gotta love matching in psych.....

[anesthesiarocks]

yesterday an attending emails me at a top 20 program in the southeast(that I didnt even rank because I dont want to go there) and she tells me they ranked me in their top 6(meaning I would be guaranteed to go there had I put it number one)

In what other field of medicine can a person with crappy board scores, a 2.something gpa, mediocre letters of rec, and some poor narrative comments during non-psych rotations(ie medicine and surgery) have "name" programs rank them to match? Gotta love psych! The funny thing is that I had no real interest in going there in the first place and only took the interview because I was bored and wanted a free steak/hotel for the night.

Say what you want, but this is the least competitive specialty of them all. Yes, there are far more unfilled positions in other fields(im, family, etc), but for a person to match at a "top" im program they need to be a good candidate. If a person wants to match at a top psych program they basically have to come from an american allopathic school, have a pulse(most of the time), and not have a serious criminal record

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[HMSPSYCH]

I would add mental stability (no Cluster B) to your list.

Call me bias but I'm not aware of any national 'top tier' programs in the SE. The best programs are out west and up here in the NE. Successful applicants to these programs generally have great scores/LoRs/med school grades/research/etc.

 

[anesthesiarocks]

I would add mental stability (no Cluster B) to your list.

Call me bias but I'm not aware of any national 'top tier' programs in the SE. The best programs are out west and up here in the NE. Successful applicants to these programs generally have great scores/LoRs/med school grades/research/etc.

heh....I didnt mean "top tier" as in top 8 or whatever. I mean "top tier" as in top 20ish. The point is that a crappy student wanting to do IM with crappy scores and crappy letters, etc wouldn't match at places like emory, duke, vandy, uva, unc(Im not going to give away the specific program), but apparently in psych you can...and easily too!

Nothing against psychiatrists(hell Im going to be one), but lets not act like we dont have the least competitive specialty out there.

 

[RaistlinMajere]

Nothing against psychiatrists(hell Im going to be one), but lets not act like we dont have the least competitive specialty out there.

I know what you are saying and agree, but might re-frame this to "a less competitive" specialty as opposed to the least competitive. There are other fields which one could argue are less competitive. In fact, the deans at my school believe that neuro is less competitive than psych. Also, at the top-tier programs psych is still very competitive.

Everywhere I interviewed PD's mentioned that applications in psych were way up. I expect momentum to continue to build for psych as more and more people appreciate how awesome it is.

 

[CarleneM]

While psych is "less competitive" in terms of board scores and perhaps grades in surgery and medicine, many people who want to do psych at top tier places have known for quite some time. Most of the applicants I met at the most competitive places had long track records of research, advocacy/public health, or strong international psychiatry work- track records going back to college or even high school. I don't know what type of board scores they had. But I do know that if some of my classmates who are matching into rad onc, derm, etc, tried to do psych but had no prior interest or commitment, they wouldn't necessarily be looked at as favorably, no matter how sick their step 1 score.

I think once you get to the absolute top of any specialty, the application process is reasonably competitive. That being said, fear of scrambling, having no idea where we'll end up, etc is less of an issue for psych and I am grateful for that. It does seem to be more of a buyer's market in general than many other fields.

 

[2tall]

First and foremost...who cares if it is the least competitive specialty?

Anyone can look at the NRMP stats and see that those matching in psych, pm&r, and family medicine have the lowest avg step 1 scores. If I were a student interested in one of the aforementioned fields, I'd feel less pressure going into step 1 than my colleagues interested in derm, rads, or neurosurg. I'd aim at 215 not 245.

You wanna compare matching in psych to matching in IM (which has twice as many programs and 5X as many open spots). That makes a whole lotta sense. Would that make an IM top 40 program comparable to a psych top 20 program?

So you mean to tell us that you've just received an e-mail from an attending at the medical college of virginia internal medicine residency program stating you were "ranked to match"? You're obviously very proud of that (and so are we). It's a very solid program.

