NYC Tier-2 programs Montefiore - Beth Israel - St.Luke's - LIJ views

[SunburstTan]

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Hi fellow applicants,
I'm a run of the mill US grad from a decent MS, but no PhD or MPH to get a ticket to Columbia.

I wanted to offer and solicit feedback about the "2nd tier" programs in NYC
Please feel free to contribute with your experiences at the interview, the feel of the place, as well as gossip from friends and faculty.

- Montefiore:

• (+): you save money on rent and food, good line-up of teaching faculty; residents are content, reasonable call.
• (-): located in the Bronx, no real research.

- Beth Israel: ?? no experience, no sources


- St.Luke's:

• (+): warm PD and affiliation with Columbia, great research opportunities, loacted on UWS near Central park
• (-): does not pay well to live on UWS

- LIJ - Hofstra: I got more intel here: I know the chief and 2 residents at Zucker Hillside

• (+): highest $$, cheap rent, R3 moonlighting opportunities, learn telepsychaitry, lukewarm attempts at doing research (3-4 serious productive investigators, everyone else is dicking around). Plenty of supervision and help.
• (-): Brutal R3 year not getting better (ED call is insane, residents are in clinic only 14hrs/week but case loads can go up to 80 patients!), far from Manhattan. Administration suddenly sent PD into retirement and did not even permit him to warn the residents. Psych ED has abusive attendings and negative atmosphere.
• (+/-) therapy education skewed toward psychodynamic (5 psychodynamic courses vs. 1 CBT lecture in entire R3 year); new program director is a good guy, still has to assert himself. Residents are experts in schizophrenia and clozapine; haphazard knowledge of everything else.

 

[MiddleRoad]

I didn't interview nor am I a resident at any of the above, so my comments are all based on second hand information and reputation.

I have worked with both residents and attendings from LIJ and St. Luke's. They have all been well-trained, knowledgable clinicians. You mention the salary at St Luke's being low for the UWS, but they offer housing in midtown for residents.

People have great things to say about Einstein, but it is definitely known to be a cush residency. For those who feel that the intense clinical exposure of the type you'd get at any of the Manhattan programs should be a necessary part of training, this is not the program for you.

As for Beth Israel, I haven't heard much either.

 

[prittypistol]

Any word on Maimonides psych?

 

[Nasrudin]

Wow, SunburstTan. I just re-read this after reflecting about NYC programs on my itinerary. Do you think your intel on LIJ accurately reflects the intention of the program to revamp the R3 curriculum?

I have had doubts on what exactly am I getting from interview days--I wonder if it wouldn't be quite easy for me be lead around by the nose. Making interview day possibly less reliable than personal knowledge and relationships with residents by orders of magnitude.

 

[Psychotic]

Wow, SunburstTan. I just re-read this after reflecting about NYC programs on my itinerary. Do you think your intel on LIJ accurately reflects the intention of the program to revamp the R3 curriculum?

I have had doubts on what exactly am I getting from interview days--I wonder if it wouldn't be quite easy for me be lead around by the nose. Making interview day possibly less reliable than personal knowledge and relationships with residents by orders of magnitude.

These interview days are huge sales jobs - psychiatry is a buyers market, and we applicants are the buyers. I have not learned anything about a program on these days that I didn't already know, and most programs are selling the whole time you are in their presence. There really isn't a substantial difference between most of these programs, other than their location. You are correct - your best source of information is an insider you trust, and most of us don't have that kind of access.

Frankly, they could reduce the number of interviews (sales calls) and make the days shorter and more pleasant for all, and you could actually get to the airport in time to fly out on interview day, and maybe look around town a bit, too.

The real shame is that you should be spending more of your time investigating the city itself (especially if you do not know the area), not staring at the inside of the 4 walls of the program. Chances are you arrive at your hotel after dark (it is winter, after all), or you scurry straight from the airport to the evening before gathering in the dark, and then you get over to the interview site early in the morning for coffee and donuts, and leave just in time to catch a cab to the airport, never really experiencing the city.

Yes, the people you meet are a very important factor. But everyone I have met has been pleasant, so I have nothing to differentiate the programs based on those interactions, and the programs are more similar than not, so I don't really feel I know much more about a program after the interview than I did before. In other words, my pre-interview rankings are pretty much the same as post-interview, and maybe that is a good confirmation, but I feel like I am missing something in all of this.

Just ranting...feel fortunate to have had so many interviews, and more to come, but I am really weary at this point.

 

[Nasrudin]

Yep. I'm starting to realize this too. I find myself regurgitating selling points in my program reviews while half of me is like damn....you drank the kool-aid didn't you? Really there isn't a lot that separates them besides locations. My hard measures for rank list are starting to look like location, (salary + benefits + moonlighting potential)/(cost of living + workload), in-house fellowships, then back to some gut feel, but finally location in the end.

