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PGY3 Overall Rating: 15-Jun- 2007 Teaching: Atmosphere: Research: Schedule PGY-1 rotations: consist of both psychiatry (child & adolescent, VA inpatient, general adult, night float) and off-service rotations (ER, medicine, neurology, peds if you like). Residents do not take psych call on any psych rotation except night float and generally do not have to admit patients during the day (except at VA). Off-service call is taken per the service (usu. between Q4 and Q8). Days on psychiatry typically last from 7 or 8am until around 5pm. In the '07-'08 year, a new system of rotation blocks will be established in order to provide regular times for residents to attend lectures. PGY-2 rotations: all year is psychiatry except 1 month of neurology consults. Rotations include: general adult, geriatrics, dual diagnosis, C/L and night float. Schedule is usually around 8-5pm, again no overnight call except for night float months. PGY-3: Entirely outpatient year. Various clinic opportunities are available and include: VA outpt. clinic, student mental health clinic, C&A clinic, community mental health clinic and the resident outpt. clinic at the Institute of Psychiatry. This is a great year in which you have some autonomy, including your very own office and the ability to schedule your clinic patients when you want. You take overnight call approx. Q10-12 in which you are the supervising resident for two junior residents. PGY-4: Mostly a year entirely devoted to elective time. Many people opt to continue one or more of their outpatient clinic experiences from PGY-3 year. You can do a month-long experience learning to administer ECT. You can go back to the inpatient units as a junior attending. You can spend time focusing on particular populations (e.g. geriatic, forensic, public psychiatry). You can do a little bit of all of them; you really have a lot of freedom to make the most of your time in the way you see best. Research track: The research track participants complete a regular PGY-1 and PGY-2 year. Starting in PGY-3, they have a structures series of lectures on conducting research and they participate in (usu.) clinic research under the guidance of a faculty mentor. They do about 50% time outpatient PGY-3 stuff (as above) and 50% research. This continues through the PGY-4 year. It's a nice way to build in a lot of research experience without extending the length of your residency. Teaching PGY-1 didactics: A new program will be instituted during the 2007 - 2008 year. The seminars and lectures will be done in a series of 3-month blocks, corresponding to the 3-month block schedule of rotations. Residents on-service will attend lectures while those off-service can attend as time permits. The blocks will repeat in order to ensure that all PGY-1 residents have a chance to attend the entire PGY-1 curriculum of lectures and seminars. Also somewhat unique to our PGY-1 curriculum is that a year-long introduction to psychotherapy seminar is in place. PGY-2 didactics: Being revamped for '07-'08. The psychotherapy year-long seminar continues this year. Lecture topics cover more in-depth psychopathology, treatments, pharmacology, etc. PGY-3 didactics: This year is largely exposure to various different types and theories of psychotherapy (e.g. CBT, psychodyamic, interpersonal, short-term solution-oriented, couples, group). There is also a more in-depth psychopharm series that is year-long. This year is lecture intensive, up to 6 hours per week of seminars. Our residents recently ranked #4 in the nation on a widely-administered, standardized psychodynamic psychotherapy exam. Our faculty ranked #1 on the same test. PGY-4 lectures: 1.5 hours per week going over a variety of topics. The beginning of year consists of introduction to various career sectors. Then, there is a series of financial and job-search oriented seminars (e.g. contract negotiation, financial planning, etc.). There are some orphan psychiatry topics and the year finishes up with neurology and psychiatry board review preparation. The department has spent a lot of time over the last 3 years to improve the didactic series across all 4 years. Contrary to a recent review, the same lecturer does not do nearly all the lectures. I think there is a nice variety of lectures from various specialties (psychiatry, neurology, medicine) and across different backgrounds (clinical vs. research). There is also a weekly 1-hr. Grand Rounds, which covers wide-ranging topics. Our speakers in the past have generally been of good quality and widely-known. All lecture time is protected time. Whether or not you make it to lecture is up to you. Atmosphere Most of our residents are smart, easy to get along with and happy with the program. Like any program, we have a few that are clearly unhappy and want to let everyone know about it; but in a department with 60+ residents and fellows, it's