Do you think I'm overthinking?

[299373]

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I am a USIMG in my internship year in psych and I am realizing I was not fully equipped during interviews to make an informed decision about which residency program is right for me. I am considering re-applying to a different psych program or possibly transferring. The reason for this is that I do not think the teaching (via lectures or from attendings) have been adequate (even with basic topics like the psychiatric interview or suicidality) and I find myself feeling like it is all up to me to acquire information. My program is small and there is not a lot of faculty; unfortunately, I was not yet aware of the importance of this when I was interviewing.

My goal is to some day do research, but I am also very interested in psychoanalysis/psychodynamics, and am considering possibly combining the two (maybe something like neuropsychoanalysis). My current program has maybe 2-3 people doing active research in areas that I am not particularly interested in.

My question is, my feeling is that all of the above listed things will have a significant impact on my future career and I am even considering applying again this September and starting over, which would mean I would have 'lost' 2 years; although internship year was a good experience as an opportunity to get used to the US system. Do you think there's faulty reasoning in anything I've just said, or that I'm assigning to much significance to didactics etc? Do you think it would be worth it in your personal opinion?

Sorry for the long post, and thanks.

 

[toothless rufus]

I don't think that's the greatest idea.

 

[299373]

Thanks for the input. Can you explain why?

 

[Manicsleep]

Let me think about it.

 

[atsai3]

I think you should go with Subway over Qdoba.

-AT.

 

[toothless rufus]

I think you should go with Subway over Qdoba.

-AT.

I think that's right.

 

[digitlnoize]

While I certainly understand your frustrations, I think that by the time you're in residency, you shouldn't be relying on others to teach you that much. There are plenty of resources out there for basic learning, many mentioned on here.

My other thought is that it shouldn't be too difficult to find an academic job somewhere after residency and start working on your research goals at that point.

Just my two cents, take it or leave it...

 

[atsai3]

i am a usimg in my internship year in psych and i am realizing i was not fully equipped during interviews to make an informed decision about which residency program is right for me. I am considering re-applying to a different psych program or possibly transferring. The reason for this is that i do not think the teaching (via lectures or from attendings) have been adequate (even with basic topics like the psychiatric interview or suicidality) and i find myself feeling like it is all up to me to acquire information. My program is small and there is not a lot of faculty; unfortunately, i was not yet aware of the importance of this when i was interviewing.

My goal is to some day do research, but i am also very interested in psychoanalysis/psychodynamics, and am considering possibly combining the two (maybe something like neuropsychoanalysis). My current program has maybe 2-3 people doing active research in areas that i am not particularly interested in.

My question is, my feeling is that all of the above listed things will have a significant impact on my future career and i am even considering applying again this september and starting over, which would mean i would have 'lost' 2 years; although internship year was a good experience as an opportunity to get used to the us system. Do you think there's faulty reasoning in anything i've just said, or that i'm assigning to much significance to didactics etc? Do you think it would be worth it in your personal opinion?

Sorry for the long post, and thanks.

cc

 

[299373]

atsai?

 

[GeniusofLove]

I am a USIMG in my internship year in psych and I am realizing I was not fully equipped during interviews to make an informed decision about which residency program is right for me. I am considering re-applying to a different psych program or possibly transferring. The reason for this is that I do not think the teaching (via lectures or from attendings) have been adequate (even with basic topics like the psychiatric interview or suicidality) and I find myself feeling like it is all up to me to acquire information. My program is small and there is not a lot of faculty; unfortunately, I was not yet aware of the importance of this when I was interviewing.

My goal is to some day do research, but I am also very interested in psychoanalysis/psychodynamics, and am considering possibly combining the two (maybe something like neuropsychoanalysis). My current program has maybe 2-3 people doing active research in areas that I am not particularly interested in.

My question is, my feeling is that all of the above listed things will have a significant impact on my future career and I am even considering applying again this September and starting over, which would mean I would have 'lost' 2 years; although internship year was a good experience as an opportunity to get used to the US system. Do you think there's faulty reasoning in anything I've just said, or that I'm assigning to much significance to didactics etc? Do you think it would be worth it in your personal opinion?

Sorry for the long post, and thanks.