 

[Psychotic]

Yep. I'm starting to realize this too. I find myself regurgitating selling points in my program reviews while half of me is like damn....you drank the kool-aid didn't you? Really there isn't a lot that separates them besides locations. My hard measures for rank list are starting to look like location, (salary + benefits + moonlighting potential)/(cost of living + workload), in-house fellowships, then back to some gut feel, but finally location in the end.

That is exactly how I am looking at it - assemble all the facts (you first have to separate the facts from the hype, gloss, and kool-aid), but in the end, gut feel about the program, and location, will dictate the ROL.

The only surprises for me so far have been about location. One program has risen much higher, maybe to the top of the list, based on my feeling about the program (facts and gut) and more to my surprise at how much I liked the city after almost canceling the danged interview about a month ago (it is program that is praised but in a city that is disparaged on SDN). So you never know until you go and see a place for yourself - give yourself the chance to be surprised.

 

[SunburstTan]

Wow, SunburstTan. I just re-read this after reflecting about NYC programs on my itinerary. Do you think your intel on LIJ accurately reflects the intention of the program to revamp the R3 curriculum?

They are making a lot of changes, including serious plans to have NO R3 CALL by the time we reach it. Apparently current R3's staged a revolt about call conditions and complained all the way to the top. They are also trying to be very exclusive - apparently they received 1300 applications, intervieing 130, for 12 spots. (They are planning to cut down the program from 16 to 12 per year, advertising it as being better for the residents, but I think in reality what happened is that LIJ started a new anesthesiology program, which brings in more money).

Current R3s/chiefs are more skeptical about education changes (call changes are definitely coming). As in every other place, the education is highly dependent on the faculty, and this place has a long tradition of psychodynamic focus and schizophrenia focus. (There are over 20 psychodynamic supervisors for the R3's (each resident goes to 2 different psychodynamic supervisors/week all year). There are only 2 CBT supervisors.) No one is researching/practicing anxiety, PTSD, depression, bipolar, sleep, pain, so teaching on those topics is sporadic and/or self-directed. In R1-R2 years there are structured psychopharm leactures, but all psychopharm education in R3 year is by residents presenting to each other...

 

[Nasrudin]

In the interest of continuing this conversation aimed at a greater understanding of these programs I thought it might be useful to consider the commuting possibilities for each.

LIJ--seems like you're going to be in queens or Long Island. I don't care much for either. Long Island seems like a wealthy suburban sort of cheese ball of a place. Like somewhere in southeast Florida. And queens seems like it's entirely soviet-inspired. Block after block or square brick buildings all the same height. Dreary and dreadful. Commuting around these places is the worst sort of commuting to me. Like crappy LA driving except in crappier weather. Location isn't good from my point of view.

Beth Israel--Amazing walking commutes through anywhere in midtown manhattan where their subsidized housing units are located. The trouble here is that Mt. Sinai just bought them and there is worry among residents that what was once a huge benefit to being at this program--amazing rents for living in manhattan--is on questionable ground now after the buy out. So amazing but possibly a risk now--how much of one seems impossible to tell from an applicants perspective.

AE-Bronx--while not having the diversity of neighborhoods that Brooklyn has, it seems to have more than a non-local might think. Also the D train and the number 4 train connect you to manhattan. I'm wondering in the 3rd year if it wouldn't be possible to commute in on the subway from Harlem or somewhere else affordable but closer to more central parts of the city? Because I think this program has some strengths that make a longer commute well worth it as senior resident. I like train/walking commuting way, way more than driving.

Any thoughts are appreciated. I have no insider knowledge, just a love of New York and an intense curiosity over choosing from and being chosen for these programs.

 

[eastcoastdr]

In the interest of continuing this conversation aimed at a greater understanding of these programs I thought it might be useful to consider the commuting possibilities for each.

LIJ--seems like you're going to be in queens or Long Island. I don't care much for either. Long Island seems like a wealthy suburban sort of cheese ball of a place. Like somewhere in southeast Florida. And queens seems like it's entirely soviet-inspired. Block after block or square brick buildings all the same height. Dreary and dreadful. Commuting around these places is the worst sort of commuting to me. Like crappy LA driving except in crappier weather. Location isn't good from my point of view.

Beth Israel--Amazing walking commutes through anywhere in midtown manhattan where their subsidized housing units are located. The trouble here is that Mt. Sinai just bought them and there is worry among residents that what was once a huge benefit to being at this program--amazing rents for living in manhattan--is on questionable ground now after the buy out. So amazing but possibly a risk now--how much of one seems impossible to tell from an applicants perspective.

AE-Bronx--while not having the diversity of neighborhoods that Brooklyn has, it seems to have more than a non-local might think. Also the D train and the number 4 train connect you to manhattan. I'm wondering in the 3rd year if it wouldn't be possible to commute in on the subway from Harlem or somewhere else affordable but closer to more central parts of the city? Because I think this program has some strengths that make a longer commute well worth it as senior resident. I like train/walking commuting way, way more than driving.

