Match 2018

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whopper

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Any thoughts, observations?

Someone in my family didn't match and was shooting for psychiatry. What struck me as real odd was she interviewed at over 20 programs, is very passionate about psychiatry (let's all admit we see a lot of applicants applying into it as a safety or their only hope to practice in America and don't give a damn about psychiatry itself) yet she still didn't get in. Heck, I was even telling her she might've been interviewing too much.

Was the amount of applicants in psychiatry way up this year? She's in a DO program. I'm wondering if that had anything to do with it. Many programs traditionally put in DOs secondary to MDs (I'm not saying this to criticize DOs, this is merely a fact).

She did tell me that this year there were only about 12 openings this year not filled.

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Last year it was 3. There are still applicants who apply as a backup specialty, but the days of IMGs applying to psych because it’s the easiest specialty to get into are long gone.
 
Hard to say without knowing board scores, extracurriculars, grades in med school, research, where she applied, etc.
 
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The 4 people I know at my DO school who applied all matched psych, including me. We interviewed at 12-15 programs, which seems standard nowadays. On the interview trail, I found that all other applicants were passionate about Psychiatry. Only encountered 3 other non-US students. I was surprised that so many people knew they wanted to do a fellowship and how often it was asked during interviews.

At 20 interviews I’m sorry to say that it is likely bad interviewing skills/socialization.
 
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How many did she rank? Statistically speaking, as a DO student ranking 11+ programs you approach an almost 95% chance of matching (iirc from NRMP data 2016).

I am a DO student who just matched and the interview trail was littered with passionate applicants with insanely high board scores. I felt like a massive underdog the entire time and feel fortunate to have matched now before it continues to get harder
 
She ranked over 20. I think it was about 25. A problem might've been she was reaching, applying to top programs in terms of competitiveness, and I did tell her to have some safeties lined up. I don't know how she did on interviews but I told her that programs won't give an interview unless they're already interested so she might've had a recurring pattern during interviews that blew her out of the water that she was not aware.
 
She ranked over 20. I think it was about 25. A problem might've been she was reaching, applying to top programs in terms of competitiveness, and I did tell her to have some safeties lined up. I don't know how she did on interviews but I told her that programs won't give an interview unless they're already interested so she might've had a recurring pattern during interviews that blew her out of the water that she was not aware.

Did she have her step 2 CK and CS equivalents (I don't know the name of the DO versions) in before the rank list deadline? Some people are still giving the outdated advice that you only need them for graduation, but that is very bad advice these days.

Also per the NRMP, AMG MD applications to psychiatry were up about 15% this year. In terms of the profile of applicants we won't know for sure until the new Charting the Match is published in the fall.
 
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Classmate of mine didn't match psych this year (I think 10-12 interviews). They're going through SOAP hoping for one of the open psych spots, but it seems unlikely given the odds. Our school doesn't have great psych advising, they really want psych and don't want IM/FM. Would it be best to do a prelim year or a year of FM and reapply to psych next year vs. research or anything else?

They would make a great psychiatrist and I would be happy to send any of my family/friends to see them, really unfortunate situation.
 
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HOW THE HELL ARE PEOPLE RANKING 20 PLACES AND NOT MATCHING!???
 
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My guess is that psychm didn't explicitly tell programs that he was going to also rank uncoupled. Programs must have seen two failures and tied them together. Still, 20 places interviewed them. Maybe they didn't look for a pass just before lists went in and they worried she wouldn't graduate and then he wouldn't come either.
Bad situation. Good luck with SOAP. Try and grab something.
 
As someone who interviewed applicants this year, I can tell you that most of the people we interviewed were superstars, both in terms of on paper and during interview. These people definitely did not choose psych as a backup. Not sure what happened with your relative, but my guess is interview, unfortunately. I think interview is important for any field, but especially in psych. I would encourage her to do a few mock interviews with her academic advisors or psych attending prior to SOAP interviews, if at all possible.
 
We would have been fine with just one of us matching and the other trying to SOAP nearby and/or re-apply. I definitely wish I mentioned we would be fine if programs just ranked one of us but during this whole process I have been given completely contrasting advice by everyone including different program directors. Contact us, don't contact us, we don't care if you're a couple, we do care that you're a couple. All the interviews were awesome and positive, and programs told us how they could accommodate us.

