Choosing a residency program for specific fellowships (particularly - sleep)

[shan564]

We all know that it's best to do your residency at a program that offers a particular fellowship. But I've recently been developing an interest in sleep medicine from a psychiatric perspective, and I'd like to choose my residency accordingly.

From what I've been reading, there are only 3-4 sleep fellowships (particularly Mississippi-Jackson and Thomas Jefferson - and also Dartmouth, but I probably won't get in there) that are psychiatry-focused. So I'll probably rank those programs high up, but I'm an IMG, so there's a reasonable chance that I won't get one of my top choices. Also, I'm concerned that if I do get into one of those programs and then don't get the fellowship, I might not have the best chances for fellowships elsewhere, since those programs aren't the most prestigious in the world.

My three main options at the moment are:
1. Do a combined med/psych residency - I was actually thinking about ranking the med/psych programs high anyway, since I find med/psych relatively interesting. Many people here have pointed out that med/psych has fairly vague career prospects, but others have mentioned that it would put me in a strong position for a sleep fellowship (since sleep fellowships accept both psychiatrists and IM guys). The drawback is that I wouldn't have a lot of elective time to do sleep rotations and sleep research.

2. Do a research-heavy general psych residency; focus my research and electives on sleep - This is actually a reasonable choice for me too. I like research and I'd like to go to a research-heavy program. But I'm wondering if a sleep fellowship might prefer a med/psych doc over a general psychiatrist with sleep experience.

3. Just try to go to one of the residency programs with a psych-oriented sleep fellowship - this seems like it could also knock out #2, but I'm concerned that graduates of a place like Mississippi-Jackson might not be seen as favorably for fellowships as graduates of a better-known research institution.


In case it matters, I'm a US citizen, went to med school in Australia, have reasonable board scores (227 step 1, 242 step 2ck), have decent rec letters (although two are from Australian doctors, which is probably relevant), no psychiatry research (except for one case report, if that counts), and an overall "decent" CV.


Thanks for the help!

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[BobA]

We all know that it's best to do your residency at a program that offers a particular fellowship. But I've recently been developing an interest in sleep medicine from a psychiatric perspective, and I'd like to choose my residency accordingly.

From what I've been reading, there are only 3-4 sleep fellowships (particularly Mississippi-Jackson and Thomas Jefferson - and also Dartmouth, but I probably won't get in there) that are psychiatry-focused. So I'll probably rank those programs high up, but I'm an IMG, so there's a reasonable chance that I won't get one of my top choices. Also, I'm concerned that if I do get into one of those programs and then don't get the fellowship, I might not have the best chances for fellowships elsewhere, since those programs aren't the most prestigious in the world.

My three main options at the moment are:
1. Do a combined med/psych residency - I was actually thinking about ranking the med/psych programs high anyway, since I find med/psych relatively interesting. Many people here have pointed out that med/psych has fairly vague career prospects, but others have mentioned that it would put me in a strong position for a sleep fellowship (since sleep fellowships accept both psychiatrists and IM guys). The drawback is that I wouldn't have a lot of elective time to do sleep rotations and sleep research.

2. Do a research-heavy general psych residency; focus my research and electives on sleep - This is actually a reasonable choice for me too. I like research and I'd like to go to a research-heavy program. But I'm wondering if a sleep fellowship might prefer a med/psych doc over a general psychiatrist with sleep experience.

3. Just try to go to one of the residency programs with a psych-oriented sleep fellowship - this seems like it could also knock out #2, but I'm concerned that graduates of a place like Mississippi-Jackson might not be seen as favorably for fellowships as graduates of a better-known research institution.


In case it matters, I'm a US citizen, went to med school in Australia, have reasonable board scores (227 step 1, 242 step 2ck), have decent rec letters (although two are from Australian doctors, which is probably relevant), no psychiatry research (except for one case report, if that counts), and an overall "decent" CV.


Thanks for the help!

If you definitely want to do Sleep you should strongly consider taking the IM route. There aren't many jobs for psych-trained sleep docs - you'll have to move for the job. Unless you plan to open your own lab.

 

[shan564]

Well, I'm not 100% sure about sleep, but I am 100% sure about psych... and even within sleep, I'd prefer to deal with psychiatric sleep issues rather than running a big sleep apnea clinic. I don't mind moving for the job... and I actually also don't mind taking a loan to open my own lab or work primarily as a psychiatrist while I gradually build up my sleep practice.

 

[twright]

We all know that it's best to do your residency at a program that offers a particular fellowship. But I've recently been developing an interest in sleep medicine from a psychiatric perspective, and I'd like to choose my residency accordingly.

