Stength of a program's C & A fellowship

[psychophelia]

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It seems as though there is little information available comparing the strengths and weaknesses of individual child psych programs. As a current applicant to general adult psych programs, I think the strength of the child psych fellowship will be a BIG factor in formulating my rank list. For example, do psych program like UPenn and Longwood, with their CHOP and Boston Childrens affiliations, have stronger C&A fellowships then other elite programs?

And I would also appreciate if anyone would care to comment on what they believe to be the strongest overall C&A programs...and why.

Thanks in advance.

 

[rtennis18]

In terms of research strength for child psych, I would say these are the top programs:
Columbia/Cornell, University of Pittsburgh, UCLA, Stanford, MGH/McLean, Johns Hopkins

In terms of clinical experience, I would say these are the top programs:
NYU, Brown, Yale, UCSF, Harvard Cambridge

 

[HMSPSYCH]

For example, do psych program like UPenn and Longwood, with their CHOP and Boston Childrens affiliations, have stronger C&A fellowships then other elite programs?

Thanks in advance.

These are my thoughts on some of the Boston programs.

Cambridge- community program so clinical exposure can be limited. Strong family therapy, good psychopharmacology. ‘Easiest' work/call schedule of the three. Limited research. Has outpatient eating disorder clinic. Internal moonlighting opportunities available.

Mgh- exceptional research with lots of big ‘controversial' names. Strong psychopharm/biologic emphasis with adequate psychotherapy/FT training. Limited substance abuse exposure. Responsibilities at multiple sites during calls can be difficult. Paid calls (~$100). Heaviest work load of the three programs. Has day program and ECT. Not the ‘premiere' Children's hospital in the region and clinical exposure can vary.

Children's- terrific evidence based psychotherapy (CBT) training, good psychodynamic training, and good psychopharm exposure. Strong CL/inpatient training with emphasis on psychosocial/therapeutic approach. One of a few med-psych units in the area. Exceptional clinical exposure as one of the premiere children's hospitals in the country. No day treatment program. Adequate outpatient services. Research available. No internal moonlighting opportunities but can moonlight at OSH.

Tuft/Umass- don't know much about these 2.

My sense is if you want the best overall training in C&A psychiatry, you cannot go wrong with well known places like CHOP, Children's Boston, Rainbows, Nationals, etc. MGH, cornell/columbia, stanford are well known for general psychiatry training but not the best CAP training sites.

 

[Doc Samson]

These are my thoughts on some of the Boston programs.

Cambridge- community program so clinical exposure can be limited. Strong family therapy, good psychopharmacology. ‘Easiest' work/call schedule of the three. Limited research. Has outpatient eating disorder clinic. Internal moonlighting opportunities available.

Mgh- exceptional research with lots of big ‘controversial' names. Strong psychopharm/biologic emphasis with adequate psychotherapy/FT training. Limited substance abuse exposure. Responsibilities at multiple sites during calls can be difficult. Paid calls (~$100). Heaviest work load of the three programs. Has day program and ECT. Not the ‘premiere' Children's hospital in the region and clinical exposure can vary.

Children's- terrific evidence based psychotherapy (CBT) training, good psychodynamic training, and good psychopharm exposure. Strong CL/inpatient training with emphasis on psychosocial/therapeutic approach. One of a few med-psych units in the area. Exceptional clinical exposure as one of the premiere children's hospitals in the country. No day treatment program. Adequate outpatient services. Research available. No internal moonlighting opportunities but can moonlight at OSH.

Tuft/Umass- don't know much about these 2.

My sense is if you want the best overall training in C&A psychiatry, you cannot go wrong with well known places like CHOP, Children's Boston, Rainbows, Nationals, etc. MGH, cornell/columbia, stanford are well known for general psychiatry training but not the best CAP training sites.