going to be hard to make everyone happy all the time. While I enjoy having a close friendship with some of my colleagues, what I feel is most important is that all my classmates are professional and collegial. I've never had a problem switching calls or getting someone to cover for me for emergency or vacation. Most of the attendings are extremely approachable and great teachers. The atmosphere is warm and there isn't a lot of "malignant teaching." Like us, some get stretched a bit thin with over-commitments. However, the vast majority of the time your attending is available in person or by phone, day or night. One nice thing is that our department is very well respected among the other departments within the hospital. The Institute of Psychiatry is a beautiful, free-standing psychiatric hospital. Most units get plenty of natural light and open space. The resident work-spaces and offices are generally well-kept, have computers and desk space. The call-rooms do leave something to be desired, and it's possible that new rooms will be given to us after the main hospital opens it's new building in fall 2007. As they are, there is a separate room for each resident on call, a student room, a kitchen and a lounge. There is one TV and computer for all to share (that's the bad part). The GME provides meal vouchers for all of the 24-hour call shifts; we can use these to order out to various local restaurants (usu. pizza or deli-type fare). There are very few graduates of foreign medical schools in our program. The number varies from year to year, recent ranges are zero to two. Outside of residency, you have plenty of time to have a life. The most restrictive year is obviously PGY-1, and then it just gets better and better (remember, no call at during PGY-4). Even first year, we have it fairly good compared to other programs. The GME Resident's council recently approved an 8% increase in the base salaries of all the residents, to make our stipends more competitive with other programs in the southeast. Charleston itself has a fairly high cost of living compared to other cities in the southeast, but it pales in comparison to larger cities nationwide. The housing market has been strong recently, making it more difficult for residents to own homes nearby the hospital (within a 5-10 mile radius). Rent is still very affordable on a single resident salary. That said, every person in my class currently owns, just so you have some perspective. In terms of things to do, there are several local beaches and a fun downtown area. I'd say the cultural events far exceed the size of this city (that said, there's obviously not the kind of variety you are going to get in NY, LA, etc.). We do not have any major league sports, but do have minor league baseball, soccer and hockey. We do have a pro tennis tournament each year and several nationally-known golf courses. I have had good luck finding sports to participate in on the recreational level through the local County parks and recreation (soccer, kayaking, hiking, football, etc.). The music scene is hit or miss, with some national acts making their ways through here but many hitting nearby towns in SC, NC and GA. The largest complaint I've heard about Charleston is that it is sometimes difficult for spouses/sig. others to find employment. This, of course, is industry-specific, but is something to take note of if you're bringing someone with you. Conclusion Overall, I'm happy that I ended up at MUSC and would rank it highly if I had to choose again. I think we do a good job of attracting fun and intelligent people that are a pleasure to work with. Some of the highlights for me include: a yearly 2-day resident retreat at one of the local beaches (paid for by the dept.), an educational committee that is highly responsive to resident input and made up of resident reps from each class, a free membership (4 years) to the health & wellness center (awesome!), free parking (4 years), a system for comp days that can accumulate over the course of the residency, and a professional expense fund ($1000+) for funding travel, books and other expenses. Some drawbacks for me: Charleston is not as diverse a city as I would prefer and local moonlighting is a bit hard to come by (but it does exist). I feel that my training here will leave me very well prepared for practice when I leave. No matter where you are, you can choose to take advantage of the opportunities available to you or not; you get out of it what you put in. We have a very good pass rate for both written and oral boards. In fact, the department stages mock oral exams each year for the third and fourth years (with outside faculty examiners, written feedback, etc.). I'd say about a 1/3 of each class elects to do a fellowship in child and adolescent (which they begin in their 4th year). In addition to C&A, we also have fellowhsips available in: addictions, geriatrics and forensics.

