ranking Midwest programs

[DynamicDidactic]

FWIW, when I was there no one in psychiatry at Northwestern appeared to be happy. Attendings, residents, psychologists, socials workers, OTs, secretaries, or patients. Its a pretty tough gig with NW being the only no-fee mental health provider for all of Chicago and has a popular inpatient unit. Additionally, the hospital is not very supportive of the psychiatry dept stemming from a string of suicides a few years ago. I can say that the DBT training was pretty subpar, can't speak for the other psychotherapy training. Psychiatrists and psychologists don't seem to stick around.

But this is all from an outsider's point of view.

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[SoulinNeed]

Anyone with recent knowledge know what kind of patient population Rush sees?

 

[lockian]

I love where this thread has gone...

 

[Merovinge]

Anyone with recent knowledge know what kind of patient population Rush sees?

Moderately diverse due to a (relatively) high pt volume and being in the medical district. A higher % private insurance than most Chicago programs and the program has very strong ties to private practice in general (attendings work both their and do PP unlike at many academic programs).

 

[SoulinNeed]

Moderately diverse due to a (relatively) high pt volume and being in the medical district. A higher % private insurance than most Chicago programs and the program has very strong ties to private practice in general (attendings work both their and do PP unlike at many academic programs).

That sounds great, actually, because my goal is PP within the actual city of Chicago. Sorry to be specific, but can you tell me how the patient population compared to say, Northwestern or UIC? Thanks!

 

[Merovinge]

That sounds great, actually, because my goal is PP within the actual city of Chicago. Sorry to be specific, but can you tell me how the patient population compared to say, Northwestern or UIC? Thanks!

NW - Similar to Rush, fair split between private insurance and public aid, particularly on call/ED there is a lot of homeless that happens to hang out in River North/Gold Coast who stroll through.

UIC - Heavily public aid, nearly all inpatients are. Outpatient you see a fair amount of college/graduate students. Definitely more working class population, disease severity is probably more severe on the average and either NW or Rush.

If you want to get good at interacting with folks who might pay cash someday/higher SES than I would definitely choose NW or Rush. It's a very different experience than dealing with low/working class SES and will certainly influence the way you practice, even if it's subtle differences.

 

[SoulinNeed]

NW - Similar to Rush, fair split between private insurance and public aid, particularly on call/ED there is a lot of homeless that happens to hang out in River North/Gold Coast who stroll through.

UIC - Heavily public aid, nearly all inpatients are. Outpatient you see a fair amount of college/graduate students. Definitely more working class population, disease severity is probably more severe on the average and either NW or Rush.

If you want to get good at interacting with folks who might pay cash someday/higher SES than I would definitely choose NW or Rush. It's a very different experience than dealing with low/working class SES and will certainly influence the way you practice, even if it's subtle differences.

Thanks for your help. Do you know if Rush residents still rotate through Cook County and Cermack? Or if NU does? And do you have any idea what kind of patient population Loyola and Advocate see? Thanks.

 

[WingedOx]

Thanks for your help. Do you know if Rush residents still rotate through Cook County and Cermack? Or if NU does? And do you have any idea what kind of patient population Loyola and Advocate see? Thanks.

I'm pretty sure Cook County is still Rush's territory. I'm not sure I'd exactly want that job though. A busy urban ED without an attached psych unit sounds awful.

Loyola's location is kinda wedged between the western burbs and the west and southwest sides of Chicago, so you get a decent racial and economic diversity there. Their program is known to be very VA-heavy for what it's worth.

Advocate is in Park Ridge, which is kind of a generic whitebread suburb.

 

[Merovinge]

I'm pretty sure Cook County is still Rush's territory. I'm not sure I'd exactly want that job though. A busy urban ED without an attached psych unit sounds awful.

Loyola's location is kinda wedged between the western burbs and the west and southwest sides of Chicago, so you get a decent racial and economic diversity there. Their program is known to be very VA-heavy for what it's worth.

Advocate is in Park Ridge, which is kind of a generic whitebread suburb.

This is correct on all accounts. Cook is not a huge part of your time at Rush as best I know but added to give diversity to their otherwise higher SES population. NW rotates extensively at the Jesse Brown VA to get exposure to vets, low SES, and substance abuse. Advocate is a small suburban program but I have a friend who did his training there and had a great experience. If you want to stay in Chicago, there should be good programs to fit most anyone.

 

[SoulinNeed]

This is correct on all accounts. Cook is not a huge part of your time at Rush as best I know but added to give diversity to their otherwise higher SES population. NW rotates extensively at the Jesse Brown VA to get exposure to vets, low SES, and substance abuse. Advocate is a small suburban program but I have a friend who did his training there and had a great experience. If you want to stay in Chicago, there should be good programs to fit most anyone.

Yeah, I appreciate that Rush rotates through Cook and Cermack (guessing they still do), but it makes me apprehensive about it. If I choose to go to Rush, it's because of Rush. I don't want to spend a great deal of time outside of it, so I'm wondering how much time you really spend at Cook. I used to work at Stroger, but admittedly it's not a patient population I'm interested in, and I honestly wonder what the teaching resources are like there.