Any thoughts are appreciated. I have no insider knowledge, just a love of New York and an intense curiosity over choosing from and being chosen for these programs.

I've lived in NYC and I agree with you. Long Island is a much calmer more suburban-like place. If you are tired of the city feel but still want access to manhattan every now and then, LI would be a great place for you.
BIMC's subsidized housing is amazing. It's located in one of the best parts of town (East Village) and very reasonably priced for that area. However I am curious too about how the recent merger will affect this. As for the Bronx..You can definitely live in certain parts of Manhattan (provided you can afford it) and commute via subway. Upper East Side is definitely feasible..and some parts of the UES are more affordable than the more lively, busier parts of Lower manhattan.

New York City is definitely the kind of place you have to experience before committing to living there. If anyone is on the fence about ranking NYC due to location I would suggest a weekend visit or something. Ride subways, eat cart food, see some sights..get to know NYC and see if its right for you 🙂 My main gripes with the city are the cost of living (but many people live just fine on a budget in NYC) and the fact that you have to walk or take public transportation everywhere (which really sucks in the freezing cold when you are carrying heavy groceries).

 

[Nasrudin]

I've lived in NYC and I agree with you. Long Island is a much calmer more suburban-like place. If you are tired of the city feel but still want access to manhattan every now and then, LI would be a great place for you.
BIMC's subsidized housing is amazing. It's located in one of the best parts of town (East Village) and very reasonably priced for that area. However I am curious too about how the recent merger will affect this. As for the Bronx..You can definitely live in certain parts of Manhattan (provided you can afford it) and commute via subway. Upper East Side is definitely feasible..and some parts of the UES are more affordable than the more lively, busier parts of Lower manhattan.

New York City is definitely the kind of place you have to experience before committing to living there. If anyone is on the fence about ranking NYC due to location I would suggest a weekend visit or something. Ride subways, eat cart food, see some sights..get to know NYC and see if its right for you 🙂 My main gripes with the city are the cost of living (but many people live just fine on a budget in NYC) and the fact that you have to walk or take public transportation everywhere (which really sucks in the freezing cold when you are carrying heavy groceries).

Yeah. But think of all the incidental exercise you get. I can't think of anything more modernly depressing than sitting all day just to sit in a car for an hour to go home and sit some more in a boring suburban place before falling asleep and repeating. When I was visiting the city I walked my butt off in crappy freezing rain and still fell in love with the city. Sitting in traffic with beautiful weather like LA is not as attractive lifestyle-wise for me. There's very few cities where you can actually walk and take trains as part of your daily thing. Very few. It's one of the reasons why we're so f'n fat as a country. But that just my feeling on it. I appreciate all opinions.

 

[VMSmith]

I'm wondering in the 3rd year if it wouldn't be possible to commute in on the subway from Harlem or somewhere else affordable but closer to more central parts of the city? Because I think this program has some strengths that make a longer commute well worth it as senior resident. I like train/walking commuting way, way more than driving.
.

Yes, I know several former residents in a variety of specialties (including psychiatry) who moved to Manhattan (mostly Upper East Side) later on in their residencies.

 

[Psychotic]

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[Nasrudin]

RE BIMC:

I realize the hospital systems merged under one corporate entity (Continuum), but how does ownership change affect the structure and operation of the for now separate residency programs? And why do current BIMC residents feel that they may be losing one of their key perks, the subsidized housing? Is there a basis in fact for this fear? I am curious if Mt Sinai residents harbor any similar concerns since they also have highly coveted subsidized housing, arguably nicer than BIMC?

Also, technically, wasn't Mt Sinai's hospital the one that was acquired, not BIMC? Continuum already owned BIMC and St Lukes / Roosevelt, and then more recently it acquired Mt Sinai. My take on this is that BIMC and St Lukes/Roosevelt's residency programs have remained autonomous (as far as I know), so why do people now have this fear that something is different this time around?

Good points--all stuff I didn't know. I didn't even realize there was a parent entity--continuum. I thought it was all Sinai initiatives. Makes sense. Yeah actually I've been talking to people on the interview trail and from all accounts the residency programs will remain separate. So I'm not worried about having to look for a new spot if I went there so much as having to find housing. The issue there is that I heard Sinai-continuum might have ambitions of turning the housing structure adjacent to the hospital into a health care structure, thus compromising their ability to provide subsidized housing. Such a huge project would likely take years to begin. So it's not a huge factor, but a few of my New York options are neck and neck in my mind and will likely all be at the top of my list. So minor factors are becoming more important as we approach rank list dates.

So I appreciate these insights.

