From the Residents to Applicants: A Unique Training Environment
Creating a rank list of programs can seem like a daunting task! Looking at individual programs, there are many factors to consider, including: the strength of clinical training; the exposure to a variety of training environments; camaraderie between attendings and residents; the level of supervision; and the physical environment where you spend your time. These factors become surprisingly important during the 1461 days of your residency training!
Aside from the quality of the program itself, there are also more personal aspects to think of. Location is important to many people, especially when considering proximity to loved ones, recreational opportunities, climate, and housing opportunities.
As residents of the Psychiatry Residency Program of the University of Vermont Medical Center, we have compiled a list of what we think are the best attributes of our program. This is not an all-inclusive list, but it does detail the key aspects which highlight what we believe makes this program special.
New Facilities and Old Affiliations
Our training takes place in modern inpatient and outpatient facilities located within a tertiary medical center in beautiful downtown Burlington, overlooking Lake Champlain. There are comfortable resident workstations and spacious conference rooms located on each of the inpatient psychiatry units. Electronic medical records are widely used in the inpatient and outpatient settings. As third and fourth year residents, we have private offices located at the University Health Center campus, which is a five-minute walk from the main hospital. Many of these offices have a spectacular view of Lake Champlain, and all of the offices are adorned with artwork and furniture picked out by the residents and purchased by the program.
Other training sites are geographically clustered so that residents can move between assignments and clinics in a matter of minutes. Two exceptions are Washington County Mental Health and Northwestern Counseling and Support Services, which are two of the four available community psychiatry locations during the third year of training. These sites are a 30-45 minute drive from Burlington, for which residents are reimbursed for mileage and parking is free.
Continuity clinics are a core part of residency, and training in psychotherapy begins early. Residents start seeing a psychotherapy patient and are assigned a psychotherapy supervisor in their PGY2 year. This is continued and expanded upon in the PGY3 and 4 years. Residents follow patients longitudinally, and see a broad variety of diagnoses in adult, child, and geriatric populations. Residents also have the opportunity to work with the Veteran population through our affiliation with the Veterans Affairs (VA). Residents rotate through the inpatient addiction unit at the VA hospital in White River Junction and some residents have their PGY3 outpatient continuity clinic at the VA’s Community Based Outpatient Clinic in Burlington.
The community mental health agency in Chittenden County, known as The Howard Center, offers excellent clinical and residential programs, as well as comprehensive case management options. The crisis service is staffed around the clock with master’s level clinicians who assist residents in psychiatric screening and disposition of all emergency cases.
Education Takes Precedence
The program uses a wide range of factors to track the residents' progress and clinical aptitude to help us graduate as highly competent clinicians. 360-degree evaluations allow us to best examine our strengths and weaknesses in the eyes of our peers and supervisors. The psychiatry residency in-service training exam is taken yearly, as are clinical skills examinations, so that we are prepared for ABPN Board Examinations after residency. Mentors are always available and willing to help us in achieving our competency goals.
Other educational opportunities include Journal Club, Grand Rounds, Board Preparation Study, Morbidity and Mortality conferences, psychotherapy seminars, and "Combined Rounds" during which residents and students observe an attending physician perform a psychiatric interview on an actual patient. Attending outside educational conferences are also encouraged, for which education days and education funds are allocated.
Routine Competency Assessments
In addition to the above educational evaluations, the competency of the program as a whole is assessed by residents in detail at our bi-annual resident retreats. During these fun gatherings, feedback on each individual rotation is compiled by the chief resident and is anonymously provided to the program director. The program director in turn creates an action plan to ameliorate each and every one of the resident concerns, and this is collated into a document and provided to the residents in a transparent manner.
Call is Humane
The call schedule is reasonable and flexible. We have a night float system (Sunday through Thursday 8pm-8am) in which PGY1 and 2 residents do a total of one month and PGY3 residents do approximately 12 days of night float per year. Additionally, we have a weekday short call system that runs Monday through Thursday from 5pm-8pm and our Friday night call shift is from 5pm to 8am Saturday. Because Friday is a 24-hour shift and can be busy, we only schedule PGY2’s and 3’s for these shifts. Weekend call coverage is provided in 12-hour blocks. The average monthly call consists of 1-2 short call shifts and 1-2 weekend call shifts. Residents trade and adjust calls to meet personal needs and rarely have difficulty in doing so. The PGY4 year is entirely free of call, unless there is an emergency, with the exception of supervisory calls with first-year residents early in the year.
Faculty are Highly Accessible
The core faculty members, including the chairman, medical director, residency director, medical education director, and clinic leaders are highly invested in training residents. Every faculty member takes night and weekend call in support of the resident on duty. This allows for ample exposure to each faculty member and his/her teaching style. Daily rounding with attendings and the multidisciplinary team on the inpatient psychiatry units fosters many teaching opportunities and a high standard of patient care.
The residency director and program administrator are deeply committed to the program and work tirelessly to maintain a high standard. Residents feel supported, and the program director and administrator always have an open door! Residents are also key participants in recruitment efforts and advise the director on candidate selections each year.
Many communities within Vermont are underserved, which results in ample opportunities for residents to remain in the area and practice psychiatry at the completion of their training. Referring hospitals and clinics regularly hold recruitment events for regional placements. In addition to the child psychiatry fellowship opportunity within our department, there is a four-year psychoanalytic training program in Burlington that became available in the fall of 2011.
Our group of residents feel that being in a small program is a strength, as we all get to know each other well and have a genuine respect for one another. This is also true of our relationships with faculty, many of which we know on a first name basis!
Meet the Residents