Shared/Part-time Psychiatry Residency

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AthensBeth

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I'm a new mom taking a year off before starting psychiatry residency in 2010. I'm enjoying this time with my new baby so much, and I'm starting to dread starting residency with its 60 to 80 hour weeks. I think I'd enjoy my training much more if I could stretch it out over a longer time, affording me time to spend with my family. I'd consider being part-time for the entire training, or at least the first two years. Is anyone interested in sharing a residency spot with me in 2010? I prefer a program in Virginia, Maryland, or DC. I think it would be worth approaching programs about the idea, even if they don't specify that they allow this option.

Please write me a personal message if you're interested!
 
I imagine it would be rather unlikely that any residency, in psychiatry or any other specialty, would make such an accommodation. Yes, you could make the argument that the same amount of work would be done, split between two residents. However, what happens after the rest of your class graduates? Do you then stick around and help out the following year's class? Do they then do that much less work? What would the class after them feel about that? And then there is intern year, where you are providing service to the departments of Medicine and Neurology, who are generally not that interested in people working part-time. Not to mention the fact that you and your partner in part-time training would have to match at the same program, which is never guaranteed.

If I were you, I would focus on finding programs that are family-friendly and where the work hours are not so bad. All in all, psychiatry is a pretty easy residency. The 4th year is typically all elective, so this might be a time when you could work out a part-time arrangement. Then, after you graduate, you can be as part-time as you want to be.
 
I stand corrected. Though I'm doubtful most programs that don't offer part-time/shared positions at the outset would be willing to change, given the reasons I stated above.
 
I'd consider being part-time for the entire training, or at least the first two years
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I haven't read the ACGME guidelines concerning this, and I'm actually surprised its allowed. I remember reading through the ACGME guidelines, and don't remember it mentioned an allowance for part time positions. However if some programs are allowing it, its most definitely got to ACGME allowable, and I haven't read those guidelines recently, so I'm not claiming to be an expert on it.

I don't think though that its a bad option if the program is willing to allow it. They should know what they're getting themselves into, and several residents do start having children while in residency. However if a program is not already allowing for it, I wouldn't necessarily expect them to do so. Programs accept residents with the work that resident will do on a pre-planned basis. If they have x full time positions, they pretty much want all positions filled full time. To allow for part timers can screw things up in terms of logistics.

The program in the poster's case has to first allow a part time position. If not, I don't know how open they'd be.

But if they do allow for it--then--to Athens Beth-, I don't think you'd have too much of a problem. All spots filled out this upcoming year, and there's plenty very much wanting to go into psychiatry that did not get in.

Best of luck and hope everything works out.
 
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Shared residencies were proposed in the 70s and have been a route taken by some women since then. If you google "part-time residency" + psychiatry, you get a hit for a 1991 article about how it programs should be encouraged to provide this option. I'm surprised that it hasn't gained popularity since the internet age, since it is now so much easier to connect with other people and find a partner interesting in sharing. It seems like a great solution. I realize that psychiatry residency isn't quite as demanding as other specialties, but many mothers prefer to work part-time when their children are young (and a part-time psych residency would still be more demanding than a typical part-time job).

I feel like these responses are kind of negative, which may explain why part-time residencies haven't taken off. I don't understand why it seems so hard to coordinate. 41 residency programs have tackled it, so it seems like even ones that don't have it could too. It's a possibility that the ones that don't offer it have never been asked to provide this option. Why is it so complicated to not move on with your class? People take leaves of absence and get set back with the earlier class all the time. It seems very simple to me, on any rotation, to share a position with someone. If the schedule calls for medicine wards 6 days a week, then one person works 3 days and the other works the remainder. If the call schedule demands 4 calls a month, the two people half the calls. It seems very simple. As for the above post questioning whether we would have less work-- It is half the work and twice the years! Simple.
 
I think the major obstacle is really a obstruction to a paradigm shift---a PC term for people not having an open mind to try something different.

IMHO, and I'm giving my biased opinion, part time residencies should be encouraged unless someone has objective evidence to the contrary that they do not produce good doctors for the same reasons you mentioned.

