BIG MISTAKE - MATCH

[Freud1988]

Hey guys, so I matched EM this year. I only interviewed at 2 EM places and 9 psych programs and I ended up matching EM instead of psych.

I applied to both psych and EM but now I am realizing I don't want to do EM. I really want to do PSYCH but the match is over. What can I do??? Any advice???

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[nancysinatra]

I will switch with you. You can take my psychiatry job and I will take your EM residency spot.

Anyway why did you not only apply and interview in, but also rank, two specialties that are so different from each other? You know you can always find a psych spot at some point - maybe start looking during your intern year. I think you have a Match obligation to start the EM residency, is that correct? But if you give up the EM spot you might not be able to get it back. I don't know, but that'd be my worry.

 

[DermViser]

Hey guys, so I matched EM this year. I only interviewed at 2 EM places and 9 psych programs and I ended up matching EM instead of psych.

I applied to both psych and EM but now I am realizing I don't want to do EM. I really want to do PSYCH but the match is over. What can I do??? Any advice???

Did you rank all 9 psych positions above EM? My understanding is there are many Psych programs that allow you to enter after completing the first year as there are tons of people who see the light after their internship. I don't know whether it's through ERAS though but through a paper application.

 

[Makati2008]

Hey guys, so I matched EM this year. I only interviewed at 2 EM places and 9 psych programs and I ended up matching EM instead of psych.

I applied to both psych and EM but now I am realizing I don't want to do EM. I really want to do PSYCH but the match is over. What can I do??? Any advice???

I would do the EM residency and be grateful. Many folks would kill to be in your position

 

[Nasrudin]

I would do the EM residency and be grateful. Many folks would kill to be in your position

What?! I wouldn't. EM is for people who want to do EM. The same with psych.

If you made a mistake, knowing it and planning the intern year accordingly might be the best thing. You could develop multiple contingencies and who knows...you might like EM more than you thought and you may be just getting cold feet.

I know I began to think of what might have been as all my colleagues were getting ready to venture off in different directions. I thought about if I would have liked anesthesiology or PM&R or other things. But...I'm good. I made the right choice.

But the finality of getting towards the upper years in a residency is serious. Such that if you want to make a jump you better get ready and do it. Or you end up like nancysinatra--wishing you had but too deep in to change it. There is no way I would repeat any part of a residency. But I can just possibly envision a jump after intern year if I could stay on track. Luckily I'm happy and have always been able to accommodate a cheerful enough disposition to whatever situation I end up in, in any case.

 

[shan564]

I agree with everything that Nasrudin said above, as I usually do. You might like EM. But try to make contingency plans to the extent that your program will allow.

A lot of people switch to psych after starting a different residency. Some of your intern year rotations would likely transfer. You might want to talk to the psych PD at the institution where you matched.

As for whether you can switch now, I don't think that's a possibility. When you enter into the Match contract, I'm pretty sure that backing out is a violation that's punishable by death.

 

[TexasPhysician]

The problem you may run into is funding. Assuming you matched at a 3 year EM program, you won't have full funding at psych programs if you transfer. This results in many quality programs passing on you.

The positive thing is that EM involves a lot of psychiatric problems. My top 2 specialties in my decision were EM and psych.

You must have ranked both for a reason. Really think about whether you want to switch as it isn't easy.

 

[Shikima]

Complete the EM program and do a psych program afterwards.

 

[OldPsychDoc]

At this stage in the game you are contractually obligated to start your EM residency. The good news is that a least a little bit of it (not much, unfortunately) is going to apply toward a PGY1 year in Psychiatry. If you get on good terms with your program, you can look to switch next summer, and it looks like PGY2 psych positions will now be exempt from the whole "all-in" thing, so you might luck out as a straight PGY2 applicant. You might even get lucky and be able to transfer off-cycle this winter if a PGY1 slot is open someplace, and your EM program is willing to release you--but you're going to need to be on good terms with your EM PD and find a willing program on the other end. So bloom where you're planted for now, and good luck.

(If you're exceptionally lucky--there might be a Psych resident somewhere who is wishing they'd picked EM and you could arrange a swap. But a lot of stars need to align for that.)

 

[MacDonaldTriad]

I know the NRMP police will give people trouble and prevent a matched graduate from taking a different PGY-I position, but I’m still unclear about some details. From what I have seen, slave labor ended with the 13 amendment in January of 1865. We are not allowed to poach residents from each other, but it happens all of the time.

