stbdre

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Help - have read people's posts about residency programs at duke and unc...but post interviews I am still having trouble deciding which is a better fit. Clearly both are excellent programs, and I don't have time to go back for second looks to reassess. Anyone have any input?

Just for kicks, anyone have any input re: Wake Forest psych residency?

thanks in advance to any and all who reply to this post...
 

OldPsychDoc

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stbdre said:
Help - have read people's posts about residency programs at duke and unc...but post interviews I am still having trouble deciding which is a better fit. Clearly both are excellent programs, and I don't have time to go back for second looks to reassess. Anyone have any input?

Just for kicks, anyone have any input re: Wake Forest psych residency?

thanks in advance to any and all who reply to this post...
You could wait and see who wins on Wednesday night...it's at Chapel Hill, though so that probably gives the edge to the 'Heels.
 

jayman

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I'm pretty certain I heard that the game this wednesday is at Cameron in Durham, and that Duke-UNC part II at the end of the regular season will be at the Dean Dome.

So a slight advantage goes to the Dukies this Wednesday night...but it's gonna be a hell of a game.

-Jayman :D
 
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OldPsychDoc

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jayman said:
I'm pretty certain I heard that the game this wednesday is at Cameron in Durham, and that Duke-UNC part II at the end of the regular season will be at the Dean Dome.

So a slight advantage goes to the Dukies this Wednesday night...but it's gonna be a hell of a game.

-Jayman :D
You are exactly correct--I misinterpreted the website I checked originally.
D'ya suppose Coach K's little syncopal episode today will affect the outcome at all?
 

jackiemanuel

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I know nothing about Wake Forest psych, though I do admire their basketball team.

I have tickets to the Feb. 9 and Mar. 6 Carolina-Duke games, and I can tell you right now that UNC is a much better basketball team (though anything could happen in those games) and psych program.

If you know that you want to do research with a specific professor at Duke, or think you might be interested in med-psych, then I would match at Duke. (Let me say again that the PD at Duke is the best I met on the trail, but when I asked residents what they liked about the program she was the only concrete thing they could name.)

Otherwise, I would go to Carolina. Duke residents come to Carolina when they want to get child & adolescent experience or when they want to study public health. Duke undergrads who return to the area for psych training also go to Carolina. (If you don't believe me, look up the Carolina interns and residents who attended Duke and send them an email-- they all wanted to like Duke more but after visiting, their decision was clear.) When the new state hospital is built, UNC and Duke will share the facility, but Carolina will have priority. Carolina has a dedicated hospital, and more inpatient units, including the Southeast's only eating disorders unit. Carolina sends 7-10 students a year into psychiatry. Duke has sent 1 student over the past four years. The internship year at Carolina is more difficult, but after that, the program is very humane.

I have worked at or studied at both schools; feel free to PM me if you have any further questions.

--J.M.
 

Boofus4L

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i interviewed at both programs and really liked them both so I found myself in a very similar situation. My UNC interview was first...

The dessert the night before was held at a Chief Residents house and I was very impressed by the people who showed up. All very nice. All very relaxed. My interview day confirmed this opinion. I really like the way that the program is structured with the major outpatient year in PGY-2 so that you can then have 3 full years to learn therapy. The only problem with the program's structure is that it is pretty much set in stone. You can't substitute peds for medicine, for example. Everybody has the same experience over their 4 years with no individualized electives until PGY-4. Also, Dr. Dawkins came off as very cold and not as personable as I would have liked (therapist-like detachment). The PGY-1 intense year doesn't seem to me to be a positive or a negative, but some people would rather spread the pain out over more time (depends on who you talked to). Another thing to consider, the residents were almost all from the area (if not NC, then the SE) and almost everybody's eventual career choice seemed to be outpatient/fellowship. So, after my interview day, I really loved the program and thought I might go here...

And then I visited Duke. They took us out to dinner at a local restaurant where residents from all years showed up, many of them with their spouses. We were clearly the rowdiest bunch at the restaurant, laughing and making a ruckus until the restaurant kicked us out. The next morning started early with an evidence-based medicine session which was taught by one of the residents. It was a very useful discussion of statistical terms that you come across in articles every day. You had your interviews (I met with some very cool people), sat in on a 1st year lecture, and then went to the family studies center. Dr. Thrall, the PD, was about the nicest person I think that I've ever met. She was warm and instantly relatable, and all of the residents have a story where she went out of her way to do something incredible for them. I chose to sit in on the 1st-year therapy class and I was very impressed by the level of discussion about DBT (video examples were used). At one point, a resident came by and saw me sitting there and he pulled me aside to have a 20-minute talk about his experiences. The final part of the long day was the family studies center where you work with 1-way mirrors. Let me just say that this was the best therapy teaching I have seen anywhere in my 15-program tour. Really, it was amazing. I came into Duke hearing that they were a research-only type place but between the class and the therapy observed, I realized that it was an incredible place and I left thinking it was my #1...

