FREQUENTLY ASKED QUESTIONS

General FAQs

New Developments

International Medical Graduate, (IMG), FAQs

FAQs and answers contributed by Residents

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General FAQs

1.     Is the residency program accredited by ACGME?

 We are a fully accredited program.

2.      Is WPIC a “biological” program?

WPIC is on the cutting edge of combining psychotherapy and psychopharmacology in the treatment of major psychiatric disorders, and thus ascribes to no one school of thought. There is as much research conducted at WPIC in psychotherapy as pharmacotherapy. Research Programs at WPIC are part of a balanced portfolio spanning neuroscience, pharmacology, social psychiatry and psychotherapy.

In accord with this the training program takes a balanced (not just eclectic) approach to patient care, on a continuum between the largely biological approaches at one end and purely psychosocial approaches at the other, responsive to the individual patient’s needs on that continuum.  The needs of patients are continually assessed and evidence based treatments and management strategies utilized to optimize outcome for the patient.

3.      Do residents get enough exposure to psychotherapy?

There is a strong commitment in the program to the development of sound psychotherapeutic skills, across all modalities of therapy, even in an era of diminished coverage for such services.  We believe that psychotherapy is a powerful educational experience and aids significantly in general psychiatric competence.

Dr. Karen Katunich, PhD, is the Director of Psychotherapy Training at WPIC.

Training exists for brief psychotherapies [Interpersonal Psychotherapy (IPT) & Cognitive Behavioral Therapy (CBT)], family and group therapy, Dialectical Behavioral Therapy (DBT), Motivational Interviewing and Supportive Psychtherapy

Longitudinal Psychotherapy training is overseen by the Clinical Training Committee which is devoted solely to resident education.  Residents first begin with lectures on psychotherapeutic principles during PGY-1 and PGY-2, followed by case assignments commencing in the middle of PGY-2. 

Longer term psychodynamic therapy remains an excellent training experience. One long term case can be assigned through the Clinic without Walls (a collaboration between WPIC and Pittsburgh Psychoanalytic Institute).

Residents have the opportunity to choose supervisors, and there is a wealth of full time & voluntary faculty available for supervision, including analysts associated with the Pittsburgh Psychoanalytic Institute. 

The Resident and Psychology Intern "Psychotherapy Training Clinic" commenced on July 1 2006. This is a flat fee training clinic which is supported by WPIC and greatly simplifies access to suitable patients for all therapy modalities.

The PIT, (Psychotherapy in Training), program is a mechanism by which residents, as part of their training, can obtain their own psychotherapy at a greatly reduced cost with some of the City's best providers.

4.      What is the balance between service needs and education?

WPIC and Residency Training are uniquely devoted to ensuring that residents’ education is their primary goal: by providing protected educational time, caps on patient load, and continuous evaluations of clinical teaching sites. 

5.      Is there an opportunity for residents to get involved with research?

There are multiple opportunities to become involved in research, although this is by no means a graduation requirement.  For interested applicants, a research track program provides significant time during residency devoted to research.  Residents can apply for research track any time prior to their 3rd year.  All residents have the opportunity to involve themselves in ongoing research, and to pursue research fellowship training as early as the PGY-4.

 6.     Do residents stay at WPIC to eventually join the faculty?

Up to one quarter to a half of graduating residents join WPIC as faculty.  Some residents stay on as clinical or research fellows, subsequently joining the faculty.  Many others remain in the area, affiliated through voluntary faculty status.  WPIC is eager to hire WPIC housestaff as faculty.

7.      Women in the program?

Diversity is always our priority and for the past 5 years at least 45% of our entering Residents have been female.  WPIC is in the forefront of established and developing programs in the area of women’s issues in psychiatry.  There are several prominent women faculty in clinical, research, and administrative arenas.  They are always available for mentorship or informal discussions.

8.      What is the balance between inpatient and outpatient training?

There is a good balance between the two.  The curriculum combines concurrent inpatient and outpatient experiences beginning in the PGY-1 (half-day outpatient/wk), and C/L psychiatry rotation is now during PGY-2.  Thus, all of PGY-3 is an outpatient experience, including long-term psychotherapy.