I think the combo of applying to the same specialty and the CS fails were the death sentence. Is there any tactful way to contact any program directors about reasons why we did not match? I just don't want this to happen again if we re-apply. Maybe we would have to explore uncoupling but I don't even know what changes need to be made unless they tell us. This whole thing is a nightmare. Oh well. Also, no responses or calls through SOAP yet either.

If your on decent terms with them, by far your best source for match related information/advice would be the psych program director at your home medschool.
 
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We would have been fine with just one of us matching and the other trying to SOAP nearby and/or re-apply. I definitely wish I mentioned we would be fine if programs just ranked one of us but during this whole process I have been given completely contrasting advice by everyone including different program directors. Contact us, don't contact us, we don't care if you're a couple, we do care that you're a couple. All the interviews were awesome and positive, and programs told us how they could accommodate us.

I think the combo of applying to the same specialty and the CS fails were the death sentence. Is there any tactful way to contact any program directors about reasons why we did not match? I just don't want this to happen again if we re-apply. Maybe we would have to explore uncoupling but I don't even know what changes need to be made unless they tell us. This whole thing is a nightmare. Oh well. Also, no responses or calls through SOAP yet either.

I think it would be okay to reach out, but I wouldn't do it right now. I would wait a bit. I can understand why programs may not want to rank you both and also why they think you're just a package deal. I think you take a chance when you match a couple to the same specialty in the same class, especially if it's a small class.
 
We would have been fine with just one of us matching and the other trying to SOAP nearby and/or re-apply. I definitely wish I mentioned we would be fine if programs just ranked one of us but during this whole process I have been given completely contrasting advice by everyone including different program directors. Contact us, don't contact us, we don't care if you're a couple, we do care that you're a couple. All the interviews were awesome and positive, and programs told us how they could accommodate us.

I think the combo of applying to the same specialty and the CS fails were the death sentence. Is there any tactful way to contact any program directors about reasons why we did not match? I just don't want this to happen again if we re-apply. Maybe we would have to explore uncoupling but I don't even know what changes need to be made unless they tell us. This whole thing is a nightmare. Oh well. Also, no responses or calls through SOAP yet either.
I feel for you and your partner. :(

Unsolicited advice: Pick any specialty you can tolerate and move on with life. I know that sounds terrible but Ive seen my colleagues hold out for YEARS for a certain specialty and not match.
 
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She's in a DO program. I'm wondering if that had anything to do with it. Many programs traditionally put in DOs secondary to MDs (I'm not saying this to criticize DOs, this is merely a fact).

I agree with you that many PD’s consider DO to be <<<< MD.

Knowing that, most DO’s should apply to 50%+ safety schools. If the rank list doesn’t heavily reflect that, no reason to investigate further.
 
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My friends and I that matched psych as DO's ranked between 8-15 programs. I think it really depends on the programs ranked. I'll admit my list of 11 was a mix of university and community programs in TX, OK, and LA. Not sure how competitive they are but I'll be happy.
 
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As someone who interviewed applicants this year, I can tell you that most of the people we interviewed were superstars, both in terms of on paper and during interview. These people definitely did not choose psych as a backup. Not sure what happened with your relative, but my guess is interview, unfortunately. I think interview is important for any field, but especially in psych. I would encourage her to do a few mock interviews with her academic advisors or psych attending prior to SOAP interviews, if at all possible.
While I overall agree with your assessment, we all got a bit of amusement when an applicant (who had seemed completely legit) was spotted interviewing with ortho later that month.
 
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While I overall agree with your assessment, we all got a bit of amusement when an applicant (who had seemed completely legit) was spotted interviewing with ortho later that month.

I get that no program wants to feel like a back-up. That said, two of the nicest, hardest working, people I’ve ever known just went unmatched after shooting for ortho. I think any psych program would have been lucky to have them. My heart hurts for them!
 