So, do trainees have to complete the entire PGY-I year before leaving? Do they have to quit one, wait a day or a week, or a month and then join a new program? I know that the NRMP people have to bless transfers even when both programs are in agreement, but I can’t imagine why they would stand in the way of such a situation. In fact, I have heard of directors being threatened by the NRMP for being anything less than fully cooperative in letting residents go. I think I understand the theory and the stated policy, but the practice doesn’t look much like the theory

 

[Freud1988]

Thanks for all the advice! I actually ranked EM #3, and ranked two pysch reach programs #1, #2. I never imagined I would match EM. I know many of you are thinking how foolish to rank a program high that you did not intend on doing. I know I know it was a mistake!

Based on what you guys said, I guess I will have to find a psych resident who is willing to switch or wait until intern year to find a open program.

EM and pysch are different, but those were the only 2 rotations that I enjoyed, but now I just can't imagine doing EM.

Thank you all for your help and I will keep you updated with my situation.

 

[Nasrudin]

Thanks for all the advice! I actually ranked EM #3, and ranked two pysch reach programs #1, #2. I never imagined I would match EM. I know many of you are thinking how foolish to rank a program high that you did not intend on doing. I know I know it was a mistake!

Based on what you guys said, I guess I will have to find a psych resident who is willing to switch or wait until intern year to find a open program.

EM and pysch are different, but those were the only 2 rotations that I enjoyed, but now I just can't imagine doing EM.

Thank you all for your help and I will keep you updated with my situation.

Good luck. I can understand your mistake. I know several people personally who ranked different specialties just like you did. And It's hard to decide what work to commit to for a lifetime.

 

[Leo Aquarius]

I don't want EM. And I could have matched into EM. Psych residents are happy with their choice as I'm sure EM residents are happy with theirs... for the most part.

I still don't understand the mania surrounding EM. I lived it for 1 month and strongly disliked the lifestyle. It kills a person very very slowly imho.

 

[Makati2008]

I don't want EM. And I could have matched into EM. Psych residents are happy with their choice as I'm sure EM residents are happy with theirs... for the most part.

I still don't understand the mania surrounding EM. I lived it for 1 month and strongly disliked the lifestyle. It kills a person very very slowly imho.

Oddly I felt the same about psych....

 

[Nasrudin]

Oddly I felt the same about psych....

Not so oddly I feel the same way about someone counseling someone else with Napolean like confidence to do a particular job for the rest of their life and to shut up and feel lucky about it....without even knowing that person.

 

[Makati2008]

Not so oddly I feel the same way about someone counseling someone else with Napolean like confidence to do a particular job for the rest of their life and to shut up and feel lucky about it....without even knowing that person.

Lol if you say so man. To each his own.

 

[Nasrudin]

Lol if you say so man. To each his own.

I do in fact, say so. And it's to each his own which was my point running counter to yours.

 

[Makati2008]

I do in fact, say so. And it's to each his own which was my point running counter to yours.

Bye bye

 

[Nasrudin]

Bye bye

On your way.

 

[Venko]

Wow, I'm sorry you are facing a difficult moment but one with the potential to do great things for your life.

I was a psych resident who switched into EM and it has been great for me. I think (as is common) nasrudin is wise. I would agree that you should be aware of your urge to switch and plan a way to do so but give the EM residency a chance. It may be jitters may not. With time you will increase your likelihood of knowing the truth behind your desire to switch.

Good luck!

 

[Leo Aquarius]

People switching into psych is usually the trend.

 

[Elisabeth Kate]

Oddly I felt the same about psych....

Hm, so let me see if there could be some hidden motivation to you being on the psych forum trying to dissuade someone from a career in psychiatry.

 

[Makati2008]

Negative.

 

[Atom bum]

People switching into psych is usually the trend.

I wonder if that is because it is generally easier to switch into psych than out of though.

 

[Leo Aquarius]

You don't see lots of residents switch into Peds, unless they want to work with children.
Likewise, Psych is so specific that you would have to be a fool to pick it without wanting to do it. It's not like EM where anyone can do it.

You're thinking like a med student. When you enter residency you will see the appeal of psychiatry I guarantee it even if you don't like it.

 

[Venko]

You don't see lots of residents switch into Peds, unless they want to work with children.
Likewise, Psych is so specific that you would have to be a fool to pick it without wanting to do it. It's not like EM where anyone can do it.

Do you really mean that about EM?

Having done both, I would bet that most students don't fully understand what they are getting into in either specialty (probably all specialties). As for anyone doing EM, I can say I don't believe everyone is built for it, just like not everyone is built to be a surgeon, psychiatrist, ophthalmologist, or internist. There are definitely character traits that lend themselves to success and some for failure with respect to EM.

