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Any medical student who considers training as a triple board resident is obviously not choosing the path of least resistance. Although pediatric residents will be done in three years, and adult psychiatry lasts four, medical students who choose triple board are committing themselves to a five year program where they will be expected to become skilled pediatricians and adult and child psychiatrists, holding themselves to the same high standards applied to colleagues in each respected field. It is a unique journey, both challenging in the vast amount of material covered and variety of patient care experiences, but also incredibly rewarding.

As one of the original triple board programs, Utah recognizes that even though we attract bright, skilled and determined residents and offer each resident exceptional learning opportunities, at the same time, we pride ourselves in the support we offer each individual resident through their residency. This "survival guide" includes basic concepts of support and encouragement we believe should be a fundamental component of residency programs in any field, as well as addressing the specific challenges commonly faced by residents learning in multiple systems of care.

Orientation

Pediatric Orientation Rafting Trip

Before our residents see their first patient, they have the opportunity to bond with their fellow pediatric residents, attendings and pediatric training director on the Green River in Southern Utah. The two-day river trip is a great opportunity for both interns to form friendships and truly become a part of their pediatric class.

Retreats

Pediatric Intern Retreat

After a couple months of actually practicing medicine, interns take two days off with the rest of their pediatric class for a retreat in Deer Park where the pediatric residents take time to relax, engage in some team building exercises and explore the outdoors. All of our interns who are on psychiatry at the time of the retreat remark how great it is to reconnect with their pediatric colleagues and remind them that they will be on service in just a few short months.

Second-Year Adult Psychiatry Retreat

With a year under one's belt, both residents are excused from pediatric and psychiatry clinical duties to attend the adult psychiatry overnight retreat with their original psychiatry class. We feel it is important for residents to maintain a connection with their psychiatry class since the following year they will be senior adult psychiatry residents alongside their classmates.

Biannual TB Retreats

Each year the Triple Board Program holds a fall and spring retreat. The fall retreat is an overnight retreat held at a resort outside of Park City. At the retreat, along with plenty of time for catching up with each other and enjoying the outdoors, we have the opportunity to meet with program directors of both adult psychiatry and pediatrics, as well as work together on a project for the program. The spring retreat is an all day retreat that is a great opportunity to reflect on successes of the past year and make sure that any challenges have been addressed for the upcoming residents.

Meetings

Monthly TB Lunches

Each month all the residents meet together for lunch with the training directors and program coordinator. We update ourselves on upcoming events, address any concerns or questions regarding specific rotations or schedules and have a chance to catch up with each other.

Transition Meetings

Although the chief residents pride themselves on keeping their pulse on the program and are well aware of upcoming transitions, residents also reach out to the classes that follow them. Whether it is over beers, pizza or on Facebook, residents share with each other pointers for their upcoming rotations. And although we expect our senior residents to take an active role with the junior residents, often times we find that the co-residents in a given year are invaluable support to each other, especially since we switch departments on average every six months the first years of our residency.   

Biannual Meetings With Training Directors

Dr. Doug Gray, our training director, and Dr. Kristi Kleinschmit, our assistant training director, make it clear from day one that their doors are always open. But just in case no problems arise, we have two individual meetings a year. This is a great opportunity for residents to talk about their rotations and to brainstorm about planning for future rotations and creating additional opportunities in specific areas of interest.

Other

Socials/Birthdays/Weddings/Births/Movies

Most of our residents have traveled a long way to train in Utah and therefore are not always able to make it home for birthdays, holidays or an occasional movie night. However, amongst ourselves as well as residents/partners in three different programs, are tons of coworkers at the hospitals and clinics, as well as the vast and tolerant city of Salt Lake. Residents, either single or with partners/families, quickly find a support system that they can rely on.

Working Within Different Programs

Chief residents, with the support of the training directors, are given the task of maintaining open communication with both the adult psychiatry and pediatric programs. We have residents on the education committees for all three fields and are constantly integrating changes by both pediatrics and psychiatry into our own structure so that we are sure that whether our residents on the pediatric wards or outpatient forensic psychiatry, they always have the highest quality experiences and meet the requirements necessary for graduation.

No one ever said residency was easy, but it doesn't have to break you either. Our residents are smart, hard working and incredibly dedicated to their patients. We recognize the effort and sacrifice our residents make because they believe that a triple board training program will, in the end, make them doctors that will be better prepared to address the complex needs of their patients and their patient's families. Over the years, we have identified the challenging aspects of training in three different programs at the same time and have developed and continue to improve the support we provide to our residents as they navigate their paths. We want our graduates to not only say that they got an exceptional training experience, but that overall, they enjoyed the ride. For the rest of your career, if you choose triple board, you will find yourself explaining to people, doctors and patients alike, what triple board is and why you did it. If you come to Utah, you can tell them that even though the idea of training in the "Wild West" was a bit intimidating at first, at least you always had your survival guide.

If you have any specific questions about how the residency program works in Salt Lake or triple board in general, please contact our chief resident, Beth Gargaro at beth.gargaro@hsc.utah.edu.

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