 

[HMSPSYCH]

I had several med. school classmates (mid-tier US MD) who matched into great IM, gen. surgery, anesth. programs of their choice with lower step scores and lukewarm CVs/LoRs/transcripts. But they were passionate about these fields, had good work ethics, and they were good at their jobs. I would agree that psychiatry is a ‘less competitive’ field but applicants who pursue this medical specialty should only do so because they are passionate about mental health care, willing to work hard, likes general medicine, and possess reasonable interpersonal skills. Many of my residency/fellow classmates were/are highly intelligent and could have gone into derm., ortho., optho., etc.. But they all knew at early stages of their careers that psychiatry was right for them. None of them went into psychiatry because they thought they could not match into other fields. And now I would bet that 99% of them are happy and are great at their jobs.

 

[colleezfascia]

Why are we all trying to justify ourselves...This just seems silly.

Choose a field that you love and feel you'd be good at. period.

At the end of the day, who the heck cares about how "prestigious" the field, program, or fellowship may be.

Do what makes you happy and go where you feel most comfortable.

 

[2tall]

I don't think anyone was attempting to justify the field or themselves. We are only pointing out the fallacy of the statement: a mediocre candidate can ''easily'' match into a top program. That doesn't apply to any specialty.

 

[BobA]

I would add mental stability (no Cluster B) to your list.

Call me bias but I'm not aware of any national 'top tier' programs in the SE. The best programs are out west and up here in the NE. Successful applicants to these programs generally have great scores/LoRs/med school grades/research/etc.

This goes back to a post I made earlier about psych's rep in different parts of the country. I'm from an upper-middle class New England background and psychiatry is held in pretty high-regard up there. People tend to be more educated and have less of a religious/moralistic bent in the northeast.

I was unpleasantly surprised to find psych held in such low-regard at my med school in the southeast. And not just by doctors, but by people I know in the community.

So I think you see a different quality of applicant in the southeast than you do in say New England or new york or California. These med students who grew up down here have such a negative view of psych that they'd rather go into PMR or gas then become a psychiatrist.

It's sad, really, because patients suffer from little access to quality psychiatrists.

 

[BobA]

heh....I didnt mean "top tier" as in top 8 or whatever. I mean "top tier" as in top 20ish. The point is that a crappy student wanting to do IM with crappy scores and crappy letters, etc wouldn't match at places like emory, duke, vandy, uva, unc(Im not going to give away the specific program), but apparently in psych you can...and easily too!

Nothing against psychiatrists(hell Im going to be one), but lets not act like we dont have the least competitive specialty out there.

I'm gonna call you out and say that it wasn't Duke or UNC. Likely wasn't emory either. Eventhough these places are in the psychiatric wasteland that is in the nation's bible belt they still attract good candidates.

 

[anesthesiarocks]

I'm gonna call you out and say that it wasn't Duke or UNC. Likely wasn't emory either. Eventhough these places are in the psychiatric wasteland that is in the nation's bible belt they still attract good candidates.

well I'll counter and say that it was one of those places......for the record I had no interest in duke so let's just say it was either emory or UNC.

And if you actually think that there is that much of a regional bias, I think you're wrong. Interventional cardiologists at emory or unc view psychiatrists the same as interverntional cardiologists at columbia or nyu. And as long as you're cool with that, no big sweat.

But on this board I see a lot of "will people respect me as a doctor" type of nonsense. And the answer is, in many ways(even amongst the educated upper middle class on the coasts) is no. And if people cant get over that, then do IM or something else.

Personally I dont care, so it doesnt bother me. If people want to view me as a physician, thats fine. If they dont(and many dont), I wont lose any sleep over it.

 

[anesthesiarocks]

These med students who grew up down here have such a negative view of psych that they'd rather go into PMR or gas then become a psychiatrist.
.

nonsense....the qualities that attract someone to psychiatry(no procedures, lots of time with patients one on one, etc) are in direct opposition to those that attract someone to anesthesiology(nothing but procedures, very technical, in and out, etc).

The idea that someone could be going back and forth between gas and psych is about as realistic as someone trying to decide between beyonce or calista flockhart.