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I get that no program wants to feel like a back-up. That said, two of the nicest, hardest working, people I’ve ever known just
I get that no program wants to feel like a back-up. That said, two of the nicest, hardest working, people I’ve ever known just went unmatched after shooting for ortho. I think any psych program would have been lucky to have them. My heart hurts for them!

And of course it hurts also for all those lovely people who have been so excited about psych over the years and are now facing the SOAP. Good luck everyone! <3.
 
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Looks like things are getting more and more competitive, and psych is no longer a true "safety," which is great. We need more top-quality going into psychiatry, and I love that it's no longer seen as a "bottom barrel" specialty. I think we'll be seeing more of the same in the years to come, as more MD/DO students graduate due to higher class sizes/more med schools, with the same number of available residency spots. Things will get even tougher for IMG/Caribbean grads.
 
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SOAP into internal medicine. Reapply psych next year. Or wait until after IM is complete and be dual boarded. Or finish IM and do an awesome fellowship like GI, cards, or nephrology.
 
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Yes get a transitional or prelim year - I know someone who did an IM year and transferred to psych. Only a couple of months counted, but still, it was possible.

You just don't want to do nada this year if you can help it.
 
Looks like things are getting more and more competitive, and psych is no longer a true "safety," which is great. We need more top-quality going into psychiatry, and I love that it's no longer seen as a "bottom barrel" specialty. I think we'll be seeing more of the same in the years to come, as more MD/DO students graduate due to higher class sizes/more med schools, with the same number of available residency spots. Things will get even tougher for IMG/Caribbean grads.

Not sure more USMGs means "more competitive" or "higher quality". As people mentioned, it's mostly DOs who are taking the spots and squeezing IMGs out, making things more competitive for them. The best barometer for competitiveness would be Step scores/% allopathic US seniors.
 
Really? Because 50 interviews seems like a necessity especially with the couples component factored in for some people. I am sure these programs are super accommodating to this? Give me a break.

Cool your jets turbo. I'm not considering any other factor (like that they are couples matching) except that if they don't get a SOAP position there is a chance they will never match again, never SOAP yet again, never find a spot outside the match, and they will never have any sort of clinical career at all.

It's pretty ****ing simple no matter who you are. You don't match, you need to SOAP into anything. ANYTHING. Being able to transfer once in a program, or complete it and get another residency, is much better and more likely than trying to match a second time around. Every year out from graduation it gets worse. If someone doesn't match the first time when they conceivably were at their most attractive to programs, how does that get better next year? It doesn't.

So they need to frakking SOAP in something. I brought up generic intern years like in IM, transitional, prelim, because I personally know someone who transferred from IM cat to psych after completing the year.
 
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Really? Because 50 interviews seems like a necessity especially with the couples component factored in for some people. I am sure these programs are super accommodating to this? Give me a break.

Give me a break. Sometimes if both partners want to be practicing physicians, they have to be geographically separated.

I did LDR on separate coasts for 4 years straight.

One of my friends couple matched, and ended up almost halfway across the country from one another. After one year one of them was able to transfer to 1 hour drive away, and they had separate residences.

After 3 years they have gotten married and working on a baby, although they won't live together if she gets pregnant.

After 4 years, they will finally be able to share a house.
 
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For the non-matchers:

When one of you is a good applicant and the other has hardcore red flags, you need to consider ranking in a way that protects both of you should a couple's match to the same program not work out, and consider LDR. If you don't, well, there's a chance you'll be boned. I know couples that did this conservative style of ranking, and ended up in separate locations. But they are going to get board certified.

SOAP!!

You could take Step 3 and blow it out of the water, it's not clear how much this might help, but it can't hurt unless you suck ass on it.

Find something to do for a year to make yourself a better applicant. Others and SDN will have better ideas than me. Network.

If you have to do ERAS again, you need to consider what was wrong with your app the first time. Your interview skills. New LOR.

I see so many people fail the match because they didn't apply broadly enough or to tiers "below" their school and where they thought there scores should get them. A lot of training takes place at community programs you've never heard of in not very exciting places.

Psychiatry in Alaska sounds a lot better than not being matched right about now, doesn't it???

