Smaller community-based residency programs

[sideshow bob]

I am interested in doing a psychiatry residency at a smaller community-based site. So far, looking only at the west coast, mainly through colleagues' suggestions and using this forum, I can basically come up with one: San Mateo.

Anyone know of other similar sites, actually anywhere in the US?

Criterion, not necessarily in this order:
small program, good teaching of psychotherapy skills, fewer night-time on-call hours, tilted toward the bio-psycho-social model and away from pharmacology, community-based hospital for in-patient training

Thanks in Advance

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[TheWowEffect]

I am interested in doing a psychiatry residency at a smaller community-based site. So far, looking only at the west coast, mainly through colleagues' suggestions and using this forum, I can basically come up with one: San Mateo.

Anyone know of other similar sites, actually anywhere in the US?

Criterion, not necessarily in this order:
small program, good teaching of psychotherapy skills, fewer night-time on-call hours, tilted toward the bio-psycho-social model and away from pharmacology, community-based hospital for in-patient training

Thanks in Advance

tilted toward the bio-psycho-social model and away from pharmacology

This is quite a contradcitory position. All programs (which are almost all programs) "tilted towards bio-psycho-social model" are also quite strong in pharmacology (whatever that means). I guess you mean to say that you are looking for programs tilted towards psychodynamics. There are many like this. Why would you want to move away from pharmacology? After all, pharmacology is the backbone of medicine. Sorry to sound rude, may be you should have gone for a psychology degree or something. I guess by "fewer night-time on-call" you mean programs that make you work less harder. There are many like this too. I am sure some people on this forum can guide you towards these programs. Good luck!

 

[Regnvejr]

Criterion, not necessarily in this order:
small program, good teaching of psychotherapy skills, fewer night-time on-call hours, tilted toward the bio-psycho-social model and away from pharmacology, community-based hospital for in-patient training

Thanks in Advance

U of South Dakota. 6 residents and 2 child & adolescent fellows each year, total about 22 residents & fellows. Takes the APA requirements of proficiency in 5 types of therapy quite serious, taught by therapists (We felt it was to much during the residency and fellowship, now its a godsend). 24 weekend on-calls in the first 3 years, mainly done in 2 years. Evening call 1st 2 years weekly, mainly till 9pm then pager.

Lost of mock examinations with specific biopsychosocial presentation. Wednesdays till about 3 pm is didactic training only, no workups that day, only rounding. 3rd year clinic only after 3pm on Wednesdays. In-house pharmacy with staff pharmacist and 3-4 students. New hospital with 110 beds (child, adolescent, adult, adult acute, geriatric) and partial program. Community clinic rotations. Monthly "grand rounds" speaker series. Focus on rural psychiatry. ECT facility on-site.

I felt it was great, definitely prepared me well.

 

[mathilda25]

Here are some on West coast

California Pacific Medical Center - in San Francisco
supportive environment, excellent psychodynamic psychotherapy training (seemed to be really really strong compared to other programs) small program (4 residents/year) and purely community, all call is from home

UCSF-Fresno - small, community, nice people there - light call (mostly from home)

Reno - small, supportive, community based, all call from home. light load.

Cedars-Sinai - 5 residents/year. all private hospital based in Beverly hills.

 

[sideshow bob]

Thanks, Mathilda25 - that's exactly what I was looking for.

And to WowFactor - Wow! Interesting response! You live up to your moniker. An earlier thread was started here wherein someone asked which programs "emphasized psychopharm more than psychodynamics" and that was treated as a legitimate question, apparently. But you suggest that if I'm interested in programs that lean the other way, I would somehow be happier as a psychologist??? That if I want a program that isn't dominated by the psychopharmacological view that somehow I can't become competent in prescribing meds and become trained in using them appropriately when they are warranted?? Wow! Stunning position.

And as far as the use of the term "psychodynamic" rather than bio-psycho-social; I'm not a psychiatry resident, so I may not be aware of the vernacular use of these terms. But if I look up the meaning of BSP online, it reads as follows: "of, relating to, or concerned with the biological, psychological, and social aspects in contrast to the strictly biomedical aspects of disease".
Given that definition from Merriam Webster, which seems to gybe with what I learned in medical school, it seems a more apt term for what I am describing.
I asked a prof. of psychiatry yesterday what is implied by the term "psychodynamic", and he related that it implies theories derived from Freud and in that lineage. This is not necessarily what I am interested in pursuing in psychiatry residency. CBT/DBT and other forms of short-term therapy have been shown to be as effective as meds, and I don't believe these are "psychodynamic" in nature. Perhaps I am wrong. Maybe this is not the terminology in use today. But if that is the case, the terminology is confusing, IMO.
In addition, things like mindfulness and other cutting-edge therapies, which have good evidence-based backing, and which I am interested in learning, I think also don't fit under the rubric of "psychodynamic", but would be better described as "bio-psycho-social". Perhaps you can help me with my understanding.