PGY2 Overall Rating: 22-Apr- 2007 Teaching: Atmosphere: Research: Schedule Intern year involves several non-psychiatric rotations, as is typical of most institutions. Interns have the option to take a peds elective, in lieu of a general medicine month. Most find the gen med month, however, much less painful. You take medicine, peds, and neuro calls as per their program requirements. During all Psych months you split the weekend coverage (8 hrs) between 2-3 other residents. The ER rotation is sub-par as a dedicated Psych ER does not exist at MUSC. Rotations on the psych floors vary from the most time intense general floor (11-12hr days) to the least time intense child floor (5-6hr days). Most of the day involves filling out paperwork and dedicated attending teaching time is near non-existant (1hr per week - maybe). A night float system is in effect and therefore one does not take call throughout the year. Instead one has call 15-20 times (24 hr weekends) for 2 months of the year (PGY1 through PGYII). Ok for some, but a negative if you hate shift work. As a PGYIII you are on call (in hospital) q12 as a supervisor to the other resident. Attending mandatory lectures during the daytime became difficult during these months. While the system has it's advantages, patient continuity suffers and the ER attendings can bully & pressure you into decisions. Plus the 20+ page admission database can slow you down a tad. You complete a 15 minute check-out with an attending in the AM where you get some feedback. Second year is more of the same in terms of time comittment and rotations. Instead of C&A you have an addictions rotation. MUSC has a NFL contract, but you as a resident will never treat these patients. You will have 4 consult months which are uneducational, especially those that occur at the main hospital. The consult attending was too busy to teach and unable to give residents decision making independence. The attending seemed spread quite thin as he also worked as an attending on our general psych floor and as the teaching director of the 3rd year psych course. 3rd year includes call throughout the year (q12) and psychotherapy patients throughout the day. 4th year is 4th year - no call, electives, less/minimal work, increased time at the beach. Teaching Overall the faculty are pretty strong, especially some of the researchers, but you have limited contact with them. A few of the better faculty members have left recently, paving the way for young "talent". A lack of hiring from outside MUSC is concerning as you are learning from people that were in your shoes less than 1 year ago. The didactics occur and the quantity is fine, but the quality is sub-par. The scattered scheduling also makes it difficult to attend all lectures, which are mandatory by the way. During the first 3 years of residency more than 1/2 of our lectures are taught by one person. Case conferences happen infrequently, but when they occur they are worthwhile. The Update in Psychiatry is quite good and I attended it last year; however, I had to use vacation time to do so. Grand Rounds speakers are usually nationally recognized. Atmosphere Charleston is a pretty cool city, but it's small and very expensive. For a single person it can be difficult socially and financially. 3BR homes currently go for $275-300,000+ depending on distance from the hospital/beach. Apartments are about $800-850 for 1BR, but because of the high cost of housing, generally have months-long wait list. Also consider the non-competitive PGY-1 salary of $38,000 for 2007-8! The cost of living in Charleston is higher then Atlanta (-2.5%), the same as Chapel Hill (-0.1%), and much higher than Columbia, SC (-12.4%). Plus, spouse employment in the non-medical field can be problematic. Moonlighting in Charleston is insufficient to meet the demand. 4-5 "lucky" residents get to make good cash moonlighting full weekends in Greenville, 3.5 hrs away from Charleston. The music scene is low key, but you can travel to Myrtle Beach's House of Blues for big shows (2.5 hrs away). The Theatre scene is limited to local acts in small venues. You'll need to go to Atlanta, Charlotte, or Jacksonville for professional sports. Minor league/semi-pro hockey, soccer, and baseball are present. If you like touring plantation homes and going to the beach then this is your kind of city. The other residents are generally fun to hang out with. There are a few foreign med grads, but most people are from the South East. Ethnic diversity within the department is minimal, which is concerning. There are some overly competitive residents (gunners) that you need to watch out for. The call rooms are outdated, without computers or TVs. Charleston has a great number of superb restaurants, but they all serve classic Southern/Amercian cuisine. Ethnic restaurants are limited and really good ethnic restaurants don't exist. Conclusion The location of the program is great (especially when hurricane season is over) - 15 minutes to the beach. The stand-alone Institute of Psychiatry is a plus. The Psychiatry program is well respected by other residents and other programs. The drawback of Charleston is that the severity of psychopathology is lacking in comparison to big cities such as NYC, Atlanta, etc. C&A is limited to Behavioral disorders and contact with PDD is limited. Cost of living is high, salaries are not competitive, moonlighting is scarce, and spouse employment is problematic. The current training director (Santos) is awesome and truly cares about his residents and has time for them. The previous chair (Oldham) was well respected, but at this time a new chair has yet to be named. Residents are generally happy, although 2 residents in the current PGY-III class switched to Neurology and 1 resident in this same class left the program all together after 2nd year. The 1 unfilled position in the 2007 match is not reflective of the programs recent match history, but still somewhat concerning. If reapplying, I would be happy to end up at MUSC, but I would not have ranked the program as highly the second time around. Peace.