 

[gbv]

nonsense....the qualities that attract someone to psychiatry(no procedures, lots of time with patients one on one, etc) are in direct opposition to those that attract someone to anesthesiology(nothing but procedures, very technical, in and out, etc).

The idea that someone could be going back and forth between gas and psych is about as realistic as someone trying to decide between beyonce or calista flockhart.

then I think it's fair to say you have not met many people with Psychiatry in their differential for specialty choice.

off the top of my head, I've had fellow classmates who have made decisions on OB/GYN vs. Psych (chose Psych); Ophtho vs. Psych (chose Ophtho); Derm vs. Psych (chose Psych); Gen Surg vs. Psych (chose Gen Surg); Rads vs. Psych (chose Rads); Anesthesia vs. Psych (chose Psych); Urology vs. Psych (chose Psych); Family vs. Psych (chose Family); IM vs. Psych (chose IM). Some of these are at first blush similar in nature, some at first blush very different.

This is a lot more common than you think.

 

[Kazema]

I made my choice between psych, anesthesia, and vascular surgery.

People can have different reasons for liking different specialties.

 

[HMSPSYCH]

nonsense....the qualities that attract someone to psychiatry(no procedures, lots of time with patients one on one, etc) are in direct opposition to those that attract someone to anesthesiology(nothing but procedures, very technical, in and out, etc).

The idea that someone could be going back and forth between gas and psych is about as realistic as someone trying to decide between beyonce or calista flockhart.

Psychiatry can be procedural heavy if this is your thing. There are psychiatrists out there who perform ECTs (with gas specialists at their side) every day. rTMS, VNS are other procedural alternatives.

Not sure if we can spend lots of time with patients in the real world anymore. 15 minutes med. checks have become more common due to insurance restrictions.

Work hours can be intense if you want to get paid above the normal $160-180K range. One advantage I’ve seen is that competent psychiatrists who work 10-12 hours/6 days a week would bring in $300,000+/year vs. the same IM/FP/etc. guys/gals making $200,000 working the same hours.

I like the beyonce vs. calista lockhart(ugh) comparison. Beyonce, of course, representing psychiatry.

 

[daru1]

psych vs. peds...

 

[anesthesiarocks]

Psychiatry can be procedural heavy if this is your thing. There are psychiatrists out there who perform ECTs (with gas specialists at their side) every day. rTMS, VNS are other procedural alternatives.

Not sure if we can spend lots of time with patients in the real world anymore. 15 minutes med. checks have become more common due to insurance restrictions.

Work hours can be intense if you want to get paid above the normal $160-180K range. One advantage I’ve seen is that competent psychiatrists who work 10-12 hours/6 days a week would bring in $300,000+/year vs. the same IM/FP/etc. guys/gals making $200,000 working the same hours.

I like the beyonce vs. calista lockhart(ugh) comparison. Beyonce, of course, representing psychiatry.

ect is not a "procedure" in any real sense of how most people would define a medical procedure. The one managing the "procedural" aspect of it is the anesthesiologist(or more likely crna)

 

[gbv]

I like the beyonce vs. calista lockhart(ugh) comparison. Beyonce, of course, representing psychiatry.

Definitely!

 

[diosa428]

then I think it's fair to say you have not met many people with Psychiatry in their differential for specialty choice.

off the top of my head, I've had fellow classmates who have made decisions on OB/GYN vs. Psych (chose Psych); Ophtho vs. Psych (chose Ophtho); Derm vs. Psych (chose Psych); Gen Surg vs. Psych (chose Gen Surg); Rads vs. Psych (chose Rads); Anesthesia vs. Psych (chose Psych); Urology vs. Psych (chose Psych); Family vs. Psych (chose Family); IM vs. Psych (chose IM). Some of these are at first blush similar in nature, some at first blush very different.

This is a lot more common than you think.

Yeah I was between optho and psych for a while. I've also known people thinking ob/gyn vs psych and path vs psych.

