VA psychiatry

[xjoc]

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I'm applying to residency this year and am looking at several programs where a significant amount of training occurs at the VA. How would this affect my training, and how would the experience differ from program without such a heavy VA component? My medical school has no association with a VA, so I'm pretty clueless as to the differences, especially related to psychiatry.

 

[Igor4sugry]

Are you a D.O.? Just apply broadly, and avoid the East coasts and you will be fine. VA heavy programs I think cause you to have less exposure. You are stuck doing things the VA way.

 

[Doctor Bagel]

I agree that you wouldn't want to be primarily at the VA, but the VA is a good place to train. The primary downside is that the population isn't as demographically diverse as you'd like (primarily women, generally lower socioeconomic status). The VA is also a huge bureaucracy, which can get really irritating, and you get to deal with a lot of institutional transference issues that affect treatment. Patients can be pretty entitled, too (although arguably they really are entitled due to their service, but it can be frustrating). Lots of good exposure to trauma, geriatrics and addiction. Also, they try to offer a lot of evidence-based types of therapies and I think have one of the better psychology internships. Apparently quality of physicians varies from location to location, but they can be really solid (and probably usually are at academic places).

 

[deleted314290]

Most of your VA work would likely be inpatient and ED, with maybe a day or two a week of outpatient in the 3rd and 4th years. The VA is a great place to learn. Yes there is hierarchy and lots of red tape, but you have someone checking over you at all times. When you first start, this is great because you will get paged or called if your orders are problematic. Social workers usually tell you the important details for disposition, pharmacists tell your any issues with meds, etc etc. This allows you to get confidence in other areas such as clinical interviewing, learning your role, etc. There are disadvantages as mentioned above, but you really going to learn a lot. Just my two cents. Good luck.

 

[MLT2MT2DO]

I agree that you wouldn't want to be primarily at the VA, but the VA is a good place to train. The primary downside is that the population isn't as demographically diverse as you'd like (primarily women, generally lower socioeconomic status). The VA is also a huge bureaucracy, which can get really irritating, and you get to deal with a lot of institutional transference issues that affect treatment. Patients can be pretty entitled, too (although arguably they really are entitled due to their service, but it can be frustrating). Lots of good exposure to trauma, geriatrics and addiction. Also, they try to offer a lot of evidence-based types of therapies and I think have one of the better psychology internships. Apparently quality of physicians varies from location to location, but they can be really solid (and probably usually are at academic places).

I know residency just started for me but so far I find our non VA population feeling much more entitled than our VA patients.

If you want to talk about entitled in the VA I'd point more towards ancillary staff

 

[Shikima]

I know residency just started for me but so far I find our non VA population feeling much more entitled than our VA patients.

If you want to talk about entitled in the VA I'd point more towards ancillary staff

And now you understand what unions do.

 

[DD214_DOC]

Well, you'd get very familiar with malingering and substance use disorders.