what should i look for in psych residencies

[dorian24]

Right now, I'm just looking through doximity / freida. I'm trying to find programs that weave a strong therapy focus with a biological one. Apart from that, are there other things I should be focusing on? Any suggestions for solid programs would be helpful as well! I don't really have preferences for geographical region.

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[Dharma]

Totally valid resource: 2019 Top Party Schools in America

 

[Old&InTheWay]

In general, when visiting web forums, you should read through the sticky threads before posting. Also search; common questions have been asked and answered many times.

But I'll get you started: Applicants: How to research programs of interest

 

[pbdoctor1]

My only suggestion is to avoid malignant programs at all costs even if they tell you they have a strong therapy component. These programs have problems systemically such as funding problems, limited education, toxic attending or PD, etc and unlikely to be changed quickly. You don't want to be tangled in the problem and get in trouble or be banned from practicing medicine. Your training director holds a lot of power and can or will end your career as they choose to. Usually burnout is rampant in those places and the risk is too high.

In general most programs are good and vary based on the current PD and faculty. These faculty can change even during your residency so be weary of that and your own preference may change as you progress. Typically the fit especially with the program director is the most important aspect including evaluating the interactions you have with residents and faculty. It's 4 years and even a so so program can have great attendings who are incredible at teaching psychotherapy. See who you genuinely connect with and expect the reality to be different. Go to a place that encourages learning and is open to your development and changes. Lots of great programs out there but avoid the malignant places at all costs!

 

[futuredo32]

During interviews I tried to see if the residents seemed happy or if they were faking it. I also looked to see how they interacted with each other- did they like each other, or did they try to one up the other. Did they look tired (were the girls wearing make up and had their hair done or did they have no make up and a pony tail ie they were too tired to take care of their appearance).. I was interested in therapy and focused heavily on that. I would agree the PD is key and avoid malignant programs and new programs. I started at a new program and big changes happened, I switched to a program after that and loved the PD but she retired and the PD who replaced her was AWFUL. It was the residents that made it tolerable enough to stay. We got each other through. If you oops you can probably switch to another program. I and others transferred out of my first program and some transferred out of my 2nd program. They usually have open spots for pgy2s or 3s because people leave for child psych for their 4th year. I'd also look for a program with a high pass rate for the boards. What is the call schedule like is pretty big. You don't want to be working 80 hours a week with little time to read. IF the PD didn't leave my first program and big negative changes wouldn't have happened it would have been a really great program.

 

[Old&InTheWay]

Did they look tired (were the girls wearing make up and had their hair done or did they have no make up and a pony tail ie they were too tired to take care of their appearance)..

Unless you expect this of everyone, you shouldn't expect it of anyone.

Also, since most residents are >18, they're probably not "girls."

 

[Beepboop]

Unless you expect this of everyone, you shouldn't expect it of anyone.

Also, since most residents are >18, they're probably not "girls."

Agreed, I didn't know not wearing make up gave off the impression that I was too tired to care. -____-.

 

[futuredo32]

Unless you expect this of everyone, you shouldn't expect it of anyone.

Also, since most residents are >18, they're probably not "girls."

My friends and I are over 18 and we use the phrase girls or guys. Personally I found this to be accurate. At the programs with light or reasonable call the girls wore make up and did their hair and looked nice. At programs that I later read were malignant or the residents actually said call or hours in general were awful, the girls just wore pony tails no make up. If you don't want to use that as a standard, do they all look tired? Obviously if one person finished call they are probably going to look tired but if everyone looks tired...……...

The make up and hair analogy was true for me. My first program before our PD left and life was good, I wore make up did my hair because I had time to do so and we were treated well. The PD
left and on inpatient rotations when I worked up to 120 hours a week (true story) I could have cared less what I looked like I was beyond tired. Second program was really malignant, overworked and treated like crap, I didn't care what I looked like either. I see the same in a lot of my female patients. When they are depressed, they don't take care of their physical appearance. But when the females start feeling better, they come in with make up and their hair looks nice. Too much make up - sometimes a sign of mania.

 

[dorian24]

My only suggestion is to avoid malignant programs at all costs even if they tell you they have a strong therapy component. These programs have problems systemically such as funding problems, limited education, toxic attending or PD, etc and unlikely to be changed quickly. You don't want to be tangled in the problem and get in trouble or be banned from practicing medicine. Your training director holds a lot of power and can or will end your career as they choose to. Usually burnout is rampant in those places and the risk is too high.

In general most programs are good and vary based on the current PD and faculty. These faculty can change even during your residency so be weary of that and your own preference may change as you progress. Typically the fit especially with the program director is the most important aspect including evaluating the interactions you have with residents and faculty. It's 4 years and even a so so program can have great attendings who are incredible at teaching psychotherapy. See who you genuinely connect with and expect the reality to be different. Go to a place that encourages learning and is open to your development and changes. Lots of great programs out there but avoid the malignant places at all costs!