9.      What is call like?

In-house call is limited to PGY-1 and 2 in the General Program.  Average is 1 call/6 days at WPIC in PGY-1.  PGY-2 residents have call roughly every 10 to 12 days. Weekend floor calls are 24 hours and Emergency Room, (DEC),  calls consist of 12-hour shifts (8:30-8:30).  Both PGY-1 and PGY-2 residents and can leave post-24 hour call, at noon.  If not on call, residents have the weekend off.  Faculty back-up is always available.

10.      What is medical back up like?

We have our own medical and laboratory service comprised of a family medicine doctors, pediatricians and geriatricians.  In addition, sub-specialty consultation is available through UPMC.  Physicians are also available at night for phone consultation, or patients can be transferred to UPMC Presbyterian, next door, for urgent/emergent evaluation.  Medical emergencies are managed by the psychiatric housestaff, with assistance from the code teams from UPMC Presbyterian, who also respond to these.

11.      What is medicine/pediatrics like?

Medicine is a 6-month rotation comprising 3 months Family Medicine at St. Margaret's Hospital 1 month of MCPP, (Medical Care of the Psychiatric Patient, Medical Director, Dr. Linda Haynes), and 2 months of Neurology.  There is no call in adult Neurology.  Call is approximately every 4 nights in at St. Margaret's.  Most residents regard the internship as an excellent and collegial experience, where WPIC interns are integral and respected members of the medical team.

For combined child/adult program interns, Pediatrics is a 3-month rotation at Children’s Hospital, and call is every 4th night.  Residents also do 1 month of MCPP and 2 months Neurology, (1 month in child neurology and 1 Month in adult neurology).  This is likewise considered an excellent and collegial experience.

12.      Do residents have to opportunity to formulate treatment plans for their patients or do they carry out plans dictated by attendings?

Attendings will allow as much autonomy as residents feel comfortable with, and commensurate with the resident’s level of skill.  Developing leadership skills is integral to the training program.

13.      What are the core lectures like?  Are they a good preparation for the boards?  Do residents have the opportunity to attend lectures?

Lectures cover all the basics, in addition to special areas of expertise* given by leaders in the field.  These are also designed to be preparatory for the Boards (WPIC has very high pass rate).  The curriculum allows weekly protected time of 4 hours for regular classes, 1 hour for a Facility Wide Journal Club, 1-2 hours of case conferences, and 1 ½ hours for Grand Rounds.

*Short-term therapies, psychopharmacology, neurosciences, imaging, etc.

14.      Accessibility to the Chairman?  Training Directors?

The Chairman attends monthly meetings with residents and is involved in case conferences and lectures, and is available at all times for individual discussions regarding developing academic careers. 

The Training Director and Co-Directors meet regularly with Residents individually to assess training needs and goals. There is active collaboration between Training Directors and Residents in all facets of the training program coordinated through regular business meetings. The Training Director and Co-Directors also have a strong pastoral role and are always available for help and advice.

15.      Are resident concerns and opinions taken seriously by administration? 

Yes.  Residents meet weekly for housestaff meetings to discuss issues among themselves, and the housestaff officers represent these views in appropriate faculty forums.  Housestaff officers and class representatives meet with training directors monthly.  In addition, resident representatives meet regularly with the chairman and service chiefs to informally address issues.  Finally, the annual Resident Retreat generates suggestions for change that are rapidly incorporated into the program, emphasizing the responsiveness of the institution.  Residents serve on all major academic & administrative committees.

16.      How is the Institution developing?

Like all medical centers, health care reform is a key area in the developing mission of WPIC.  We are at the forefront of defining and developing viable mental health care systems for today’s climate of managed cost.  WPIC programs are expanding and include many new sites in communities and affiliated hospitals.  The residents are integrally involved in problem-solving new challenges with faculty and administration. 

The influx of new faculty, and particularly the presence of many former residents, speaks to the vigor of the Institution.

