Psychiatry

Fourth year medical students may apply online using VSLO for elective clinical clerkships.

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Frequently Asked Questions

QUESTIONS RELATED TO APPLYING:

Question: Where do interns come from?
Answer: We have interns, including both MD's and DO's, from diverse programs all over the world.

Question: Are board exam scores weighed heavily?
Answer: We review applications holistically. Cutoff board exam scores are dependent on the applicant pool each year. We accept both COMLEX and USMLE with no preference for either exam. If you took both exams, please submit both scores.

Question: How does not having the USMLE Step 2 CS/COMLEX Level 2 PE score due to its cancellation affect the application process?
Answer: This is a nationwide problem across all residency programs as many students have not been able to take the examination due to the COVID-19 pandemic. This will not be held against you at our program, especially since we know that many testing centers are closed. We will review each case on a case-by-case basis.

Question: Will completing an audition rotation help my chances of matching?
Answer: Audition rotations have traditionally been an opportunity for applicants to gain an "inside look" to experience the program, but are not required.

QUESTIONS RELATED TO TRAINING:

Question: What is your patient population like?
Answer: We primarily work with underserved populations in our community. We work with refugees, inmates, homeless individuals. We also have great cultural diversity among the population we serve. However, we treat the whole population. We treat many patients who have private insurance and patients who have public insurance such as Medicare and Medicaid. Because there is no VA inpatient psychiatry unit in Tarrant County, we often treat veterans in the inpatient unit. We also get exposure to the incarcerated population, especially in the consult-liaison setting and with PG-4 year electives at MHMR. We also have JPS Connection, a patient assistance program and resource for uninsured patients.

Question: What does the psychopathology look like?
Answer: Pathology is varied, from unipolar depression to bipolar mania to schizophrenia to anxiety to PTSD. You will also see a lot of uncommon psychiatric disorders as well as many psychiatric manifestations of medical illnesses while you train at JPS. We have treated neuropsychiatric manifestations of scurvy, Lupus induced psychosis, Wilson's disease, and Diogenes' syndrome to name a few.

Question: What is the structure of inpatient psychiatry rotations?
Answer: The inpatient rotations primary occur during the PGY1 and 2 years. Inpatient rotations predominantly are structured with one intern or one second year resident working directly with an inpatient attending, as well as a multidisciplinary team including peer support specialists, social workings, charge nurses, students, pharmacists, and more. However, due to the increase in ACGME accredited positions, some teams now have an intern paired with a PGY-2 resident along with the other members of the team. This unique experience, structured more like a traditional inpatient medicine team, does allow for interns to learn from both their attendings and their upper-level residents. Interns and residents are always supervised by the inpatient attending in person every day, thus neither interns nor residents have sole responsibility for any patient. Attendings quite readily cover protected time to ensure patients' needs are meet when the resident or intern is unavailable. Interns work on a graduated exposure, slowly increasing the number of inpatients that they co-manage with the attending. By the second semester, interns are quite capable of co-managing the entire team with the attending. Patient caps for weekend call were implemented, clinic patient panels were reduced, and over-all patient assignments per inpatient team are reducing every year as more attendings and non-teaching providers assist with patient care.

Question: What are the locations for the rotation sites?
Answer: PGY-1/2 residents primarily rotate in our inpatient psychiatric hospital and main hospital. Interns complete their family medicine rotation at a clinic in the homeless shelter community. PGY-3 residents rotate at two JPS behavioral health clinic sites for the whole year. PGY-4 residents rotate in the local branch of the state hospital (Local Commitment Alternative) and complete electives with MHMR and other places in DFW.

Question: For internal medicine months, do we share calls with the internists?
Answer: You will rotate with the JPS Family Medicine residents that have their own academic medicine service. Our Family Medicine program is one of the top in the country and has vast Internal Medicine experience. You will share calls with them every 6 days for new admissions.