 

[eastcoastdr]

RE BIMC:

I realize the hospital systems merged under one corporate entity (Continuum), but how does ownership change affect the structure and operation of the for now separate residency programs? And why do current BIMC residents feel that they may be losing one of their key perks, the subsidized housing? Is there a basis in fact for this fear? I am curious if Mt Sinai residents harbor any similar concerns since they also have highly coveted subsidized housing, arguably nicer than BIMC?

Also, technically, wasn't Mt Sinai's hospital the one that was acquired, not BIMC? Continuum already owned BIMC and St Lukes / Roosevelt, and then more recently it acquired Mt Sinai. My take on this is that BIMC and St Lukes/Roosevelt's residency programs have remained autonomous (as far as I know), so why do people now have this fear that something is different this time around?

I interviewed at BIMC and I haven't gotten around to writing an official review yet. They said in their presentation that the merger with Sinai will NOT affect the residency programs. MSSM, SLR, NYEEI and BIMC will have their own separate residencies and fellowships, their own PDs, their own application process, own salaries etc. Salary and benefits (including housing) have been guaranteed. The housing will remain separate too. BIMC keeps theirs, and MSSM keeps theirs. At least that's what the PD at BIMC said. He said if anything, its a good thing because residents can very easily do electives and research at all 3 hospitals. This is a good thing for certain fields like Child and Forensics, bc MSSM has the only child inpatient unit in manhattan, and an affiliation with Manhattan State facility. Also this now means that MSSM medical students will be rotating at BIMC, SLR and NYEEI, and that BIMC is no longer affiliated with AECOM. Also BIMC now gets the privilege of being listed as "university program" or something.

SLR, NYEEI, BIMC (and previously LICH) all USED to be Continuum Health Partners. CHP, on their website, now say they are a part of MSSM. According to this article below it looks like CHP and MSSM merged, and they agreed to take on the Mount Sinai name.
http://www.mountsinai.org/about-us/newsroom/press-releases/mscontinuum

 

[eastcoastdr]

dp when trying to edit sorry

 

[Psychotic]

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[Nasrudin]

Thanks eastcoastdr and psychotic. I'm starting to get a better sense of what I might be doing ranking these places in a minute. Can I ask you guys or anyone who might be local a few things:

1. What would make you chose either SLR or BI over each other? I just want a local's perspective on this, I will end up going with my own gut but I'm still early on in forming my opinions, so before I get taken in by the interview process or 2nd looks of either I wanted to see how the natives see things.

2. What is therapy flavor of all these programs? I'm still in the womb with my own concept of what sort of therapy appeals to me, but I have some distinct instinctual aversion to psychoanalysis. I'm more oriented personality wise to supportive therapy, group therapy, and cognitive behavioral therapy. I appreciate that our psychodynamic forbearers helped create the patient therapist relationship and that psychodynamic principles may be broadly useful. But I'm just not an analyst and even in the womb I know this somehow. I really want strong connections and mentoring relationships with my future home, wherever that may be, so I was curious if anybody had thoughts about therapy training in NYC at these programs.

Again these are finer points of distinction aimed at parsing out the top of my ranklist. Appreciate any insight.

 

[Psychotic]

,

 

[notdeadyet]

I'm still in the womb with my own concept of what sort of therapy appeals to me, but I have some distinct instinctual aversion to psychoanalysis. I'm more oriented personality wise to supportive therapy, group therapy, and cognitive behavioral therapy. I appreciate that our psychodynamic forbearers helped create the patient therapist relationship and that psychodynamic principles may be broadly useful. But I'm just not an analyst and even in the womb I know this...

I'd be careful about using psychoanalytic and psychodynamic interchangeably.

Psychoanalysis is really its own animal. If you rule out anything psychodynamic, you're really limited to mostly workbook based therapies. And you'll find that doing things like CBT and the like, you'll have much better success with a good psychodynamic foundation. Otherwise, I think you're kind of operating at a masters level of training.



Sent from my iPhone using Tapatalk

 

[Nasrudin]

Yeah I hear you, I didn't mean them as synonyms but one,as you say a more fundamental part of all therapy and the other a fully developed traditional style. As I understand them psychodynamics was part of the discovery process of the psychoanalytic tradition that is now used more broadly by non-analysts.

Psychotic,

Thanks. I can see the logistical point you're making.

 

[prittypistol]

I think as far as location Beth Israel offers housing in a fun neighborhood. Whereas SLR housing is in a quiet spot of midtown just north of Hell's Kitchen. The beauty is they have a bus that runs from the door to the building to the st lukes hospital all the time so you never need a subway or to go far to get to and from work.

As far as program goes I got the impression that SLR provides a really strong clinical education and skillset.- turns out competent successful psychiatrists vs "advanced med students" in the end. The confidence of the residents was very impressive. For BI I wouldn't say it was worse or anything like that but it didn't seem to be as strong or as talked about.