From what I've been reading, there are only 3-4 sleep fellowships (particularly Mississippi-Jackson and Thomas Jefferson - and also Dartmouth, but I probably won't get in there) that are psychiatry-focused. So I'll probably rank those programs high up, but I'm an IMG, so there's a reasonable chance that I won't get one of my top choices. Also, I'm concerned that if I do get into one of those programs and then don't get the fellowship, I might not have the best chances for fellowships elsewhere, since those programs aren't the most prestigious in the world.

My three main options at the moment are:
1. Do a combined med/psych residency - I was actually thinking about ranking the med/psych programs high anyway, since I find med/psych relatively interesting. Many people here have pointed out that med/psych has fairly vague career prospects, but others have mentioned that it would put me in a strong position for a sleep fellowship (since sleep fellowships accept both psychiatrists and IM guys). The drawback is that I wouldn't have a lot of elective time to do sleep rotations and sleep research.

2. Do a research-heavy general psych residency; focus my research and electives on sleep - This is actually a reasonable choice for me too. I like research and I'd like to go to a research-heavy program. But I'm wondering if a sleep fellowship might prefer a med/psych doc over a general psychiatrist with sleep experience.

3. Just try to go to one of the residency programs with a psych-oriented sleep fellowship - this seems like it could also knock out #2, but I'm concerned that graduates of a place like Mississippi-Jackson might not be seen as favorably for fellowships as graduates of a better-known research institution.


In case it matters, I'm a US citizen, went to med school in Australia, have reasonable board scores (227 step 1, 242 step 2ck), have decent rec letters (although two are from Australian doctors, which is probably relevant), no psychiatry research (except for one case report, if that counts), and an overall "decent" CV.


Thanks for the help!

I don't know what it takes to get into a sleep fellowship, but my guess is that you need to have done some research. If that is the case, then you will have more time for research if you do a psych residency rather than med/psych. At most med/psych programs you are still taking Q4 ICU call as a senior during your PGY5 year.

I would not recommend going to a residency solely because of its sleep fellowship. A lot can happen during residency, i.e., you may change your mind. If you are at a less competitive program, then changing your mind will be harder. (i.e., if you go to MGH and decide you want to do addictions, it will be easier than if you go to Mississippi-Jackson and decide you want to do addictions)

 

[mass1]

You have strong scores. I would suggest going for Dartmouth. I, too, am an IMG and I had an interview there last year, and from what I was told their sleep program is psychiatry based. Since you are 100% psychiatry, seems like this is the best bet. What helped me get an interview there last year was emailing the PD after the interview season was heavily underway, and as people decline, spots open up, so you may wanna try that. (I ended up ranking another program as my number 1, however, due to location)

 

[shan564]

I would not recommend going to a residency solely because of its sleep fellowship. A lot can happen during residency, i.e., you may change your mind. If you are at a less competitive program, then changing your mind will be harder. (i.e., if you go to MGH and decide you want to do addictions, it will be easier than if you go to Mississippi-Jackson and decide you want to do addictions)

Yeah, that's another thing I was thinking about... MGH is probably out of my league, but I think that places like WashU (which is high on my list because I'm from St. Louis) and other "fancy" programs are more likely to provide me with a strong base if things change.

You have strong scores. I would suggest going for Dartmouth. I, too, am an IMG and I had an interview there last year, and from what I was told their sleep program is psychiatry based. Since you are 100% psychiatry, seems like this is the best bet. What helped me get an interview there last year was emailing the PD after the interview season was heavily underway, and as people decline, spots open up, so you may wanna try that. (I ended up ranking another program as my number 1, however, due to location)

Thanks for the info - it's good to have that bit of advice from somebody who has already been through the process. But my concern is that if a place just squeezes me in for an interview, I probably wasn't a great candidate there in the first place.

When I looked at Dartmouth's "current residents" list, there wasn't a single IMG in all four years... I'll still interview there if they'll have me, but I'm not expecting too much.

 

[mass1]

Yeah I really liked WashU's program (and went there for undergrad) and alumni get great jobs/fellowships.

I applied to both med/psych and psych for total of 126 programs...got 40 invites and went to 22. Definitely overkill looking back but I was scared of not matching as an IMG. But feel free to PM me with any questions since it seems your path is similar to mine. I applied mostly to northeast, midwest, and south.

 

[splik]

When I looked at Dartmouth's "current residents" list, there wasn't a single IMG in all four years... I'll still interview there if they'll have me, but I'm not expecting too much.

There's at least one

 

[silas2642]

There's at least one

I interviewed at Dartmouth a few years ago and my impression was that this program was perhaps a little "less desired" by some AMG's simply due to the location. You really have to be okay with living in the middle of nowhere. Hanover is absolutely gorgeous, but if you want a ton of stuff to do that doesn't involve snow pants and sub-zero temperatures, you may be a bit hard pressed for entertainment. It also struck me as a more difficult place to meet people but as a good location if you're raising a young family.