17.      What do graduating residents do?

In the last few years, approximately a fourth to a half of the graduating class joined WPIC as Faculty.  Some joined clinical or research fellowships (geriatrics, research, etc.) and the rest went into practice.  No one experienced difficulty in finding jobs.

18.      Are residents happy?  Do they do things as a group?

Yes, the level of enthusiasm for learning and education is infectious. Please feel free to ask our Residents or watch and hear them on video.

There are an increasing number of happy hours, holiday parties and casual get-togethers with faculty.

19.      What is Pittsburgh like? (Activities, climate, cost of living etc)

Pittsburgh has a very high quality of life, and was recently voted, "America's most livable city", by "Places Rated Almanac". Pittsburgh is a town of education, home to 17 Colleges and Universities. It is a very manageable city with a rich cultural life, some of the nation's best museums, first class ballet, theater and symphony, and a burgeoning Restaurant scene.

Have a look for yourself    A New Vision.  A New Tomorrow  a great video about Pittsburgh and UPMC

Located just an afternoon drive away from Washington DC, New York City and Toronto, we think of ourselves as an East Coast City with Mid-Western Hospitality. In addition to all of this, the airport provides excellent transport links with the rest of the US and is only about 30 minutes drive away from WPIC.

20.      Where do residents live?

Rental apartments are plentiful in Shadyside and Squirrel Hill within the city (5-10 minutes away).  Housing is very affordable in Pittsburgh, and residents frequently buy homes/condos.

21.      Where do residents park?

University of Pittsburgh provides a variety of parking lots.  All are 5-10 minutes away. Residents park at WPIC free of charge while on call. We do not subsidize parking but have, instead, increased the annual educational stipend available to each resident.

22.    Does WPIC support and train residents who are interested in teaching?

Absolutely. Residents have a significant educational role at the University of Pittsburgh, and WPIC values this mission, which is also an ACGME requirement. The most important teaching role for residents has been teaching third-year medical students during their clinical clerkship on psychiatry; residents are also involved in other clinical and elective experiences with medical students, and many serve as small group facilitators in preclinical courses or as mentors for students interested in psychiatry as a possible specialty. Some lecture to medical student audiences on a variety of topics, or created educational materials (quizzes, websites) to further the teaching mission of the department. Residents receive much formal and informal feedback on their teaching efforts, and this information is reviewed in annual meetings with the training director.

Residents teach other trainees and students in a variety of settings, most prominently during WPIC-wide journal clubs and clinical grand rounds, where they work with faculty advisors on how best to teach. We plan on expanding the formal feedback given to residents following their teaching, in the hopes of helping residents improve quality over time.

The department supports the teaching mission in other ways. In previous years, we have run a series of workshops on a variety of topics related to education: learning styles, giving feedback, teacher/learner roles, the five “microskills,” and the “challenging” learner. We have incorporated this material into required curricular offerings for PGY-I and higher residents as part of the "Residents as Teachers" program with additional topics (e.g., “How to give a lecture”) for interested residents.

This is now complimented by the AACE Track.

23.      What are the strengths of the program?

Enormous resources (clinical, research, library, medical center, etc.). Perhaps the largest array of clinical services for a University based psychiatry program in the Country.

Wonderful collegial atmosphere.

Proactive stance with regard to changing health care models.

Good balance between clinical and research training.

Specialized inpatient and outpatient services most within a few blocks of WPIC.

Highly proficient resident peers.

One year, flexible, elective time.

24.      New developments/changes in the Program over the last year?

July 2007 – Curriculum revision. In PGY1 we changed the emphasis of the “Introduction to Psychotherapy” course in line with resident feedback. We introduced a larger didactic component on terminology and a standardized patient portion on engagement skills. Feedback has been excellent. PGY4 psychotherapy didactics changed to include a revision of core concepts and how psychotherapeutic theory can be implemented in real world practice. In addition a service based 12 week formal interview skills training course was started during the PGY1 Psychiatry ER (DEC) rotation.