PGY4 Overall Rating: 13-Oct- 2006 Teaching: Atmosphere: Research: Schedule I am currently a PGY 4 and contrary to what a different review states, I do, indeed work! The PGY4 year is composed entirely of electives, much like other programs. There is a diverse range of experiences available here in the Charleston area including: emergency psychiatry (triage in local ER as well as home visits with mobile crisis, hostage negotiation didactics and participation in standoffs), community psychiatry (working at local mental health centers or taking part in the ROADS or Mental Health Intensive Case Management program, which allows residents to travel to pts' homes for healthcare), psychotherapy (through the Crime Victims' Center, Adult Resident Clinic, Counseling & Psychological Services program for MUSC students), sex therapy (through various community practitioners), forensic psychiatry (through the solicitor's office and local county jail), med management (VA clinic), neurology clinics (movement disorders, memory disorders, sleep disorders, etc), ECT clinic, hospital administration and substance abuse, to name a few. Due to the innate flexibility of the PGY4 year, you can design your own schedule. My schedule includes a variety of these clinics and I work an average of 40-42 hours per week. Every day is different and the variety is great. Electives can last as little as a month or as long as the entire year. If a resident is interested in creating his/her own elective, the faculty and administration is very supportive of helping to create such a rotation. Teaching The faculty at MUSC are outstanding. They represent a diverse range of interests and are passionate about teaching. Didactics are solid, although there is always room for some improvement here and there (primarily the psychopharm lecture series in our PGY3 year...it could stand to be revised so as not to be so dry). The nice thing is that MUSC encompasses individuals with diverse interests, so there's always someone available to teach some of the finer points of psychiatry. Inpatient supervision can be lacking during the PGY1 and 2 years, but if the resident is diligent about it, the attendings will make a point to schedule one hour weekly sessions with the resident. PGY3 and PGY4 years have frequent supervision with attendings. The PGY3 year alone typically has approximately 5 hours/week of supervision. As a PGY4, didactics remain protected. We have didactics from 1-3 on Tuesdays and this year they are generally composed of board prep (neuro and psych) as well as lectures regarding post-residency psychiatric practice. We have grand rounds on a weekly basis (Fridays 11:30am-1:00pm) and they are protected, as well. We have world-class speakers who are well-known in their fields, as well as occasional case presentations that are always outstanding. There is a good range of clinical and research presentations provided each year. In addition, each June the department hosts an "Update in Psychiatry" on various cutting-edge issues in psychiatry. This is usually a sold-out event. MUSC is also the host of the South Carolina Psychiatric Association's annual meeting which is always well attended and which brings renowned clincians in the field of psychiatry to the area. Atmosphere I could not have asked for a better group of residents to share this experience with. MUSC does an outstanding job of recruiting individuals who are intelligent, hard-working and friendly. This is largely due to the fact that residents play an active role in the recruiting process. About 60% of the Resident Selection Committee is composed of residents and they are directly involved in interviewing and ranking the candidates. I can truly say there is not one resident to whom I would not recommend my patients. The comeraderie here is great, kicked off by an orientation for the interns full of casual dinners, brunches and boat rides. Happy hours are a common event, as well as wine tastings, parties and cultural events. There is SO MUCH to do in the Charleston area! For those who would like to explore the history and culture of the south, start with a visit to one of our local plantations like Boone Hall, Middleton Place or Magnolia Gardens. Many of these places host events year round, including bluegrass festivals, A Taste of Charleston, chili and barbecue cook offs, Charleston Pops concerts and civil war reenactments. In the spring and fall the Preservation Society of Charleston hosts their annual Tour of Homes, allowing the pubic to view privately owned, historic homes in the downtown area. Walk the beautiful downtown streets at dusk or visit the local museums. The French Quarter of Charleston hosts a quarterly art walk through the downtown galleries, providing an opportunity to peruse the local art scene, meet artists, have a glass of wine and munch on hors d’oeuvres. Wander through one of the cemeteries, home to a number of the signers of the Declaration of Independence. Stroll past Rainbow Row to the beautiful Battery and spend the afternoon in the park or join the folks fishing off of the Battery wall. If shopping is