Eli5: how will the merger affect specialties like fm, pmr, psych?

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sabsaf123

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Ive read the threads on the merger and there seems to be some conflicting information. Some say that many DO residencies will clos down while others say that certain fields, like fm, will actually grow. The general consensus seems to be that DO students aiming for highly competitive fields, like derm, ortho, urology, etc. will find it harder after a few years. What about those of us interested in fields considered "less competitive"? Will the board scores and grades required to get into fm or psych remain close to the same in 2020?

If someone really wants to do fm, and are willing to move anywhere to do it, will they still have a good chance if there boards/grades are below average?
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Yes. Chances are you'll be able to still have some capacity to pick out location and etc even if you're below average or in the bottom 10 percentile. However if you've got like 2 COMLEX 1 failures, then possibly you'll have to end up going somewhere significantly less desirable.

Generally all of these specialties will continue to probably remain uncompetitive and relatively easy to match into. Especially so in FM where board scores seem to as a whole not matter in regard to domestic graduates.
 
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Goro said:
Ditto this.

I'm beginning to think that trying to predict the effects of the merger will be like trying to predict the results of the 2020 election.
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Hillary being reelected with a high 80% chance? Bad example I imagine lol, the majority of presidents are reelected.
 
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Drrrrrr. Celty said:
Yes. Chances are you'll be able to still have some capacity to pick out location and etc even if you're below average or in the bottom 10 percentile. However if you've got like 2 COMLEX 1 failures, then possibly you'll have to end up going somewhere significantly less desirable.

Generally all of these specialties will continue to probably remain uncompetitive and relatively easy to match into. Especially so in FM where board scores seem to as a whole not matter in regard to domestic graduates.
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Board scores are definitely important in my program. I'm blown away at the scores of the people we interview too. 240's are the norm. 250's are not uncommon.
 
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SLC said:
Board scores are definitely important in my program. I'm blown away at the scores of the people we interview too. 240's are the norm. 250's are not uncommon.
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Overall for FM tho?
 
According to SDN, if you are a US student, you pass your boards and you have a pulse, you should be able to match into FM/IM/Psych... I don't believe that's the case.
 
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W19 said:
According to SDN, if you are a US student, you pass your boards and you have a pulse, you should be able to match into FM/IM/Psych... I don't believe that's the case.
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for USMDs in 2016,

FM - 1254/1313 matched, for 95.5%
IM - 3051/3113 matched, for 98.0%
psych - 737/815 matched, for 90.4%
http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

the first time pass rate for Step 1 for USMDs is ~96%, overall it's 94%.
http://www.usmle.org/performance-data/default.aspx

What about these numbers do you not believe?
 
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the argus said:
for USMDs in 2016,

FM - 1254/1313 matched, for 95.5%
IM - 3051/3113 matched, for 98.0%
psych - 737/815 matched, for 90.4%
http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

the first time pass rate for Step 1 for USMDs is ~96%, overall it's 94%.
http://www.usmle.org/performance-data/default.aspx

What about these numbers do you not believe?
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I was about to do the same thing... he has said this type of stuff in a few different forums now and the numbers just don't line up with that view.
 
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AnatomyGrey12 said:
I was about to do the same thing... he has said this type of stuff in a few different forums now and the numbers just don't line up with that view.
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I think he's pessimistic due to Psych being competitive nowadays. In real life, I do know quite a bunch of smart kids opting into Psych nowadays. I'm talking about people from top MDs like Columbia and Northwestern.
 
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the argus said:
for USMDs in 2016,

FM - 1254/1313 matched, for 95.5%
IM - 3051/3113 matched, for 98.0%
psych - 737/815 matched, for 90.4%
http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

the first time pass rate for Step 1 for USMDs is ~96%, overall it's 94%.
http://www.usmle.org/performance-data/default.aspx

What about these numbers do you not believe?
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I can't believe the psych numbers are so low. 90%??!? How the hell did psych become so competitive? I'm not comfortable taking out a $300,000 mortgage and having a 1/10 chance of being homeless. And that's for USMDs. I imagine the odds for DOs must be even worse.

In the title, the OP was asking about PM&R as well. Their match rate was even less.
 
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sazerac said:
I can't believe the psych numbers are so low. 90%??!? How the hell did psych become so competitive? I'm not comfortable taking out a $300,000 mortgage and having a 1/10 chance of being homeless. And that's for USMDs. I imagine the odds for DOs must be even worse.