July 2007 - New “Chief Resident for Education” role initiated with oversight on resident driven educational initiatives and the Residents as teachers program, in addition to the written and oral boards revision courses. Concept presented at AADPRT meeting in March 2008.

August 2007 – Completion of the second “WPIC Summer School”. Community Care Behavioral
Working with the CCBHO managed care company formulated an eight lecture series on managed care for psychiatrists.

September 2007 – Special Course – working with the Center for Instructional Development and Distance Education, (CIDDE), formulated a four lecture series on education for paychiatrists.

September 2007 – Implementation of annual Objective Structured Clinical Examinations, (OSCEs). To comply with ACGME guidelines we introduced OSCE exams. This involved getting the Faculty to develop “Board style” clinical vignettes and OSCE questions and the recruitment of standardized patients. We had a one day exam with up to 26 stations. Feedback was excellent from both examiners and candidates.

October 2007 - Addiction Psychiatry Fellowship - Working with Dr. Antoine Douaihy received ACGME approval for a new Addictions Fellowship for WPIC.

November 2007 - Public Service Psychiatry Fellowship - Working with Drs Ryan, Sowers and Marin we gained an infrastructure grant from the Commonwealth of Pennsylvania to start a Center for Public Service Psychiatry. As part of this we are starting a Public Service Psychiatry Fellowship and have recruited one fellow starting July 12008.

January 2008 – Academic Administrator Clinician Educator, (AACE) Track pilot commenced - Working with Chief Resident for Education and Ambulatory Chief formulated a new specialized track for residents in PGY3 and above interested in a career as a Clinician Educator Administrator. This started formally on July 1 2008.

June 2008 - Oxford American Handbook of Psychiatry published after 12 months of editing and proofing. This was a joint educational project over 14 months between Faculty and Residents at WPIC to rewrite the UK edition and produce an over 1,000 page pocket book designed to comprehensively cover most of psychiatry in a format easy to use at the bedside.

July 2008 - Dr. Abigail Schlesinger, MD, Assistant Professor, appointed as Associate Residency Training Director with responsibility for the Child Fellows and Triple Board residents.

25.    New developments/changes in the Program over the next year?

Curriculum Revision – Addition of a “Trauma Psychiatry” course to the PGY2 didactics. This course will encompass trauma related disorders across the lifespan and include traumatic brain injury in addition to PTSD and related disorders. Didactic Evaluation forms revised and updated to include items more “anchored” within each didactic course and to provide comparisons both across and within each course and class.

Webcams - Installation of within firewall webcams to commence on resident computers to record psychotherapy sessions. Recorded sessions will be used by residents and supervisors to enhance the quality of psychotherapy supervision.

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 International Medical Graduate, (IMG), FAQs

1.         What is your cut off score in USMLE Steps 1&2 for accepting applications?

We have no absolute requirements but our average score is in the upper 80’s.

2.         Do you require US clinical experience (research, externship or observership)?

No, but it is obviously an advantage as is research and academic experience

3.         Does your program participate through ERAS?

Yes, the application deadline is mid-December

4.         How many IMGs are there on your program?

WPIC is an equal opportunities employer and operates an open policy in regard to resident recruitment. All residents are taken onto the program based on achievement and excellence. Numbers of IMGs vary from year to year.

5.         Do you consider year of graduation in accepting applications?

Not generally, though the amount of time since you last practiced medicine may be a factor. Each application is treated on merit and suitability for the program.

6.         How many letters of recommendation do you require with each application?

Three

7.         Would having passed USMLE Step 3 benefit me in any way?

Yes, passing STEP 3 is required to transition from PGY2 to PGY3, and for an H1B Visa application, therefore having passed the exam already would be an advantage.

8.         Do you sponsor visas for IMG's?

Yes we do. Sponsorship and type of visa is decided on a case by case basis. We have previously sponsored both J1 and H1B visas.

9.        Does Psychiatry experience in another country help me in any way?

Previous experience or training in psychiatry shows a commitment to the specialty which can only help a candidate. It is unlikely, however, that training outside of the US will reduce the psychiatry residency training requirements.