By way of full disclosure: Mrs. DS is a graduate of the MGH/McLean CAP program. Now that's out of the way:

MGH/McLean is widely regarded as the #1 CAP program in the nation. Its reputation far outstrips Children's Boston (which is typically thought of as the #3 program in Boston after MGH/McLean and Cambridge). The psychotherapy training is far more than "adequate". Children's may have a better overall rep for peds as a hospital, but for CAP it's not even close. IN terms of substance abuse exposure, the residential program at McLean (where fellows spend 4 months) has plenty.

 

[HMSPSYCH]

MGH/McLean is widely regarded as the #1 CAP program in the nation. Its reputation far outstrips Children's Boston (which is typically thought of as the #3 program in Boston after MGH/McLean and Cambridge). The psychotherapy training is far more than "adequate". Children's may have a better overall rep for peds as a hospital, but for CAP it's not even close. IN terms of substance abuse exposure, the residential program at McLean (where fellows spend 4 months) has plenty.

While many do perceive MGH/Mclean as the #1 program in the nation for just about every medical specialty as it is 'Man's Greatest Hospital', it is not the case in CAP training (although I wish otherwise) or anything dealing with the pediatric population. Places like CHOP and Boston Children's are well known internationally to be far superior Children Hospitals than MGH and thereby the clinical exposure are superior as everyone comes to these places first for their children treatment. Judging from the unfilled match list the past 2 years, it's a joke to make the claim that Cambridge is #2.

 

[billypilgrim37]

MGH/Mclean is NOT widely regarded as the #1CAP program in the nation as such designation is merely your subjective interpretation. Places like CHOP and Boston Children's are well known to be far superior Children Hospitals than MGH and thereby the clinical exposure are superior as everyone comes to these places first for their children treatment. Looking at the unfilled list the past 2 years, to rank Cambridge at #2 is a joke.

Have to agree with DS on all accounts here. Maybe the Children's program is wonderful, but if it is, nobody knows it. It's not on anybody's radar as a top program. At all. I don't think it would be on most people's top 10.

That's just reputation, not actual quality. If you say it's the best thing on the planet, I can't argue with you. But DS's "subjective interpretation" is much more in line with the at-large "subjective interpretation."

 

[HMSPSYCH]

Maybe the Children's program is wonderful, but if it is, nobody knows it. It's not on anybody's radar as a top program. At all. I don't think it would be on most people's top 10.
"

Went back to edit the original reply to avoid sounding harsh.

Ok, man, if you say so. But you should ask where folks like Joe Biederman trained.

 

[billypilgrim37]

My main conception of the place comes from interviewing at Longwood where the residents made it very clear that they felt the biggest weakness at their program was C&A, and that they felt that someone would need to go to MGH or Cambridge after residency there. Their selling point to me was that almost all of their graduates that wanted to go to MGH for C&A wound up matching there. Prior to interviewing there, I'd never even heard of the fellowship at Children's.

None of this speaks to the actual quality of the training at Children's. It's not very important to me (or anyone, I'd imagine) where Joe Biederman trained. The leaders in all of psychiatry research trained at a wide mixture of top and middle tier programs.

Being #3 in one of the best cities for psychiatry in the world isn't such an insult.

 

[notdeadyet]

This discussion shows very differing views coming from posters who seem to be in the know and have firsthand and recent knowledge.

This is why folks should probably not get too overly focused on what the "best" programs are and trust their gut. Talk to your faculty you trust, read up on the program, and educate yourself, but go with the program that seems right for you, rather than because you've heard it's The Best.

 

[Doc Samson]

My main conception of the place comes from interviewing at Longwood where the residents made it very clear that they felt the biggest weakness at their program was C&A, and that they felt that someone would need to go to MGH or Cambridge after residency there. Their selling point to me was that almost all of their graduates that wanted to go to MGH for C&A wound up matching there. Prior to interviewing there, I'd never even heard of the fellowship at Children's.