(TBC in next post)
 

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Over the next month, I had heard a bunch of stuff about the Duke and UNC programs that started to change my perspective. One person said that the Duke chairman told him that if he had no research interests then this wasn't the place for him. People said that residents at UNC were happier than those at Duke. Eventually, I became very unsure of my personal impression and I was back to having a different favorite each day. I loved the structure of UNC and the child/eating disorder units. I had a better time at Duke the night before but was I really sure about the therapy training? I wrote thank you letters to all my interviewers at both programs and one of the UNC interns responded by asking about my family (which we had briefly discussed) and inviting me to stay with her if I revisited. Suddenly, UNC seemed like a better place but I wasn't sure. So I called to schedule a revisit...

1) UNC revisit - When I tried to contact the intern who had so graciously offered me a place to stay, she did not get back to me (3 weeks notice). I had sent Dr. Dawkins a question and, when she replied to me a week later, it was with a minimal response two-line email. I felt like I was getting no love for some reason. I wanted to see a UNC didactic and sat in on one of the intern lectures. Only 4 interns showed up (and 4 people revisiting?!?) and the lecture was very basic and dull. Power-point dreary. Nobody seemed like they wanted to be there, including the lecturer. Then, we didn't get to meet Dr. Dawkins. Karlina Matthews (assistant) was SO nice, but I wanted to see Dr. Dawkins again and she wasn't "available." The next day I visited Dorothea Dix and was shown around by two separate attendings. Very cool people who knew many of the patients by name. Old and dirty facility, but it had a warm feel to it. I met multiple residents of all years who were friendly and nice and took the time to talk to me. They admitted that the 1st year lecture series sucks but said that after that it gets way better and that the teaching there was excellent. All in all, UNC didn't do any active recruiting of me but they were very nice and reminded me why I liked them so much in the first place.

2) Duke revisit - When I called to schedule a revisit, a resident I'd met randomly volunteered to host me. Not only have me stay at his home, but he wanted to pick me up at the airport and loan me his wife's car for the weekend!! He left me clean towels and a little bar of soap on my pillow and kept running out early in the morning and coming home with chocolate croissants! Really, it went beyond simply offering his services. I went to rounds at Duke in the morning and then I was told by one resident that someone I had met at my interview over lunch wanted me to page him to meet (he was genuinely excited that I came back). I did page him and we had lunch again in the Duke cafeteria with two other residents. One of them was med-psych, but two of them were planning on careers as outpatient psychiatrists and said that Duke did nothing but encourage their interests. I then went to visit John Umstead and was shown around by a PGY-2 who seemed a bit overwhelmed by running the entire service mostly by himself. He thought it was an amazing learning experience but that he personally wanted a little more guidance. Actually, he had emailed Dr. Thrall earlier that week with his concerns and said that, already, his attending was spending much more time with him. The same resident spoke very highly about the attending supervision at the VA and on the inpatient unit. I also met with a child fellow out there who said that she plans on doing a few months at UNC and that most UNC child fellows spend some time at Umstead. She felt that UNC (cushy, private, short length of stay) and Umstead (state facility, very sick patients, some never leave) were fairly different patient populations and that it was best to train at both places if possible. She spent 90 minutes talking to me and was amazingly candid about all her experiences. I didn't have the chance to have a meeting with Dr. Thrall at the end of the day, but only because she was running out the door to do a supervision with a resident. She said hello and we spoke for 2 minutes and then she told me to call her before I left.

In summary...
1) Residents - Duke. Both great, Duke was more my type of fun people.
2) Inpatient Units - UNC. UNC has some amazing units, Duke gives you more independence with less supervision.
3) Teaching - Duke. Amazing lectures, world-experts, therapy impressive contrary to expectations.
4) Research - Duke. EBM sessions well taught, availability of world-class faculty in many areas whereas UNC specializes in eating disorders, psychosis.
5) Leadership - Duke. Dr. Krishnan and Dr. Thrall meet with you frequently and are very responsive to concerns. At UNC, there is currently no Chair or Vice-Chair. When asked about Dr. Dawkins, residents admitted she wasn't warm and fuzzy but said that she was very quick to respond and did her job very well.

