DC programs? Baylor?

[LizAlf82]

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What have people heard about DC-area psych residencies (Hopkins, St. Elizabeth's, Georgetown, GW)? What about Baylor? I'm looking for info on reputation, psychopharm/psychotherapy balance, and just general pros and cons.

Thanks so much!

 

[MDhasbeen]

in baltimore you've got hopkins and univ of maryland/sheppard pratt. i'm at the latter, so i can't speak much for the former other than saying hopkins is psychopharm heavy (last i heard they rotate their psych residents through an icu for crying out loud). maryland has the pros and cons of any larger program (we've got about 60 or so residents total, with each class being on avg 12 or so in size). thus far i've loved maryland. call is heavier the first 2 yrs, q4 on medicine (though moonlighting is used as well during the workweek), q5 to q6 otherwise. no call on neuro or consults. then, come pgy3 and pgy4, you're only used as in-house and telephone back-up for the junior residents once every few months. as you can imagine, i'm totally loving pgy3 right now. lots of time to read and focus on outpatients. and since the program is huge, you have your pick of urban community sites or the slightly more affluent population near sheppard pratt. we've also got pretty much any fellowship you can think of. the training program is very much soliciting feedback from us in trying to improve things as the quality of various rotations or didactics change with time (ie they once pulled all the residents from the baltimore va since the psych rotation there was subpar and essentially nonteaching). not sure about the reputation. in terms of research dollars, the program rakes in a decent amount based on size alone. it obviously doesn't have the name brand association as hopkins does, but many psychiatrists have probably heard of sheppard pratt at some time. and yes, you specified dc area, but i live in between dc and baltimore and dc is a relatively easy half-hour drive to the metro away. 🙂

 

[Doc Samson]

in baltimore you've got hopkins and univ of maryland/sheppard pratt. i'm at the latter, so i can't speak much for the former other than saying hopkins is psychopharm heavy (last i heard they rotate their psych residents through an icu for crying out loud). maryland has the pros and cons of any larger program (we've got about 60 or so residents total, with each class being on avg 12 or so in size). thus far i've loved maryland. call is heavier the first 2 yrs, q4 on medicine (though moonlighting is used as well during the workweek), q5 to q6 otherwise. no call on neuro or consults. then, come pgy3 and pgy4, you're only used as in-house and telephone back-up for the junior residents once every few months. as you can imagine, i'm totally loving pgy3 right now. lots of time to read and focus on outpatients. and since the program is huge, you have your pick of urban community sites or the slightly more affluent population near sheppard pratt. we've also got pretty much any fellowship you can think of. the training program is very much soliciting feedback from us in trying to improve things as the quality of various rotations or didactics change with time (ie they once pulled all the residents from the baltimore va since the psych rotation there was subpar and essentially nonteaching). not sure about the reputation. in terms of research dollars, the program rakes in a decent amount based on size alone. it obviously doesn't have the name brand association as hopkins does, but many psychiatrists have probably heard of sheppard pratt at some time. and yes, you specified dc area, but i live in between dc and baltimore and dc is a relatively easy half-hour drive to the metro away. 🙂

I'm not sure I understand the connection between being "psychopharm heavy" and rotating through the ICU. Many balanced (and even psychotherapy heavy) programs have ICU months included in their PGY-1 medicine experience (which I think is a very good thing).

 

[billypilgrim37]

I'm not sure I understand the connection between being "psychopharm heavy" and rotating through the ICU. Many balanced (and even psychotherapy heavy) programs have ICU months included in their PGY-1 medicine experience (which I think is a very good thing).

It seems the correlation between people whose programs required them to rotate them in the ICU and people who think it was a good thing approaches 1, and the correlation between people whose programs did not require them to rotate in the ICU and them thinking that was pretty good too is close to 1 as well.