Is there a way to determine a residency is malignant before applying to the program?

 

[whackamole21]

Is there a way to determine a residency is malignant before applying to the program?

Apparently you should look at the “current residents” section of their websites, find all the “girls” on Facebook, then go through all of their pictures to see how often they wear makeup or not.

 

[Mass Effect]

Is there a way to determine a residency is malignant before applying to the program?

I wouldn't waste your time worrying about this. Malignant psych programs are exceedingly rare.

 

[Taddy Mason]

Apparently I married a lazy, burnt out, slob of a girl.

 

[Sushirolls]

I highly suggest applicants throw their perceptions of name recognition and brand out the window. Also throw the notion of "fit" out the window.

This is a 4 year job, where at the end of it you want the most diverse training you can get. But you can't completely look at residency training strictly as a job mentality, unfortunately. This is in part because the PD is essentially your God and can be an asset to help you succeed in rough patches, or they rain down holy terror upon you and end your career with the snap of a finger. They will also be the one to filter any ridiculousness when rotating off service to be your advocate (or not). Ask the current residents how they feel about the PD and even the associate PD if there is one as they will fill in if/when the the PD steps down. I didn't fully appreciate the value of a quality PD until after residency when learning about other people's experiences.

There are programs that shelter residents form lower SES and severe schizophrenia and other civil commitment cases. Other programs only deal with this population and not the higher functioning.

Sit down, look at the 4 year map of the rotations. How diverse are they really? Is this a VA heavy program where you are their cheap labor? I suggest applicants base their review of the rotations as the primary factor. Will you get an education worthy of 4 years of your life? Psychiatry doesn't really need 4 years, and resentment may surface in your 4th year. Pick a program that makes you glad you're still in training. That will serve you more than chasing location, 'name recognition' (patients don't care), and the magical thing called 'fit.'

Psych ED exposure?
ECT?
TMS?
Ketamine infusions?
Moonlighting? Highly recommend you do it.
Chronic pain rehab rotations? Cleveland Clinic, Mayo, and Hopkins have them.
Addiction specific units?
Child pain rehab units?
How robust is the CL rotation? or is it a small hospital where you are cheap labor?
State hospital forensic units?
Geriatric specialists?
Time spent with neuropsychologists?
Small taste of community mental health (caution here that you aren't only doing this...)
Subspecialty clinic rotations like women's health? Oncology? Cardiology? Movement disorders? etc
Will the program let you make your own subspecialty clinic to follow your desires?
Business exposure! Do you have means to rotate for electives with the hospital admin?
Rotations, are they being taught by midlevels?
Inpatient units, how many and how diverse are they?

Want to know one way to spot a malignant program? Look for high percentages of residents matching into Child and Adolescent fellowships. Hone in on the PGY-III residents who have applied for C&A and try to ascertain from them if they truly are all about C&A or its simply a means to escape their bad program early.

 

[Amygdarya]

Not having perfectly styled hair and makeup is a sign of individual priorities rather than lack of time. It is, after all, 2019, and it is not expected from every young woman to wear make up and have perfectly styled hair, so many really don't care about these things.

Something that I was too chilcken to do during my own interviews but appreciate current applicants doing: ask residents about the hardest part of the residency, what they wish were different about their program, what the program may lack (eg. certain patient populations). If residents evade these questions or give you some pre-packaged BS, you have your answer. I honestly talk about our call and the part that made me miserable and just as honestly say why I'm so happy to be here. (And please don't mind my hair!)

 

[futuredo32]

Semantics? Really? Why not stick to the topic at hand. Girls,women ;females.. I'm sure the OP is intelligent enough to get the gist. There is a lot of leniency in the psych forum and many take advantage of it which is unfortunate. It gets threads derailed and makes some avoid the forum. Maybe ask yourself prior to posting if the comment is useful relevant and kind .if not maybe consider not replying

(Side note, I see there is a comment below mine from someone on my ignore list . I mentioned when I opted to use this function to the person I opted to ignore because I found many of their comments rude that I would be using the ignore option, not sure if he/she missed that part or didn't think I was serious, but I was and don't have to see his/her comments any longer, so once again, I will point out that I did use the ignore function for you and don't see your comments so you wont be getting a reply. I mentioned it at the time because I didn't want to be rude and not reply to your comments. But I don't deserve rude or snarky comments and thanks to the ignore function I don't have to see them. )

 

[clausewitz2]

Semantics? Really? Why not stick to the topic at hand. Girls,women ;females.. I'm sure the OP is intelligent enough to get the gist. There is a lot of leniency in the psych forum and many take advantage of it which is unfortunate. It gets threads derailed and makes some avoid the forum. Maybe ask yourself prior to posting if the comment is useful relevant and kind .if not maybe consider not replying

Why do you comment if you don't ever want the responses you get? I am really curious what you expect the outcome to be.