When you have a great application from a great school, besides the fact that a lot of these programs might wonder how serious you are about their program, is that they will *want* you. You make their community program look good on the hospital website with your fancy med school listed there. Programs like people with good scores because they want you to pass your boards - program accreditation relies on the class pass rate, actually.

I came from a school with a very well respected name, and otherwise average stats. I applied broadly. I was surprised how "nice" of name schools interviewed me. I was trying to do things geographically with an SO, so I ended up applying to community programs I had never heard of in OK and such.

I applied to so many programs, I went on 24 interviews in almost that many cities. A wide range. I ranked them all. I got #3, but in any case, it's better to be wanted by a nowhere program than beg for crumbs from top programs and end up with nothing.
 
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Being from a great school with great stats and lots of interviews at places in the same tier - is not a guarantee to match.

Apply and interview at a few places that might be otherwise *thrilled* to have you.

Ditto if you're adding in the complication of couples matching.
 
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She ranked over 20. I think it was about 25. A problem might've been she was reaching, applying to top programs in terms of competitiveness, and I did tell her to have some safeties lined up. I don't know how she did on interviews but I told her that programs won't give an interview unless they're already interested so she might've had a recurring pattern during interviews that blew her out of the water that she was not aware.

Hopefully I addressed this piece of this. Based on what you say I think this is the problem.
 
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Also my understanding is the DOs need to take the USMLE because for the most part to most PDs (outside AOA) COMLEX is meaningless, even if it's technically acceptable.

Anyone that has a Step failure or in their couples match cannot **** around. You need to interview a huge number of nowhere places, and consider not matching together at all. Or accept that only one of you is going to practice medicine??
 
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Also my understanding is the DOs need to take the USMLE because for the most part to most PDs (outside AOA) COMLEX is meaningless, even if it's technically acceptable.

Anyone that has a Step failure or in their couples match cannot **** around. You need to interview a huge number of nowhere places, and consider not matching together at all. Or accept that only one of you is going to practice medicine??

It's not a necessity yet, but it's becoming more important and will likely continue with that trend with the upcoming merger. I know of 6 individuals from my DO school (myself included) who did not take USMLE and we all matched psych.
 
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It's not a necessity yet, but it's becoming more important and will likely continue with that trend with the upcoming merger. I know of 6 individuals from my DO school (myself included) who did not take USMLE and we all matched psych.

Everything somewhere works out for someone. Congrats.

Me, I would be very conservative and take USMLE if I were a DO. To each his own I suppose.
 
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So I have 800 applications and interview about 100. 200 are DOs and half have USMLE, what do you think we are going to do? If you are trying to compete with MDs, don't highlight the differences. Things are tightening and although I'm sorry for those unmatched, this is an overdue correction I welcome. Our hours are good, our pay has caught up, this is the result. Thank you millennials for ignoring your parents. Just dive in and kick tail in your programs and all will be well.
 
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Thanks for all the replies. I know that as a DO she already had some odds against her but I figured that would've already been played out before the interview process. I've done the process before as a chief resident and know programs don't give out interviews unless already interested.

She did not take USMLE (AGAINST MY ADVICE!) and only used Comlex. I figured this would've hurt her but again if so...then why did she get so many interviews? It still could play out against her post-interviews in the typical "we only got 1 spot and here's one with a USMLE and one without a USMLE), but I figured it that was such a big factor it would've already blown her out of the water pre-interview stage.

So I figure it was either incredibly bad luck or her doing something during interviews, on top of seeming uptick of applicants this year.
 
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As a DO, I'm anxiously awaiting my Match results, but I can say for certain that having Step 1/2CK helped my application immensely. Multiple interviewers commented on this. I'd assume it provides an easier comparison when it comes down to whom should be ranked above whom.

I wish her the best and hope she finds the path that makes her most happy.
 
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1. Yes, DO programs are sadly secondary to MD ones. For some programs it doesn't matter to much, for many it has some impact.

2. There were 6 openings in SOAP last year, 16 this year, but apparently one program (6 spots) did not submit a list in time and thus entered SOAP.

3. Reaching is definitely an issue, especially as a DO where you may not be accepted. I screened schools by checking the composition of their residents.