None of this speaks to the actual quality of the training at Children's. It's not very important to me (or anyone, I'd imagine) where Joe Biederman trained. The leaders in all of psychiatry research trained at a wide mixture of top and middle tier programs.

Being #3 in one of the best cities for psychiatry in the world isn't such an insult.

Right - Longwood has always had excellent results in CAP fellowship placement with graduates getting their 1st choice of fellowship (MGH, Cambridge, Columbia, NYU, UCLA, UCSF, Stanford in recent years). I am unaware of any Longwood grad who went to Children's in the past 7+ years.

Yes, Joe Biederman did a fellowship at Children's (coming in as an IMG from Argentina with residency done in Israel), graduating in '79. Then he did a fellowship at MGH, where he has remained as faculty for the past ~30 years. I'm not sure what the quality of trainees at a program in 1979 (when, for instance, Tufts was regarded as taking over from the Massachusetts Mental Health Center as the foremost residency program) has to do with fellowship quality in 2009.

 

[whopper]

A strange irony is that one of the worst psychiatrists I've ever seen graduated from CHOP, and one of the worst residents I've seen got into one of the top fellowships in terms of reptuation and prestige.

That's not to say those programs are bad. I think those 2 cases were outliers.

 

[HMSPSYCH]

Right - I am unaware of any Longwood grad who went to Children's in the past 7+ years.

QUOTE]

Sounds like you're saying because no Longwood resident has gone to Children's the past several years this means it's a 'poorer' quality program. So if no HMS grads in recent years have chosen to come to Longwood and instead choose Cambridge or Columbia/Cornell, does this mean this is a poor program? Absolutely not as Longwood is a quality program.
MGH is undoubtedly the research powerhouse in the area, if not the country, and one can not really go wrong with either of the 3 programs. But to say the clinical experiences at Cambridge and/or MGH are superior to places like Children's Boston based on secondary sources or perhaps outdated infomation is incorrect and a disservice to future trainees.

 

[Doc Samson]

Right - I am unaware of any Longwood grad who went to Children's in the past 7+ years.

QUOTE]

Sounds like you're saying because no Longwood resident has gone to Children's the past several years this means it's a 'poorer' quality program. So if no HMS grads in recent years have chosen to come to Longwood and instead choose Cambridge or Columbia/Cornell, does this mean this is a poor program? Absolutely not as Longwood is a quality program.
MGH is undoubtedly the research powerhouse in the area, if not the country, and one can not really go wrong with either of the 3 programs. But to say the clinical experiences at Cambridge and/or MGH are superior to places like Children's Boston based on secondary sources or perhaps outdated infomation is incorrect and a disservice to future trainees.

Didn't say a single thing about the clinical experience (vs your claim of only "adequate" psychotherapy training at MGH/McLean, or your questioning "clinical exposure" at MGH/McLean). Only said that the widely held perception of program strength ranks MGH/McLean way ahead of Children's. Nonetheless, I don't think you can fault the clinical experience at MGH/McLean given the clinical exposure to the pediatric populations of MGH, McLean, and Franciscan's Hospitals.

I have no direct investment in MGH/McLean CAP being "better" than anyone else - but I think it's disingenuous to claim that it is not broadly held by the community at large as the strongest CAP fellowship.

And, in the interests of full disclosure of potential bias - since you're listed as a fellow in Boston, can we assume that you're a current Children's fellow?

To the OP: as you can see from this discussion - no, it doesn't matter whether you go to residency at a program with a CAP fellowship since strong fellowships take applicants from strong residencies, not necessarily from in house.

 

[billypilgrim37]

To the OP: as you can see from this discussion - no, it doesn't matter whether you go to residency at a program with a CAP fellowship since strong fellowships take applicants from strong residencies, not necessarily from in house.

Agreed. It only matters if you want to buy a house and don't want to have to move. 😉

 

[Doc Samson]

So if no HMS grads in recent years have chosen to come to Longwood.