 

[Crayola227]

I almost never did my hair or make up for all of med school and residency. In my personal life I tend to do both up to the nines in all social spheres. When it comes to work, I am usually too tired and that has nothing to do with malignancy or specialty. Besides that, I'm actually not interested in being particularly "done up" at work. I want to be seen as serious more than pretty.

 

[Crayola227]

Also I noted that ob/gyn residents, who seemed to me to get the least amount of sleep, and have some of the most malignant program cultures, very often have their hair and make up done up (hair often up, but still styled). At my school lash extensions were all the rage for them, just so it would look like they had on mascara despite not actually putting on any that would get smudged with sleep. Some even talked about make up tattooing, lol.

Just saying, I would look for other things besides grooming to suss out malignancy, there's other ways to tell if people are miserable.

In fact, I think hair/make up, should the time exist, is a classic way for women to cope with negative feelings and in the work place (not saying that all women who do these things feel that way).

 

[futuredo32]

Appearance is one component of the MMSE. I think it speaks volumes. DEFINITELY not the ONLY thing to look for but one aspect. One can look their best at work and after work. And, in my case it did reflect my level of happiness at my residency programs.
One red flag for me was how the interviews go. At one program, it was a panel interview and I was so uncomfortable. They pimped me during the interview. Psychiatry is a small world so I sat through it and then sent an email the next day thanking them for the opportunity to interview but stated it wasn't a good fit. My first program had 2 amazing interviews and it turned out that one was VERY involved in the program and THE best attending I have ever worked with. I knew two attendings from my TRI year also and liked them (one is my primary care doctor now 🙂 they do addictions and FP. So keep your eyes out during audition rotations too.
You will just get a "Feeling" when you interview. I would say trust that feeling. IF my original program had gone as it was intended , it would have been an amazing residency.

 

[futuredo32]

I almost never did my hair or make up for all of med school and residency. In my personal life I tend to do both up to the nines in all social spheres. When it comes to work, I am usually too tired and that has nothing to do with malignancy or specialty. Besides that, I'm actually not interested in being particularly "done up" at work. I want to be seen as serious more than pretty.

Serious and pretty can't coincide? And usually patients who are depressed have a poor appearance while those who are improving start to care about their physical appearance in my experience. Not EVERY patient, but overall...……..

 

[Crayola227]

Serious and pretty can't coincide? And usually patients who are depressed have a poor appearance while those who are improving start to care about their physical appearance in my experience. Not EVERY patient, but overall...……..

They can, that's why I said MORE serious than pretty. One way to look more serious and less "pretty" is to just skip make up and hair. It may not go further towards looking more serious you could argue, but it DEFINITELY looks more like you're NOT trying to be pretty (by this society's standards) when you don't. I'm not trying to draw attention to my lips, eyes, cheeks, or mimic arousal.

You can be serious and pretty. I'm just saying not doing hair and make up is one way to tone down "pretty."

There are more than one ways to groom oneself or improve and look like you care about appearance. I always wear matching necklace and earrings, that's how I show some caring for grooming and appearance that is not sexual in nature (I'll not get into how a necklace can also accentuate certain secondary sexual characteristics). I wear bright colours because I like them and they complement my natural colouring. I wear my hair down because I don't like my ears.

But by anyone's measure, I'm otherwise "plain" at work, and it's a conscious choice, not depression.

 

[Crayola227]

Appearance is one component of the MMSE. I think it speaks volumes. DEFINITELY not the ONLY thing to look for but one aspect. One can look their best at work and after work. And, in my case it did reflect my level of happiness at my residency programs.
One red flag for me was how the interviews go. At one program, it was a panel interview and I was so uncomfortable. They pimped me during the interview. Psychiatry is a small world so I sat through it and then sent an email the next day thanking them for the opportunity to interview but stated it wasn't a good fit. My first program had 2 amazing interviews and it turned out that one was VERY involved in the program and THE best attending I have ever worked with. I knew two attendings from my TRI year also and liked them (one is my primary care doctor now 🙂 they do addictions and FP. So keep your eyes out during audition rotations too.
You will just get a "Feeling" when you interview. I would say trust that feeling. IF my original program had gone as it was intended , it would have been an amazing residency.

I get what you're saying on MMSE.

From my limited anecdotal experience, I don't find that psych women are a particularly flashy bunch like derm ladies and such can be.

I think this reasoning about how groomed female physicians are and how that relates to the MMSE is limited, primarily because of our awareness of it. I found the most type A people in some of the most type A programs that are the MOST miserable to be the best presented. I embrace the work place where women felt like they could skip make up and wear their hair in a ponytail and it was fine.

 

[Old&InTheWay]

@futuredo32 Sorry if you feel I have derailed the thread or felt attacked. My point was that reinforcing the idea that women need to present themselves in a certain way to society (and in a way men are not expected to) devalues women and is harmful to all of us. Yes it is semantics, and semantics are important and relevant, because what we say and what it means reflects and impacts what and how we and others think. I also recognize you were almost certainly not intending to be derogatory in any way. But again, it’s important to aware of the cultural brainwashing we are all subjected to.

