As an Osteopathic Applicant, would you guys recommend doing more than my 3rd year core in Psychiatry? So far that's the only Psych rotation that I have completed. I'm still debating between psych/IM/EM and so I'm not sure if I have space during my 4th year electives to add on a psych rotation.
I did my core in 3rd year, and also one elective late in 3rd year. Did 1.5 auditions before submitting my app, but they didn't count towards applications in any way, I think I would've gotten interviews at those places anyways.
I DO think that psych letters are generally slightly more important than in some other fields. If your letter writers convey your sincere interest, I think that really helps. Almost every one of my interviewers commented on my LOR's. Also, you'll probably want 2 letter writers in your field of choice, so there's that.
If you want more advice, feel free to PM me and I'll tell you my story. Short version: DO student, average grades, average COMLEX, no USMLE, 2 psych letters, 1 medicine letter. Applied to ~30 places, MD only (way too many, but overkill is better than not enough kill). Got interviews at pretty much every place I applied, except the ones I withdrew from after the offers came rolling in. Interviewed at 15, ranked 13, matched at #1.
Reasons I didn't choose IM or EM:
IM: I liked cards, but declining salaries, eternal fellowship didn't interest me. Also competitive and it's highly probably you can wind up in general IM, which would suck. Hospitalisting isn't "bad", but I don't love it either. Shift work, forever. It's like your a waiter, but in a hospital. You won't want to be doing that when you're 40 with a spouse and kids. You'll want to go home and 5 and on the weekends like a normal human being. Difficult to do in IM/EM.
EM: I like EM. I really do. Again, not a fan of the rotating 24 coverage shifts. Not forever. Also, and this is some magic 8 ball work on my part, which you're free to disagree with, I emphatically believe that EM will be a HEAVILY over saturated market within the next 10-20 years. As the gov't runs out of money, they'll have to start making some changes to EMTALA, or at least what types of ER visits will be covered, because they can't afford to keep paying ER docs to do primary care. Primary care ED visits currently account for a huge % of all ER visits (25-50%+ depending on who you believe), and if you take away most of those visits, and the frequent fliers, you'll have a LOT of ER docs twiddling their thumbs. Also, EM has been one of the fastest growing fields for many years, and has one of the lowest average ages amongst practicing physicians.
Contrast this with Psych, which has a crazy shortage of providers, one of the HIGHEST average ages (which will only make the shortage worse), no EMTALA crap, great hours, reasonable (if underestimated) pay, time to talk to patients (usually), and great, interesting pathology, and it's a no-brainer to me. I also happened to enjoy psych the most, and I want my own office, so the low overhead appealed to me.
Medical Student, Third Year. 