I don't think it's so much the FACT that programs have their residents' rotate in the ICU that bothers me, but the way these programs really beat their chest on the interview trail about how they train REAL doctors (implying, of course, that others aren't training us to be REAL doctors). To be fair to DS, I never got that vibe from Longwood. But MGH, Hopkins, several others, there's a total chip on the shoulder about the fact that 1 month in the ICU magically makes their residents uniquely qualified to be real doctors while everybody else is just a bunch of dummies who think Beta Blockers are the girls that keep frat boys from getting laid on Thursday nights.

Good quality medicine months can come in many forms, from tertiary care ICU months to community hospitals with open units. The responsibility for decision making you are allowed and the teaching you receive from your peers and supervisors are much more indicative of medicine month quality than whether you necessarily get to float a swan or not.

 

[erg923]

To be fair to DS, I never got that vibe from Longwood. But MGH, Hopkins, several others, there's a total chip on the shoulder about the fact that 1 month in the ICU magically makes their residents uniquely qualified to be real doctors while everybody else is just a bunch of dummies who think Beta Blockers are the girls that keep frat boys from getting laid on Thursday nights.

......Hey...I know that girl!!

 

[Doc Samson]

It seems the correlation between people whose programs required them to rotate them in the ICU and people who think it was a good thing approaches 1, and the correlation between people whose programs did not require them to rotate in the ICU and them thinking that was pretty good too is close to 1 as well.

I don't think it's so much the FACT that programs have their residents' rotate in the ICU that bothers me, but the way these programs really beat their chest on the interview trail about how they train REAL doctors (implying, of course, that others aren't training us to be REAL doctors). To be fair to DS, I never got that vibe from Longwood. But MGH, Hopkins, several others, there's a total chip on the shoulder about the fact that 1 month in the ICU magically makes their residents uniquely qualified to be real doctors while everybody else is just a bunch of dummies who think Beta Blockers are the girls that keep frat boys from getting laid on Thursday nights.

Good quality medicine months can come in many forms, from tertiary care ICU months to community hospitals with open units. The responsibility for decision making you are allowed and the teaching you receive from your peers and supervisors are much more indicative of medicine month quality than whether you necessarily get to float a swan or not.

I am well aware of the vibe that you're talking about, and no, I didn't find it at Longwood either (although we do 2 months in the ICU). Regardless, when you're called for a consult to the ICU it does help to know what you're talking about when it comes to Propofol, Precedex, Versed, etc., and the best way to gain that familiarity is to work there.

 

[MDhasbeen]

I'm not sure I understand the connection between being "psychopharm heavy" and rotating through the ICU. Many balanced (and even psychotherapy heavy) programs have ICU months included in their PGY-1 medicine experience (which I think is a very good thing).

yeah, what billy said. and don't get me wrong. hopkins was high on my list too. i seriously considered them because i'm somewhat psychosomatic fellowship curious. the icu time might've been very useful except for the fact that i'd already done an icu month as a 4th year med student. so, in retrospect, i'm really glad i went with maryland. simple fact is that icu-level work isn't nearly as important as learning how to do basic, outpatient primary care medicine for the vast majority of psychiatrists out there as we are the only physician quite a number of people see their whole lives. anywho, one of the residents in my program is married to a hopkins resident. she tells me enough for me to know that hopkins isn't as heavy in the ways of things such as outpatient psychotherapy supervision etc., which is how i concluded they don't emphasize the therapy portion as much as the medication portion of our work.

 

[Chimed]

she tells me enough for me to know that hopkins isn't as heavy in the ways of things such as outpatient psychotherapy supervision etc., which is how i concluded they don't emphasize the therapy portion as much as the medication portion of our work.

I don't think there is any secret that Hopkins does not emphasize psychotherapy, and they made it quite clear when I interviewed there. In fact, the PD told me straight out that he thought psychotherapy was just a structured way of helping people figure out common sense solutions to their psychosocial problems (to be fair, I don't remember his exact quote, but it was something like that) and that it had much more to do with a perceived authority of the physician (i.e. placebo) then any type of technique.