help deciding between interview invites

[rkaz]

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[rkaz]

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[shinystar2014]

It's definitely a hard decision! Unfortunately I don't know anything about the programs you listed. However, I can share with you my thought process in regards to this decision. I thought about the programs I had already interviewed at that I really liked. Then I thought whether I had a good feeling about the interview day and whether it seemed reasonable that I could match there. Then I went through the several programs I was considering on cancelling and thought whether or not I could ever fathom choosing it over the programs I already interviewed at that seemed to go reasonably well. I took into account information about the program itself (mostly class size) and also thought of geographical area. Definitely did NOT do this with my entire list, just with a few that I was already thinking about cancelling. Not sure if this will be helpful for you, but thought I would share.

 

[Fenster]

I specifically have to make an immediate decision between Univ of Mississippi - Jackson, and Univ of Nevada - Las Vegas, as they have overlapping dates. It seems like Mississippi has some interesting fellowships, which is a positive for me. Las Vegas however is in a more interesting city (I presume). It's hard to decide by only going off their websites.

I'd definitely drop Missisippi if only because of their ACGME probation. But then again, I'm yet to hear good things about the LV program so it's up to you.

 

[Nasrudin]

Geography seem easiest here. You're touring like a rocknroll band coming up the hard way. Some of those places qualify as the taints and armpits of these United States. If that phases you not in the least I'm wondering if you're some sort of alien anthropologist on an exploratory mission to catalogue the various deficiencies of the human race.

 

[rkaz]

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[rkaz]

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[splik]

The ACGME requirements are really lowest common denominator especially for psychiatry. Something egregious must have happened for a program to be put on probation. There are only 2 psychiatry residency programs currently on probation (the other one is ETSU). you have tons of interviews, some at some great programs. programs on probation are at serious risk of losing their accreditation and the residents thus being out of a job. This rarely happens in practice, but is not a risk at most programs. annoyingly the process is not transparent and you cant find out why the program is on probation so there you go. Sometimes it gets into the public domain (c.f. ETSU). in surgical specialties it is much more common for programs to be on probation, but it is rare in psychiatry and a major red flag. avoid.

 

[Psychotic]

The only 2 programs I would encourage you to attend from your lower list are Scott and White and LSU-NO; Temple would be a pretty OK place to live unless you need the bright lights of a big city, and even then you are close to Austin and Dallas for diversion. After that, maybe keep West Virginia based on the program more than the location. I base these comments on everything I have read about these programs over the last 2 years, plus some familiarity I have with the locations. Shreveport, for instance, is really not a bad place to live, but the program is borderline - all of the residency progs there are borderline, really. The Nevada programs sound shaky as hell to me. And I would punt the Miss program for the probation thing alone - without knowing what the whole story is there, why even bother? You don't need that.

From your top list, I personally would nix Detroit. Have you ever been there? It is a miserable city...the others on your top list are good, but Detroit is an awful place to live.

How many are you hoping to attend, in total? I think it is easy to overkill this process - I have done it, and I am starting to regret it - I have attended 7 interviews so far, and I am going to limp across the finish line over the next 6 weeks with about 5 more to go, and I am thinking about canceling at least 2 of them, and even then I am half dreading the others...this process will drain the life out of you, not to mention the money out of your bank account.

 

[rkaz]

in surgical specialties it is much more common for programs to be on probation, but it is rare in psychiatry and a major red flag. avoid.

Thank you for that explanation. I had no idea the probation thing was so serious and that it could result in de-accreditation and resident loss of job. I presumed it was more of a minor slap on the wrist for something... e.g., like 1 resident being found to work 84 hours one week, or the program not submitting some paperwork on time to the ACGME. I am thankful to have found the potential ramifications out now.

 

[TexasPhysician]

The only 2 programs I would encourage you to attend from your lower list are Scott and White and LSU-NO; Temple would be a pretty OK place to live unless you need the bright lights of a big city, and even then you are close to Austin and Dallas for diversion. After that, maybe keep West Virginia based on the program more than the location. I base these comments on everything I have read about these programs over the last 2 years, plus some familiarity I have with the locations. Shreveport, for instance, is really not a bad place to live, but the program is borderline - all of the residency progs there are borderline, really. The Nevada programs sound shaky as hell to me. And I would punt the Miss program for the probation thing alone - without knowing what the whole story is there, why even bother? You don't need that.

From your top list, I personally would nix Detroit. Have you ever been there? It is a miserable city...the others on your top list are good, but Detroit is an awful place to live.

How many are you hoping to attend, in total? I think it is easy to overkill this process - I have done it, and I am starting to regret it - I have attended 7 interviews so far, and I am going to limp across the finish line over the next 6 weeks with about 5 more to go, and I am thinking about canceling at least 2 of them, and even then I am half dreading the others...this process will drain the life out of you, not to mention the money out of your bank account.

I second this advice. Scott & White and LSU NO are quality programs. With Detroit crashing financially, I wouldn't want to live there.

