From the Residents to Applicants: A Unique Training Environment
Creating a rank list of programs can be a daunting task! And perhaps even more so during this era of virtual interviews, as our “gut feeling” for a program is based on less experiential data than prior to the pandemic. Looking at individual programs, there are many factors to consider, including the strength of clinical training, the exposure to a variety of training opportunities, the camaraderie between attendings and residents, the level of supervision, and the physical environments where you spend your time. Aside from the quality of the program itself, there are also more personal aspects to consider. Location may be important including proximity to loved ones, recreational opportunities, climate, and housing opportunities.
All these factors (and more) are important to consider as you make choices about where you would like to invest 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 that we believe make 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. We even have free parking on site which many programs do not have. 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 picked out by the residents and purchased by the program. We primarily use the electronic health record system Epic in our inpatient and outpatient settings.
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 (one of two community mental health sites where PGY-3 residents rotate) and Vermont Psychiatric Care Hospital (the state hospital for Level 1 involuntary patients where PGY-2 residents may choose to rotate). These sites are a 40-45 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. In the PGY-2 year, residents begin pursuing weekly meetings with their first psychotherapy patient as well as an assigned psychotherapy supervisor. Residents follow patients longitudinally across their PGY-3 and 4 years, 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 residential treatment program for substance use disorders at the VA hospital in White River Junction (mostly remote except for commuting one day a week) and some residents have their PGY-3 outpatient continuity clinic at Burlington Lakeside VA Clinic.
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
Our program uses a wide range of tools and platforms to track the residents’ progress and clinical aptitude and facilitate our development into 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-training exam is taken yearly, as are clinical skills examinations. 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 psychopharmacology lectures. Residents are encouraged to attend outside educational conferences (including APA, AACAP, and Psych Congress), for which education days and education funds may be 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.
The call schedule is reasonable and flexible. We have a night float system (Sunday through Thursday 8pm-8am) in which PGY-1 and 2 residents do a total of one month and PGY-3 residents do approximately 12 shifts 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 PGY-2’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 PGY-4 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.
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 10 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 their 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 whom we know on a first name basis!