Thermal, I'm sorry to hear about your situation. I don't understand why others are reacting so glibly to your question. Presumably, they don't have sympathy because they believe most programs will ill-prepare you for psychiatry and, so, why switch. From my perspective, if you have serious doubts about your training, what is the harm in looking elsewhere and possibly taking decisive action? If it were my career, I would consider the same thing. I'd just have to be sure that a) my situation is uniquely bad and b) the alternatives are worth the huge hassle.

 

[whopper]

You may just want to get out of your current program by graduating from it, then furthering your education through fellowship or doing more CMEs than the usual doctors do.

Psychiatry, if one takes it seriously, is a life-long learning process. Although I'm an attending, I'm still thinking of shifting job positions because I want to do a new scenario where I'll learn more. The only reason why I will not do another fellowship is because I've got a family to feed and my tolerance for being being at the bottom of the totem pole has decreased considerably. There are plenty of post-residency training opportunities.

If you got into a good fellowship, you will likely get the challenge and better education it seems you want, while increasing your opportunities and earning potential without having to start all over again as a PGY-1.

 

[299373]

Thanks for the serious answers. I did a lot of research about transferring etc. and I never saw anyone who wanted to transfer for a 'better education'; they were usually for family reasons or because they got into a fight with their PD etc. So I figured it wouldn't be usual or recommended to change programs for what I was feeling.

I think there's a lot to be picked up from just hearing a knowledgeable attending make a brief comment about something - I think it's much harder to learn some things afterwards with CME etc., but I hope I'm wrong.

 

[nitemagi]

OP,

I think you need to really tease out your reasons for transferring.
Is it your clinical education, or longer term career goals. If research is seriously your goal as a primary endpoint, you're probably going to need to do a research fellowship regardless of where you're at now. If you feel your clinical training isn't up to snuff, important to evaluate how much of that Will be improved at another program. There's a lot less handholding than you might think at many programs. I'm a strong believer in adult, lifelong, self-directed learning. Having good attendings can be fine for a foundation, but I do not believe they should be the basis of good/bad training.

And do Not start over. Plenty of programs recruit different levels, due to flakiness, fast-trackers, etc.

Also think about other levels of supervision, such as connection with various institutes, mentors, workshop trainings, etc. Maximize everything you can...

 

[GmailQueen]

I also think you should just stay at your current program. First of all, I think that it's always difficult to tease out details on the interview trail - you can't really tell how good the teaching is at a certain program until you get there, etc. Everyone will be all smiles and "everything is awesome here" on your interview day. Second of all, there aren't a lot of programs in the country who will give you substantial time to develop research interests, aside from those with designated research tracks, which would be difficult for you to switch into because I think they are generally few and far between and often compete for MD/PhDs.

I also think that your selection will be quite limited if you reapply. If you try to transfer to a PGY2 or 3 spot, you'll have to take what you can get in terms of programs that HAVE an available spot. As you've already noted, most people transfer for personal reasons (spouse, family, etc) and you're reason for transferring might seem somewhat suspicious to other programs - basically, if a resident is unhappy with their program because of teaching, or work hours, or clinical duties, a residency may feel they are taking a greater risk accepting them vs. someone with no complaints about their program but who needs to transfer for family reasons, since the first person may just have issues with residency in general (and may not like the new program any better). The same thought might occur to programs if you try to match into a PGY1 spot.
Also, in order to transfer, you have to talk to your PD before you start the application process. If you don't successfully transfer, you will be stuck at a program that your PD now knows you are unhappy with. While I would say that a true professional would not hold that against you, it seems from stories on this board that it may not always work out that way.

Basically, there are no guarantees, except the spot you currently have. I'd just suck it up. I doubt there are many interns out there that love every aspect of their program.

 

[299373]

Thanks everyone for the thoughtful input. I have decided to make the best of my current situation, as many of you recommended. My program has one advantage: the hours are pretty good, even for a psych program. So I am thinking of applying for a 1-year psychoanalytic psychotherapy fellowship, which consists of evening classes you can take during residency, to make more out of my time. And I agree that for the most part, education during residency should be acquired by the resident himself/herself. If there is anything lacking in my program, I guess I will have to make up for it myself.

Good luck to everyone!