sideshow

 

[TheWowEffect]

And to WowFactor - Wow! Interesting response! You live up to your moniker. An earlier thread was started here wherein someone asked which programs "emphasized psychopharm more than psychodynamics" and that was treated as a legitimate question, apparently. But you suggest that if I'm interested in programs that lean the other way, I would somehow be happier as a psychologist??? That if I want a program that isn't dominated by the psychopharmacological view that somehow I can't become competent in prescribing meds and become trained in using them appropriately when they are warranted?? Wow! Stunning position.

And as far as the use of the term "psychodynamic" rather than bio-psycho-social; I'm not a psychiatry resident, so I may not be aware of the vernacular use of these terms. But if I look up the meaning of BSP online, it reads as follows: "of, relating to, or concerned with the biological, psychological, and social aspects in contrast to the strictly biomedical aspects of disease".
Given that definition from Merriam Webster, which seems to gybe with what I learned in medical school, it seems a more apt term for what I am describing.
I asked a prof. of psychiatry yesterday what is implied by the term "psychodynamic", and he related that it implies theories derived from Freud and in that lineage. This is not necessarily what I am interested in pursuing in psychiatry residency. CBT/DBT and other forms of short-term therapy have been shown to be as effective as meds, and I don't believe these are "psychodynamic" in nature. Perhaps I am wrong. Maybe this is not the terminology in use today. But if that is the case, the terminology is confusing, IMO.
In addition, things like mindfulness and other cutting-edge therapies, which have good evidence-based backing, and which I am interested in learning, I think also don't fit under the rubric of "psychodynamic", but would be better described as "bio-psycho-social". Perhaps you can help me with my understanding.


sideshow

I am glad you have a broader view of psychotherapy. I think you have a very legitimate question but I don't believe you can move away from pharmacology anymore, which is what your question implied. Similarly, there is no way any psychiatry program can move away from psychotherapy. Certainly, there are programs that emphasize one form of psychotherapy over the other. I don't think you have to look at only smaller community based programs for better psychotherapy training. I am at a larger-big-city-based-call heavy university program, and very strong psychotherapy training is provided to us. However, we are encouraged not to choose a one-dimensional approach. We are allowed to develop our skills in a more comprehensive bio-psycho-social model. I don't think there is any program that does not believe in this model, and if there is, it will serve you well to stay away from such a program.

The main difference these days is advocating who provides the psychotherapy. I believe there should be a more open and flexible approach to this issue. Certainly, any psychiatrists who choose to do psychotherapy post-training should be allowed to do so. I also think all residents should be trained well in psychotherapy during training. This ensures that they refer and supervise appropriately when working with therapists. I believe that for a more optimal use of resources, psychiatry as field will be better served if a more collaborative approach with therapists is employed.

Coming back to your original question- IMHO, a bigger program will provide you more resources to tailor your training in a certain manner. However, if you want an easier program in terms of call, a smaller community program might be a better option. In my experience, doing call was a huge factor in a steeper learning curve for me.

 

[Nika]

Here are some on West coast

California Pacific Medical Center - in San Francisco
supportive environment, excellent psychodynamic psychotherapy training (seemed to be really really strong compared to other programs) small program (4 residents/year) and purely community, all call is from home

UCSF-Fresno - small, community, nice people there - light call (mostly from home)

Reno - small, supportive, community based, all call from home. light load.

Cedars-Sinai - 5 residents/year. all private hospital based in Beverly hills.

Some additions:
Pacific Medical Center - calls from home but you need to be in the hospital in 10-20 minutes. There are no dispo issues on call (!!!!) (SW job), no H&P in the middle of the night (!!!!) (attendings dictate them next day). Call schedule PG1 Q5 (6 month), PG2 Q6-7.
Reno - you don't need to be in the hospital on call AT ALL!
Fresno - nice program, bad place
Cedars-Sinai - hospital is the best hospital that I've ever seen. Good child psychiatry. Good opportunity to stay in the area and practice psych in Beverly Hills. But I know that residents there are overworked and underpaid. PD is pretty strange guy....

 

[Doctor Bagel]

It doesn't fit your location preferences, but OU-Tulsa seems to fit the other things you like. My understanding is that they have fairly decent psychotherapy training, the program is pretty small, the psych hospital is a private hospital (not university), and hey, it's at the country's first "school of community medicine." On inpatient it's home call.