 

[HMSPSYCH]

ect is not a "procedure" in any real sense of how most people would define a medical procedure. The one managing the "procedural" aspect of it is the anesthesiologist(or more likely crna)

when one introduces electric currents,via an instrument, to induce brief seizure activities.Which, btw, can be observed on eeg monitoring, this is a medical procedure. anesth. (MD or CRNA) are there to keep the patients sedated and his/her muscles relaxed.

 

[2tall]

when one introduces electric currents,via an instrument, to induce brief seizure activities.Which, btw, can be observed on eeg monitoring, this is a medical procedure. anesth. (MD or CRNA) are there to keep the patients sedated and his/her muscles relaxed.

A 3-second push of a button while technically a procedure is tantamount to ringing a doorbell.

 

[Poitiers2]

People tend to be more educated and have less of a religious/moralistic bent in the northeast.

I seriously doubt this has much to do with eduation. Perhaps more self-reliant cultures tend not to look at psychiatry as highly? Come on. New York is not that educated of a place, and yet where does the greatest concentration of psychiatry residencies abide? We're talking only 27% of the people having bachelor's degrees here. I can name plenty of places with a much higher percentage of educated people where psychiatry is not held in as high of esteem.

Or are you really only talking about the "right" parts of Manhattan?

You may have a point on the religious end of things. Not so sure I buy into the moral argument. People who tend to be more spiritually grounded naturally have a built in system of beliefs that gives them strength--one that has been demonstrated to convey mental health. At times this may be problematic in light of particular situations, but with depression, for instance, I find it quite useful.

 

[Regnvejr]

This is a lot more common than you think.

We had one resident move from psychiatry to pathology, and then back to psychiatry again. Took a bit of finagling with the residency committee, but it all worked out. Awesome psychiatrist, by the way

 

[psychforme]

I consider low "competitiveness" a good thing.

 

[Milo]

Are you talking about present day Calista or Ally McBeal Calista?

 

[anesthesiarocks]

A 3-second push of a button while technically a procedure is tantamount to ringing a doorbell.

exactly.....my point was in that instance anything that required technical skills of any degree whatsoever is done by the anesthesia team....not the psychiatrist. Now deciding whether ect is a good thing to do is the role of psych, but lets not act like it's a "procedure"

 

[billypilgrim37]

A 3-second push of a button while technically a procedure is tantamount to ringing a doorbell.

I always wondered why my door bell had EEG leads attached to it...

 

[masterofmonkeys]

People tend to be more educated and have less of a religious/moralistic bent in the northeast.

lol. It's not expressed as judeocentric religious or moralistic bent but it's there. Tell them you're a libertarian and listen to the abuse and character assassination that follows.

 

[Faebinder]

heh....I didnt mean "top tier" as in top 8 or whatever. I mean "top tier" as in top 20ish. The point is that a crappy student wanting to do IM with crappy scores and crappy letters, etc wouldn't match at places like emory, duke, vandy, uva, unc(Im not going to give away the specific program), but apparently in psych you can...and easily too!

Nothing against psychiatrists(hell Im going to be one), but lets not act like we dont have the least competitive specialty out there.

That's what I like about psych... We don't need to truly screen people. People will screen themselves with your mentality. Good luck with anesthesia.

...and with that, you belong on my ignore list and I vote for

 

[TheWowEffect]

A 3-second push of a button while technically a procedure is tantamount to ringing a doorbell.

Quoting OLDPSYCHDOC from another thread-

In addition to evaluating the patient and determining the appropriateness of ECT for their condition (we get quite a few referrals of pts with Axis 2 issues where either the doc or the patient is looking for some kind of "quick fix"), we oversee the pre-ECT workup--head CT, EKG, labs, taper the anticonvulsants and benzos (yeah, it's kinda hard to get a therapeutic seizure when someone's taking 4 mg klonopin a day!), to say nothing of patient education, consenting the procedure, etc. In ECT itself, we determine the electrode placement, prep the contact surfaces, coordinate with anesthesia re: VSs, dosing, etc, manage the timing of med administrations (not good to paralyze an awake patient!), decide when to administer the seizure, monitor the motor and EEG seizure activity (yes we read the EEG strip--we don't need to call a neuro consult!), decide whether the treatment is adequate (aiming for a minimum of 30 sec EEG seizure activity), possibly administer a second or third seizure, supervise the patient's initial recovery, monitor and treat side effects (nausea, pain, agitation) in coordination with anesthesia, and document, document, document.