I've known several females who dropped out of medical school because they felt they could either become a doctor or have children, and that the 2 choices were almost mutually exclusive.

While of course they are not mutually exclusive--several factors make it hard to be a parent & a doctor. People often enter medical school in their mid 20s--> join residency in their late 20s to early 30s, and graduate in their mid 30s. So that puts most women in a point in their lives where they've only got a few months to have a kid before becoming of advanced maternal age.

And I completely acknowledge that this is sexist on several levels for or against men or women depending on how to look at it, but its also true.

For someone--anyone (male or female) to want to do a part time residency so they could actually be a parent, and with several of the old school mentality that there's something wrong with it (unless they can actually show some objective data as to why)--well that to me is just the old school closed mindedness that exists in medical culture.
 
Whopper, I completely agree with you. And these constructed obstacles only seem to exist in the American medical culture. In Europe, residencies, like other jobs there, accommodate parents and women on maternity leave. Yet here, people seem to resent or judge people who desire to develop there careers while raising children. And how ironic for us as health professionals...as mental health professionals at that... to not acknowledge the importance of helping people attain this balance.
 
Whereas I am sympathetic in principle to the idea of a shared or part-time residency, I am having a strong visceral reaction to the very idea of dragging out internship over 2 years. You and your family may enjoy life more in the long run if you at least plow through PGY1 fulltime. (Rip that band-aid off!)
 
AthensBeth said:
Whopper, I completely agree with you. And these constructed obstacles only seem to exist in the American medical culture. In Europe, residencies, like other jobs there, accommodate parents and women on maternity leave. Yet here, people seem to resent or judge people who desire to develop there careers while raising children. And how ironic for us as health professionals...as mental health professionals at that... to not acknowledge the importance of helping people attain this balance.
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Ahem...I have two kids, one of which is three months old. I have just been appointed to what is essentially a PGY-2 in psychiatry in the UK, resigning from my Academic Fellowship in FM. I must say that, just because the UK law affords women strong employment protection and relatively good pay whilst on maternity leave, it does not mean your colleagues or employers are not resentful of having to accommodate your lifestyle choice. As far as part-time training is concerned... When I was investigating my prospects in psychiatry, heavily pregnant, I was told by the attendings here that I needed to consider whether I wanted "to train part-time after the baby is born, because there are no funds available to accommodate part-time trainees in our Deanery". In other words - do you want to train part-time or do you want to train with us? Nice choice.

My personal opinion - part-time training can only really work well in an out-patients based specialties, like FM, where you can do your sessions as you please with minimal impact on other team members and the patients. Even if you have a job-share, service provisions are likely to be affected, since the continuity of care will be affected to some extent even with the best of intentions.
 
I am aware of a handful of e.g. Family Med residencies that share the last two of the three years. But they don't share or split the internship, to my knowledge.
Wasn't clear from this thread if any of the 41 share internship year or not.

Thanks,
Bob
 
Not sure Sideshow Bob the specifics about those 41 programs. I do know that the U of Michigan program websites specifically states that they offer part-time tracks at all points of the residency program. But that's just one of the 41.
 
For those wondering how a part-time residency is possible during intern year, I've done some research by speaking with participating programs. PGY-1 and PGY-II are completed on a one-month-on/one month-off type of schedule. The outpatient year can be completed in a typical part-time fashion (2 1/2 days a week).

I'm still looking for someone interested in a shared psychiatry position... so far, no takers. Maybe others share your visceral reaction, BabyPsychDoc!
 
I hope you find someone to take you up on this offer, AthensBeth! Perhaps they are not lurking on SDN as I do find the population here to be somewhat more... intense, at times. 😉 Medicine needs more forward-thinking, open minded and flexible individuals such as yourself. Best of luck to you.
 
Haha, thanks Psychelle. "Intense" is a nice way to put it.
 
UW Seattle IIRC is quite open to the idea. There were one or two doing it when I interviewed, I think. I agree that internship would be unfeasible to split, but after that, why not?
 
W had 2 cases while I was resident, A husband/wife team was sharing the first year, another resident got pregnant and was 1/2 time the last 2 years.
 