4. Someone in our program was a former FM resident. So it can happen.

5. You should take the USMLE Step 1 at least. It helps puts things in perspective and it was mentioned on my interviews. You should have your CK/CS scores ideally before ERAS deadline date, and definitely before programs rank.
 
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I understand that it is desirable for DO applicants to have a USMLE score but still 20+ ranks even with only COMLEX and not matching doesn't sound quite right. I'd chalk it up to top heavy programs +/- interview skills +/- some other part of the story we probably aren't hearing.
 
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Everything somewhere works out for someone. Congrats.

Me, I would be very conservative and take USMLE if I were a DO. To each his own I suppose.

Keep in mind, when my class took Step/Level 1 it was 2 years ago and psych was still seen as one of the fields where a pulse gets you in somewhere as long as you're from a US school. So it was a much more viable and reasonable option, especially for those who believed they'd do relatively poorly on USMLE.

Today I'd advise every DO student applying for anything to take USMLE unless they really believe they'll fail (failing or scoring <200 on NBMEs). I personally wish they'd just merge the board exams, but as long as the AOA is holding on to OMM I don't think it'll happen unless ACGME throws some weight around like they did for the merger.
 
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As far as having all these interviews and this meaning there's interest and then wondering why matching doesn't happen....

I know in some other specialties, like IM, the program will interview TEN applicants for every one slot. This is because obviously there will be insta-rejects, but also possibly applicants that weren't that serious but playing the numbers game of interviews... and the program wants to be sure their list is long enough to get as close to GUARANTEEING all spots filled because holes suck.

The burden of expense of interviews is on the applicant. It's not *that* onerous for a program to interview as above to create a safely long list.

Unfortunately, all it takes not to match at like all 12 programs you interviews, is for you to be too low on various lists and it depends on how low down the list they have to go.

I'm not sure how low on the list psych programs end up going on average. I imagine it also greatly depends on the institution.

Say the program interviews 100 people for 10 slots. Say 20% are rejects for various reasons. That's still 80 people to rank for 10 spots. Stay they only get as far as 30 down the list to fill. Say you were 35. That's hardly the syttiest place in the world to be - middle of the pack, but they obviously saw you as a safety and not a higher priority for snagging for reals.

If they don't think you're serious about coming to the program, they might likely still rank you just on the off chance provided they don't think you'll be truly malignant stuck at their program (why not? hardly harm in doing so for the most part).

When you get more actual total number of applicants, as seems the case in psych, and if you're getting an increase in number of applications put in by each person, and the program has to interview more people to keep up....

In other fields this effect makes it more difficult for both applicants and programs. Some people also see this as making it more likely for applicants to keep ending up lower in some lists X however many they interviewed at, and then they don't match.

TLDR:
The increase in applicants and their cross-applying to more programs, has put pressure on programs to interview a greater number of people and have a longer match list to ensure filling. The side effect of this is that this may mean the interview no longer holds as much meaning for indicating how strong interest is (for example in IM which was said to interview 10 applicants for every 1 slot).

Sadly this may be compensated by applicants by attending more interviews, even ones they're not excited about. Programs interview more applicants they aren't that excited about.

All it takes is being just a bit low on the list of the places you interview X however many, and you don't match.
 
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crayola227 may be a more right than not as far as the details of numbers, but the point is spot on. We have to interview more people per slot and we can no longer just interview the highest gunners and still fill. It is a whole new world, but slots are becoming more valuable and it is looking like it is a little less of a buyer's market. Don't get too nervous, it still has a long way to go before it becomes "competitive" for US grads with average records. We will know much more in a couple of days. I also could be a complete idiot susceptible to SDN bias trends but I'm always optimistic until I see the full measure of who I get. Happy hunting everyone and embrace radical acceptance for you new homes. You will make strong ties and just do your best where ever you end up. It doesn't help to show up pissed off. There will be good people who you can relate to with similar stories no matter where you end up. This is the one truth I am sure of. The other one is that post graduate performance is hard to predict based upon pre-graduate performance. You are starting over and your medical education will not impress your peers. You have to earn that. So go out and be great.
 
