Psych fellowships

[Joob]

So, I am fairly convinced that I am going to do a Psych residency, preferably at Tripler. My question is if I do an addiction fellowship or a 3+2 child psych, would I have an extra year of commitment after training? It seems that some residencies call the PGY-1 an internship, which wouldn't add to the commitment and others call PGY-1 the first year of residency, which would.

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[GeoLeoX]

So, I am fairly convinced that I am going to do a Psych residency, preferably at Tripler. My question is if I do an addiction fellowship or a 3+2 child psych, would I have an extra year of commitment after training? It seems that some residencies call the PGY-1 an internship, which wouldn't add to the commitment and others call PGY-1 the first year of residency, which would.

I not sure how it works for the combined adult/child psych, but if I were to guess I think that it's like any other 5 year residency. Which means you owe 5 years of payback post-residency.

Fellowships accumulate 1 year commitment (Active Duty Service Obligation (ADSO)) for 6 months of sponsored fellowship. Therefore a 1 year fellowship adds 2 years of commitment.

Assuming you have a 4 year HPSP scholarship and based on a 4 year psych residency at the end of residency you will owe 4 more years of ADSO. If you are selected for a one year fellowship directly out of residency your ADSO will be fulfilled 7 years from the time you graduate residency (4 years of commitment + 1 year of fellowship + 2 years of additional payback for the fellowship). If you do the 5 year combined adult/child psych then tack an extra year on the payback.

 

[Yellowstone]

I not sure how it works for the combined adult/child psych, but if I were to guess I think that it's like any other 5 year residency. Which means you owe 5 years of payback post-residency.

Fellowships accumulate 1 year commitment (Active Duty Service Obligation (ADSO)) for 6 months of sponsored fellowship. Therefore a 1 year fellowship adds 2 years of commitment.

Assuming you have a 4 year HPSP scholarship and based on a 4 year psych residency at the end of residency you will owe 4 more years of ADSO. If you are selected for a one year fellowship directly out of residency your ADSO will be fulfilled 7 years from the time you graduate residency (4 years of commitment + 1 year of fellowship + 2 years of additional payback for the fellowship). If you do the 5 year combined adult/child psych then tack an extra year on the payback.

This is not quite correct. Fellowship payback is 6 months per 6 months, with a minimum two-year obligation after completion of training.

For the OP, you would owe four years payback after completion of residency, assuming you did a 4-year HPSP and a one-year internship followed by 3 years of residency. If you did a 3+2 child psych straight through (if that's even offered), you would still owe just four years after finishing training.

While in residency training you are simultaneously paying back HPSP obligations at the same time you are adding additional commitment. So, after medical school you owe 4 years (again assuming 4-year HPSP). Internship (PGY-1) is 'dead time', thus you still owe four years. During a 3-year residency (PGY 2-4) you pay back three, but incur an additional three, so therefore you still owe 4 years [4-3+3=4]. During a 4-year residency (PGY 2-5) you pay back the 4 years from school, but still incur an additional four years obligation [4-4+4=4].

For fellowship, again it is a 6-month per 6-month obligation, with a minimum of two years owed after completion of fellowship. If you go into fellowship owing just one year (assuming you have done some payback first and haven't gone straight from internship to residency to fellowship), then a 1-year fellowship will leave you with two years of obligated payback [1+1=2]. If you go into fellowship without owing any time, then a 1-year fellowship will still leave you with two years obligated service.

For the OP, if you do a psych internship followed by 3 years of residency, followed by a 1-year fellowship all in succession, you would owe 5 years after completion of fellowship.

 

[GeoLeoX]

This is not quite correct. Fellowship payback is 6 months per 6 months, with a minimum two-year obligation after completion of training.

That depends. For a military-sponsored civilian fellowship it is 1 year for 6 months. That's what my contract says. And as the military continues to drop fellowships left and right it is becoming more likely that military physicians will be training in sponsored civilian fellowships. Psych, unlike my specialty, still does have a number of military fellowships.

 

[IgD]

I was a military psychiatrist. The Navy only recognizes two psych fellowships: Child and Forensics.

In the civilian world, the 4th year of psych residency can count as the first year of a psych fellowship. Normally a psych residency is 4 years including the PGY1 year and a child psych fellowship is 2. In the civilian world you can do both residency and fellowship in 5 years instead of 6. The Navy won't let you combine the first year of fellowship and last year of residency like that.

What they do in the Navy is require you to do a utilization tour in between residency and fellowship. So the training pipeline for the average psychiatrist looks something like this:

Internship
2 year GMO Tour
Remaining 3 years of psych residency
3 year utilization tour
2 years of child psych fellowship

So after 11 years of all that you end up owing 2 years after the fellowship.

 

[AFDuck]

What are the odds a Navy psych applicant will be forced into a GMO these days? From what I've heard, the primary care and less competitive fields (like psych) are increasingly training straight through. For the OP, who I'm guessing is Army as Tripler is his/her goal, the odds of a GMO tour when applying to psych are likely nil.

 

[Yellowstone]

That depends. For a military-sponsored civilian fellowship it is 1 year for 6 months. That's what my contract says.

Interesting, I also have a military-sponsored civilian fellowship from the Navy, and it is 6 months per 6 months. But the bottom line is that you can't finish a fellowship without owing at least two years after training.