Advice needed for matching into psychiatry

[zenlife]

So I will be very honest about myself...and I need some really solid real advice.

I've wanted to do primary care. I didn't match for 2 years straight now. I'm a US Citizen who went to a small Caribbean school. My scores are honestly on the lower end of pass. I failed Step 3. I have been out of school since the end of 2013. I passed Step 1, 2CK and CS all in my first attempt, but like I said, with passing scores on the lower end.

At some point before application season began last year, I experienced a change of heart and started to find psychiatry more appealing. However, before I could show my development of interest, application deadlines began to approach and I applied broadly to primary care spots and psychiatry.

I didn't match this year. I know there are less than 100 psychiatry programs out there. Should I decide to apply again, I would only care to match into psychiatry.

Given all that I said, can someone please give me some advice as to what can be done? What route should I take? Thank you.

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[MacDonaldTriad]

I think there are 250 programs and about 1600 spots to match into. At this point, you should look for post-match openings. You can also look at the APA clearinghouse for openings. Be open to moving about anywhere and something will probably come up. There may be a small flood of positions at the end of June because that is when interns fail to show up sometimes.

 

[zenlife]

Thank you so much. Any advice about my Step 3 situation though? I know some psychiatry programs want you to pass it before match.

Also, how do I look for post-match openings?

 

[mgdsh]

Thank you so much. Any advice about my Step 3 situation though? I know some psychiatry programs want you to pass it before match.

Also, how do I look for post-match openings?

Take Step 3 (make sure you have a passing score in place before applying), get some more experience (say an externship - ideally at a place you can apply to), and perhaps get a letter from that externship. From there, apply broadly. Make sure someone you trust reviews your personal statement.

If all that doesn't work out, then it's probably time to move on.

 

[st2205]

Have you looked in to prelim spots for IM or (yikes) surgery? What are your thoughts on that? 1. That may assist with your step 3, 2. It will make you license-able so you can at least work somewhere doing something until you figure other stuff out. It would also open the door to PGY2 spots.

 

[MacDonaldTriad]

Passing step III will go a long way to help erase the failure. Once all three are passed, licensing issues go away and your failure only stands as a performance issue, but not an issue in terms of qualification. Jump on any openings you hear about, and do what zenlife suggests while next year’s match comes around.

 

[splik]

Have you looked in to prelim spots for IM or (yikes) surgery? What are your thoughts on that? 1. That may assist with your step 3, 2. It will make you license-able so you can at least work somewhere doing something until you figure other stuff out. It would also open the door to PGY2 spots.

it wouldn't make them licenseables, IMGs need at least 2 years of residency (sometimes 3) to get a license in every state.

 

[st2205]

it wouldn't make them licenseables, IMGs need at least 2 years of residency (sometimes 3) to get a license in every state.

Didn't know that.

 

[MacDonaldTriad]

Yes but having part III will insure you will not have to stop training in the middle of your 4 years.

 

[zenlife]

But given my situation, what are my odds honestly? I'm competing with American MD and DO graduates. I feel that programs will even choose a non-US Citizen foreign grad just because the scores are higher, which kind of hits harder. I'm willing to put in the effort, but I feel that at least in primary care, everything is based on scores (that includes FM). I have been positive and worked my way through regardless of what may appear to be "setbacks," but I still would like to know that at this point, what are my chances?

 

[mgdsh]

But given my situation, what are my odds honestly? I'm competing with American MD and DO graduates. I feel that programs will even choose a non-US Citizen foreign grad just because the scores are higher, which kind of hits harder. I'm willing to put in the effort, but I feel that at least in primary care, everything is based on scores (that includes FM). I have been positive and worked my way through regardless of what may appear to be "setbacks," but I still would like to know that at this point, what are my chances?

Well give us more concrete details. What were your exact scores? Which Caribbean school did you go to? What was your GPA? Where did you complete your rotations? What were your grades in Psych, FM, IM? Specialty and rank wise, where are your letters of rec from? How many interviews have you gotten each year? How many places did you apply to each? Is it also maybe worth polishing up on your interview skills?

Finally, there's a decision you have to make as well. How badly do you want this? What are your other alternatives? Is it worth the risk for you to devote another year to this (It's now or never sort of thing)?

 

[Flushot]

I'm curious how the last year has been. What things have you done so you can talk about it in an app and/or interview? Can you get fresh letters from these experiences? Anything clinical that can be demonstrated? There's a lot more to think about beyond scores, which are just a baseline right now.

 

[zenlife]

Step 1: 193
Step 2 CK: 202
Step 2 CS: pass (on first attempt)
GPA: Pass/Fail System. All courses passed
Rotations: mostly outpatient clinics in Illinois
Grades for FM, IM, Psych - we were given a score for different cateogories (knowledge, clinical skills, attendance, etc...) with a range from 0-5 (5 being the highest). Most of my scores are 4-5. A score of 1 or 0 is considered an automatic fail in the rotation. All my student evaluations were positive.
LORS: Since I was interested in primary care, I applied with 2 FM, 1 Psych and 1 IM LOR when applying for Psych. They came from IMG US Physicians. These physicians are not connected to any residency programs (which is probably a drawback).
In the past 2 years, I have only received 1 interview per interview season. Both were in FM. Last year was the first time I applied for Psychiatry. I had not Psychiatry interviews because I'm sure residencies looked at my application and saw a clear interest in FM.

In the past 2 years, I've done as much as I could geared towards FM. I'm currently working in a doctors' office as an MA/Scribe. And since my interest in Psychiatry began not too long before apps were due for the 2015 match, I wasn't able to really show much on paper for it.

 

[OldPsychDoc]

You really need something that screams Psych. As you rightly surmise, your FM focus was probably interpreted by many psych PDs as a lack of real interest in our field. That plus marginal boards, lower tier offshore school, and no personal connections to a psych program will essentially doom you. Realize that your application is down in that stack of 900 others with very similar stats, and no compelling reason to consider for a psych program. You NEED a connection to a decent psych program to prove your aptitude and gain some advocates for your application. Getting Step 3 passed wouldn't hurt, either--many other applicants in your situation will have it done, and you're slipping to the bottom half of that 900 without it.

It's an uphill climb, but if you can show you've learned something in this process, you'll rise to the top.

 

[zenlife]

Thank you for your honesty. You are absolutely right.

If I decide to gear my resume towards Psychiatry now and I have a list of FM activities from last year, how will that affect my application? (Let's say I also decide to retake Step 3 and pass it)

 

[OldPsychDoc]

Thank you for your honesty. You are absolutely right.

If I decide to gear my resume towards Psychiatry now and I have a list of FM activities from last year, how will that affect my application? (Let's say I also decide to retake Step 3 and pass it)

Probably not an issue if you've got some psych-oriented activity in the next 6 months.

 

[pisekar]

Did you see your recommendation letters?

 

[zenlife]

I could be wrong but this year, when I spoke with a few people students with really high scores matched into psychiatry. Are scores really that much of a priority?