I've just skimmed through but I think sometimes the option is money. If a residency has funding for X positions/year for four years and someone extends it throws all of that off. They may make money the first year the person goes part-time but after that it is a losing venture because for each academic year that follows they pay for the X normal positions plus whatever FTE the part-timer is working. Sharing would be different.

I'm a mom of two small children who took 3 years to do my 3-4 year of med school and am now 'ripping off the band-aid' and doing residency full time. It kind of sucks but I don't want to extend anymore, we just want to get done with the training so we can move on with our lives. I'm thankful I picked a pretty humane program and have good childcare but it is still quite hard and tiring. We have had some part-timers in our residency but there was one resident who really pushed the envelope and dragged it out forever and I think kind of ruined it for anyone behind them, because of that whole funding issue I described. It always comes back to the $$$.

If part time is what you want I certainly wish you luck in your endeavor.
 
Beezley, I think you are right. In my failing quest to work part-time, I have found this out. I think it works most smoothly when you have a partner to share with, or there are so many part-timers coming through the program that the halves add up to wholes.
 
Hello, just curious if you were able to find a shared residency position? I'm hoping to apply for psychatry res. this fall and am very interested in doing a part-time option since I have two young kids!
 
We had someone do this at our program because they had no other option.

The work load was distributed out as 4 weeks on and 4 weeks off. However, lectures, grand rounds etc. were mandatory. I think it actually was harder than doing 4 years straight but the person was an excellent psychiatrist at the end of it all.
 
amygreen said:
Hello, just curious if you were able to find a shared residency position? I'm hoping to apply for psychatry res. this fall and am very interested in doing a part-time option since I have two young kids!
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I'm interested too. I'm looking for an off cycle position as PGY1/PGY2 since I've completed most of my rotations as a PGY1 in a psych residency program a year ago.
 
sindhu said:
I'm interested too. I'm looking for an off cycle position as PGY1/PGY2 since I've completed most of my rotations as a PGY1 in a psych residency program a year ago.
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I am interested as well. I am in same position as sindhu. Hi SINDHU.DID YOU APPLY THIS YEAR WHAT'S THE SITUATION. what are you doing currently.
 
unlucky said:
I am interested as well. I am in same position as sindhu. Hi SINDHU.DID YOU APPLY THIS YEAR WHAT'S THE SITUATION. what are you doing currently.
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Applied to programs and waiting. No luck yet. If you want to connect, you can contact me via phone or email to share information.
 
I am a mom as well and am looking to do a shared pediatrics residency starting in 2013. How did your search for a part time psych residency work out? Any advice for finding a partner?
 
I am sorry but this is why pregnant women should not be starting a residency. Not fair to every other hard working full-time resident who you end up having to cover your work.
 
Wallstreet said:
I am sorry but this is why pregnant women should not be starting a residency. Not fair to every other hard working full-time resident who you end up having to cover your work.
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:smack:

You should have a fair system but we all cover each others work. Their are people covering yours as well. You will never follow a patient 24/7/365 for the rest of your life.
 
heya. i do not have children, i simply want to work part-time, not being driven by money or any desire to prove to the world i can work full time. i think psychiatry is best done by me part-time, for various reasons, but i won't convince anyone of this. my only issue is, is this possible? do i need to have 'an excuse' other than "i just want to work part-time" in order to get a part-time residency? i am fairly new to exploring this option, so any advice is helpful - ie. how to get a list of programs that offer part-time training (without the need of a family or any other reason). thank you for ur help.
 
AthensBeth,

If you can't find a part-time program that works, the other option, which I strongly encourage, is to find a "lifestyle friendly" program. There are programs out there where you can still emerge a very competent psychiatrist and work (barring call) 40- 50 hour weeks. When I look back at my residency experience, the idea of dragging it out any further seems awful. And I liked my program.
 
sumina13 said:
heya. i do not have children, i simply want to work part-time, not being driven by money or any desire to prove to the world i can work full time. i think psychiatry is best done by me part-time, for various reasons, but i won't convince anyone of this. my only issue is, is this possible? do i need to have 'an excuse' other than "i just want to work part-time" in order to get a part-time residency? i am fairly new to exploring this option, so any advice is helpful - ie. how to get a list of programs that offer part-time training (without the need of a family or any other reason). thank you for ur help.
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Rightly or wrongly, I definitely think you're going to need to give programs a compelling reason for wanting to work part time other than just preferring not to work full time.
There is a danger of programs perceiving a desire to work less than full time as laziness, and nobody wants a lazy resident.
 