 

[Mass Effect]

Appearance is one component of the MMSE

I wasn't going to weigh in on this part of the debate, but I can't ignore the above. I think you've missed the point of the MSE if you think it's appropriate to judge a program's malignancy by whether or not their residents wear makeup. To suggest that a woman who doesn't wear makeup or puts her hair in a ponytail does so because she is too tired to take care of her appearance is incredibly insulting, short-sighted, and shows a lack of understanding and appreciation for the way "appearance" is supposed to be judged on the MMSE, not to mention lack of respect for individuality and individual choices.

 

[futuredo32]

I wasn't going to weigh in on this part of the debate, but I can't ignore the above. I think you've missed the point of the MSE if you think it's appropriate to judge a program's malignancy by whether or not their residents wear makeup. To suggest that a woman who doesn't wear makeup or puts her hair in a ponytail does so because she is too tired to take care of her appearance is incredibly insulting, short-sighted, and shows a lack of understanding and appreciation for the way "appearance" is supposed to be judged on the MMSE, not to mention lack of respect for individuality and individual choices.

I wasn't saying they were EXACTLY the same. MOST females DO wear make up and LIKE to look pretty. In residency programs, and I interviewed heavily there WAS a correlation. And PERSONALLY there was a correlation. And actually at my 2nd program every resident was on some medication for anxiety or depression...………………………………..

 

[futuredo32]

@futuredo32 Sorry if you feel I have derailed the thread or felt attacked. My point was that reinforcing the idea that women need to present themselves in a certain way to society (and in a way men are not expected to) devalues women and is harmful to all of us. Yes it is semantics, and semantics are important and relevant, because what we say and what it means reflects and impacts what and how we and others think. I also recognize you were almost certainly not intending to be derogatory in any way. But again, it’s important to aware of the cultural brainwashing we are all subjected to.

The truth is females ARE treated differently in society . Women get old while men get "distinguished". Look at Hollywood. Several males get the lead with zero cosmetic work tons of wrinkles and grey or white hair. But females? They need to dye their hair to cover the grey, get botox and plastic surgery to get those roles. Yes there are exceptions, but overall...……… It's true. A few of my patients in high profile jobs feel pressured to get cosmetic surgery in order to keep their jobs and their fears are not unwarranted for these particular patients. (These are a few of my private practice patients in high prestige type jobs). It IS sad and it IS unfair but it IS reality. I am reapplying for a second residency next year and on paper they will see my age, but I am doing quite a bit cosmetically (not plastic surgery proper) to have the youngest looking face possible because of the standards we have in the US about women and aging. I would be doing it regardless to live up to society's expectation of women and yes, it does feel good to look younger.

As for the term "girl" I meant no disrespect toward the female gender. My friends and colleagues even use the terms "girls and guys" not males or females .

Sorry to the OP for the derailment.

 

[futuredo32]

I get what you're saying on MMSE.

From my limited anecdotal experience, I don't find that psych women are a particularly flashy bunch like derm ladies and such can be.

I think this reasoning about how groomed female physicians are and how that relates to the MMSE is limited, primarily because of our awareness of it. I found the most type A people in some of the most type A programs that are the MOST miserable to be the best presented. I embrace the work place where women felt like they could skip make up and wear their hair in a ponytail and it was fine.

I found the opposite. I would be willing to guess you interviewed at much higher tier programs than I would even consider applying to. At my first program we actually went to Grand Rounds at a higher tier program which supposedly is really an easy program with respect to hours worked and number of patients seen. The females there were all wearing make up and dressed well and their hair looked great. They certainly had time to do it.
And on the interview trail when I asked about call, I certainly noticed a correlation between the high hours and females who looked like they could care less about their appearance and programs where there was little call and the females at these programs had females who wore make up and did their hair. And again, when I was at my first program when the original PD was there I wore make up and did my hair daily and so did most of the other females, but after she left things took a really bad turn. Inpatient months at this program I honestly worked up to 120 hours a week. (And I complained to the interim PD, the attendings and no one cared. I was so tired I got into two accidents and got a ticket in a week). I was TOO TIRED to do anything with my appearance and even drive safely. My second program, TWO of the females in the entire program wore make up and did their hair. The rest of us looked pretty bad. And all of the residents were on a med for depression or anxiety. I interviewed for FP and IM my last year of residency and noticed the same trend, so it's not just psych.

So to the OP in my personal experience, one way to determine if the residents are happy and not overworked, is honestly if the females are wearing make up and have some sort of hair style. This obviously isn't the only way to tell but at my second program residents were carefully selected to be involved in the interview process and coached on what to say to applicants. I also think how they get along at the lunches or pre-interview dinners is indicative of how the residents at the program treat each other. At my 2nd program, it was the residents that got each other through an incredibly malignant program (along with psych meds for anxiety or depression).

