what would you do?

[MDgonnabe]

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hello, folks! hope all's going well for those of you ms 4's caught in the throes of the final crunch towards the rol submission deadline. i'm personally finding myself in a slight dilemma and would appreciate any insight/advice. the situation in general is such:

say you want to practice psych in region x of the country. you also know you want to do c-l psych after a fellowship in region x's residency program. problem #1: region x's residency program is pretty gosh darned competitive, and your chances of getting a spot are slim at best. however, that competitive program has a branch program which is much less competitive and allows you to train at the more competitive program for your first two years (when you'd be doing c-l, anyway). problem #2: the less competitive program ships you into a very rural environment for your final two years. would you choose to go to the less competitive program affiliated with the competitive program, or would you go elsewhere altogether for your residency and hope you can somehow get back to region x's fellowship and learn the ropes of region x's psych environment down the line? if you don't feel comfortable discussing this via post, please feel free to pm me! my head's ready to explode over all this. 🙂

 

[OldPsychDoc]

Either option could work, but especially if you are pretty sure you want to stay in this region and go after Top Program's fellowship, I'd rank the Affiliated Program second (after Top Program--don't count yourself out!) simply because it will give you a chance to start out "connected" and improve your likelihood of coming back. The rural piece might end up being good in the long run. (Is this Washington, perchance?)

hello, folks! hope all's going well for those of you ms 4's caught in the throes of the final crunch towards the rol submission deadline. i'm personally finding myself in a slight dilemma and would appreciate any insight/advice. the situation in general is such:

say you want to practice psych in region x of the country. you also know you want to do c-l psych after a fellowship in region x's residency program. problem #1: region x's residency program is pretty gosh darned competitive, and your chances of getting a spot are slim at best. however, that competitive program has a branch program which is much less competitive and allows you to train at the more competitive program for your first two years (when you'd be doing c-l, anyway). problem #2: the less competitive program ships you into a very rural environment for your final two years. would you choose to go to the less competitive program affiliated with the competitive program, or would you go elsewhere altogether for your residency and hope you can somehow get back to region x's fellowship and learn the ropes of region x's psych environment down the line? if you don't feel comfortable discussing this via post, please feel free to pm me! my head's ready to explode over all this. 🙂

 

[MDgonnabe]

(Is this Washington, perchance?)

yes it is, opd. you're too good. 🙂 i fell in love with seattle a while back and want to do c-l in the vicinity. i figure that it couldn't hurt for the faculty at uw to get to know me through my first two years when it comes time for fellowship interviews. but even in the spokane track itself, i'd enjoy the opportunity to go out onto indian reservations and whatnot, really dig in and help needy communities out. the people are wonderful at both programs.

 

[Solideliquid]

hello, folks! hope all's going well for those of you ms 4's caught in the throes of the final crunch towards the rol submission deadline. i'm personally finding myself in a slight dilemma and would appreciate any insight/advice. the situation in general is such:

say you want to practice psych in region x of the country. you also know you want to do c-l psych after a fellowship in region x's residency program. problem #1: region x's residency program is pretty gosh darned competitive, and your chances of getting a spot are slim at best. however, that competitive program has a branch program which is much less competitive and allows you to train at the more competitive program for your first two years (when you'd be doing c-l, anyway). problem #2: the less competitive program ships you into a very rural environment for your final two years. would you choose to go to the less competitive program affiliated with the competitive program, or would you go elsewhere altogether for your residency and hope you can somehow get back to region x's fellowship and learn the ropes of region x's psych environment down the line? if you don't feel comfortable discussing this via post, please feel free to pm me! my head's ready to explode over all this. 🙂

Enjoy Spokane...lol I did not get an interview from them, but I would have ranked them pretty high on my list.

