Just to clarify a few things about the state of the psychiatry residency program at Vanderbilt (since I'm a second year resident here)...
1. yes, the program is undergoing a lot of changes now since the introduction of our new chair in January. however, the vast majority of the changes are quite positive. they are being made in response to, not in spite of, suggestions made by existing residents. for example, residents had been asking for an opportunity to do outpatient work earlier in their training. now, during first and second year, residents spend time at the local downtown clinic doing outpatient psychiatry. also, the "big names" on the faculty roster have always been active teachers in the program, and are even more so now that there is more of a focus on education. one of the things that our chair has done has been to bring them out of the lab and into the classroom. these top researchers now give lectures, teach at journal clubs, and run the weekly clinical case conference.
other changes...
the consult/liason service is undergoing several important revisions to make it a more educational and less work-focused rotation. our chair was one of the chief attendings of the consult service at Mass Gen before leaving and loves consult/liason psychiatry. he is planning on starting a fellowship in psychosomatic medicine (C/L) within the next year or two and is taking steps in that direction. starting in July, we will have a CL chief resident position..something we have not had in the past. this should add to the teaching on the service, something i personally believe is a good thing. CL psychiatry is the interface between medicine and psych and you'll see things on this service that you won't see on any other. the CL service is also the "face of psychiatry" to the rest of the hospital. to a large extent, they shape the way the rest of the hospital views the department. having just come off of CL in October i can say first hand that the rest of the hospital seems to have a good impression of the department. and as the service grows, takes on fellows, etc. so will our reputation among our colleagues.
for years, psychiatry residents rotated at the local state psych hospital. starting in july, we will not be doing that anymore...for several reasons. one is financial. vanderbilt supplied several of the attendings as well as two resident/month, and medical students. we were not compensated nearly enough to make that financially feasible. sending that many resources over there also strained us somewhat on other rotations...the VA rotation has always been a very busy one, for example. those residents will now be added to existing rotations (the CL serivce, the VA, etc.) to more evenly distribute the load. this is a GOOD thing. we will also be accepting more of the patients at VPH (the vandy psych hospital) that would have been sent to the state hospital and treating them in-house. also a GOOD thing.
starting in january, residents will be doing physical exams (with chaperones, of course) on newly admitted patients. this has caused some residents to be nervous, but the fact is that MOST psych programs have residents do physical exams. going into psychiatry is not a way to circumvent ever having to touch a patient again.
however you feel about a "no benzo" clinic, this is the way most mental health providers in the middle tennessee area are going. interestingly, i just had this conversation today with a psych nurse practitioner at one of the local mental health clinics. he told me his clinic had gone "no benzo" several months back (not sure just how long) but that he liked it. i talked two months ago with an attending on one of the inpatient units and he didn't like it. the residents have mixed feelings (some like it, some don't). it's been in effect now at vandy for some months now and things have settled down quite a bit.
2. my own personal experience at vandy has been a very positive one. the residents, staff, and attendings here are, almost without exception, very good to work with. as an intern, my off-serivce rotations were fine and i learned a lot, but i would always look forward to coming back to psych because of both the people and the subject matter. because of the proximity of top researchers, i have always felt that we are taught not just "textbook" psychiatry but also cutting edge psychiatry. i have always felt supported by our program director (who, by the way, is one of the primary reasons most of us chose to come here.) example, sept of last year, my grandmother passed away while i was on a child inpt rotation. i got the call at 8am, was in her office 15min later, she arranged for coverage right away, and i was on the road home within the hour - no questions asked. her job, and (as far as i can tell) genuine wish, is to make the time you spend at vandy a good experience for residents.
3. final points about the program that you should know if you're thinking of applying or have applied...we get an elective month our first year that you can tailor to your interests. i split my month between forensic psych and learning more about developmental disabilities. child psychiatry is my interest, particularly dev dis and autism. vanderbilt works closely with the Kennedy Center, an internationally acclaimed research insitution for developmental disabilities. i spent three days/week learning from clinicians and researchers there. spending time with those guys was one of the highlights of my residency. also, our new chair is a researcher as well as a clinician and is trying to foster more interest in, and more of a focus on, research. if this is something you're interested in, you would get a great deal of support if you chose to come here (almost a direct quote from the man himself).
4. we went several years without a permanent chair for one big reason. several years ago, vanderbilt university as a whole adopted what was termed a "Top Ten in Ten" attitude. in other words, they wanted to be one of the top ten hospitals in the country in ten years. so, a LOT of money was spent, faculty were recruited for many departments, buildings have been and are being built, and things have been hectic. the psychiatry department also adopted that philosophy. in that vein, they wanted to attract one of the top names in the field of psychiatry to be their chair. they interviewed several candidates before attracting and recruiting our current chair. (not many departments across the country can claim to be able to attract absolutely any candidate they want on the first try) he's considerably more than "a few years out of residency" but he is young (40s i would guess...i haven't actually walked up to the man and said "hey boss, how old are you?"), energetic, and seems to be excited about his plans for the department.
hope this helps. i don't want to give the impression that every day here is pure sunshine, it's not. but every day isn't sunshine at any residency program anywhere. i do want to give the impression that vanderbilt univeristy is a great place to come learn psychiatry. i have been very happy here, as have most residents to my knowledge. yes, we're undergoing a lot of changes, but most residents are EXCITED about most of the changes. we think they will make us a stronger program and better clinicians.
if you have any questions or concerns, let me know.
I think I'm going to withdraw my application!!!!