more your style, head to the market area and peruse the wares after a light lunch at one of the many outstanding restaurants in the market area. In the spring, select from a wide array of cultural events at the annual Spoleto Festival USA. Or find more resident-wallet friendly events through Piccolo Spoleto. The local colleges, ballet companies, theater groups and comedy groups contribute to a diverse array of performances annually. Catch one of the Broadway Series performances that come five times a year to the area, or become a season ticket holder (it’s actually affordable!). If you’re looking for an outdoorsy adventure, head to James Island County Park and climb the rock wall, kayak or have an outdoor barbecue. Bike or hike the well-preserved trails of the local parks. Visit one of the area water parks with the family. Choose from a number of the family-oriented beaches in the Charleston area and spend the day in the warm ocean water (May through October at least). Fish off the Folly Beach pier where you may pull up a small dogfish. Join one of the local sports leagues, or form a team for MUSC’s intramural sports program (our department has had a good showing in softball, basketball and flag football). If you’d prefer to be a spectator, tickets are always available for our minor league baseball team (Charleston Riverdogs), the Eastern Conference Hockey League team (SC Stingrays) or the semi-pro soccer team (The Battery). If you’re more of a night owl, Charleston has its fair share of clubs. Whether it’s psychedelic 70’s, excellent 80’s, flamenco or club music you’re looking for, you’ll find a club or lounge catering to your needs. Pedi cabs will happily transport you between locales. Enjoy karaoke? Our residents have been known to belt out a few tunes on stage in local spots. Or perhaps you like to flex your mental muscle after hours? We have residents who partake in trivia challenges at area restaurants. And of course, there are the frequent happy hours, barbecues, dinners, Halloween parties, cookie exchanges, Christmas parties, bridal and baby showers, camping trips, salsa dance classes, boat trips, game nights and poker games. Residents top off the end of a year of hard work and learning with our annual retreat. A beach house on Folly is reserved for the week, with the retreat taking place on a Thursday and Friday. During this time, all clinical duties (including call!) are covered by the attending physicians. The retreat is an opportunity to relax, reconnect with peers outside of work, listen to fun, low-key lectures, play in the sand and unwind. Karaoke, family feud games (psychiatry style of course), fishing, swimming, relay races and the like are enjoyed by both residents and their families. Our residents work hard, but they know how to have a good time. Whatever your interest, you’re sure to find it in Charleston and you’re more than likely to find a resident to share the fun with. As you can tell, we definitely have a life outside of work! Conclusion I have been very happy with life here at MUSC. The program is very resident-friendly and responsive to the needs and input of the residents. Most recently we have been working to reconstruct our database and change the format of one of our busiest clinical rotations, based on resident feedback. These have been huge feats, and we hope to be able to implement the changes by the end of the academic year. In addition, residents have been spearheading (and the dept has been strongly supporting) the effort to reinstate individual psychotherapy for the residents. Having spoken with residents in many other programs, I am continually impressed with the quality of the program here. Our department is well-respected, stable and strong. We have "hired from within" in the past, but these individuals are of high quality and, in speaking to residents and chairs of other programs, this is not unusual. As for the call rooms, I have yet to spend a night in one considered luxurious at any place that I have worked (as a medical student rotating through 6-10 different health systems and as a resident). Ours aren't too shabby by comparison. There is a general lounge area with a TV, computer, phone and fax. The call rooms are adjacent to it with their own phones. The beauty of call at MUSC is the night float system, which greatly alleviates the need to work a full shift postcall. It can be difficult to make didactics on these days, but it is not impossible. Finally, our program likes to keep the residents happy, so there are a number of great incentives available. We have a one-time moving allowance of $1000 given to interns upon their arrival to assist with bills that inevitably come due after the loan money has run out and before the first paycheck arrives. As a PGY1 and 2, $100/month is added to a book fund to be used for educational purposes (books, conferences, etc). Parking is 2 blocks from the Institute of Psychiatry and paid for by the department. Furthermore, we have a comp day program. For each holiday worked and for each weekend day that rounds go past 2pm, a "floating day" is given to be used as a vacation day at any time during the resident's four years. This is in addition to our 15 days of vacation (weekends don't count so you can take up to 9 days off in a row). Being a resident at MUSC has been a rewarding experience. I would rank them first again in a heartbeat. I cannot recommend the program highly enough and I will truly be sad to leave the MUSC family upon graduation. I welcome all inquiries about the program from prospective applicants.