 

[rkaz]

How many are you hoping to attend, in total? I think it is easy to overkill this process - I have done it, and I am starting to regret it - I have attended 7 interviews so far, and I am going to limp across the finish line over the next 6 weeks with about 5 more to go, and I am thinking about canceling at least 2 of them, and even then I am half dreading the others...this process will drain the life out of you, not to mention the money out of your bank account.

Thanks for your suggestions regarding various programs. I have never been to Detroit.

Congrats on all your interviews. 🙂 I totally relate to the financial crunch, as I'm also feeling stress over money at this time as well. I've had 6 interviews thus far, and I'm thinking about going to between 13-15 total. (I had 4 interviews within a 7 day period when I was off rotations, and I was fine with it - definitely taxing, but it was okay.) I realize it may be more than I need. However, because my stats are lower, I realize that I may be lower on program's rank lists than other candidates - hence the need to go on more interviews to ensure matching somewhere. Of course I'd love to match into my favorite programs, but I also want to be realistic about my chances.

 

[rkaz]

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[Nasrudin]

Rkaz,

Congrats on so many interviews. I was only being provocative to get you to think about your own tastes for places to live. I'm certainly not a top applicant and like you have some wonderful opportunities that have surprised me. If there's one thing I've learned on the trail is that if you're a good student and a good person to work with you have surprising market value in the psych match.

Such that you can actually think about either places or programs or both much more critically than your typical derm or ortho applicant. But it's your tastes that matter. I'm very picky about location. Being in a rural southern place for example would be dismal. But some people love it. All the up in your buisness-ness, the bible thumpin, the binary black/white racial construct, the echoes of the civil war defeat permeating the airwaves with the ridiculous micro-nationalism of nashville's cheesy pop music machine, and the ignorance frankly. Do you like places with skyrocketing rates of illiteracy? With post apocalyptic scenery? Then seriously consider not living in Mississippi or Detroit. And so on.

Just my opinions. I only implore you to have your own. It's 4 years of your life.

 

[rkaz]

Thanks Nasrudin. I agree that being at a place you are happy with totally matters, and location can be a big part of that.

 

[Nasrudin]

Yeah, I can see why you're having trouble counterbalancing your needs/wants. I have heard some researchers talk about how it matters less where you go than people think if you have the ability to execute the work yourself--and that protected time to do the work is the more important concern. But I suppose you need a medical school unless you could find a role in educating junior residents. Good luck.

 

[splik]

Thanks Nasrudin. I agree that being at a place you are happy with totally matters, and location can be a big part of that.

In terms of where I'd be happiest, I think I'd be happiest staying local in my city (Phoenix) and being in the midst of family (as my parents, sister, and cousins all live in my city). I interviewed at Banner Good Sam, a local community program, and felt totally at home and comfortable and happy to be there. My only issue is that I love to teach and I have research interests, and can see myself working in academics someday - so I am concerned that going to a community program might close doors as they do not have all the cool electives or teaching tracks or mentorship of the larger academic programs that I've loved interviewing at. Maybe I could still do fellowships elsewhere and still work in academics after coming out of a community residency program, but I am unsure if this would work out the way I'd like in terms of future opportunities.

What is the main factor that applicants for psychiatry use to choose a residency? Location. Does this make sense? yes! Does this make for happy residents? yes! It sounds like you think that Banner Good Sam is a good fit for you and in the perfect location around family. The whole community vs academic for psychiatry residency is BS really. most programs claiming to be university programs are really community programs. They have med students, they have residents so there would be perfect opportunity for you to be involved in teaching and curriculum development. There may even be more flexibility to shake things up than at larger places. Additionally, you could get involved with teaching psychiatry to docs in other specialties as a senior resident - something that is very important so they dont just throw benzos at every anxious patient, or give seroquel to every sleepless patient. You have plenty of opportunities and there is nothing to stop you augmenting this with national opportunities through the Association for Academic Psychiatry or the AADPRT both of which have schemes for residents.

As for research, sorry but you are not going to have some major research career wherever you go. Hell most MD/PhDs don't even have research track careers.

I don't think it will terribly disadvantage you in terms of having a clinician educator career by going to the program you think you'd be happiest at. May be it will make you a more effective clinician and educator. And remember fellowships are so ridiculously uncompetitive that for the most part you will not have any problems getting into a good one if you become a good resident.

I don't know anything about this program other than it is not competitive at all (which is great for you) and the Chair is call Dr. McLoone which is the most amazing name for a psychiatrist so take my comments in a more general sense.

 

[OldPsychDoc]

What is the main factor that applicants for psychiatry use to choose a residency? Location. Does this make sense? yes! Does this make for happy residents? yes! It sounds like you think that Banner Good Sam is a good fit for you and in the perfect location around family. The whole community vs academic for psychiatry residency is BS really. most programs claiming to be university programs are really community programs. They have med students, they have residents so there would be perfect opportunity for you to be involved in teaching and curriculum development. There may even be more flexibility to shake things up than at larger places. Additionally, you could get involved with teaching psychiatry to docs in other specialties as a senior resident - something that is very important so they dont just throw benzos at every anxious patient, or give seroquel to every sleepless patient. You have plenty of opportunities and there is nothing to stop you augmenting this with national opportunities through the Association for Academic Psychiatry or the AADPRT both of which have schemes for residents.