DebDynamite said:
AthensBeth,

If you can't find a part-time program that works, the other option, which I strongly encourage, is to find a "lifestyle friendly" program. There are programs out there where you can still emerge a very competent psychiatrist and work (barring call) 40- 50 hour weeks. When I look back at my residency experience, the idea of dragging it out any further seems awful. And I liked my program.
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Exactly. There are plenty of lifestyle programs out there.
 
I have no idea why a program would want to bite the financial bullet on this. I think my compensation package says I get like 50k/year of salary and like 25k/year worth of benefits (which, of course, do not necessarily cost the corporation 25k cash, but through creative accounting, does count against the program's ability to employ residents). So, if they have 75k/year per resident, split between two residents, that's 37.5k. We already said the benefits cost 25k, which would leave the program with 12.5k to pay you in salary. Since the program probably winds up compensating more than that for a half time resident (assuming benefits, which seems reasonable), the program would inevitably stand to lose money compared to having a single full-time resident.

I wonder what ever happened to AthensBeth. She was so delightfully pleasant throughout this thread, I can't imagine any program not dying to bend to her every arbitrary whim. I just hope they didn't have the wrong kind of coffee in the lounge.
 
I'm pretty sure both Brown and Einstein in NY allow residents to do part time with kids...even if not advertised(?) they allow residents to work out such schedules.
 
right. i think i am out of touch with the USA. to think that part-time is 40-50hours a week is to me more like full-time. i have been training in europe and the maximum hours allowed for working during specialty training are 48hours per week - now, granted sometimes this goes to 60 because u need to get stuff done, sometimes it wont and 40 or 48 hours is all u would need/be expected to give. my idea of part-time is working no more than 30hours per week on paper (though one may spend hours outside of that studying, etc). is this impossible at residency level in the USA then?

also, the idea of having to explain to my employer why i want to work part-time is an interesting one. shouldn't i be paid for paid for the time i work and as such, if i work less, less pay? based on the calculations of billypilgrim37, financially, i would be getting paid a lot less then 1/2 for the job.

any books out there on part-time psychiatry residency training in the USA?? - 'google' is no help so far. i have also contacted a few programs and await for their reply...
 
Remember, we still have single SHIFTS that last for 30 hours. It's not unheard of to have worked 40 hours for the week by Tuesday night. As a 4th year fellow, I'm still usually logging about 60 hours, not including reading and writing at night. Some of that is by choice, as I'm not lazy, and I only get to be a resident/fellow once, and I'd rather learn what I'm doing before I have the opportunity to kill people unsupervised.
 
I have received a few replies about working part-time and so far, either it is not available, or it is negotiable usually by the 3rd and 4th year. I think having family, as one may expect, is considered a good reason.

thank you for the posts and please share your knowledge.
 
sumina13 said:
right. i think i am out of touch with the USA. to think that part-time is 40-50hours a week is to me more like full-time. i have been training in europe and the maximum hours allowed for working during specialty training are 48hours per week - now, granted sometimes this goes to 60 because u need to get stuff done, sometimes it wont and 40 or 48 hours is all u would need/be expected to give. my idea of part-time is working no more than 30hours per week on paper (though one may spend hours outside of that studying, etc). is this impossible at residency level in the USA then?

also, the idea of having to explain to my employer why i want to work part-time is an interesting one. shouldn't i be paid for paid for the time i work and as such, if i work less, less pay? based on the calculations of billypilgrim37, financially, i would be getting paid a lot less then 1/2 for the job.

any books out there on part-time psychiatry residency training in the USA?? - 'google' is no help so far. i have also contacted a few programs and await for their reply...
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you are somewhat misleading/misguided - the EWTR has 48 hour week rule averaged out over 6 months including vacation and sick leave (unlike the 80-hour ACGME ruling) - whilst the hours are undoubtedly more enlightened in Europe and flexible training is offered as standard, I often worked 70-80 hours a week, it was just that we had a lot more days off compared with in the US (I had about 8 weeks off last year not including 1 week sick leave) so on average I was working about 50 hours a week. That was for medicine, for psych it's probably cushier. There is obviously variation between hospitals - some of my friends worked much harder, some were twiddling their thumbs with no patients
 
You should try it out, you might find you don't want to be part time
 
I fell for posting in a 2.5 year old thread. Wonder what AthensBeth decided to do?
 