 

[MDgonnabe]

Enjoy Spokane...lol I did not get an interview from them, but I would have ranked them pretty high on my list.

you didn't get an interview? they told me they had a lot of cancellations this year, probably at the last second, which is a huge shame. at any rate, for some reason everyone i speak with about this is all "eeew spokane. don't do that to yourself!" i admit, spokane's not exactly the liberal, cultural mecca most of the other cities of the world are. but #1: it's a lot cheaper than most other residency locations. #2: it's safer. #3: it presents a unique clinical scenario not everyone's trained in. #4: it's still within traveling distance of seattle. #5: lots of moonlighting opportunities. #6: NO CALL. #7: it's not like i'll be spending all 4 years let alone forever there. #7: helping underserved regions of the country. #8: ZIM!!!!!!

 

[Solideliquid]

you didn't get an interview? they told me they had a lot of cancellations this year, probably at the last second, which is a huge shame. at any rate, for some reason everyone i speak with about this is all "eeew spokane. don't do that to yourself!" i admit, spokane's not exactly the liberal, cultural mecca most of the other cities of the world are. but #1: it's a lot cheaper than most other residency locations. #2: it's safer. #3: it presents a unique clinical scenario not everyone's trained in. #4: it's still within traveling distance of seattle. #5: lots of moonlighting opportunities. #6: NO CALL. #7: it's not like i'll be spending all 4 years let alone forever there. #7: helping underserved regions of the country. #8: ZIM!!!!!!

LOL, I agree with #8!

Seriously, it's a good program, and Spokane is not that bad...then again if you have a family asking them to move to a new town halfway into your residency can be veeery messy.

 

[MDgonnabe]

LOL, I agree with #8!

Seriously, it's a good program, and Spokane is not that bad...then again if you have a family asking them to move to a new town halfway into your residency can be veeery messy.

well, that's not an issue for me as i'm happily single and have no kids. i can't even honestly imagine why anyone with a family would want to be at uw period. i mean, that place is intense. the im program there was on probation for hours violations this past year. the fact is: go there and you're never going to see your kids or spouse your first two years. also, the city's just like any city, that is to say expensive and not exactly conducive to family life. moving elsewhere would be the least of your concerns and probably in your best interest if you had a family.

 

[Solideliquid]

well, that's not an issue for me as i'm happily single and have no kids. i can't even honestly imagine why anyone with a family would want to be at uw period. i mean, that place is intense. the im program there was on probation for hours violations this past year. the fact is: go there and you're never going to see your kids or spouse your first two years. also, the city's just like any city, that is to say expensive and not exactly conducive to family life. moving elsewhere would be the least of your concerns and probably in your best interest if you had a family.

I knew they had some problems with their IM program, but I didn't think their psych program was so demanding..

 

[MDgonnabe]

I knew they had some problems with their IM program, but I didn't think their psych program was so demanding..

one of the faculty who interviewed me mentioned that, for whatever the reason, there's less funding for western residencies. thus there are far more patients per resident out west than east. this is across specialties. i know the psych portion of the uw program isn't nearly as hard as the med months. even still, the residents were plainly tired during my and others' interviews there so... make what you will of it.

 

[Solideliquid]

one of the faculty who interviewed me mentioned that, for whatever the reason, there's less funding for western residencies. thus there are far more patients per resident out west than east. this is across specialties. i know the psych portion of the uw program isn't nearly as hard as the med months. even still, the residents were plainly tired during my and others' interviews there so... make what you will of it.

Well, thanks for the insight! I was going to consider them for the scramble if I didn't match.

Good thing I won't now because I am looking for a laid-back residency.

 

[MDgonnabe]

Well, thanks for the insight! I was going to consider them for the scramble if I didn't match.

Good thing I won't now because I am looking for a laid-back residency.

that's the weird thing about it. from what i've heard about western programs, it seems as though the people are in fact more laid back. seeing as i'm in med school on the east coast and did a rotation away on the west, i can personally attest to this as well. maybe it's mainly the uw system that the interviewer was referring to seeing as they cover a 5 state area. kinda crazy if you ask me, yet the system still somehow survives. i think your best bet would be to look into the programs which weren't filled in the past few years, get in touch with residents there, and ask them about their patient workload since i'm sure it's highly variable from program to program regardless of geographic considerations.