Public Psychiatry Fellowships you can fast track into

[reca]

Wondering if anyone knows which public psychiatry fellowships it's possible to fast track into? I know Yale offers it but apparently it's already been filled this year. I'm interested in public psychiatry and would like to do a fellowship (but not so much that I want to add an extra year of training). Thanks!

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[Sushirolls]

It is called moonlighting. Go moonlight at a local community mental health center. No need for a fellowship. It's not enough of a niche in psychiatry to warrant a fellowship. Those that have them [brace for inflammatory comment] are merely duping people into a year of servitude for lesser pay.

Some one, anyone, please correct me if I am wrong in this harsh reductionist assessment.

 

[reca]

Sure, that's why I'm asking about programs which allow you to fast track and do it as a PGY-4.

 

[Sushirolls]

I'm not aware of it as an accredited ABMS specialty, so the chances of a Program Director to voluntarily give away their future PGY-IV to some other program is highly unlikely.

 

[yanks26dmb]

most of them will allow PGY-4s. Please contact programs of interest with your CV and cover letter, assuming that your program director is supportive. It is a little late in the game, but I'm sure there are available slots.

Is it possible to fast track in any other fellowships? Accredited or not..

 

[Monocles]

Eh, sometimes it's worth escaping your current adult program if you really hate it.

If I weren't dead set on child psych even back as an M3 I probably still would have fast tracked into a fellowship just to get out of my adult training. Super happy now as a child fellow and no ragrets!

 

[MacDonaldTriad]

I'm not aware of it as an accredited ABMS specialty, so the chances of a Program Director to voluntarily give away their future PGY-IV to some other program is highly unlikely.

Slavery ended in 1865, no matter how against this a PD might be, there isn't much he/she could do about it other than not recommending you. Even this would probably just look like sour grapes and not kill your chances. The ACGME would look at this as a transfer in adult training. Just make sure that you have 12 continuous months of outpatient in the same program. I wouldn't want to be the PD of the "public psychiatry fellowship" because that PD will be certifying his/her "fellows" as being capable of unsupervised independent practice after only training them for one year.

 

[Merovinge]

Slavery ended in 1865, no matter how against this a PD might be, there isn't much he/she could do about it other than not recommending you. Even this would probably just look like sour grapes and not kill your chances. The ACGME would look at this as a transfer in adult training. Just make sure that you have 12 continuous months of outpatient in the same program. I wouldn't want to be the PD of the "public psychiatry fellowship" because that PD will be certifying his/her "fellows" as being capable of unsupervised independent practice after only training them for one year.

I've heard you reference PDs having to certify folks after 1 year as being a scary prospect. Is there some sort of harm that actually befalls training programs if something a graduate does is particularly egregious? Having listened to Dr. Death, it seems like his fellowship program was allowing a wildly low amount of cases and certifying him but I've not heard anything became of it.

 

[MacDonaldTriad]

That is true if you program has a public psych fellowship. I believe Columbia and UCSF public fellowships are for PGY-Vs because you work 60% time in their public mental health systems and go to classes the other days.

 

[deleted736562]

Meh, as someone who transferred as a PGY-4, I cannot see why a PD shouldn't necessarily trust the decision making of another PD or the letters of recommendations from attendings. In many ways this is a much safer bet than getting a fresh out of med school PGY 1 with barely any psychiatry experience.

 

[OldPsychDoc]

Meh, as someone who transferred as a PGY-4, I cannot see why a PD shouldn't necessarily trust the decision making of another PD or the letters of recommendations from attendings. In many ways this is a much safer bet than getting a fresh out of med school PGY 1 with barely any psychiatry experience.

I'm sure that @MacDonaldTriad would never try to unload a Problem Child on a colleague. 😀

 

[MacDonaldTriad]

I'm sure that @MacDonaldTriad would never try to unload a Problem Child on a colleague. 😀

Yes, it is standard operating procedure to unload these problems on an unwitting public. Of course this is rare because Dean's letters always tell the truth and the whole truth so help them god. (sarcasm😛)

 

[Mass Effect]

Meh, as someone who transferred as a PGY-4, I cannot see why a PD shouldn't necessarily trust the decision making of another PD or the letters of recommendations from attendings. In many ways this is a much safer bet than getting a fresh out of med school PGY 1 with barely any psychiatry experience.

I don't know about that. As a PGY 1, you're expecting they know nothing and you will have 4 years to train them. As a PGY 4, you're expecting they've learned psychiatry well enough that they're almost ready for independent practice and you have to vouch for that a year later. It's a different standard.

 

[deleted736562]

What kind of PD would risk their reputation and that of the program to recommend someone who's trouble after knowing said individual for 3 years? God help us if this is how the PD world operates, lol.

 

[MacDonaldTriad]

What kind of PD would risk their reputation and that of the program to recommend someone who's trouble after knowing said individual for 3 years? God help us if this is how the PD world operates, lol.