I also never hear anything about Loyola and Advocate's Psych programs, so I'm curious to hear more about them. Glad to hear that your friend had a good experience at Advocate.

 

[WingedOx]

Yeah, I appreciate that Rush rotates through Cook and Cermack (guessing they still do), but it makes me apprehensive about it. If I choose to go to Rush, it's because of Rush. I don't want to spend a great deal of time outside of it, so I'm wondering how much time you really spend at Cook. I used to work at Stroger, but admittedly it's not a patient population I'm interested in, and I honestly wonder what the teaching resources are like there.

I also never hear anything about Loyola and Advocate's Psych programs, so I'm curious to hear more about them. Glad to hear that your friend had a good experience at Advocate.

I'm going to hop on my high horse a bit here.

Diversity of patient population is extremely important when training in psych... particularly since the most intense pathology that you see are going to be in places like Stroger. Anyone can do "setraline for soccer moms". It's getting a patient stabilized when everything on all three parts of the biopsychosocial spectrum are going to hell that makes you a good psychiatrist. My beef with Stroger is that because of the lack of in inpatient unit there, you don't get to see the care of populations like that from start to finish (not sure what role the residents have with their outpatient clinics).

I don't mean to knock Rush as a program at all because it's a solid program, but if you're going to train in a city as screwed up as Chicago, you should see it as a training opportunity. Your learning curve is a lot steeper dealing with Uptown and Back of the Yards than River North... but that's a good thing.

 

[Merovinge]

I'm going to hop on my high horse a bit here.

Diversity of patient population is extremely important when training in psych... particularly since the most intense pathology that you see are going to be in places like Stroger. Anyone can do "setraline for soccer moms". It's getting a patient stabilized when everything on all three parts of the biopsychosocial spectrum are going to hell that makes you a good psychiatrist. My beef with Stroger is that because of the lack of in inpatient unit there, you don't get to see the care of populations like that from start to finish (not sure what role the residents have with their outpatient clinics).

I don't mean to knock Rush as a program at all because it's a solid program, but if you're going to train in a city as screwed up as Chicago, you should see it as a training opportunity. Your learning curve is a lot steeper dealing with Uptown and Back of the Yards than River North... but that's a good thing.

I couldn't agree more and do think that training is THE time to see the most severe psychopathology possible as long as reasonable supervision/support is in place. I would not let a few months out of 48 sway one's decision much and you will get a lot out of working with all populations. That said, if you are 100% sure you want to be a river north psychiatrist, choose Rush or NW and start the path. Nothing wrong with being honest with yourself and I think people are generally happier/better doctors when their fellow residents and attendings have reasonably similar belief systems.

 

[SoulinNeed]

I'm going to hop on my high horse a bit here.

Diversity of patient population is extremely important when training in psych... particularly since the most intense pathology that you see are going to be in places like Stroger. Anyone can do "setraline for soccer moms". It's getting a patient stabilized when everything on all three parts of the biopsychosocial spectrum are going to hell that makes you a good psychiatrist. My beef with Stroger is that because of the lack of in inpatient unit there, you don't get to see the care of populations like that from start to finish (not sure what role the residents have with their outpatient clinics).

I don't mean to knock Rush as a program at all because it's a solid program, but if you're going to train in a city as screwed up as Chicago, you should see it as a training opportunity. Your learning curve is a lot steeper dealing with Uptown and Back of the Yards than River North... but that's a good thing.

I think you may have misunderstood me. I absolutely want to see different populations. Just not at Stroger. The patient population at Stroger is what I'm not interested. Not because they're poor, but because, like I said, I've worked at Stroger before. I just have my doubts about how great of a learning environment it is. You'll certainly see all kinds of pathology there, but I don't know if the teaching resources are in place there for you to learn about it, especially if it's just ED. Not saying I'm right. I just have my doubts, and thus, are asking questions about it. I've spoken to residents there (not in Psych, however), and they seem to imply that it's too hectic for much. Now, I know there's some benefit to working in a hectic environment, but not if you can't learn. Just my concern.

 

[WingedOx]

I think you may have misunderstood me. I absolutely want to see different populations. Just not at Stroger. The patient population at Stroger is what I'm not interested. Not because they're poor, but because, like I said, I've worked at Stroger before. I just have my doubts about how great of a learning environment it is. You'll certainly see all kinds of pathology there, but I don't know if the teaching resources are in place there for you to learn about it, especially if it's just ED. Not saying I'm right. I just have my doubts, and thus, are asking questions about it.

sure, but what types of "teaching resources" are you looking for?

 

[SoulinNeed]

I couldn't agree more and do think that training is THE time to see the most severe psychopathology possible as long as reasonable supervision/support is in place. I would not let a few months out of 48 sway one's decision much and you will get a lot out of working with all populations. That said, if you are 100% sure you want to be a river north psychiatrist, choose Rush or NW and start the path. Nothing wrong with being honest with yourself and I think people are generally happier/better doctors when their fellow residents and attendings have reasonably similar belief systems.

If it's just a few months, then that's fine. That was honestly my big question.