Question: How is night call?
Answer: Our interns complete two months of night shifts in our psychiatric emergency center. There are no night shifts during the inpatient psychiatry months. Currently, there is no night call after intern year. Many residents find the night shifts very manageable since you work five 11-hour shifts per week (total 55 hours) with weekends free.

Question: How much emphasis is placed on psychotherapy during your training?
Answer: There are strong opportunities available for psychotherapy training for interested residents. Many faculty at our department are psychodynamically trained, but there are resources for other types of psychotherapy available. In fact, we also have a clinical psychology internship program in our department. You get one afternoon weekly for psychotherapy in PGY-3/4, and residents typically carry 1-3 psychotherapy patients. Also, there are several online courses for psychotherapy training (CBT, TF-CBT, DBT, etc.) that may be supported with professional development funds ($1500 per YEAR during PGY-2 onwards). Supervision will be provided as weekly individual or small-group and large group in PGY-1/2, and weekly individual and large group in PGY-2/3.

QUESTIONS RELATED TO PROFESSIONAL DEVELOPMENT:

Question: Are there any mentors or advisors available for residents?
Answer: Each intern meets monthly with a faculty mentor and a "Big Sib" (PGY-3 or PGY-4) for mentorship and residency advice (i.e., how to navigate certain rotations).

Question: What do your residents do after they graduate?
Answer: Many residents begin working as attendings after residency, but a significant number also decide to enter fellowship. The past few graduating classes have sent residents to strong fellowship training programs in forensics, addiction, consult-liaison, community, and child & adolescent psychiatry.

Question: Does your program offer any leadership opportunities?
Answer: Yes. Chief resident duties are divided between an academic chief and an operations chief, who are traditionally selected from the third and fourth year classes, respectively. We also have several resident chair positions including Moonlighting, Recruitment, Research, Mentorship, and Well-being. Residents also can serve as House Staff officers, representing all JPS residency programs. There are also numerous opportunities to get involved with different hospital committees (i.e., Ethics, Patient Safety, etc.). Residents are encouraged to be involved in leadership at the county, state, and national levels.

Question: Does your program offer any research opportunities?
Answer: Residents are required to complete one scholarly activity by the time they graduate, however, have ample opportunity for more. Residents frequently present at (inter)national conferences and at our own annual JPS Research Symposium. Many of our residents have also published papers in peer-reviewed medical journals. Starting in PGY-3, residents get a half day per week of protected time for scholarly activity. Our Resident Research Chair serves as a liaison between residents and our research faculty to assist with facilitating connections for research projects.

Question: Does your program offer any moonlighting opportunities?
Answer: Residents can begin moonlighting during PGY-2 after passing COMLEX Level 3/USMLE Step 3 and maintain good academic standing per program director evaluation. Currently, we have internal moonlighting opportunities available for weekend inpatient psychiatry and psychiatric emergency center shifts. Our Resident Moonlighting Chair works with the administration to organize and schedule this process for our residents.

Question: Are there any subspecialty psychiatry fellowship programs at your hospital?
Answer: At this time, we do not have any psychiatric fellowships. However, previous residents have matched to strong training programs across the nation in forensics, consult-liaison, research, and child & adolescent.

QUESTIONS RELATED TO WELLNESS:

Question: What wellness initiatives are at your program?
Answer: Our Employee Assistance Program is a great support and can help residents organize counseling sessions. We also have a wellness coordinator dedicated to all residents at JPS who moderates process groups and presents lectures related to well-being during our didactics. JPS also reimburses for Uber/Lyft (to home and back) after a call shift. We also try to have socially distanced monthly events. Hopefully, if the pandemic improves, we will have our annual resident retreat again. In addition to our PTO, we also get an additional four Well-being days total for the year.

Question: What are process groups and does your residency have them?
Answer: Process groups during residency are a form of group psychotherapy that are targeted to resident issues, such as burnout, wellness, navigating work stresses, etc. This provides a safe and confidential space for residents to discuss their challenges with each other. We have monthly 1-hour process groups led by our hospital-wide residency wellness coordinator and organized by our Resident Well-being Chair.