We know our core program values and we pivot towards these as we think about the training culture and content in this program.
Why choose this smaller, emerging community academic program? Well, firstly, because your priority is that of being a clinician, and even more, if you are interested in developing skills as a clinician educator. In this underserved area of the United States, we believe we have a responsibility to leverage our expertise as psychiatrists to educate patients, primary care providers, and the larger community. As such we have a significant focus on consultation liaison psychiatry, both in the hospital setting and in high fidelity collaborative care psychiatry. Our residents get training what we believe to be models of the future in addressing access to mental health care for the majority of patients, especially those that are underserved. We require longitudinal collaborative care training as well as rural telepsychiatry training. We also provide required rotations in medication assisted treatment for addiction disorders, and motivational interviewing training that is coded to fidelity.
We recognize the dilemma of shortage of psychiatrists but firmly believe that moving psychiatrists to the role of “providers” practicing medication management is not the solution. Our program has a deep commitment to the importance psychotherapy has in patient care, and embeds this training across PGY years, starting in PGY1 with faculty who introduce supportive therapy, motivational interviewing and CBT on hospital based services, and expanding developmentally beyond that to CBT, ACT, full supportive therapy seminar, MI, psychodynamic therapy training, group therapy, harm reduction therapy and more. We are known for training in intensive short term dynamic therapy, and have 2 master educators in this area. Therapy training includes seminars, videotaped therapy supervision, personal psychotherapy requirements in residency, and the opportunity to watch psychotherapy experts in action doing therapy on real patient cases.
Our faculty are exceptional – it has been very important to us to hire a psychiatrists specifically invested in teaching, and lifelong learning, with a commitment to continuous improvement. We have faculty from a diverse set of training sites, bringing in a variety of perspectives, skill sets and interests, to enhance the content and viewpoints in our program.
We have a growth mindset. We believe that it is critical to know about our deficits, so that we can improve. We have sought and responded to feedback, and we track outcomes yearly in our resident surveys. Our program aims for transparency; we believe that our residents are the people who can bring us the most valuable information about our program quality, and environment, and we will continue to work to create good interpersonal working relationships based on trust.
We are flexible and nimble in our ability to respond to feedback, and to changes in rotation availability. That’s the joy of working in a smaller community, with an institutional sponsor who allows us to grow and create new training paradigms without a lot of structural barriers.
We aim for creativity in our interactions, with each other, learners, and in our educational paradigms. We have been able to develop some imaginative training options because we embrace change and imaginative ideas – digital therapy options for treatment, low threshold, harm reduction approaches for addiction disorders, homeless clinic for patients with severe mental illness.
We have worked to develop compassion in our program, in terms of the concern that we show for each other, in our working environment. We are well aware of the high levels of burnout in physicians, and over the past few years we have moved away from individual solutions for burnout and much more towards looking at system problems and solutions. We have changed our approach to problems such as work and educational hours, making rotation changes such as removing required intern medicine night float, to pivot to a place of understanding, involving residents openly in this discussion.
We actually want work to be fun, because it’s much more fun when it’s that way. We have a great group of residents who come to work, ready to pitch in and be part of the team, but speak up for themselves, and prioritize their families and outside adventures. Taking care of our health as physicians is important, and as such we hope that we have created a culture where residents and faculty are encouraged and can actually attend the medical appointments that keep us healthy. We want our staff, residents and faculty to have purpose and meaning in their work and believe that this is possible only when we are taking care of ourselves well.
Our program has an intentional focus on mastery – this is a small program and as a resident, you will not get lost in the group. The other side of this is that you will be held accountable for learning the skills, attitudes and knowledge essential in becoming an excellent psychiatrist. Development of competence is a responsibility that we as educators have to both you as a resident, but also the patients who will be cared for you in the many years to come.