You've mentioned this on onther threads - it's not really true. Longwood has had a reasonable representation of HMS grads given the remarkably low N of HMSers going into psychiatry.

 

[HMSPSYCH]

You've mentioned this on onther threads - it's not really true. Longwood has had a reasonable representation of HMS grads given the remarkably low N of HMSers going into psychiatry.

Nope, wasn't me. There you go making making wild claims again. Earlier you claimed "MGH is widely perceived as the #1 CAP program and its reputation far outstrips Children's Boston (which is typically thought of as the #3 program in Boston after MGH/McLean and Cambridge)". And again you claimed "the psychotherapy training is far more than "adequate". This is based on what? because no Longwood residents have come to Children's for whatever reasons? Or is it something you heard as the other poster wrote when he/she heard while interviewing for residency.

Sounds like these are your opinions which you are trying to present as facts.

Went to a mid-tier local med school, residency at longwood, CAP at mgh, and is taking a couple of years off for research at bwh/childrens. Based on what i've seen, the department has grown and is much better than what I remembered as a trainee. In terms of clinical experiences, CHB trainees see more psychopathology (zebras and common variants) at one location in a week than what I saw in 2 months.

To original poster: visit places like CHOP and Children's and form your own opinions. 'Strong' fellowship, 'strong' residencies do not equal competent psychiatrists. During my training at these so called 'strong programs' there were a few 'freak shows' with Axis II slackers who look great on papers but I wouldn't trust walking my dog.

 

[Doc Samson]

Nope, wasn't me. There you go making making wild claims again. Earlier you claimed "MGH is widely perceived as the #1 CAP program and its reputation far outstrips Children's Boston (which is typically thought of as the #3 program in Boston after MGH/McLean and Cambridge)". And again you claimed "the psychotherapy training is far more than "adequate". This is based on what? because no Longwood residents have come to Children's for whatever reasons? Or is it something you heard as the other poster wrote when he/she heard while interviewing for residency.

Sounds like these are your opinions which you are trying to present as facts.

Went to a mid-tier local med school, residency at longwood, CAP at mgh, and is taking a couple of years off for research at bwh/childrens. Based on what i've seen, the department has grown and is much better than what I remembered as a trainee. In terms of clinical experiences, CHB trainees see more psychopathology (zebras and common variants) at one location in a week than what I saw in 2 months.


To original poster: visit places like CHOP and Children's and form your own opinions. 'Strong' fellowship, 'strong' residencies do not equal competent psychiatrists. During my training at these so called 'strong programs' there were a few 'freak shows' with Axis II slackers who look great on papers but I wouldn't trust walking my dog.

I checked back, and you're right - you were not the person who previously posted that HMS grads didn't go to Longwood - my apologies.

I don't think that stating that psychotherapy training at MGH/McLean is more than adequate is a particularly wild claim. This is based on my wife having gone through the program as a fellow and staying on as faculty, my interactions with her classmates and supervisors, having several very good friends also go through the program and my interactions with them.

Obviously no-one can make a definitive argument whether one program is objectively superior to another. There is, however, subjective public opinion - which as shown by posts on this thread and others in the past, seems to indicate that MGH/McLean is a stronger program than Children's. Prior to your post, I had never heard anyone claim otherwise. In fact, looking back at your prior posts this is a position you yourself had previously espoused in this thread http://forums.studentdoctor.net/showthread.php?t=624535:

(I'm not technically skilled enough to quote it directly here, so I just copy-and-pasted and also bolded the key phrase)

Billypilgrim, I sent you a private message. All the CAP fellowships at HMS are separate entities from the general adult departments. Bader is the brand new inpatient unit at CHB where adult residents rotate through. C&L continues to be really strong at CHB, which is good since most of us only had a few weeks of peds in medical school.

Similarly to the adult programs, MGH/McLean is probably the most desirable in the Boston area. But the work and all the driving between mgh and mclean and other places during the winter months can be challenging. But the training is good.