PGY-1 year

[Smitty]

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I'm a 4th year med student considering psych. I know that the first year of psych residency is usually 4 months of primary care with 2 months of neuro and 6 months of psych. Are the 4 months of primary care inpatient or outpatient? I've heard that it depends on where you go. Can anyone give me an idea as to how many programs out there require inpatient vs. outpatient during the first year? Thanks.

 

[monocyte]

You will almost certainly have several months of inpatient medicine. I think 4 months is the minimum. (If anyone out there knows better please correct me.)

I'd suggest visiting the websites of programs you're interested in...they should post this sort of information.

Good luck!

 

[mdblue]

4 months of primary care-that's what the board requires from you. It does not matter wha you do.
Hope this helps.

 

[willow212]

Most programs I visited have their medicine months as inpatient. Some also require more months (6 months). I agree that you should look up the websites of the programs you are most interested in for more info. Good luck!

 

[Asher]

At the programs I interviewed at, generally one half or more of the primary care months are inpatient -- whether they are in internal medicine, EM, family, or peds varies from program to program. Generally, the two months of neuro include one inpatient and one outpatient.

A question to ask when you are interviewing is about how intensive the medicine months are. At some places, the psych intern functions as a full member of the team whereas at others you have less responsibility or are put on easier services.

 

[16846]

A question to ask when you are interviewing is about how intensive the medicine months are. At some places, the psych intern functions as a full member of the team whereas at others you have less responsibility or are put on easier services.

Can you elaborate more on this point or a source which has more information on this topic? This is one issue I am greatly concerned about

I believe I would be able to really shine as a psych. resident in the psych portion of a program, but am concerned about my potential performance in the medicine portion of a program.

 

[Anasazi23]

I think this is more or less a "word of mouth" thing. Not one of the psychiatry residency interviews I went on stated that medicine was anything less than "intense." Then again, a friend of mine at Brown said her medicine was "easy." 😕 The residents, however, may make you privy to the more realistic situation.

Don't be afraid of medicine. Despite what some think, it's an important and necessary exposure on top of that received in medical school which will help you to hone your PE, lab, EKG, and other skills which are necessary to become a good psychiatrist. Worst case scenario - it's only 6 months. Most are 4.

Good luck.

 

[Asher]

When I was on interviews, I just asked Pgy-1s and Pgy-2s what their medicine experience were like in terms of the level of responsibility on the team -- ie, did they carry as many patients as the other interns, were they expected to perform at the same level as the other interns, did they take call as frequently and stay overnight (at one program I visited the psych resident on medicine was usually sent home before midnight while the rest of the team stayed at the hospital). I also would look at the setting for the inpatient months. Several programs have all or a majority of their medicine blocks based out of a VA hospital. This doesn't make the months inherently easier but it does give a more limited (usually) group of patients and pathology.

I also asked residents about how they handled medical issues that might arise on the inpatient services. Some hospitals have med-psych wards for these patients and allow psych residents to keep at least the basics of medicine management refreshed. At other places, all issues (including management of rather uncomplicated problems) go directly to medicine.

ETA: It is also important to ask current residents about their experiences on the neurology service (i.e. was there adequate teaching and supervision, does it mainly consist of scutwork, do you have in house call on your own?).