Inasmuch as it involves a "particular method for performing a task, a series of small tasks or step taken to accomplish an end", this does qualify as a "medical procedure", and it is billed for as such. No one will get rich doing ECT, but an RVU is an RVU...

 

[cleareyedguy]

In what other field of medicine can a person with crappy board scores, a 2.something gpa, mediocre letters of rec, and some poor narrative comments during non-psych rotations(ie medicine and surgery) have "name" programs rank them to match? Gotta love psych! The funny thing is that I had no real interest in going there in the first place and only took the interview because I was bored and wanted a free steak/hotel for the night.

This paragraph says less about psychiatry than it does about you.

 

[TheWowEffect]

This paragraph says less about psychiatry than it does about you.

I thought so too, especially the bold part.

In what other field of medicine can a person with crappy board scores, a 2.something gpa, mediocre letters of rec, and some poor narrative comments during non-psych rotations(ie medicine and surgery) have "name" programs rank them to match? Gotta love psych! The funny thing is that I had no real interest in going there in the first place and only took the interview because I was bored and wanted a free steak/hotel for the night.

 

[HMSPSYCH]

Originally Posted by 2tall
A 3-second push of a button while technically a procedure is tantamount to ringing a doorbell.
Quoting OLDPSYCHDOC from another thread-


Quote:
In addition to evaluating the patient and determining the appropriateness of ECT for their condition (we get quite a few referrals of pts with Axis 2 issues where either the doc or the patient is looking for some kind of "quick fix"), we oversee the pre-ECT workup--head CT, EKG, labs, taper the anticonvulsants and benzos (yeah, it's kinda hard to get a therapeutic seizure when someone's taking 4 mg klonopin a day!), to say nothing of patient education, consenting the procedure, etc. In ECT itself, we determine the electrode placement, prep the contact surfaces, coordinate with anesthesia re: VSs, dosing, etc, manage the timing of med administrations (not good to paralyze an awake patient!), decide when to administer the seizure, monitor the motor and EEG seizure activity (yes we read the EEG strip--we don't need to call a neuro consult!), decide whether the treatment is adequate (aiming for a minimum of 30 sec EEG seizure activity), possibly administer a second or third seizure, supervise the patient's initial recovery, monitor and treat side effects (nausea, pain, agitation) in coordination with anesthesia, and document, document, document.

Inasmuch as it involves a "particular method for performing a task, a series of small tasks or step taken to accomplish an end", this does qualify as a "medical procedure", and it is billed for as such. No one will get rich doing ECT, but an RVU is an RVU...

Great find. thanks. Clearly, ECT is poorly understood by some.

 

[HMSPSYCH]

This paragraph says less about psychiatry than it does about you.

Agree with you 100%.

 

[billypilgrim37]

While yeah, I find the OP's attitude as troublesome as the rest of you, he does make a valid point. There are some very good programs in the South and the Midwest that seriously struggle to recruit strong candidates.

If Duke, UNC, or Emory was in New York, we'd probably consider them roughly as prestigious as NYU or Penn. But they're in the South. And that's really all there is to say about that. The psychiatric applicant demographic, for whatever reason, values a certain pretentious urbanism that you simply don't find in Durham.

So yes, the top programs in the Northeast and West Coast are competitive. But overall, there are more slots at very good programs than there are very good applicants.

I have a very strong guess about which program he's referring to (it's not one of the 5 he listed, either), and it's totally believable that someone with much obvious cluster B traits and mediocre performances could match there by simple virtue of graduating from a US medical school and not having any major flags in their record. And I'm guessing the OP is a skilled enough BS artist to be able to hide his attitudes long enough for an interview day.

