Choosing a Residency program is a big decision and the choice can be a difficult one. Here are some questions we commonly hear from prospective residents:
What is the program’s ACGME accreditation status?
Our program enjoys full accreditation from the ACGME. In the most recent Letter of Notification, we were particularly pleased to once again receive the following commendation:
"The Review Committee commended the program for its demonstrated substantial compliance with the ACGME's Program Requirements and Institutional Requirements without citations."
Our next site visit is scheduled for 2019.
What kind of psychotherapy training is available in the program?
We are committed to providing excellent quality, comprehensive training in all aspects of clinical psychiatry. Currently, about 15% of the didactic curriculum is devoted to psychoanalytic therapy, 15% to cognitive and behavioral therapies, and 20% to other therapies (interpersonal, family, group, multimodal, etc.).
Formal psychotherapy training begins in PGY-1 with training in motivation interviewing and introductory material on psychodynamic psychotherapy. This is followed by an 18-hr PGY-2 seminar, "Theory and Practice of Psychodynamic Psychotherapy,” accompanied by individual psychodynamic supervision. PGY-3 includes a series of integrated didactic and supervisory mentorships on cognitive/behavioral therapy, dialectic/behavioral therapy, and interpersonal psychotherapy, followed in PGY-4 by mentorships in psychoanalytic therapy and family/couples therapy. Additional seminars during PGY-3 and PGY-4 cover multimodal therapy, treatment of personality disorders, grief counseling, and advanced topics in psychodynamic psychotherapy.
Residents begin treatment of patients with supervised psychodynamic psychotherapy during PGY-2 and continue these cases throughout residency. During PGY-3 all residents are expected to spend at least 5 hours per week seeing psychotherapy cases and receiving individual supervision. Additional time and patients are available to residents seeking more experience. Supervision is provided by full-time psychiatry faculty and practicing community psychiatrists with adjunct faculty appointments.
Many affiliated supervisors are training faculty for the Michigan Psychoanalytic Institute, who have generously provided time for supervision and didactic instruction of residents. Members of the Institute are involved in all aspects of curriculum planning in psychodynamic theory and practice.
Isn’t the University of Michigan a big, research-oriented, academic medical center?
Big? Yes. The Psychiatry Department includes over 180 full-time faculty and many additional affiliated psychiatrists, psychologists, social workers, and others. Yet the department feels more intimate than those numbers would suggest. Residents in the program have ready access to the entire faculty for supervision, consultation, informal advice, or just to talk about what they are up to. A strong mentorship atmosphere in the department encourages close relationships among all faculty and between faculty and residents.
Research-oriented? Yes. The department has an exceptionally strong research program, including both basic science and clinical investigation. Research grants currently total more than $20 millionannually, placing the department among the top 10-15 recipients of NIMH funding nationally. Nevertheless, we are fundamentally a clinical department. Most faculty are primarily clinicians and even most of the laboratory-based researchers are scheduled for clinics every week, devoting a significant portion of time and effort to direct care of their patients. This arrangement reflects both the interests of the faculty and the philosophy of the department, and it ensures that every member of the faculty and every research project have close ties to the front lines of clinical care.
Academic? Yes. The department stands at the cutting edge of clinical practice and basic research, with faculty of national and international reputation leading the way. Education is among our highest priorities and we offer innovative training programs unsurpassed in the academic world. Nevertheless, although we provide tertiary care for all of Michigan and much of the Midwest, we are primarily a clinical training program and a community health resource. We provide physician service to local community mental health and primary care clinics, and we staff outpatient programs throughout the area. Over 90% of our patients consider us their primary mental health providers.
What is the patient population like?
A recent review of our patient population showed a remarkable diversity of ethnicity, socioeconomic and education level, age, and diagnosis. In fact, the demographics of our patients correspond closely to the population of southeast Michigan in particular, and the nation in general. The many levels of clinical service we provide, including to community mental health, managed care, private and group insurance plans, and others, brings a broad spectrum of patients into our care. We are a public hospital and the designated provider of emergency and inpatient care for community mental health. About 50% of our patients are sponsored by public programs such as MediCare, Medicaid, or the Washtenaw Health Plan, a local program providing healthcare coverage to indigent and underinsured patients.
Are residents required to do research?
The ACGME requires that residents be involved in “scholarly activity” and be trained in “research literacy,” including habits of intellectual inquiry, critical thinking, and informed analysis of the literature. We address this through formal didactics in how to read and appraise clinical research studies and with a faculty mentorship program to assist residents with the development of an individual scholarly project of their own design. Over the past few years, such projects have included new research, systematic reviews of existing studies, published case studies, development of clinical guidelines, creation of new training materials, organization of outreach programs, and other projects of interest to the resident.
In addition, opportunities to conduct research are available for interested residents. We do not expect that most residents will engage in formal research, but innumerable opportunities to become involved in projects present themselves across the years of training and many residents find their interest piqued at some point. A high percentage of the residents have published or presented at national meetings before graduation.
For residents anticipating an academic career, we have two specialty tracks to prepare them for success as faculty members. The Research Track is for residents aiming for tenure-track positions focused on grant-funded research. The Clinical Scholars Track prepares residents for an academic career focused on education, clinical work, or other scholarly activity.
Where do residents go after graduation from the program?
Anywhere they want to go. Training at the University of Michigan is universally recognized as of the highest caliber and our graduates are well received at academic and clinical centers across the country. About a third of our graduates choose to stay in or around Ann Arbor, a third elsewhere in Michigan or surrounding states, and a third are scattered throughout the country. Nearly 40% of our graduates enter academia; more than 60% go directly into clinical practice. Over 70% of our graduates have elected to continue training in a fellowship program prior to either academic or clinical careers. Graduates of the program following each of these paths have consistently reported that they were well prepared clinically and academically for the challenges that awaited them.
How do residents perform on the board exams?
Our graduates have an outstanding record on the ABPN certification examination. Nearly all (97.2%) of our graduates have chosen to sit for the ABPN examination over the past 10 years, 100% of whom passed on the first attempt. More specifically, since the current examination was implemented in 2011, all 77 of 77 University of Michigan candidates passed on the first attempt. (For comparison, the ABPN reports that the overall pass rate of its candidates nationally is 89.5%.) This perfect record is a reflection both of the caliber of our residents and the quality of the teaching they receive.
How sensitive is the program to personal and family issues?
The program is attentive to the interests and well-being of every resident. We have a generous contract negotiated by the House Officer Association on behalf of all University of Michigan residents. All residents enjoy liberal personal and family leave policies, including paid maternity and paternity leave. The Psychiatry Program also offers flexible scheduling, a high level of personal support, night-float rotations to minimize overnight call, and other innovations to accommodate the many demands of personal and family schedules. It should come as no surprise that our residents express a high level of satisfaction with their training experience.
How competitive are Michigan’s salary and benefits?
The University of Michigan offers highly competitive salaries and tremendous benefits to our residents/fellows. An overview of salary, benefits and employment eligibility is available on the GME Office website, under “Prospective Residents/Fellows”.