This reminds me of the old Ally McBeal show. Ally had a psychiatrist played by Tracy Ullman who had a laugh track button on her desk. She would push it and then explain: "I'm sorry, sometimes my patients say things that are so naïve, my own laughter isn't enough."

Honestly this happens a lot and it isn't always a lack of integrity. Sometimes trainees can see the writing on the wall and make plans to transfer to a place where they can start fresh. If the PD doesn't have a paper trail strong enough to fire them, the PD has to be very careful about criticizing the trainee for legal reasons. Maybe some of it is just wanting someone to leave, but giving a poor job reference has created legal battles. Sometimes you can get the latent language of faint praise, but often is blatant undeserved over the top praise. As bad as this is, medical schools are much worse at moving people through and graduating them in my opinion. They may remediate students, make them repeat things, but seldom do they fail anyone out.

 

[reca]

They may remediate students, make them repeat things, but seldom do they fail anyone out.

We must have gone to very different med schools. Had upwards of 10% of my class fail out. At a state US MD school.

 

[Mass Effect]

What kind of PD would risk their reputation and that of the program to recommend someone who's trouble after knowing said individual for 3 years? God help us if this is how the PD world operates, lol.

It's not so much recommending someone who they know is trouble. Residencies are different with different requirements, different personalities in the attendings, and different standards (even though it's supposed to be standardized). A star resident at one program can be mediocre at another. It's relative, even though it shouldn't be. Unfortunately, psych, unlike most other specialties, doesn't have procedures or objective diagnostics (labs, imaging) you have to ace to graduate. Obviously, PRITE scores are objective, but even standardized patient interviews (can't remember what they're called but the thing instead of oral boards) can be influenced by the attending observing. If a resident is super nice, helpful, loved among the residents and faculty, praised by patients, they can get through even if they don't have a strong grasp of certain pathologies or even if they don't do well on PRITE (just read this board and the consensus on PRITE and how it's treated at various residencies). Likewise, residents with attendings who don't really care about teaching and just tell you what you need to know (i.e., so patient A has this dx and you should think about treating in B way...), aren't likely to actually learn, but to do things the way the attending wants. If you have too many of this type of faculty, gaps in knowledge can be hidden by residents. The PD has no idea, depending on his/her level of involvement, and based on evals full of rainbows and butterflies, thinks said resident hung the moon.

We must have gone to very different med schools. Had upwards of 10% of my class fail out. At a state US MD school.

If we were in pre-allo or even allo, I'd probably tell you to name and shame.

 

[MacDonaldTriad]

Wow, that sounds more like law school than medical school.

 

[deleted736562]

This reminds me of the old Ally McBeal show. Ally had a psychiatrist played by Tracy Ullman who had a laugh track button on her desk. She would push it and then explain: "I'm sorry, sometimes my patients say things that are so naïve, my own laughter isn't enough."

Honestly this happens a lot and it isn't always a lack of integrity. Sometimes trainees can see the writing on the wall and make plans to transfer to a place where they can start fresh. If the PD doesn't have a paper trail strong enough to fire them, the PD has to be very careful about criticizing the trainee for legal reasons. Maybe some of it is just wanting someone to leave, but giving a poor job reference has created legal battles. Sometimes you can get the latent language of faint praise, but often is blatant undeserved over the top praise. As bad as this is, medical schools are much worse at moving people through and graduating them in my opinion. They may remediate students, make them repeat things, but seldom do they fail anyone out.

They can write a mediocre letter which pretty much everyone else can read as "this is not good". Happens all the time. They can also outright refuse to recommend, although I guess you can say the resident will be more trouble at the program. In psychiatry, reputation is everything.

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What I will say for applicants is that, those positions are available, even at "top programs" and that what you're getting is just one perspective. Email programs you're interested in, have a good reason to transfer and also the support of your program.

 

[downwithDTB]

Let's be straight, public psych fellowships aren't getting 9000 applicants, and certainly not many pgy3 applicants. If the Public PD cares *at all* about who they are hiring and "certifying" them, they will call/email the key reference, aka the chair, chief, PD or APD. This is done all the time for fellowships. If the sending PD cares *at all* about their recommendation and ability to get future grads into decent fellowships, they will give an appropriate recommendation. Something that is true and off the record, i.e. saying only "John has successfully completed the PGY1-3 curriculum" would be a kiss of death and never lead to a successful lawsuit by John. I imagine PDs who make others fall on their grenades get a bad rep really quick.

Yes, there are different standards out there, so enforce them during your fellowship!

 

[reca]

If we were in pre-allo or even allo, I'd probably tell you to name and shame.

Oh, I'm completely open about this. I've never been in favor of hiding schools' mistreatment of students. This was Mizzou. Shouldn't be a surprise to anyone familiar with the med school, it was constantly in the news when I was a student for student mistreatment/dissatisfaction/discrimination. Leadership has been changed up since I left so hopefully some of these issues have improved.