 

[notdeadyet]

If Duke, UNC, or Emory was in New York, we'd probably consider them roughly as prestigious as NYU or Penn. But they're in the South. And that's really all there is to say about that. The psychiatric applicant demographic, for whatever reason, values a certain pretentious urbanism that you simply don't find in Durham.

That's a little stereotypical, no?

For instance, I'm mostly interested in west coast programs because I'm from the west coast. Most of my friends and family are here. I've been lucky to work and travel to most of the country and have determined that this is likely where I'll settle down. I don't care for big cities, prefer hiking to theatre, and fine dining is wasted on me. It ain't an urban thing. There are some spots in the South I like a lot (Charleston, Savannah, etc.) but I'll take California over the South simply because it suits me better.

I think the reason that you have folks gunning for the coasts might have a lot to do with the fact that a sizable number of the applicants are from the coasts, no?

 

[billypilgrim37]

That's a little stereotypical, no?

Of course it was stereotypical! It's a demographic statement! Duh!

 

[BobA]

Having ranked both Duke and Penn highly I would agree that the training at each is excellent and roughly equivalent.

I agree with BP that Durham lacks the pretentious urbanism I am probably seeking - but the program is so strong I'm willing to overlook the fact that it's in Durham.

For example, I am a Yankee Urbanite living in the South and had this happen to me yesterday. I was at a coffee shop reading and 2 young (hetero) couples came in and sat down. Then they started reading and discussing the Bible as couples. This is considered totally normal behavior down here.

Being from a northern city, I wouldn't have thought twice if they had been lesbian couples reading Sylvia Plath. After all, I thought I was in an edgy alternative coffee shop. But no - it was Young Life and it totally freaked me out.

That having been said, while Durham isn't everyone's cup of tea (nor is philly), the "triangle" is home to one of the highest PhD's per capita of any urban area (Duke, NC State, and UNC-Chapel Hill all attracting some serious intellectuals).

 

[BobA]

That's a little stereotypical, no?

For instance, I'm mostly interested in west coast programs because I'm from the west coast. Most of my friends and family are here. I've been lucky to work and travel to most of the country and have determined that this is likely where I'll settle down. I don't care for big cities, prefer hiking to theatre, and fine dining is wasted on me. It ain't an urban thing. There are some spots in the South I like a lot (Charleston, Savannah, etc.) but I'll take California over the South simply because it suits me better.

I think the reason that you have folks gunning for the coasts might have a lot to do with the fact that a sizable number of the applicants are from the coasts, no?

Do you think if you were from the South that you might have grown up in a culture where psychiatry was less respected and you might not be as interested in it?

 

[nancysinatra]

In what other field of medicine can a person with crappy board scores, a 2.something gpa, mediocre letters of rec, and some poor narrative comments during non-psych rotations(ie medicine and surgery) have "name" programs rank them to match? Gotta love psych! The funny thing is that I had no real interest in going there in the first place and only took the interview because I was bored and wanted a free steak/hotel for the night.

But didn't anesthesiarocks cancel, like, a bunch of interviews because they were a whole day's drive away from his house and he was too lazy to go to them? I don't remember him being swayed by a free steak/hotel back then.

http://forums.studentdoctor.net/showthread.php?t=580160

As far as psych not being competitive, say what you will about low board scores, but I was asking this on another thread and so far the answer is non-conclusive--anyway, what exactly are board scores predictive OF? Because for all I know we here in psych are ALSO are going around getting lower gas milage on our cars than the people in derm, and that could very well be just as predictive of well, I don't know what, but SOMETHING. It just might be something totally irrelevant to our jobs. Plus, in a lot of specialties the interview is just a formality, but in psych you can be rejected on the basis of it. In surgery they interview 20-40 people on the same day and the interviews last 5 - 15 minutes. It's just a screen. So who knows. I am just not convinced from this quote that psych has dumber people than other specialties. Sure it might be less "competitive" than derm or whatever. But still psych could be the smartest specialty of all it's just that no one is measuring the right things to prove it yet.