 

[SoulinNeed]

sure, but what types of "teaching resources" are you looking for?

Without an inpatient unit, how do you get to know the patients? Are just seeing them in the ED? Are you just doing consults?

 

[Dharma]

Surprised no one brought up MCW here.

 

[OldPsychDoc]

Surprised no one brought up MCW here.

Discussion's been a bit south of the Wisconsin state line lately...

 

[Dharma]

Discussion's been a bit south of the Wisconsin state line lately...

Yeah, I was thinking that maybe 'midwest' = Chitown.

 

[Smallville86]

Yeah, the only real knock on Northwestern is their reputation for a patient population of "worried well of Lincoln Park" and "malingering homeless guys who want a place to sleep after a week of begging on the Mag Mile" with not a lot to fill the gap between those two groups. How true that rep is will depend on which resident you talk to. Otherwise it's solid all around.

So I would debate that "reputation" at Northwestern of a patient population of worried well and malingerers- as a resident here, we see a wide variety of patients on inpatient, outpatient, and C/L. If anything, I would argue that we have a better learning experience as residents, seeing both the archetypal underserved inner city population with severe mental disorder, as well as: solidly middle-class suburbanites driving in to the city; the "worried well of Lincoln Park" (which is kind of classist in hindsight); a large college student contingent (so many universities, colleges and trade schools in Chicago); and many international students/tourists. Like seriously, we had a run of Middle Eastern foreign nationals, one of our dispos involved the patient's consulate and explaining via Arabic interpreter to their mom that bipolar disorder really does exist.

I think you make a good point though, "how true that rep is will depend on which resident you talk to"- when interviewing at any place, talk to as many residents as possible to sample the greatest array of viewpoints. What frustrated me at times about residency interviews, given the smaller economies of scale and scarcity of "objective" markers (compared to medical school, undergraduate, etc.), was the disparity in opinions based on how well-informed (or tired) the resident you talked to was. So do yourself a favor, and talk to as many current residents as possible! Get emails, and email us later! And best wishes for the Match later this week, and the Matches to come

 

[Smallville86]

FWIW, when I was there no one in psychiatry at Northwestern appeared to be happy. Attendings, residents, psychologists, socials workers, OTs, secretaries, or patients. Its a pretty tough gig with NW being the only no-fee mental health provider for all of Chicago and has a popular inpatient unit. Additionally, the hospital is not very supportive of the psychiatry dept stemming from a string of suicides a few years ago. I can say that the DBT training was pretty subpar, can't speak for the other psychotherapy training. Psychiatrists and psychologists don't seem to stick around.

But this is all from an outsider's point of view.

So I'm not sure how long ago you were at NW, or in what capacity, but speaking as a current resident I would strongly disagree with your opinion. Pretty much everyone- attendings, residents, psychologists, SWs, OTs, secretaries- are very happy working here, even given that academics pays less than private practice, because we have a strong department and we actually all like each other a lot. In addition, few hospitals are supportive of psychiatry departments as we are not a huge revenue stream for systems as compared to say, orthopedics, but that reputation has greatly improved in the last 5-10 years, and on both the resident and attending level, we are well-respected and appreciated. At least well enough that they have psychiatry residents rotate on their flagship inpatient medical, ED, and neuro rotations for our pre-psych stuff. And come to our parties

 

[WingedOx]

So I would debate that "reputation" at Northwestern of a patient population of worried well and malingerers- as a resident here, we see a wide variety of patients on inpatient, outpatient, and C/L. If anything, I would argue that we have a better learning experience as residents, seeing both the archetypal underserved inner city population with severe mental disorder, as well as: solidly middle-class suburbanites driving in to the city; the "worried well of Lincoln Park" (which is kind of classist in hindsight); a large college student contingent (so many universities, colleges and trade schools in Chicago); and many international students/tourists. Like seriously, we had a run of Middle Eastern foreign nationals, one of our dispos involved the patient's consulate and explaining via Arabic interpreter to their mom that bipolar disorder really does exist.

Look, I get that you want to rep your program, and NW is likely the top program in the city right now (@OldPsychDoc even called it top 2 in the Midwest not so long ago if I remember right) but it's not sacrilege to say you're going to get a more consistent diversity of intense pathology cases at UIC or a higher tier CL experience at UofC, for example. Every program has things for which it can improve.

 

[OldPsychDoc]

Look, I get that you want to rep your program, and NW is likely the top program in the city right now (@OldPsychDoc even called it top 2 in the Midwest not so long ago if I remember right) but it's not sacrilege to say you're going to get a more consistent diversity of intense pathology cases at UIC or a higher tier CL experience at UofC, for example. Every program has things for which it can improve.

Not sure that I ever quantified it like that, but it is a very good program with great leadership.

 

[whopper]

I never attended Wash U. ,but I'm in their town. I used to be at St. Louis U. All of the attendings I work with trained at Wash U and are solid and in an upper echelon of psychiatrists I've seen.

 

[WingedOx]

Well MSU certainly lost some prestige today...

 

[OldPsychDoc]

Well MSU certainly lost some prestige today...

Poor Sparty...