As for research, sorry but you are not going to have some major research career wherever you go. Hell most MD/PhDs don't even have research track careers.

I don't think it will terribly disadvantage you in terms of having a clinician educator career by going to the program you think you'd be happiest at. May be it will make you a more effective clinician and educator. And remember fellowships are so ridiculously uncompetitive that for the most part you will not have any problems getting into a good one if you become a good resident.
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I think these are very good, realistic principles that can be generalized to most residency applicants--excepting those very few who will want to achieve the "major research careers".

 

[Psychotic]

I specifically have to make an immediate decision between Univ of Mississippi - Jackson, and Univ of Nevada - Las Vegas, as they have overlapping dates. It seems like Mississippi has some interesting fellowships, which is a positive for me. Las Vegas however is in a more interesting city (I presume). It's hard to decide by only going off their websites.

So are you telling us you are instate in Arizona? As that is where you currently attend med school, and it is also where your family lives?

If that is the case, this is a no-brainer. Drop UM and go to Las Vegas, if only for the ease and presumably lower cost of travel.

Nobody can blame you for feeling the need to attend more interviews rather than fewer because of your perception of your strength as a candidate, but my gut tells me that 8 to maybe 10 interviews is plenty for the vast majority of applicants, assuming that you would be happy to rank all of those programs. But if you have the time, money, and desire to attend 13 to 15 interviews, go for it.

 

[notdeadyet]

It may sound like an oversimplification, but happy residents tend to be better residents, and better residents tend to be more successful professionally after finishing residency. You will finish residency with better recommendations and people will go the extra mile if you were a hard worker that went the extra mile for patients and staff, and this tends to come with residents that are happy at their program. Whether this is a top 10 research funded program or a smaller regional program, it pretty much holds true.

You are better off professionally as a happy resident at a less renown program than an unhappy resident at a big name one. Decide what will make you happy and choose accordingly, whether it's geography, psychodynamic psychotherapy supervision, OCD research, nightlife, weather, being near Mom, being far away from Mom, big prestigious name, moonlighting opportunities, or basketball team. Choose a program that will make YOU happy, not anyone else. Then go there and work hard and make the most of it, and you'll be far better off professionally (and personally) than if you choose based on criteria that strangers on a web forum throw out there for you.

 

[OldPsychDoc]

😍

It may sound like an oversimplification, but happy residents tend to be better residents, and better residents tend to be more successful professionally after finishing residency. You will finish residency with better recommendations and people will go the extra mile if you were a hard worker that went the extra mile for patients and staff, and this tends to come with residents that are happy at their program. Whether this is a top 10 research funded program or a smaller regional program, it pretty much holds true.

You are better off professionally as a happy resident at a less renown program than an unhappy resident at a big name one. Decide what will make you happy and choose accordingly, whether it's geography, psychodynamic psychotherapy supervision, OCD research, nightlife, weather, being near Mom, being far away from Mom, big prestigious name, moonlighting opportunities, or basketball team. Choose a program that will make YOU happy, not anyone else. Then go there and work hard and make the most of it, and you'll be far better off professionally (and personally) than if you choose based on criteria that strangers on a web forum throw out there for you.

 

[Shikima]

I like what you've said, but the reality is, you may not get into the place that'll make you happy. Thus, you end up anywhere considering the latest matching climate where everything nearly fills 100%. Unlike a decade ago where only ~80%+ of the programs went unfilled.

 

[rkaz]

Splik, thanks for the suggestion of getting involved with those organizations you listed for research opportunities. I'll surely look into them.

Anyway, I deleted my last comment, as I realize I may be confusing happiness with comfort. Just because I am most comfortable somewhere doesn't mean that it is necessarily the best place for me, as there is merit to pushing oneself out of one's comfort zones to achieve greater personal growth. Moving to a new place may just do that for me, as I have stayed local for many years, and a change of scenery may do me good. Hence, I'm going to keep an open perspective to all my interviews.

I didn't mean to derail my own thread in terms of my musings on what would make me happiest. I realize that is out of the scope of this thread. Although I know I have some personal reflecting to do, I don't want to be annoying by sharing too much of my thought process here.

If anyone has any further comments on the programs I listed, I'd appreciate it.

 

[eastcoastdr]

I would keep LSU New Orleans if only for the extremely low cost of living, moderate weather and excellent culture/cuisine. It's definitely one of my favorite cities in the USA!

I would also consider Texas A&M. Texas is a pretty competitive state to get residency in because its supposed to be a great place to practice medicine. High reimbursements, no state income tax, and a relatively low cost of living. I'm not familiar with where this program is located exactly, but there's a lot of diversity and culture in Texas too.

 

[st2205]

OSU and MCW are dynamite programs, with an edge to MCW (great diversity of training and phenomenal lifestyle). San Antonio is a big program and has a number of different sites. It's friendly. Good training. I think you work pretty hard, though.

I'm at A&M/S&W and would be happy to answer any specific questions and shoot straight with you.