Say what you want, but this is the least competitive specialty of them all. Yes, there are far more unfilled positions in other fields(im, family, etc), but for a person to match at a "top" im program they need to be a good candidate. If a person wants to match at a top psych program they basically have to come from an american allopathic school, have a pulse(most of the time), and not have a serious criminal record

No one took my pulse at ANY of my interviews.

So, here is a question. Anesthesiarocks is annoying to a lot of people. I wouldn't want him as my fellow resident. But as a poster on SDN, he's kind of amusing. He ruffles a lot of feathers--of people who are usually used to being calm and collected. This enlivens the forum. Does anyone think he's like this in real life? Could he REALLY have gotten into a psych residency with attitudes like he's proclaiming to have? Or is he just trying to rile people up?

 

[billypilgrim37]

Could he REALLY have gotten into a psych residency with attitudes like he's proclaiming to have? Or is he just trying to rile people up?

He's either lazy, or a future analyst

 

[OldPsychDoc]

...So, here is a question. Anesthesiarocks is annoying to a lot of people. I wouldn't want him as my fellow resident. But as a poster on SDN, he's kind of amusing. He ruffles a lot of feathers--of people who are usually used to being calm and collected. This enlivens the forum. Does anyone think he's like this in real life? Could he REALLY have gotten into a psych residency with attitudes like he's proclaiming to have? Or is he just trying to rile people up?

He's probably going to be the attending that diagnoses his med students with ADHD just to make them annoyed.

 

[nancysinatra]

He's either lazy, or a future analyst

I'm actually worried I won't be a good psychiatrist because I don't have a proper dislike for some of the trolls or otherwise irritating posters on this board. Some of them are really entertaining! Like anesthesiarocks--he's buffed his lazy act down to the point where there's absolutely no shred of wasted guilt or effort, which is kind of amusing to watch.

 

[nancysinatra]

he's probably going to be the attending that diagnoses his med students with adhd just to make them annoyed.

eek!

 

[notdeadyet]

Do you think if you were from the South that you might have grown up in a culture where psychiatry was less respected and you might not be as interested in it?

I think question how much the "respect for psychiatry" issue has more to do with economic class and less to do with geography. Take some Long Beach, CA longshoremen and compare them to some from well-to-do Atlanta folks, and I am willing to bet that the latter would have more time for psych than the former.

Could be wrong, but even in liberal California, the folks enamored with psychiatry tend to be those with more money than I was raised with.

 

[BobA]

I think question how much the "respect for psychiatry" issue has more to do with economic class and less to do with geography. Take some Long Beach, CA longshoremen and compare them to some from well-to-do Atlanta folks, and I am willing to bet that the latter would have more time for psych than the former.

Could be wrong, but even in liberal California, the folks enamored with psychiatry tend to be those with more money than I was raised with.

I see your point.

However, I don't think your typical well-heeled Atlantan has the same respect for psych that your well-heeled Bostonian has.

 

[cleareyedguy]

Mental illness hits almost every family in the country.

Regardless of SE class, people respect diligence and helpfulness.

Do a good job with anyone, and they'll appreciate it.

There is fear of psychiatry, and there are some bad psychiatrists, but if you are out there doing good for people, you won't have trouble finding respect.

 

[anesthesiarocks]

While yeah, I find the OP's attitude as troublesome as the rest of you, he does make a valid point. There are some very good programs in the South and the Midwest that seriously struggle to recruit strong candidates.

If Duke, UNC, or Emory was in New York, we'd probably consider them roughly as prestigious as NYU or Penn. But they're in the South. And that's really all there is to say about that. The psychiatric applicant demographic, for whatever reason, values a certain pretentious urbanism that you simply don't find in Durham.

So yes, the top programs in the Northeast and West Coast are competitive. But overall, there are more slots at very good programs than there are very good applicants.