There are of course other factors, but what they post on their website and what truly happens at a program can be two very different things. I am making the assumption that you have a great application and can choose pretty much any program. You will be able to tell a lot more about the program during the interview than researching them online. My second program was supposedly research heavy, but in reality ONE resident did research. I should have looked to see how many residents published anything.

 

[tellme_areyoufree]

Is this a VA heavy program where you are their cheap labor?
...
Psych ED exposure?
ECT?
TMS?
Ketamine infusions?
Moonlighting? Highly recommend you do it.
Chronic pain rehab rotations? Cleveland Clinic, Mayo, and Hopkins have them.
Addiction specific units?
Child pain rehab units?
How robust is the CL rotation? or is it a small hospital where you are cheap labor?
State hospital forensic units?
Geriatric specialists?
Time spent with neuropsychologists?
Small taste of community mental health (caution here that you aren't only doing this...)
Subspecialty clinic rotations like women's health? Oncology? Cardiology? Movement disorders? etc
Will the program let you make your own subspecialty clinic to follow your desires?
Business exposure! Do you have means to rotate for electives with the hospital admin?
Rotations, are they being taught by midlevels?
Inpatient units, how many and how diverse are they?

If I might add (or maybe push back a little?), don't assume that a VA heavy residency will treat you as cheap labor, I have not felt that way at mine at all. The list of things above is great to ask about (including at a VA heavy residency - mine includes almost all of the positives above).

I looked for those things, my feelings about the PD, how happy I felt the residents were, call, pay, work hours, and vacation (I recently just started telling applicants about these things, remembering how nervous I was to ask about these for fear of looking bad). Geography was very important to me, probably should be for everybody. And re prestige, I think it can be a factor. Shouldn't be the deciding factor, but the reality is even at an "improving" prestige program I have really great opportunities through my program's affiliation with a good academic institution. So maybe instead I should say it's about opportunities, not prestige. I also had some external factors, namely where my partner got into law school - which affected my rank list. But had I not considered that, I would be miserable right now, so don't ignore important external factors.

At the end of the day I figured any accredited residency will train you to be a psychiatrist, but where would I be happy? I have to be happy to best learn, so being happy at a "worse" program beats being miserable at a "best" program any day for me.

I don't know if any of that helps you, but that was my thought process.

 

[Mass Effect]

I wasn't saying they were EXACTLY the same. MOST females DO wear make up and LIKE to look pretty. In residency programs, and I interviewed heavily there WAS a correlation. And PERSONALLY there was a correlation. And actually at my 2nd program every resident was on some medication for anxiety or depression...………………………………..

I really feel like a lot of your posts are hyperbole. As far as I know, there is no study that suggests "most females do wear makeup." I know plenty who don't. In my circle of friends in college, I was one of the only ones who wore makeup daily and ALL of us had time to do it.

Every single resident at your second program was on medication? Did you ask them all? And if so, did you also ask if they were on it before? Did you also ask if it's nature of the work or the work at that particular place or medicine in general that caused them to seek meds? Because it's no secret that there's a problem in medicine, in general, and that many students, residents, and attendings are depressed. So saying that correlates to malignancy shows lack of acknowledgement of the problem at large. Finally working 120 hours a week on a psych inpatient unit? That's either major hyperbole or you were at one of the well-known sweatshops out there that are outliers to standard psych residencies.

I maintain attributing lack of makeup on women to malignancy is ridiculous and comparing it to the MSE shows lack of understanding of "appearance" on MSE.

 

[futuredo32]

I really feel like a lot of your posts are hyperbole. As far as I know, there is no study that suggests "most females do wear makeup." I know plenty who don't. In my circle of friends in college, I was one of the only ones who wore makeup daily and ALL of us had time to do it.

Every single resident at your second program was on medication? Did you ask them all? And if so, did you also ask if they were on it before? Did you also ask if it's nature of the work or the work at that particular place or medicine in general that caused them to seek meds? Because it's no secret that there's a problem in medicine, in general, and that many students, residents, and attendings are depressed. So saying that correlates to malignancy shows lack of acknowledgement of the problem at large. Finally working 120 hours a week on a psych inpatient unit? That's either major hyperbole or you were at one of the well-known sweatshops out there that are outliers to standard psych residencies.

I maintain attributing lack of makeup on women to malignancy is ridiculous and comparing it to the MSE shows lack of understanding of "appearance" on MSE.