PGY3 Overall Rating: 09-Oct- 2006 Teaching: Atmosphere: Research: Schedule My typical day begins around 8am. I work out of several clinics doing psychotherapy and/or medication management. They are all within walking distance to one another (except for the public mental health clinic), among palm trees with a view of the harbor. I spend 1/2 day per week at the VA seeing patients mostly for medication management. The supervision there is excellent and it is a pleasant place to work. Two 1/2 days per week are spent doing mostly psychotherapy (especially cognitive behavioral therapy)at CAPS, or Center for Counseling and Psychological Services, which provides psychological/psychiatric care to the medical students here, as well as students from nursing, physical therapy, and other allied health programs. This clinic is fascinating as these patients are high functioning, often easy to identify with, and can be quite a psychotherapeutic challenge. The supervision here is good as well. I spend another 1/2 day in Child clinic for one half of the year and the other half of the year at the local public mental health clinic. They are both unique experiences, but short lived. The remainder of my time is spent (in my own office) doing psychotherapy in our free standing psychiatric hospital (The Institute of Psychiatry). Here, I see patients from all walks of life, usually for an hour per week and the approaches range from supportive, expressive/dynamic, to some cognitive behavioral styles as well. We get additional supervision here and it is very good. About 2-3 times per month I am on call as the senior admitting resident which gives opportunity for teaching, and is more laid back than being on call as a junior admitting resident. All told, I probably work about 40 hours per week. During the first and second year of my residency, I worked on the wards most of the time, or on consult services. Intern year was not as difficult as I expected it to be, and I was able to have a life outside of residency. Second year was a bit more managable time wise and we had the beginning of outpatient psychiatry, which was fun. There are also opportunities for internal as well as external moonlighting that can give you a wider range of experiences as well as a little extra cash. Teaching I have been very pleased with the faculty here. Not only do we have excellent teachers, but I have also made some friends in them as well. Most are quite approachable and eager to share their research interest as well as answer basic questions. Atmosphere There are few if any foreign medical graduates in any given class. There is only one in the entire program that I can think of now and he is US born. We have filled for about the past 10 years and most of our residents had MUSC as their first choice and were in our top picks as applicants. Resident life is very good here. A resident class consists of about 12-15 (with the Med/Psych folks included) and we all seem to get along very well. The faculty is responsive to resident concern and residents have been able to enact change in several areas of the hospital and program's functioning. Residents appear to have adequate time outside of the program to participate in a wide range of activities. Some residents vacation together, go out to dinner, play soccer, ultimate frisbee, or flag football, going to the beach, fishing, boating, nightlife, dinner/wine parties,........you name it and people are doing it here! You can have as little or as much involvement as you choose. Charleston is a great place to live! Conclusion I see our program as unique in several ways. First, we have a free standing psychiatric hospital with a broad patient population. Second, we have an excellent faculty who is supportive of residents and enjoys teaching. We have many faculy interested and involved in research and we have one of the largest research departments on campus. Third, we are well respected on campus by the other services. In fact, often during the intern year, other services comment on how superior the psych residents are in performance to their own residents!! Fourth, Charleston is a fabulous place to live. There is rich history and architecture here, the food is delicious, it is on the ocean, and is a fun and safe place to live and to raise a family. Also, I was able to buy a house here 4.5 miles from the medical center, it is a very short commute. I am happy that I chose MUSC as my first choice in the match and got it!! I interviewed at many other programs (Johns Hopkins, Duke, Chapel Hill, Stanford, Vanderbilt, etc) and found MUSC to be an outstanding balance of hard work, learning and quality of life.

