Tracey Guthrie, M.D., knows the General Adult Psychiatry Residency inside and out – as both a former resident and administrator of the program. Guthrie trained in the residency from 1995-1999 and ultimately directed the program from 2015-2024. She is currently Senior Advisor to the residency; Associate Dean for Student, Trainee, and Faculty Belonging for the Brown BioMed Office of Belonging, Equity, Diversity, and Inclusion (OBEDI); and President of the American Association of Directors of Psychiatric Residency Training (AADPRT).

First Impressions as a Rookie Resident

I was wide-eyed from the moment I first drove onto [the Butler Hospital] campus. I’d never been any place like this before. It was a lot to absorb that people had built all this – these beautiful grounds and all this allocated space – for people with mental illness. That was impressive to me. 

And that’s even before there was the Riverview Building, the Lippitt Building. Back when [Patient Assessment Services] used to be just a couple of rooms with a sliding glass window in the hallway where someone could walk up and say, “Hi, I’m here for depression.” It was not nearly as large as it is now.

A View from the Director’s Chair

I really like building things. That’s one of the cool parts of the job. You know, though, a lot of our developments came from other people. We’re so blessed with an incredibly rich faculty who will just call you up and say, “I have an idea, I want to do X. Can I do that?” And I get to say, “Yeah, let’s do it.” Whether that’s working on the curriculum, or increasing conversations about social determinants of health, or getting comfortable talking about cross-identity treatment, or trying to enrich the community psychiatry experience.

I’m proud of the people I work with, these incredible people who are so passionate about the program. That, you can’t buy on Amazon. You have to create that space. If I’m proud of anything, I hope I created that space for people to thrive.

No Place for Nostalgia in Training

When Jane Eisen left as program director [and I became director], it happened very quickly. I didn’t have time to reflect on my time in the program. For the most part, I’ve found it’s not helpful to reflect on the past with the residents, either, because that time has passed. I’ve learned it’s a brand new experience for me, and a brand new experience for them.

But if they ask me things that I think have a teaching point, like when they fail a CSV [clinical skills evaluation], I’ll tell them how I failed a CSV. They get so upset when they fail one, and I understand. I was upset, too. But I was also grateful for all of those humbling experiences. 

Special Ingredients of Residency

One of the features of the program that makes it special is its consistency. It doesn’t really have mass fluctuations. There’s this microscopic growth that feels like it’s been there all along. You do occasionally have a big change, like the RCC [Residency Continuity Clinic], which was a huge benefit because we got to observe residents directly, but now people can’t remember the program without it.

Also, I think our psychotherapy curriculum is second to none. We are lucky to have such a large number of faculty who engage with and serve our program as psychotherapy supervisors. This is not typical across the country in other psychiatry residency programs. All these people who have nurtured our psychotherapy component along were paid, at times, nothing for it. All you can give is your true, sincere, and authentic thanks.

The Lifelong Bonds of Residency

Your cohorts, the years that you work with them, are really important. I still have long-term relationships with these folks. I’ve traveled to see them, they’ve traveled to see me. I’ve been to their homes, they’ve been to mine. I’ve seen them and their families change and grow. You have very few people like that in your life, right? Maybe your siblings or people you’ve grown up with. There’s this intense period of time and training where you connect in an incredible way.