Residencies with good outpatient training

[kirkirkir]

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Hi all,

Was wondering if there are some residencies with a better outpatient focus and which institutions fall in this category.

Also, would it make a huge difference where you train vs. how you practice?

thanks 🙂

 

[Shikima]

The problem with your question is the power of suggestion. Program X could be the worst, but through endorsement, you'll think it's the best thing since sliced bread.

Just get into a program you feel comfortable with.

 

[kevinc2]

I would check out uw Madison. Outpatient year is in ur second year and more outpatient months in 3rd and 4th years as well

 

[WingedOx]

how the program is structured matters a lot less than the diversity/acuity of the patient population you're working with and the quality of the supervision.

 

[slappy]

how the program is structured matters a lot less than the diversity/acuity of the patient population you're working with and the quality of the supervision.

While this is true, one program's structure springs to my mind, as I'd long felt this was one of the reasons they seem to have amazing psychotherapy training. The program is MCW in Milwaukee, and the residents do their outpatient year in their second year of training (with analysts as supervisors), and they continue to carry as many patients as they want for the next three years. This provides for not only an extra year of free psychotherapy supervision, but, more importantly, an extra year of long-term follow-up with patients, which I feel is invaluable.

 

[WingedOx]

I assumed most places started giving people therapy patients to follow in the second year even if they're still doing inpatient and whatnot. I think I only had one patient last the full 3 years but I had more than a few I picked up during the second year that lasted thru graduation? Don't most people do this?

though I'll say for the OP, it's kind of unclear what he/she is asking. Therapy, med clinics, embedded MH in primary care, "outpatient" can mean a lot of things.

 

[hamstergang]

I assumed most places started giving people therapy patients to follow in the second year

This was not the case at most of the places I interviewed at 5 years ago, if memory serves me correctly.

 

[WingedOx]

This was not the case at most of the places I interviewed at 5 years ago, if memory serves me correctly.

damn, obviously I missed a selling point for my program at 4 straight years of pre-interview dinners.

 

[notdeadyet]

how the program is structured matters a lot less than the diversity/acuity of the patient population you're working with and the quality of the supervision.

Boy, id agree with this. I love early exposure to psychotherapy. I think the sweet spot is some exposure in PGY-2 followed by a sizable panel in PGY-3 and at least some carryover to PGY-4.

But diversity is the unsung quality to look for. You want diversity of patients and pathology.

Will you get uninsured or underinsured patients? Patients naive to psychotherapy? LGBTQ? An array of race and ethnicity? Patients of immigrant culture?

Will you be largely limited to mood/anxiety cases? How about trauma work (and training/supervision in CPT, PE, etc)? What about psychosis-focused (CBT, ACT, etc)? What about group, family, and couples?

What is the supervision like and by who? Are these experts in their fields or a hodgepodge of folks from the private practice community with questionable credentials who want to have" Acme University faculty" on their website? How many hours of supervision per week and is it individual, pairs, or small group?

I think WingedOx hit the nail on the head. Applicants tend to focus on when psychotherapy starts rather than if it's any good at a potential program. In the long run, you'll be much better off with great training at a program that had you starting psychotherapy as a PGY-3 than a place that has you picking up psychotherapy cases as a PGY-2 with ho-hum training.

 

[WingedOx]

I think WingedOx hit the nail on the head. Applicants tend to focus on when psychotherapy starts rather than if it's any good at a potential program. In the long run, you'll be much better off with great training at a program that had you starting psychotherapy as a PGY-3 than a place that has you picking up psychotherapy cases as a PGY-2 with ho-hum training

...which unfortunately isn't something that that's easily picked up on as an applicant. At interviews and dinners, one needs to ask somewhat pointed questions about patient populations you're working with and supervision quality mainly to 4th year residents, since they'll give you the best answers about their psychotherapy experiences.