Intern Overall Rating: 14-Jan- 2004 Teaching: Atmosphere: Research: Schedule A typical day on the inpatient units begins at seven, with rounds starting an hour or so later and often lasting until lunch. The social workers, nurses and pharmacologists on the treatment teams are generally top-notch, and the medical students are very helpful, active and eager to learn. At least 3 times a week, lunch will be provided in the setting of didactics, resident meetings or Grand Rounds. Afternoons are generally spent following up with direct patient care issues, as the students do the bulk of note writing. Depending on the acuity and dianosis of the various patients (caseload max of 7), activities such as family meetings, relevant literature searches, student teaching and even individual sessions can last until after 5 P.M. Teaching The faculty here have always been strong, but until recently the formal didactics have been a bit suspect. This is no longer a problem, as the schedule and material has been recently revamped. In a testament to the degree to which residents' feedback influences the program, the overhaul was largely the effort of a group of very dedicated upper level residents working in collaboration with teaching faculty. Interns are given a "bolus" of lectures during the first month that essentially cover all you need to know for intern survival. In short, the didactics are still not perfect, but no longer a weakness. From a supervision standpoint, the first 5 calls are "buddy calls" taken along with an upper level resident who helps you learn the ropes (phone numbers, paperwork, best 3AM snack, etc.). By the way, the night float system is great. We're very busy, but there's still plenty of time to look up answers to the interesting (and sometimes downright bizarre) clinical questions that come up over the course of a shift. Grand Rounds are very good, but only rarely great. Perhaps the best aspect of the teaching here is the importance the program places upon individual faculty supervision. Finally, as a resident with a strong interest in research, I find the research faculty here extremely approachable and really interested in cultivating new colleagues (no accident that many of the researchers here were once residents here). Atmosphere Of all the great things I could say about this program, by far the best are my fellow residents. Without exception, I genuinely like and respect every member of my class. The upper level residents, and especially our chiefs, are very supportive. The Institute of Psychiatry is a very attractive bit of architecture, with a long curvilinear form and lots of natural light in the wards. Unfortunately, it (along with seemingly every buiding at MUSC) is undergoing major renovation, so there's a lot of dust and detours this year. But enough about work, this is Charleston! I live downtown, less than a mile from the hospital, and my wife and I love to explore the historic streets, superb restaurants, great beaches and surprisingly hip arts scene. Residents routinely get together outside of work, and every year there's a resident retreat during which all clinical duties are assumed by faculty (even call). In short, it is like winning the residency lottery. Conclusion This is a program built upon faculty, staff and residents who want to be here and really enjoy what they do. Our chairman, Dr. Oldham, is incredibly resident-friendly and a nationally known figure. The department is one of the most highly respected at MUSC (note our US News ranking). But no program is perfect. While most of the off-service months are very good, there's no guarantee that these will be as positive as your psychiatry months. Also, it has been difficult for spouses to find employment in Charleston. Finally, we've just converted an entire floor of the IOP from mood disorders to an acute psychiatry unit, and some bugs are still being worked out. In conclusion, while it is impossible to say as an intern that I will be prepared for anything once I finish the program, I can say I won't be eager to leave. I welcome any and all inquiries.