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Thanks for all the replies. I know that as a DO she already had some odds against her but I figured that would've already been played out before the interview process.

Receiving an interview does not put all interviewees on equal footing. Programs like applicants do interview “safeties”.

In my experience, most people with multiple interviews that fail to match do so by selecting programs that are actually “reach” or “average” programs and ignore safety schools. Advisors in general are incredibly poor at advising students on the accuracy of their competitiveness.
 
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I go to a mid-tier US allopathic school with a strong psych department and am told that five of our students applying to psych had to SOAP this year.
 
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Good lord, reading this thread as a foreign medical student makes me want to cut my losses in terms of step 2/USCE.
 
I can't wait until the dust settles to see what plays out. My theory is that there's an unequal distribution of USMD and DO applicants to residency programs.

Everyone here keeps talking about how competitiveness is going up, but SO ARE RESIDENCY SLOTS. The number of new programs is keeping up with demand (in terms of US grads, total applicant pool will always be impossible). BUT, when more applicants are applying to the existing programs (especially mid to higher tier) ONLY, inevitably applicants are going to get washed out. It's all supply and demand, supply not only being total number of slots, but geographically and reputation wise as well.

The same phenomenon occurs in almost all branches of medicine. In major metro areas like LA, it's easier to get employed as a PCP than it is as an Ophthalmologist. Why? Even though nationally I'm sure there's a shortage of Ophthalmologists, more of them want to work in LA than there are spots for, thus you will see some being out of work while a PCP walks in and has multiple job offers. And with the way the match is setup, there's no repeats or time to explore your other options. Everything gets filled up at once and you're SOL if you don't win the gamble.

ALSO, just because every program says they get 800+ apps, doesn't mean the distribution is the same. One program could have 50%+ being USMD's while another has less than 10%.
 
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The # of residency positions is not keeping up with the # of new grads. It will continue to get harder to match Psychiatry, and all specialities for that matter. Per the 2016 NRMP report:
upload_2018-3-15_6-23-52.png
 
The # of residency positions is not keeping up with the # of new grads. It will continue to get harder to match Psychiatry, and all specialities for that matter. Per the 2016 NRMP report:
View attachment 230467

1) I'm referring specifically to number of students applying to Psych vs. number of new positions startings
2) The chart shows the TOTAL # of applicants (including US IMG and NON-US IMG, which make up a SUBSTANTIAL number of the applicant pool).

There will NEVER be enough positions to accomodate every US MD, DO, Canadian, US IMG, and ALL the international Physicians from ALL over the world who apply to the US to all have a residency spot. It's ridiculous.
 
1) I'm referring specifically to number of students applying to Psych vs. number of new positions startings
2) The chart shows the TOTAL # of applicants (including US IMG and NON-US IMG, which make up a SUBSTANTIAL number of the applicant pool).

There will NEVER be enough positions to accomodate every US MD, DO, Canadian, US IMG, and ALL the international Physicians from ALL over the world who apply to the US to all have a residency spot. It's ridiculous.
Ahh yes I see. Even so, there's only so much birthday cake but a lot of hungry kids at the table
 
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I go to a mid-tier US allopathic school with a strong psych department and am told that five of our students applying to psych had to SOAP this year.
I go to a "brand name" school with one of the very top psychiatry programs, and one person (that I know of) didn't match into psychiatry and had to SOAP. That person did have red flags though, and this year there was an unusually high number of psych applicants from my school and our most immediate geographic region. Still, "you're coming from a top school, don't worry about matching into psych" doesn't apply anymore. (And the person who didn't match actually was prerty reasobable and interviewed and ranked programs that would generally be consolidered noncompetitive.)
 
I go to a "brand name" school with one of the very top psychiatry programs, and one person (that I know of) didn't match into psychiatry and had to SOAP. That person did have red flags though, and this year there was an unusually high number of psych applicants from my school and our most immediate geographic region. Still, "you're coming from a top school, don't worry about matching into psych" doesn't apply anymore. (And the person who didn't match actually was prerty reasobable and interviewed and ranked programs that would generally be consolidered noncompetitive.)
Did this person apply to 50+ programs? Also, this is on the west coast?
 
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