I believe the same for psych.

 

[Armadillos]

If you could gurantee you were only working shifts contained between 7am-7pm I think EM would be one of the best gigs in medicine, but the constant rearranging of the the sleep/life schedule can grind on people. That being said I think its still a really great field for the right person, and I think the type of person who is on the fence between EM and psych is going to like EM way more than the person who was debating between EM and surgery/anesthesia.
Also obviously have to have super thick skin to do EM, getting abuse from certain patients and then always getting talked down by the rest of the physicians at the hospital who wonder why you don't do <blank> as well as a <blank>-ist.

 

[Atom bum]

You don't see lots of residents switch into Peds, unless they want to work with children.
Likewise, Psych is so specific that you would have to be a fool to pick it without wanting to do it. It's not like EM where anyone can do it.

You're thinking like a med student. When you enter residency you will see the appeal of psychiatry I guarantee it even if you don't like it.

That seems true and it is a good point, but I suppose some people would do anything to avoid kids or the lowest paying specialty.
That said, I'm sure many more people would rather do anything than work with psych patients.
I don't know.

 

[vistaril]

That seems true and it is a good point, but I suppose some people would do anything to avoid kids or the lowest paying specialty.
That said, I'm sure many more people would rather do anything than work with psych patients.
I don't know.

you are correct that psych is probably the lowest paying specialty. It's certainly the specialty with the lowest ceiling(although one could argue outpatient peds and family have lower floors, but much higher ceilings).

 

[SteinUmStein]

you are correct that psych is probably the lowest paying specialty. It's certainly the specialty with the lowest ceiling(although one could argue outpatient peds and family have lower floors, but much higher ceilings).

I think the poster you quoted was referring to peds. Also, got any data to support your post?

 

[Atom bum]

Vistaril has it rough, sticking it out in the worst specialty in medicine. For some reason he wont switch out to peds even though it apparently has higher pay.

 

[Nasrudin]

Vistaril has it rough, sticking it out in the worst specialty in medicine. For some reason he wont switch out to peds even though it apparently has higher pay.

Switching takes courage, gumption, and grit. Whereas trolling requires only a halfwit's sense of humor and skulking liar's intent.

 

[SteinUmStein]

Peds is definitely one to watch, the new Medicaid reimbursement schedule for Disney character stickers is out of control.

 

[whopper]

Follow OPD's advice. When you do EM, kick butt because you want to make yourself look good when you ask your PD for a recommendation for the psych program you want to enter.

 

[vistaril]

Vistaril has it rough, sticking it out in the worst specialty in medicine. For some reason he wont switch out to peds even though it apparently has higher pay.

peds has a lower floor. There are a few full time purely clinical jobs in certain peds settings(outpt academics junior level faculty starting off) that actually pay 125-130ish in some cases. In psych the same position would be 150-155ish. But peds also has a much higher ceiling, even for general peds if you do enough volume. And obviously some of the subspecialties(especially neonatology) have a much much higher ceiling, even though less than their adult counterparts. I know of a high volume small community neo group based out of one city in Alabama where they make 800-1.1 each(3 person group, apparently the right contracts). Obviously nobody in mh sees anything like those sorts of numbers.

So the answer is it really depends. In general they are certainly two of the lowest.

 

[Venko]

peds has a lower floor. There are a few full time purely clinical jobs in certain peds settings(outpt academics junior level faculty starting off) that actually pay 125-130ish in some cases. In psych the same position would be 150-155ish. But peds also has a much higher ceiling, even for general peds if you do enough volume. And obviously some of the subspecialties(especially neonatology) have a much much higher ceiling, even though less than their adult counterparts. I know of a high volume small community neo group based out of one city in Alabama where they make 800-1.1 each(3 person group, apparently the right contracts). Obviously nobody in mh sees anything like those sorts of numbers.

So the answer is it really depends. In general they are certainly two of the lowest.

I knew of some practices with out of pocket pay who charge very high hourly wages for psychotherapy and make over 1 mil before taxes for the year.

Every specialty has the very rare exceptions.

 

[erika604]

Hey guys, so I matched EM this year. I only interviewed at 2 EM places and 9 psych programs and I ended up matching EM instead of psych.

I applied to both psych and EM but now I am realizing I don't want to do EM. I really want to do PSYCH but the match is over. What can I do??? Any advice???

I matched in IM/psychiatry in NC. about to start but I cannot bcs of Canadian visa issues. We could swap