston may be far from home, but I do have relatives in town. And it's a better city than St. Louis, and definitely better than Rochester. But
So, at this point, I think that this might just be an exercise in self-reflection. But even after typing all of that, I am still conflicted. If you're still reading, I'd love some feedback. Maybe something that I haven't considered? Maybe I'm missing something obvious? Maybe my inexperience is leading me to have the wrong priorities? Maybe I just need to settle on a subspecialty choice and choose based on that? aaaaaahhhh
Aside from getting a strong balanced general clinical training with mostly biological psychiatry but also good enough therapy training so that I'm comfortable using it when necessary (#1 priority), my main priorities are:
2. A strong academic program with substantial research opportunity in biological/medical psychiatry, particularly in either genomics or neuroimaging/connectomics
3. Good fellowship placement - I'll choose a subspecialty when I have more experience, but I'm interested in psychosomatics, forensics, pain, and sleep.
4. Strong overall reputation among both psychiatrists and laypeople, for two reasons: (a) I'm a part-time freelance writer and I'd like to write for the lay public in the future... I'm imagining that people are more likely to read a book written by a person with a "name-brand" institutional affiliation. (b) Down the road, I'd like to spend some time practicing in South Asia and the Middle East, and name-brands like "Mayo" and "Harvard" are valued highly there.
My "top 3" choices are WashU, Mayo, and HSS. I know that a lot of people may think that those three programs may be in different "tiers" and have a lot of major differences, but they all meet my main requirements very effectively:
WashU:
(1) They place a lot of emphasis on balanced training. They're known as one of the top biological/medical psychiatry programs around, but they also start some level of therapy training in PGY1, which matures a bit in PGY2 and becomes a firm requirement in PGY3 (at least 6 therapy patients at any given time, with at least 2 in each of the three main evidence-based therapies). There is a very broad range of faculty with expertise in practically everything. They pride themselves in teaching "cutting edge" psychiatry.
Downside: no protected didactic time, and didactics are daily 1-hour sessions rather than weekly full-afternoon sessions. But all that means is that we have to work a bit harder, which is probably a good thing if it translates to better training.
(2) Academics are definitely a priority here. They have a huge neuroscience department and everybody is required to do at least 4 months of research. For those of us who are academically inclined, we can do an entire 8-month research block in PGY4 plus a 2-month elective in PGY2. They also require 4 months of "supervisor/teacher" rotations in PGY4.
(3) They have most fellowships, but the sleep fellowship at WashU is mostly neuro-based (although they've taken psych people in the past). At the moment, I think sleep is one of my top choices, but I can't imagine that going to WashU would close that door.
(4) Everybody in the medical world knows that WashU is a great place, but I'm not sure if the name will help much for my writing career or my international career. On the other hand, being with the "department of neuroscience" (which is multidisciplinary at WashU) would probably make up for that.
(location): St. Louis is slightly more desirable than the other two options - my family is within a 5-hour drive and I grew up in St. Louis. But this is only a marginal improvement over the other locations.
Mayo:
(1) They're known for the "Mayo model" of education and care, which may mostly be a brand thing, but seems to resonate with the attendings there. Teaching is really a priority for everybody in every situation. And they may have a reputation for being a bit light on the therapy exposure, but the new PD is being very aggressive about increasing therapy training in both formal and informal capacities. Their faculty research list isn't as extensive or "cutting-edge" as WashU, but each individual faculty member was quite impressive.
Downside: somewhat limited range of pathology, but that might not be as big of a deal considering my subspecialties of interest (psychosomatics and pain is particularly strong there because of the weird things that they get in the medical arena, sleep is particularly strong there because they actually have a psych-oriented sleep program, and forensics is reasonably strong because of the local prison).
(2) Academics are big here, but research isn't required like it is at WashU. Education is simply a part of the culture here, which is great... but I can't say the same about research (unlike WashU, where research is everywhere). In the end, I think those factors all balance out.
(3) The fellowship opportunities here are fully in line with what I'm interested in, especially sleep and psychosomatics.
(4) Everybody everywhere has high opinions of Mayo, but psychiatry may be the one exception to that.
(location): Rochester is probably the least desirable location, but one upside is that it's within about 5 hours from my family.
HSS:
(1) They may be based at a VA, but most of the residents place a lot of value on the diversity of clinical experience that they get from working at various different sites around the Harvard network and elsewhere. Also, they have a full day of protected didactic time, which seems to be unparalleled. And the patient load is fairly light, which allows for more time to read up on the literature about each patient's condition. The VA faculty weren't as impressive as the Harvard faculty (the faculty come from both institutions), but Harvard has a huge faculty. And the marriage of HMS and VA means access to massive resources in terms of research funding, faculty, exposure, etc.
Downside: there'll be a restricted patient population at the VA, but I think that the rotations at community hospitals and BWH might make up for that.
(2) Academics may not be huge at the VA, but they encourage us to do research throughout the Harvard network. The PD put me in touch with a high-profile professor at BWH whose research interests align well with mine (and who seems to be open to having me work with her), so I think that the HMS ties might make up for the VA aspect here.
(3) HSS graduates seem to match well at fellowships throughout the Harvard network and elsewhere in the Ivy League
(4) SDN seems to be pretty ambivalent about HSS's reputation, but I'm not sure how well that carries throughout the psychiatry community. Honestly, I think that SDN comments may have lowered my opinion of HSS despite the fact that I liked the program overall. But I guess if they get fellowships at MGH, that must mean that MGH faculty are happy with the residents when they rotate there...
(location): Boston may be far from home, but I do have relatives in town. And it's a better city than St. Louis, and definitely better than Rochester. But
So, at this point, I think that this might just be an exercise in self-reflection. But even after typing all of that, I am still conflicted. If you're still reading, I'd love some feedback. Maybe something that I haven't considered? Maybe I'm missing something obvious? Maybe my inexperience is leading me to have the wrong priorities? Maybe I just need to settle on a subspecialty choice and choose based on that? aaaaaahhhh
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