4th year student on medicine sub-I suddenly thinking about switching to psych from IM

[DrMcCoy]

I'm a 4th year and I thought I would be applying IM. I honored my psych rotation 3rd year and really enjoyed it. But I'd thought about going into IM for so long that I didn't really consider psych fully. Now, I'm realizing that out of all my rotations I enjoyed psych the absolute most and I am pretty miserable back on the medicine floors. I miss being able to spend time with my patients like I did on psych. I miss the conversation. And I even miss writing the notes! Which is a little weird.

The LORs I was planning to get are 1 psych, 3 IM. I don't know any psychiatrists but the one unfortunately, and I don't know if I would have time to do psych electives before apps go out. Is it too late for me to consider applying to psych now? I do anticipate that my psych letter will be very strong.

A close friend at school who is applying psych says that he has only 1 psych letter as well and has done no electives beyond his 3rd year psych rotation. My school apparently told him that was fine. But I'm so used to having everything planned out that I wasn't sure. Really wished I'd made this realization a little sooner.

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[OldPsychDoc]

It's not too late!

 

[amoeboid]

.

 

[st2205]

I had one psych letter. Granted this was 4 years ago. It should be okay.

 

[SmallBird]

I'm a 4th year and I thought I would be applying IM. I'm on my sub-internship now though and wondering if I didn't really think my specialty choice through properly. I honored my psych rotation 3rd year and really enjoyed it. But I'd thought about going into IM for so long that I didn't really consider psych fully. Now, I'm realizing that out of all my rotations I enjoyed psych the absolute most and I am pretty miserable back on the medicine floors. I miss being able to spend time with my patients like I did on psych. I miss the conversation. And I even miss writing the notes! Which is a little weird.

The LORs I was planning to get are 1 psych, 3 IM. I don't know any psychiatrists but the one unfortunately, and I don't know if I would have time to do psych electives before apps go out. Is it too late for me to consider applying to psych now? I do anticipate that my psych letter will be very strong.

A close friend at school who is applying psych says that he has only 1 psych letter as well and has done no electives beyond his 3rd year psych rotation. My school apparently told him that was fine. But I'm so used to having everything planned out that I wasn't sure. Really wished I'd made this realization a little sooner.

You have a potentially compelling narrative! How is the rest of your application?

 

[thoffen]

If you can come up with a good and actually meaningful narrative of why you changed your mind toward psych, it will probably be one of the better personal statements people will read.

 

[HarryMTieboutMD]

Definitely not too late at all, and you don't need to do a Sub-I. Truthfully LORs don't matter that much- one from psych and 2 from whatever else is fine (the higher the academic rank, the better). You might meet want to meet with the dept chair who can write one- might provide some name recognition as well (this was a talking point during interviews for me). Other than that you have a nice personal statement in the making (it won't be unique, but at least it will be genuine, which is by far the exception rather than the rule).

 

[MacDonaldTriad]

I was you exactly 30 years ago. Best decision I ever made except getting married to my wife. It would be tough to pick which one is the most responsible for what happiness I have because I couldn't imagine life any other way.

 

[MLT2MT2DO]

I was you exactly 30 years ago. Best decision I ever made except getting married to my wife. It would be tough to pick which one is the most responsible for what happiness I have because I couldn't imagine life any other way.

I'm guessing your wife visits these forums?

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[DrMcCoy]

Thank you all so much. I do want to write a good narrative because I'd hate for psych programs to feel like they're a backup plan. For the question about my app: my step 1 is low unfortunately (217). But my 3rd year grades are ok (honors in psych). No pubs.

I'm really encouraged to hear that it's not too late! I think I'm going to think about this for the rest of the week and see how I feel.

@MacDonaldTriad can I ask what about your job makes you happy? I will admit that besides the patients, the idea of being able to have a bit more breathing room to take care of myself and my family is a real draw to psychiatry (not to imply that you guys don't work hard - just feel like you're more reasonable about work-life balance).

 

[MacDonaldTriad]

I think being a witness to so many lives that are struggling and getting to support a patient’s perseverance is an unparalleled honor. I think it would be difficult to underestimate the power of mental illness and we fail frequently, but sometimes a small improvements can make a lot of difference. Other specialties do get to help people get better, but not in the same way and not with the same degree of alliance. There are other fun things I get to do; teaching and recruiting young talent working with some amazingly talented docs. Of course there are also down sides mostly related to red tape and an infinite number of regulatory agencies snooping everywhere at everything. Fortunately the fun outweighs the tedium most days. As far as pay and affording children, we hour per hour do about as well as anyone and we have more say in how much we are willing to do for money.

 

[northernpsy]

I'm a girl and honestly, if I went into IM, I wouldn't have kids. If I went into psych (and could afford it, considering all my loans) I think I would... It's a weird thing to consider since I'd sort of resigned myself to sacrificing that.

It shouldn't be a problem to find a job in Psych that pays enough to chip away at your loans and also gives enough flexibility to be a mother.
My son was born shortly after I became an attending and I should be done with my loans by the time I'm three years out from residency (with the caveat that I found a job that gave me significant loan forgiveness and I haven't upgraded my lifestyle much since residency). Honestly I probably could have and should have had a kid during residency if I had known how much I would enjoy being a mom.

 

[bonedrone14]

Op I know we're a bunch of psych homers here but ill second what was said above. If you're interested in it I think you owe it to yourself to explore your feelings more and give it a go if it feels right.

I was in your spot last year. Did an away in ophtho as my first month of 4th year and realized i really wished I was on the psych service. I scrambled into a couple psych rotations after that before interviews but I honestly think it didn't matter at all cause I had interviewers ask me if I was doing any more psych rotations in med school lol so they hadn't seen my 4th year schedule I guess. I read on here one time and found it to be true so far for myself...everyone's seen it with a little bit added though. If your favorite place in the world is the or, be a surgeon. If your favorite place in the hospital is the or, be an anesthesiologist. If you can do psych, you should.

It seems like you're fairly set already at this point. If you would like any more specifics since I just came through this process or anything shoot me a pm. Good luck!

 

[Attending1985]

By all means choose psych if that's where your heart and interests are but I have to say you can have a goo work like balance in medicine too. Part time hospitalist and outpatient jobs would be great.

 

[OldPsychDoc]