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FAQs and answers contributed by Residents

1.         Does WPIC force you to do research? 

Absolutely not.   Research is big here at WPIC. We are the number one grant recipient in the country from the National Institute of Mental Health.  What this does is make WPIC a place where you have the benefit of being at a place where cutting edge psychiatric research is taking place so you are always abreast of the latest and you work with attendings who are the best in their field..  Now whether you want to be actively involved in that or want to sit back and learn about it, the option is entirely yours.

2.          Does the size of the program or the size of the hospital really matter? 

Initially when I started looking at different residency programs, location and reputation were my top two criteria.  However, as I began to look at different programs I began to realize that the number of inpatient beds is very important.  Think about it.  If you are going to be at a hospital that has only 14 or 30 inpatient beds, how much pathology do you really think you are going to see?  Also if you're in a place where there are so many competing hospitals, unless you are at the top hospital, are you going to get to see the most variety of psychopathology? Not necessarily. WPIC has 276 inpatient beds and is one of the four largest free standing psychiatric hospitals in the country.  So if it exists, you will see it here.  Here at WPIC we have entire floors dedicated to children, adolescents, eating disorders, psychotic disorders, mental retardation and pervasive developmental disorder, adults, dual diagnosis (drug and alcohol), and geriatrics.

Also, if you are interested in a particular branch of psychiatry such as child psychiatry or geriatric psychiatry, it would behoove you to be at a place where they have a fellowship in that particular field.  That way you know that their inpatient and outpatient programs are very well developed.

3.            Does the number of the residents at a residency program matter? 

YES!  It can mean the difference of being on call q4 to q3x a month!  Also here at WPIC, there is no call for residents in their 3rd and 4th years!  In smaller programs, you tend to be on call more.  Also since there are only about 2-3 residents on a particular rotation at one time, you are still getting individualized attention.

4.            I heard that on call you are by yourself and you have to run codes?  What is this all about?

While you are on FLOOR call, it is true that you are the only one who will be called.  However, typically, call consists of giving verbal orders from the call room for things such a Tylenol.  At times, you are also called to when there are questions about blood sugars and blood pressure.  However, there are guidelines for both of these so you do not have to think too much! If you would ever find yourself in a "sticky" situation, there is always the family medicine Doc on call who is MORE than willing to answer calls at anytime of day or night, no matter how "stupid" you think the question is.   Also do not forget that the nurses at WPIC have tons of experience so they will often give suggestions as to what needs to be done.  There are also attendings and senior residents in the emergency room at all times so you can always call them with any questions.

We do run codes.   Let me first clarify what the majority of our codes concern. 1. loss of consciousness  2 seizure  3 chest pain.  However, everyone is sent for training for the codes (NOT just ACLS) but training on actually running a code.  Also again remember the nurses have been here longer than you and know how to run them. 

5.               What does being on the “Child Track” mean? 

Being on the Child Tract means that you will have the opportunity to do your preliminary work in pediatrics at Children's Hospital of Pittsburgh (one of the top 10 peds hospitals in the country).  I had a great time working there and I still keep in touch with my friends there.  EVERYONE appreciates you there because you are an extra helping hand on any team.  By working at Children's, you get to work and see the interface of pediatrics and psychiatry which is very invaluable to your psychiatric training.  After all, on the floors and in the clinics, many children and adolescents who come through have medical issues as well including overdoses. 

Being on child track also give you the opportunity early on to be paired up with various mentors in the field.  You are also targeted for various opportunities and grants early on which include the plethora of clinics that are here (STAR - center for at risk youth, TORDIA - treatment resistant depression in adolescents, OCD clinic, Mathilda Theiss clinic for children ages 0-5, COPE - center for overcoming problem eating, bipolar disorder clinic, mental retardation & pervasive developmental disorders, and the list goes on!). 

One of the biggest benefits of being on the child track is the seamless transition it gives you from general psychiatry residency to fellowship.  If you indicate that you would like to be on the child track, a spot is reserved for you in WPIC's Child and Adolescent Psychiatry program (did I mention it is one of the top five in the country?).

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Revised August 2008