In the title, the OP was asking about PM&R as well. Their match rate was even less.
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What are these times


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sazerac said:
I can't believe the psych numbers are so low. 90%??!? How the hell did psych become so competitive? I'm not comfortable taking out a $300,000 mortgage and having a 1/10 chance of being homeless. And that's for USMDs. I imagine the odds for DOs must be even worse.

In the title, the OP was asking about PM&R as well. Their match rate was even less.
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Psych is going to get more competitive for sure. I think without a doubt you'll need to buff your application if you want a good shot.

I also don't think it's actually become anymore competitive match wise than it ever was however.
 
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sazerac said:
I can't believe the psych numbers are so low. 90%??!? How the hell did psych become so competitive? I'm not comfortable taking out a $300,000 mortgage and having a 1/10 chance of being homeless. And that's for USMDs. I imagine the odds for DOs must be even worse.

In the title, the OP was asking about PM&R as well. Their match rate was even less.
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Looks like psych and PMR are more competitive than rads and gas these days. These are indeed some strange times we're living in. I mean look at those numbers, even if your Step 1 is near 200 you're virtually a shoo-in for rads.
 
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zero0 said:
Looks like psych and PMR are more competitive than rads and gas these days. These are indeed some strange times we're living in. I mean look at those numbers, even if your Step 1 is near 200 you're virtually a shoo-in for rads.
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Who knows. If psych continues to go up in competitiveness I'll be pissed. People need to bail.
 
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Nobody can tell.

Chill. Psych will never be competitive until another 10-15 years.

They are still letting US IMGs in from the caribbean. It is still a backup specialty for many people.

Overall we have more applicants with higher step scores applying to more places now.
 
Surprising that people are treating psych like the new derm, a few years ago it was an unpopular IMG refuge. I wonder if all these applicants really know what they're getting into? I was all in for psychiatry until I began working in a psych facility. Psych is definitely not for everyone, and can certainly NOT be considered a lifestyle specialty for every type of individual. I (selfishly) just hope peds stays at the bottom.
 
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DetectiveAlonzo said:
Nobody can tell.

Chill. Psych will never be competitive until another 10-15 years.

They are still letting US IMGs in from the caribbean. It is still a backup specialty for many people.

Overall we have more applicants with higher step scores applying to more places now.
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It's the snowball effect. A few competitive people decided they wanted Psych and mentioned how great it is and then more and more decide to join the crowd. Now Psychiatry is the new Dermatology.
 
FBurnaby said:
Surprising that people are treating psych like the new derm, a few years ago it was an unpopular IMG refuge. I wonder if all these applicants really know what they're getting into? I was all in for psychiatry until I began working in a psych facility. Psych is definitely not for everyone, and can certainly NOT be considered a lifestyle specialty for every type of individual. I (selfishly) just hope peds stays at the bottom.
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Hours wise it is definitely lifestyle friendly. Emotionally....eh.
 
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postbacpremed87 said:
It's the snowball effect. A few competitive people decided they wanted Psych and mentioned how great it is and then more and more decide to join the crowd. Now Psychiatry is the new Dermatology.
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Here's an idea....how about you guys STFU instead of blurbing about it?

And... no.

There is never any replacement for dermatology.

Most people that I know who want to do psych haven't even dealt with a psychiatric patient or a drug addict before... they see the pay and hours worked and think it is all gravy.
 
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FBurnaby said:
Surprising that people are treating psych like the new derm, a few years ago it was an unpopular IMG refuge. I wonder if all these applicants really know what they're getting into? I was all in for psychiatry until I began working in a psych facility. Psych is definitely not for everyone, and can certainly NOT be considered a lifestyle specialty for every type of individual. I (selfishly) just hope peds stays at the bottom.
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Here's the thing...

THEY DON'T KNOW WHAT THEY ARE GETTING INTO. LOL

An outpatient rotation does not teach you much.... it is the inpatient aspect where REAL psychiatry is witnessed imo.

Everybody sees the hours and pay like it's sooo great.... and then they are stuck in a room as a resident with a 300 pound heroin addict who just got out of his halfway house threatening to commit suicide needing psychiatric hospitalization.

No facility will probably want to take him in... so you are stuck with him.