Yes every resident at my 2nd program was on a medication and except 1 it started during residency and it was because the program was really malignant, many were in therapy too because of the program, they had get togethers that were essentially a support group. And yes I did work 120 hours one week. I have posted this in the past and two accidents and a ticket to show for it, other weeks it was 110 or 100 and when I did complain the attending said it wasn't my job to worry about ACGME requirements, but to just do my job and when I recorded my hours correctly I got an email from the program coordinator that I made an error and needed to correct it and when I didn't, someone else did so it didn't violate the ACGME rule. We only took call on inpatient rotations which were during our second year to start because it was a new program and the ACGME rule was passed the year the program started that a 1st year couldn't work alone but had to either work with an an attending or a second year, so there weren't many of us and one was on maternity leave and then when she came back, she didn't take call because it was deemed "unfair" to make her do so. We did 12 months of outpatient psychiatry the 6th-18th months of residency in our class. It was awful after our PD left, the interim PD was very nice and a great attending but he had zero experience as a PD or anything similar and unfortunately he was really passive, too passive to stand up for the residents. There is a new PD and I have heard things are much improved. And that was the better of the two psych programs where I did residency by far. I had no idea how malignant the second program was. What happened there was horrendous but of a personal nature and I wont share that here.

I am not basing my statement that most females wear make up on any study. I'm basing it on my personal observations. When I go out in public most females do wear make up- at work, at the drug store, the gas station, at events at the recent psych conference I attended, etc. I don't live anywhere posh either.
You are free to feel whatever you want about my understanding of the MMSE.

If you don't like my posts or feel they are hyperbole there is an ignore feature. Put me on ignore and you wont see a single one. I have started using it for people who I feel are rude and it's made my time on SDN better. I am honest when I post. I posted that it took three tries to pass the initial board certification. I am not the only one who failed on SDN and I know this because those who did fail - at least some, sent me a private message. I post that I don't want to stay in psychiatry and same thing, I get pm's from others in the same boat. Why don't they post? I am making an assumption, I didn't ask, but perhaps it's because some of you are so very rude in your replies and that is sad that they feel they can't post here. It's unfortunate that rude posts are allowed to stay here. It's unfortunate that some are so cruel in your replies. But not everyone here is rude, fortunately, which is part of the reason why I stay, the other reason is to give back to a forum that has at times been so helpful to me. This used to be such a very supportive part of SDN and rudeness was not tolerated. Real live human beings with feelings post and I am hoping that those who are rude here are kinder in real life.

To the OP I am again sorry this got off the topic of your original inquiry. I have interviewed a lot, more than most because my application is weaker than most and I have interviewed for IM and FP and though "girls wearing make up and doing their hair" was only a small part of my advice (but the aspect most commented on ) on the interview trail, I did find it to correlate with the happiness of the residents and workload of the program. I wish you well when you make your choice but I really do think you will just get a "gut feeling" at the programs that are a better fit for you. I did. As I stated before, had there not been negative changes at my initial program and had our PD stayed, it would have been a great residency program. And this is despite the fact that I realized early in my residency I wanted to leave psychiatry, but opted to stay and do a 2nd residency (it didn't used to be difficult to land a second residency in FP and after discussions with my attendings and my own psychiatrist, I thought that I liked psychotherapy enough to do some psychiatry and being a FP attending with the knowledge of a psychiatry residency behind me I would stay and be a better FP attending because so many patients see their PCP first for psych issues and some wont see a mental health professional due to the stigma that still exists.) I have posted all of the tidbits I have about what to look for in a program and therefore wont post on this thread further because I would like you to get as much input to your initial question as possible instead of having to mull through the responses to my statement about women and makeup/hair.

 

[Mass Effect]

^ We have widely differing definitions of the word rude. Giving my opinion on your opinion does not constitute being rude to me. It's the very definition of what a forum is all about. I'm sorry that you feel different.

 

[futuredo32]

^ We have widely differing definitions of the word rude. Giving my opinion on your opinion does not constitute being rude to me. It's the very definition of what a forum is all about. I'm sorry that you feel different.

I really meant for my last post on this thread to be the last post.
I didn't say you were rude, I am still seeing your posts and haven't ignored you. But your comments were not overall relevant to the OP. They were more directed toward me and my understanding of the MMSE, questioning my honesty (not rude but not appreciated). When I post here, which is less frequent now because of the less supportive nature that this part of the forum has become, I post truthful honest statements.

 

[Candidate2017]

I really meant for my last post on this thread to be the last post.
I didn't say you were rude, I am still seeing your posts and haven't ignored you. But your comments were not overall relevant to the OP. They were more directed toward me and my understanding of the MMSE, questioning my honesty (not rude but not appreciated). When I post here, which is less frequent now because of the less supportive nature that this part of the forum has become, I post truthful honest statements.

Not sure why you’re getting so much flak about this but I have found it to be true.

If residents are rocking heels, makeup, Prada purses, tanned, fit, talking about movies, their weekend plans and their kids’ soccer practice, then yes, it’s going to be very different than a program where residents have eye bags, are disheveled, dressed in sacks a wee bit too tight for their newly expanded waistlines from cafeteria food and stress eating, constantly checking their pagers and barely acknowledge each other. This is a generality of course as there are exceptions to the correlation between dress and work hours. Notably some IM and many surg subspecialty peeps are fit and well-dressed despite their hours.