I'm still around. I did a postdoc in immunology, taught some adjunct classes at a community college, and had another daughter. I'm now applying for 2014 and studying for Step III of the Boards. To my surprise, what I learned in medical school is coming back to me (four years later). I'm hoping to go to a program that's a little on the lighter side, and my girls will be 2 and 5 when I start. With my girls a little older, I feel different about doing my residency part-time and would love to get my career rolling quicker. Now that my husband's job is more geographically flexible, I have better choices. The programs in the mid-atlantic seemed to have terrible call hours and 80 hour work weeks. That may have changed since 2010, but that was my feeling.
 
AthensBeth said:
I'm still around. I did a postdoc in immunology, taught some adjunct classes at a community college, and had another daughter. I'm now applying for 2014 and studying for Step III of the Boards. To my surprise, what I learned in medical school is coming back to me (four years later). I'm hoping to go to a program that's a little on the lighter side, and my girls will be 2 and 5 when I start. With my girls a little older, I feel different about doing my residency part-time and would love to get my career rolling quicker. Now that my husband's job is more geographically flexible, I have better choices. The programs in the mid-atlantic seemed to have terrible call hours and 80 hour work weeks. That may have changed since 2010, but that was my feeling.
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Welcome back and congratulations. Do you mind if I ask where you ended up applying?
 
University of Florida. I'm from Florida and my parents are still here, so I figure some family nearby will be helpful. And the program seems to have a supportive atmosphere.
 
AthensBeth said:
University of Florida. I'm from Florida and my parents are still here, so I figure some family nearby will be helpful. And the program seems to have a supportive atmosphere.
Click to expand...

Good luck! Hope you match there!
 
There are at least 4 psych programs I know of where residents(at all stages of training) can average around 40 hours per week(some weeks 50, but some weeks 25-30). The training isn't very good for the most part, but you'll come out board certified in psychiatry eventually, and can still do a fellowship in whatever if you want to. Someone can pm me if they want the names of these programs.
 
AthensBeth said:
I'm still around. I did a postdoc in immunology, taught some adjunct classes at a community college, and had another daughter. I'm now applying for 2014 and studying for Step III of the Boards. To my surprise, what I learned in medical school is coming back to me (four years later). I'm hoping to go to a program that's a little on the lighter side, and my girls will be 2 and 5 when I start. With my girls a little older, I feel different about doing my residency part-time and would love to get my career rolling quicker. Now that my husband's job is more geographically flexible, I have better choices. The programs in the mid-atlantic seemed to have terrible call hours and 80 hour work weeks. That may have changed since 2010, but that was my feeling.
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grats

hopefully one day fathers who want to spend more time with their children will be accomodated as well
 
In my research, I did come across some fathers who choose a part-time route so that they could be around their kids more. Male or female, people should have this option. I'm really lucky that my husband works at home, so the girls will have him around while I'm taking on my intern year.
 
How exactly do part time positions work? Do you end up doing 8 years of training?
 
Yes, any year that is done part-time is doubled. From what I've heard, stretching out the third outpatient year (obviously easiest to coordinate) into two years is most common.
 
st2205 said:
How exactly do part time positions work? Do you end up doing 8 years of training?
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gosh that would make no sense.....the right answer, if one wants to take this approach, is to go to the type of program that will allow you to work very few hours 'full time' if you know what I mean....and in psych there are a good number. They aren't the programs people on this forum are familar with I'm guessing, but they are out there. People can pm me(a few already have) with specific names....
 
Well, Vistaril, sometimes people are tied to specific regions (especially people with spouses).
 
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