I'll take a specialty where A) my patients don't berate me or call me a ****ing dingus and mothereffer for keeping them in psychiatric hold for 3 days when they thought they would be released at 10:00 AM after they signed a voluntary hold form, B) I do not need security guards to conduct any interview on a patient who is off of his/her rocker, C) I do not get spit on, thrown urine or feces at, or threatened that my whole family will be killed if I do not do something for them, D) I need to remove any pens, necklaces, rings, and/or "sharp" items (cause my reading glasses may be used as a damn shank) before I go in with an actual squad of nurses and security to restrain a "combative" patient....

oh... and can't forget E) when they try to attack you.

I have personally seen a poor psych nurse get absolutely manhandled and tossed like an absolute ragdoll by an ex college football player...

She apparently didn't "approach" him the right way as the dude was trying to get his meds from the counter. All she asked was for him to politely step away from the window where the residents and doctors were.

No offense to my good psychiatrists out there but yeeaaaa....

**** get's deep.
 
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DetectiveAlonzo said:
Exactly. LOL

Everybody sees the hours and pay like it's sooo great.... and then they are stuck in a room as a resident with a 300 pound heroin addict who just got out of his halfway house threatening to commit suicide needing psychiatric hospitalization.

No facility will probably want to take him in... so you are stuck with him.

I'll take a specialty where A) my patients don't berate me or call me a ****ing dingus and mothereffer for keeping them in psychiatric hold for 3 days when they thought they would be released at 10:00 AM, B) I do not need security guards to conduct any interview on a patient who is off of his/her rocker, and C) I do not get spit on or threatened that my whole family will be killed if I do not do something for them...

oh... and can't forget when they try to attack you.

I have personally seen a poor psych nurse get absolutely manhandled and tossed like an absolute ragdoll by an ex college football player...

She apparently didn't "approach" him the right way as the dude was trying to get his meds from the counter. All she asked was for him to politely step away from the window where the residents and doctors were.

No offense to my good psychiatrists out there but yeeaaaa....

**** get's deep.
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Exactly. These things are real and can happen to YOU in residency (but they can happen in other specialties too).
 
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DetectiveAlonzo said:
uhh... no not really...

Never seen it happen when I shadowed a few residents in IM, FM, Peds, or PMR.

Even in EM.... this was WAY WAY WAYYYY less common.
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CAN...CAN. I know a former ER nurse who had her *** handed to her. She now has chronic back issues because a Psych patient attacked her. She is now working in Cardiology.
 
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DetectiveAlonzo said:
Here's an idea....how about you guys STFU instead of blurbing about it?

And... no.

There is never any replacement for dermatology.

Most people that I know who want to do psych haven't even dealt with a psychiatric patient or a drug addict before... they see the pay and hours worked and think it is all gravy.
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Psych isn't the new Derm. It's still the second most uncompetitive specialty per numbers. The match rate is entirely based on the whether a person can actually pull off being a psychiatrist or be willing to talk to people. For many that's not possible.
 
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Drrrrrr. Celty said:
Psych isn't the new Derm. It's still the second most uncompetitive specialty per numbers. The match rate is entirely based on the whether a person can actually pull off being a psychiatrist or be willing to talk to people. For many that's not possible.
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You better stop before I give you a huge hug Celty.
 
Yeah, the difference between psych and Derm is that my DO school didn't match 6 people to ACGME university Derm programs last year.
 
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Psych isn't the new Derm, but it's definitely the new EM.

For the inexperienced eye, both specialties look great on paper. Hours, pay, short residency, relatively easy to match into.
 
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DetectiveAlonzo said:
You better stop before I give you a huge hug Celty.
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Either way though if you want to go into psych you probably should be doing stuff to improve your application for psych. Ex. Show you actually want to do it and not that you decided that medicine isn't your thing or worse that you've decided that you want to do it because it's uncompetitive enough for you to get into.

Ibn Alnafis MD said:
Psych isn't the new Derm, but it's definitely the new EM.

For the inexperienced eye, both specialties look great on paper. Hours, pay, short residency, relatively easy to match into.
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In 5 years I can agree. For now? I think not and even then, psychiatry will only be EM level of competitiveness in the Northeast and West Coast.
 