 

[pbdoctor1]

I really meant for my last post on this thread to be the last post.
I didn't say you were rude, I am still seeing your posts and haven't ignored you. But your comments were not overall relevant to the OP. They were more directed toward me and my understanding of the MMSE, questioning my honesty (not rude but not appreciated). When I post here, which is less frequent now because of the less supportive nature that this part of the forum has become, I post truthful honest statements.

Your posts are honest, genuine, and appreciated. Most members support your candor and find it helpful. Thank you.

Not sure why you’re getting so much flak about this but I have found it to be true.

If residents are rocking heels, makeup, Prada purses, tanned, fit, talking about movies, their weekend plans and their kids’ soccer practice, then yes, it’s going to be very different than a program where residents have eye bags, are disheveled, dressed in sacks a wee bit too tight for their newly expanded waistlines from cafeteria food and stress eating, constantly checking their pagers and barely acknowledge each other. This is a generality of course as there are exceptions to the correlation between dress and work hours. Notably some IM and many surg subspecialty peeps are fit and well-dressed despite their hours.

The reason for the flak is because these are examples of logical fallacies by utilizing personal attacks and manipulation of the intended statement to distract away from the real argument and to trick others to agree. Politicians and trolls use this quite effectively to distract or distort from the intended argument.

Straw man fallacy: when someone argues that a person holds a view that is actually not what the other person believes. Instead, it is a distorted version of what the person believes.

Example: "futuredo32 thinks all women who don't wear makeup are in malignant programs." (trying to pretend she equates makeup as the sole attribute to determining malignant programs)

Hasty Generalization: claims too hastily made, hence they commit some sort of illicit assumption, stereotyping, unwarranted conclusion, overstatement, or exaggeration.

Example: "there's so many more good programs that are not malignant so essentially there's nothing to worry about! yay! " (we don't hear about or know of the number of malignant behaviors and it is extremely troubling and dangerous to an applicants career and mental health when they are in malignant programs)

Ad Hominem: attacking the character or circumstances of an individual who is advancing a statement or an argument instead of seeking to disprove the truth of the statement or the soundness of the argument.

Example: "futuredo32 is sexist and too foolish not to recognize that women who don't wear makeup aren't in malignant programs. I'm concerned about her capability to analyze patients as a psychiatrist."
(trying to discredit her and paint her as a sexist incompetent psychiatrist)

Example: "crooked Hillary" (it was an example off the internet)

Most of the responses above weren't intended to do this but some may have been. The worst part for a medical applicant is when they realize these tactics have been utilized to document "concerning behavior" by a malignant PD or program. These manipulative practices can be used to fire or black list residents and a common "strategy" to document a "pattern of behavior", "personality disorder", "lack of professionalism", "lack of competency", or "mental illness". In reality it's the response to the problems of the residency program or individual in power who compensates with malignant or threatening toxic abuse. Once again most residency programs don't do this but knows this happens in malignant programs. Any residency program director can do the same if they choose to. That's why the previous poster mentioned a PD as emperor GOD or the reincarnate.

 

[clausewitz2]

Your posts are honest, genuine, and appreciated. Most members support your candor and find it helpful. Thank you.



The reason for the flak is because these are examples of logical fallacies by utilizing personal attacks and manipulation of the intended statement to distract away from the real argument and to trick others to agree. Politicians and trolls use this quite effectively to distract or distort from the intended argument.

Straw man fallacy: when someone argues that a person holds a view that is actually not what the other person believes. Instead, it is a distorted version of what the person believes.

Example: "futuredo32 thinks all women who don't wear makeup are in malignant programs." (trying to pretend she equates makeup as the sole attribute to determining malignant programs)

Hasty Generalization: claims too hastily made, hence they commit some sort of illicit assumption, stereotyping, unwarranted conclusion, overstatement, or exaggeration.

Example: "there's so many more good programs that are not malignant so essentially there's nothing to worry about! yay! " (we don't hear about or know of the number of malignant behaviors and it is extremely troubling and dangerous to an applicants career and mental health when they are in malignant programs)

Ad Hominem: attacking the character or circumstances of an individual who is advancing a statement or an argument instead of seeking to disprove the truth of the statement or the soundness of the argument.

Example: "futuredo32 is sexist and too foolish not to recognize that women who don't wear makeup aren't in malignant programs. I'm concerned about her capability to analyze patients as a psychiatrist."
(trying to discredit her and paint her as a sexist incompetent psychiatrist)

Example: "crooked Hillary" (it was an example off the internet)

Most of the responses above weren't intended to do this but some may have been. The worst part for a medical applicant is when they realize these tactics have been utilized to document "concerning behavior" by a malignant PD or program. These manipulative practices can be used to end a residents career and a common "strategy" to document a "pattern of behavior", "personality disorder", "lack of professionalism", "lack of competency", or "mental illness" when in reality it's the response to the problems of the residency program or individual in power who compensates with malignant or threatening toxic means. Once again most programs don't do this but know this happens and can do the same if they choose to.

