Stuck on how to pursue public psychiatry

[grandprix]

Hello - I am currently having a dilemma in how to proceed with my goals. I would like to ultimately (10+ year plan) work part time in the field of public psychiatry, and part time in a group/private practice. However, my 5-year plan is to work in the field of public psychiatry, in a larger, urban area. I have done international mental health work, and would like to still have that as an option in the future. I am debating whether to go for my MPH at Harvard, or to pursue a public psychiatry fellowship, either at Columbia, Penn, UCSF or UW. I also want to have the option of working for the WHO or another big organization (in which case I think the MPH will be helpful). I would mostly likely only apply to the MPH program at Harvard, as I have taken summer public health courses there and feel comfortable with the curriculum and faculty.

I just want to know what people's thoughts are on public psychiatry fellowships. I know the one in Columbia pays better than others, but is it still basically cheap labor? Will it help to open doors? I like the collaborative care model in UW - can anyone shed some light into this? If anyone can provide any input in other public psychiatry fellowships, please let me know.

The MPH will only be one year, so I feel like it's not too much time to sacrifice, but it would mean going back to school, etc.

Any thoughts appreciated! I don't have any ties to any particular city, which makes things a bit harder. Thanks in advance!

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[SteinUmStein]

What kind of doors are you trying to open with a fellowship or an MPH? Academics, research, leadership? All of the above? If your focus is clinical and caring for underserved populations, I'm struggling to justify the time and expense.

 

[splik]

The columbia ppf is not "Cheap labor". You're not really providing labor for these fellowships since its heavy on didactic and practium like experiences. You will do some clinical work for which you will be paid (this basically is what pays for your time but obviously is less than what you would make otherwise because you're only really working part-time). It is the longest running, most established public psychiatry fellowship in the country.

BTW many of these fellowships will let you fasttrack and do it as a PGY-4 which is obvs a better use of time than doing as a PGY-5 since though that is the other option.

UW does not have an active public psychiatry fellowship. However they can create a bespoke fellowship in community psychiatry for you. If you contact Eric Trupin and discuss your interests with him (his own interests focus on child and adolescent mental health and juvenile justice) he will see if he can put something together and get the funding for it. They also have an integrated care fellowship which focuses more specifically on training leaders in integrated care (including collaborative care and telepsychiatry). If you contact Anna Ratzliff and discuss your interests she can tell you whether this would be a good fit. UW does do some global mental health work involving collaborative care in Vietnam and some other places, so you can see whether it would be possible to do something like this (though the funding is specifically because WA state is looking to create more leaders in the US). UW also has a more research oriented 2-yr fellowship in health services research/primary care psychiatry that I believe Jurgen Unutzer now leads (the first year would be the MPH at UW with the advantage that this would be fully funded and you would get your NIH T32 stipend for the year and don't have to pay medicare/SS taxes on it).

I have never heard of Penn having a particularly active of well regarded public psychiatry program.

UCSF has a pretty good program but is really focussed on training leaders for public mental health in the SF Bay Area, so I think it would less worth your while if you aren't that interested in settling there.

Harvard has a great MPH program for physicians since it's only 9 months and you will meet all sorts of interesting people. It sounds like you would probably want to do the Health Policy and Management Concentration. If you can find a way of getting this fully funded (and there are various schemes in the Boston area or through Harvard that will fund you to do this) then I think it would be worth doing. You really don't want to have to pay for it if you can, given your career interests guaranteeing you won't be making much money 🙂

It is course not necessary to do a public psych fellowship or an MPH for your career goals but they may help, especially if you want to settle in a particular area or develop a specific skill set. You might also consider doing an MBA or MPA/MPP which might actually be even better than an MPH for the kinds of things you are interested in.

If you are from a minority background or interested in advancing minority mental health and interested in learning more about policy, you might consider applying for the Jeanne Spurlock Congressional Fellowship (Jeanne Spurlock Congressional Fellowship)

 

[grandprix]

Thank you so much for the comments!!! You seem to know a lot about various programs! Much appreciated.

 

[MacDonaldTriad]

Most public psychiatry systems have an endless supply of open positions for psychiatrists. Very few of the psychiatrists in the trenches of public psychiatry have MPHs from Columbia. I have a relative who is in the movie business and has a cinema degree. She is the only person she knows in "the business" with a degree in it. Others have degrees, but majoring in cinema promotes laughter in her coworkers if she mentions it. If you want to get into government administration of large systems and be looked at as the doctor leader making all of those crazy policies the front line worker bees like to scorn, an MPH can help. If you just want to see public patients and feel good about helping those in need, take a job and get going. These are very different goals. If you do a fellowship in public mental health, the odds of you becoming faculty at a fellowship in public mental health is probably greater than the odds of you going to work in a public mental health clinic. This isn't a bad thing, I'm just saying your question can only be answered by asking what you want the outcome to be.

 

[nitemagi]

As my colleagues mention -- decide if you're looking to do policy work for public psych, or just clinical. The latter doesn't need an MPH.

 

[SeniorWrangler]

All the money is in addiction these days.

 

[Shikima]

All the money is in addiction these days.

Cash Cannabis. Get people stoned in the name of science.

Much like the old alcoholic who needs a couple of beers prescribed with his dinner.