In the end, Duke wins for me, with UNC being a very solid second choice.
 

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I realize I'm posting like mad but I had one more thought I wanted to share. I was unnerved by the fact that only 2-4 people from Duke go into psychiatry each year while so many (5-10) from UNC go into psychiatry. Most people use this as evidence that UNC is a better psychiatry program and I accepted this at first. Thinking about it, though, UNC and Duke are VERY different medical schools.

Duke crams all book learning into one hellish 11.5 month first year before sending you out to the wards second year. Then, you get a third year to do research and a fourth year for electives. My thought was, what type of person chooses that type of medical education? I'm not sure, really, but it seems to me that somebody attracted to that type of high-stress first two years might be pre-selected to go into something other than psychiatry. Surgery? Academics?

Could be my attempts to allay my last nagging concerns about a program I love, but I think I might have something...
 

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I'm a Duke Med student who just finished the psychiatry clerkship.

I know nothing about Carolina's psychiatry program, so I have no basis for comparison, but I think that Boofus is right on regarding his/her impressions about Duke. The residents really are a tight-knit group of fun, smart people. They hold potluck dinners, and movie night every month (and probably lots of other stuff goes on that I, a lowly med student, know nothing about). They are genuinely happy, down-to-earth, interesting people. All of the attendings I got to work with were great. Family Studies is, indeed, a big treat and trains therapists very well. I'd never considered psychiatry before I started the clerkship, but I have to say that after working with so many terriffic people over the past month, psychiatry is now at the top of my list!

And Boofus, while I do understand your need to try to make some sort of sense out of why so few Duke med students choose psychiatry, I think I should perhaps dispell some of your stereotypes about us (particularly, if you will be teaching Duke students next year). Our curriculum is different, but by all accounts we actually aren't as stressed during the first year as our (ahem) Carolina med colleagues down the street. I guess you could say we're driven, but we aren't masochists: I think that part of what accounts for the draw away from psychiatry isn't that Duke grads want to kill themselves in IM and surgery, but rather that so many students are going into the R-O-A-D lifestyle specialities, because, well, they can.
 

Boofus4L

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banannie said:
I'm a Duke Med student who just finished the psychiatry clerkship.

I know nothing about Carolina's psychiatry program, so I have no basis for comparison, but I think that Boofus is right on regarding his/her impressions about Duke. The residents really are a tight-knit group of fun, smart people. They hold potluck dinners, and movie night every month (and probably lots of other stuff goes on that I, a lowly med student, know nothing about). They are genuinely happy, down-to-earth, interesting people. All of the attendings I got to work with were great. Family Studies is, indeed, a big treat and trains therapists very well. I'd never considered psychiatry before I started the clerkship, but I have to say that after working with so many terriffic people over the past month, psychiatry is now at the top of my list!

And Boofus, while I do understand your need to try to make some sort of sense out of why so few Duke med students choose psychiatry, I think I should perhaps dispell some of your stereotypes about us (particularly, if you will be teaching Duke students next year). Our curriculum is different, but by all accounts we actually aren't as stressed during the first year as our (ahem) Carolina med colleagues down the street. I guess you could say we're driven, but we aren't masochists: I think that part of what accounts for the draw away from psychiatry isn't that Duke grads want to kill themselves in IM and surgery, but rather that so many students are going into the R-O-A-D lifestyle specialities, because, well, they can.
Banannie-

Thank you for your input. I am happy to know that if I attend Duke I will likely be teaching students who are not unusually stressed out. I hope you didn't take offense to my theory - I was simply putting a thought out there.

I also attend a top 5 medical school, where students are able to choose any specialty they wish. Many choose the ROAD lifestyle specialities, but 8-12 each year (out of a class of about 150) also choose psychiatry. so perhaps there is an alternate explanation to this question, which neither of us has figured out.

Regardless, I am very happy to hear that you had a good experience with the psychiatry department at Duke. It is nice to hear that those who have spent a significant amount of time interacting with the residents and staff are as enthusiastic about them as I am.
 

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OldPsychDoc said:
You could wait and see who wins on Wednesday night...it's at Chapel Hill, though so that probably gives the edge to the 'Heels.
Who cares who wins between Duke and UNC.... Wake is #1 Baby!!!
 
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