I have a very strong guess about which program he's referring to (it's not one of the 5 he listed, either), and it's totally believable that someone with much obvious cluster B traits and mediocre performances could match there by simple virtue of graduating from a US medical school and not having any major flags in their record. And I'm guessing the OP is a skilled enough BS artist to be able to hide his attitudes long enough for an interview day.

no, it is one of the 5 I listed...thats why I listed those.

And I dont agree that the "psychiatric applicant" values urban pretentiousness more than any other field. Let's look at radiology and psychiatry(just to pick one fairly competitive specialty out of the air):

The difference there is such a wide difference between the quality of psych applicants at Penn/MGH/NYU/Columbia and UNC/Vandy/Emory isn't because of urban pretentiousness....it's because the field is so much deeper. MUCH MUCH MUCH deeper.

In reality, psych probably only has about 80-90 really "strong" candidates every year, and believe it or not a number of these really good candidates may choose to match in...oh I dunno...gainesville, fl because they have a wife and kids who already live there(just to pick a made up hypothetical). So this leaves an even smaller number, and so if there were 60 or so really "strong" candidates in radiology(as opposed to 500 or so), there would probably be the same difference between the competitiveness of the programs in the southeast and midwest vs those in cali and ny/boston.

Because after all, 500 really good candidates cant all match at penn/MGH/Columbia/UCSF/etc........and so they spill down to the se's and midwests top programs. And then you still have a ton of spillover into just normal programs...even with really good candidates.

Also, I've heard a lot of people talk about how "stellar" all the nyu/columbia type m4's who are matching at those places are. Yes, they are mostly good, and I admit I wouldnt be able to match there, but if you think for a second that the psych applicants matching at "top 10" places in new york and cali are anywhere near as talented as the derm or radonc or ortho or whatever applicants matching at these same places, you're deluded.

I've heard of plenty of people matching at top 10 programs on the coasts in psych with decent board scores(ie about national average to a little above...220ish), not much research, and generally good(but not great or AOA) type narrative evals during third year. These are candidates who would probably be begging for a spot at the worst ortho program in the country.......so dont act like the top programs in every field are equally competitive.

 

[anesthesiarocks]

But didn't anesthesiarocks cancel, like, a bunch of interviews because they were a whole day's drive away from his house and he was too lazy to go to them? I don't remember him being swayed by a free steak/hotel back then.

http://forums.studentdoctor.net/showthread.php?t=580160

As far as psych not being competitive, say what you will about low board scores, but I was asking this on another thread and so far the answer is non-conclusive--anyway, what exactly are board scores predictive OF? Because for all I know we here in psych are ALSO are going around getting lower gas milage on our cars than the people in derm, and that could very well be just as predictive of well, I don't know what, but SOMETHING. It just might be something totally irrelevant to our jobs. Plus, in a lot of specialties the interview is just a formality, but in psych you can be rejected on the basis of it. In surgery they interview 20-40 people on the same day and the interviews last 5 - 15 minutes. It's just a screen. So who knows. I am just not convinced from this quote that psych has dumber people than other specialties. Sure it might be less "competitive" than derm or whatever. But still psych could be the smartest specialty of all it's just that no one is measuring the right things to prove it yet.



No one took my pulse at ANY of my interviews.

So, here is a question. Anesthesiarocks is annoying to a lot of people. I wouldn't want him as my fellow resident. But as a poster on SDN, he's kind of amusing. He ruffles a lot of feathers--of people who are usually used to being calm and collected. This enlivens the forum. Does anyone think he's like this in real life? Could he REALLY have gotten into a psych residency with attitudes like he's proclaiming to have? Or is he just trying to rile people up?

1) I decided to actually show up for some of those....
2) your example about comparing usmle scores to gas mileage is absurd. After all, why assume albert pujols is a better hitter than henry blanco just because pujols hits more home runs, hits for a far higher average, gets on base far more often, hits more doubles, etc....why not compare blanco and pujols shoe size?

Look.....my post wasnt meant to be hurtful. Im glad psych is so noncompetitive. I was just pointing it out...thats all.