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.