Tips for applying and analyzing programs

[psychmd03]

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I have some 4th year students I’ve written letters for as well as just rotated with me wanting some tips or recounts on important things for interviews and programs characteristics to look for to help tease apart which might be better suited for the applicant. And also the best approach on how to get some of that info.

Somethings I’ve found/remember for programs: location, research or not, how supportive is faculty, call schedules, diversity in rotation locations.

Any one has any tips/thoughts/wisdom?

 

[comp1]

Geography is orders of magnitude more important than the other aspects. That's, by far, the most important thing you can make sure the MS4's understand. They've likely been making repeated moves with undergrad and med school. They probably now view this as just another move. It's definitely not. Statistically, this is it. This is the end of the line for training and thus again, statistically, this is where they're going to live for the rest of your life. The rest of your life is a heck of a lot more important than whatever goes on for four brief years of training. If they are competitive, they need to figure out exactly where in the country they want to live for the rest of their life and where their family and partner want to live. Assuming they have that geography decision firmly locked down and they are comparing locations WITHIN a small geographic area, I think call schedule tells you a lot about a program. It likely tells you how supportive the faculty is because someone has to be doing the work. Diversity in residency locations is in no way a strength inherent to itself. If your plan is to go work for Kaiser for life and you're going to a Kaiser residency, there's no specific strength in having a county rotation. In terms of how to get the info about a program, it's not from scheduled interviews. You get it from lunches or informal chats.

 

[FlowRate]

If your plan is to go work for Kaiser for life and you're going to a Kaiser residency, there's no specific strength in having a county rotation.

I agree with the rest of what you wrote, with this one exception. Diversity of training locations exposes you to a range of practice and usually to a wider range of patient presentations. Because most residency programs limit outpatient volume pretty significantly vs. attending practice, it's potentially helpful to be in a system that affords a wider range of outpatient experiences. As an attending at Kaiser, for example, you'll probably get a broad mix of cases, but a resident may not see much SMI/Bipolar/Schizophrenia, due to relatively lower volume of those patients (unless there's thought put in to resident case assignments.) Also would be concerned for people who have the vast majority of their training in a more narrow (patient population) system like the VA (Kaiser is not particularly narrow, esp in CA.)

The thing that's lost with remote interviews, as far as I can tell, is really being able to get the vibe of a program, opportunities for off-script discussions with current residents (main potential for red flags to get raised), and to see the facilities (not the most important thing, but there's something to be said about the potential extreme ends of this range.)

 

[comp1]

I get that some people value a lot of different sites. I just don't view it as an inherent universal strength. You can end up having to spend a lot more time learning the weird quirks of the many systems as opposed to more universal psychiatric knowledge.

 

[zenmedic]

Adding on to what has already been said, I found protected didactics time to be pretty telling of a program's culture. I would ask the residents if they were actually excused from clinical duties during didactics or if they had to make up all the work. Programs where residents said they would be charting or taking nursing calls during lecture seemed much less happy on average.

 

[Stagg737]

Somethings I’ve found/remember for programs: location, research or not, how supportive is faculty, call schedules, diversity in rotation locations.

Any one has any tips/thoughts/wisdom?

If the interviewees have the opportunity to speak with residents outside of the interview day I think that's the best source of unbiased (and sometimes honest) info they'll get. Agree that geography is going to be the highest priority for most but they don't need to ask about that. Faculty support is not something they'll likely get a good feel for through virtual interviews. Research, call schedules, and rotation locations are all great questions. Imo asking for specifics about outpatient year is important. Examples would be how long are f/up and new appointments/how many patients per day? Do you have to staff every patient with faculty at the time of encounter? How many patients in a typical panel? Where I did residency we worked at 3 different clinics during my PGY-3 year and 2/3 made me hate psychiatry for a year.

I get that some people value a lot of different sites. I just don't view it as an inherent universal strength. You can end up having to spend a lot more time learning the weird quirks of the many systems as opposed to more universal psychiatric knowledge.

Sure, but that's a valuable learning experience as well. Seeing how different systems function can be an invaluable experience both in terms of what works well for you as well as things you can't stand. I think it's better to learn that through 2-3 months of rotations in residency as opposed to signing on to a job or career not know something is going to make you miserable (for example certain EMRs). Imo getting a variety of exposure is not just valuable clinically, it's valuable in getting a better understanding of how our healthcare system on a larger scale operates (and differences between private vs public vs VA systems).

Adding on to what has already been said, I found protected didactics time to be pretty telling of a program's culture. I would ask the residents if they were actually excused from clinical duties during didactics or if they had to make up all the work. Programs where residents said they would be charting or taking nursing calls during lecture seemed much less happy on average.

Agree that protected didactics times can be a great way to gauge a programs dedication to resident training. I would caution using residents saying they chart during didactics as a measuring stick though. Where I went our didactics were 100% protected to the point it was recommended to turn our pagers/messaging system off. I still had several colleagues that would chart during morning didactics during PGY-3 year even though we had protected admin time those afternoons to catch up on notes and our inboxes because residents wanted those afternoons "off".