Oh, the Internet! only here do people post lists of fallacies and mistake them for compelling arguments: Argument from fallacy - Wikipedia

Many of the people giving futuredo32 flak were doing so because she made a sort of careless generalization with problematic implications, and when this was pointed out, just doubled down on it louder and refused to acknowledge anything might be wrong with the premises of the statement.

It is not an ad hominem attack to point out that someone has jammed their fingers in their ears and repeating themselves instead of engaging in a conversation.

 

[MedMan80]

Just avoid the slave/ime sweatshops , most residents will be honest about how programs are unless they are too scared to speak up. You should have a good sense at the end of the interview day, but the interview trail is draining so sometimes it may not show.

Ask about didactic she specific, ask who teaches the didactic, ask about call schedules, there’s a huge demand for psych and what’s easier than opening a program and using residents for cheap labor, which isn’t really wrong unless they don’t have the man power to teach them.

 

[Mad Jack]

I wouldn't waste your time worrying about this. Malignant psych programs are exceedingly rare.

Outside of NYC, anyway

 

[Mass Effect]

Not sure why you’re getting so much flak about this but I have found it to be true.

If residents are rocking heels, makeup, Prada purses, tanned, fit, talking about movies, their weekend plans and their kids’ soccer practice, then yes, it’s going to be very different than a program where residents have eye bags, are disheveled, dressed in sacks a wee bit too tight for their newly expanded waistlines from cafeteria food and stress eating, constantly checking their pagers and barely acknowledge each other. This is a generality of course as there are exceptions to the correlation between dress and work hours. Notably some IM and many surg subspecialty peeps are fit and well-dressed despite their hours.

I think had it been phrased that way, she wouldn't have caught flak. Her words were "were the girls wearing make up and had their hair done or did they have no make up and a pony tail ie they were too tired to take care of their appearance." Being disheveled and not wearing makeup are two different things and one has little to do with the other and people shouldn't assume that because a woman (any woman in any profession outside of modeling and theater) doesn't wear makeup means she's too tired to take care of her appearance. Could be her appearance is just fine without makeup.

@Mad Jack good point.

 

[675015]

Am I the only one who found the frequent use of MMSE (a mini-mental that does not reference appearance at all) instead of mental status exam mildly irritating?

 

[FFH]

Before I started interview, I asked the very same question to every resident and faculty whom I respect and trust...they all said to go with the "vibe". Now that I have some time to reflect after all the interviews, residents at some programs are certain more zesty and sparkly in spirit than those at others and it seems to have a lot to do with how much the residents are in control over their lives. If the residents have the time and the self-respect to dress up or down the way they want, it is certainly a good sign, but sometimes it's hard to tell whether it comes from self-love or peer pressure or culture. My friends from big cities in OK and FL totally have different definitions of what's "casual".
We all learn better when we are inspired and in control, so vibe is a big deal to me now, if not the biggest deal.

 

[mbgr2014]

Outside of NYC, anyway

Does this mainly go for the IMG heavy hospitals, or include places like Mt Sinai Beth Israel?

 

[Mad Jack]

Does this mainly go for the IMG heavy hospitals, or include places like Mt Sinai Beth Israel?

Can't say for sure

 

[NickNaylor]

My general advice to medical students:

1) Barring some kind of extraordinary circumstance, stick with university-based programs

2) Try and figure out what you're interested in and make sure the programs you're looking at have some degree of exposure to that thing

3) Don't look for the "most chill" or "most hardcore" programs - aim for something in the middle

4) Make sure to take your geographical preferences into account, especially if you're married, have kids, etc.

 

[aim-agm]

My general advice to medical students:

1) Barring some kind of extraordinary circumstance, stick with university-based programs

What about the university-associated programs, like Mt. Sinai Beth Israel or UCLA-Olive View?

 

[Amygdarya]

Does this mainly go for the IMG heavy hospitals, or include places like Mt Sinai Beth Israel?

IMG/FMG heavy. Mt Sinai Beth Israel is not malignant and not a sweatshop; in fact, the program boasts about their residents' work-life balance. (I've also heard first person accounts that even their medicine rotation is not bad in terms of hours.)

 

[Desired Member]

I wasn't saying they were EXACTLY the same. MOST females DO wear make up and LIKE to look pretty. In residency programs, and I interviewed heavily there WAS a correlation. And PERSONALLY there was a correlation. And actually at my 2nd program every resident was on some medication for anxiety or depression...………………………………..

Now you're just being offensive.

 

[TexasPhysician]

Moonlighting encouraged? Has anyone mentioned this because I found it immensely helpful to dip my toes in multiple real world jobs to help plan what I truly wanted to do after resi/fellowship.