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DetectiveAlonzo said:
I'll take a specialty where A) my patients don't berate me or call me a ****ing dingus and mothereffer for keeping them in psychiatric hold for 3 days when they thought they would be released at 10:00 AM after they signed a voluntary hold form, B) I do not need security guards to conduct any interview on a patient who is off of his/her rocker, C) I do not get spit on, thrown urine or feces at, or threatened that my whole family will be killed if I do not do something for them, D) I need to remove any pens, necklaces, rings, and/or "sharp" items (cause my reading glasses may be used as a damn shank) before I go in with an actual squad of nurses and security to restrain a "combative" patient....

oh... and can't forget E) when they try to attack you.
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Experienced all of these in one form or another. Actually there was rarely a day (if ever) where at least one of these didn't occur. And inpatient's threats to yourself and family can be brushed off easily, I'm not sure about such statements occurring with a "cushy" outpatient setting.
 
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Idc what anybody says.... but damn... some of these FM job offers I've been looking at look pretty sweet. Also seems to be a backdoor into EM now with urgent cares starting to take FM docs that are board-certified.

I've seen places that are offering $150,000 loan repayment (over 4-5 years), with $50,000 sign-on bonuses.

There are also urgent cares that are offering $150-$170 bucks per hour... that's ALMOST EM money in some places that I've seen... with LESS patient load... only sniffles and colds. LOL

With that EM burnout rate so high... the dude who matched FM will be in the same place as the burnt out EM dude seeing colds and sniffles.

All that training gone to waste eventually. Such a damn shame.
 
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Plus, they will definitely need us DOs to fill the primary care gap as the IMGs get weeded out and as more DO schools pop up like franchises.

FM, IM are DEFINITELY gonna be doable.

7 days on, 7 days off making $285,000??? psshhh sign me up.

Picking up 2-3 extra shifts on your week off can definitely net you over $350- $375,000.

I personally know somebody that paid off their loans in under 2 years doing the above.
 
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DetectiveAlonzo said:
Plus, they will definitely need us DOs to fill the primary care gap as the IMGs get weeded out and as more DO schools pop up like franchises.

FM, IM are DEFINITELY gonna be doable.

7 days on, 7 days off making $285,000??? psshhh sign me up.

Picking up 2-3 extra shifts on your week off can definitely net you over $350- $375,000.

I personally know somebody that paid off their loans in under 2 years doing the above.
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Where are these guys practicing? Rural areas?
 
L
FBurnaby said:
Surprising that people are treating psych like the new derm, a few years ago it was an unpopular IMG refuge. I wonder if all these applicants really know what they're getting into? I was all in for psychiatry until I began working in a psych facility. Psych is definitely not for everyone, and can certainly NOT be considered a lifestyle specialty for every type of individual. I (selfishly) just hope peds stays at the bottom.
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Yeah, man, peds ain't going nowhere. You'll be fine. They have quite a few awesome subspecialities that either have less applicants than spots or the ratio is 1.1-1.2:1.

You'll be fine.
 
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DetectiveAlonzo said:
Pshhh.. not even.

This is in So-cal.

Jobs are out there yo. No matter how "dire" the situation seems on SDN.
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Yup, the reality is that it's very hard to wind up in a losing situation once you get to the point of being board certified in any specialty. There's money to be made everywhere and if you want, you can make lifestyle a priority. Of course it helps if you're flexible, but things are nowhere near as bad as SDN makes it out to seem. People on here are just addicted to worrying.
 
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I found a job that pays in the 300k range, with rocking retirement package, 200+k in loan repayment over 3 years, and residency stipend and sign-on bonus. Rural but within an hour of a large (2million population) metro area.

The jobs are most definitely out there!
 
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sazerac said:
I can't believe the psych numbers are so low. 90%??!? How the hell did psych become so competitive? I'm not comfortable taking out a $300,000 mortgage and having a 1/10 chance of being homeless. And that's for USMDs. I imagine the odds for DOs must be even worse.

In the title, the OP was asking about PM&R as well. Their match rate was even less.
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Many people get too comfortable and just try to go regional which causes them to go unmatched. Psych is more competitive now, but you should be able to match somewhere as a US MD.
 
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AlbinoHawk DO said:
Many people get too comfortable and just try to go regional which causes them to go unmatched. Psych is more competitive now, but you should be able to match somewhere as a US MD.
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What about as a DO? Do you think Psych is going to need a USMLE score now adays?
 
Drrrrrr. Celty said:
What about as a DO? Do you think Psych is going to need a USMLE score now adays?
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I don't know the answer to that, but you should always take the USMLE if you believe you can score >210.
 
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When I checked FREIDA online, the most common minimum Step 1 score required for a psych interview was 220.
 
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