MD Residency Match Information from MD Students!

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futureapppsy2 said:
Mod note: I just wanted to take a second to remind everyone of our policies and practices as they apply to *all* users:

1. If you haven concerns about content posted on the forums or specific users, please report it via the report post function instead of posting it directly on the forum. Staff (@AcronymAllergy and I, plus the other SDN mod staff) can address it then.
2. All moderator actions, discussions, and decisions are private and confidential. Except for publicly visible indications of "probation" or "banned" status, we can't discuss what actions we take or don't take with regards to other users and why we make those decisions,
3. Please remember to keep a civil and professional tone and in all posts.
4. You can "ignore" specific users if you don't wish to see posts from them by clicking on their user name and than clicking ignore. The one exception is that you can't ignore moderators.

Again, if you have any questions or concerns about anything on the forum, please report it or contact @AcronymAllergy and I so that we can discuss it as a staff.
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What is the policy on people who were banned from the board, then come back under a new user name?
 
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WisNeuro said:
I'd just refrain from calling something an "imbalance" if we really don't know if that is an issue. Not saying it isn't, just that we're making that assumption without any accompanying, non-anecdotal data.

Also, many of us don't see our situation in psychology as a true imbalance either. Just a larger portion of FSPS's not matching, sometimes rightly so.
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I didn't match the first time I applied and go to a university based PhD program. I view it as an imbalance.
 
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psychrat said:
I didn't match the first time I applied and go to a university based PhD program. I view it as an imbalance.
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It is an imbalance, correct, and a few businesses that put out 100's of students per year ensures that it will stay unbalanced. There can never be a perfect matched system, but the one we have now is truly broken when only 64% match to an accredited site.

Hey, doesn't your internship start soon? An exciting and stressful time! Good luck with everything.
 
I attend a university-based, small-cohort clinical PhD program and two people didn't match this year. We also had two not match last year.
 
As I was reading through the match statistics to address the "imbalance" term, I noticed that it seems that the number of non-APA matches is increasing while the overall match rate is staying static. I guess this is sort of off-topic, but I think the original topic was not worth addressing as it was so far-fetched. Anyway, it does worry me that the direction for the solution to the imbalance is to make it so anyone can get an internship with no standards. I have seen this play out first hand in the training of mid-levels and it is not good.
 
WisNeuro said:
It's going to happen. It should not be 100% though.
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Why shouldn't it be 100%? As a profession we should be planning entry into the profession from beginning to end. Why should we be allowing too many students or too few internships cause havoc in the system?
 
LAPsyGuy said:
Why shouldn't it be 100%? As a profession we should be planning entry into the profession from beginning to end. Why should we be allowing too many students or too few internships cause havoc in the system?
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It shouldn't be 100% because programs don't do a good job at removing people who should not be in the profession. As someone who has literally reviewed hundreds of internship applications, I can confidently say that a not insignificant portion do not have the credentials to be applying to a clinical internship. Maybe if we did a better job in the front end, sure. But, we don't.
 
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LAPsyGuy said:
Why shouldn't it be 100%? As a profession we should be planning entry into the profession from beginning to end. Why should we be allowing too many students or too few internships cause havoc in the system?
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Because getting the internship is a combination of competencey (which comes from training), and good practical sense. Its a job interiew. Some people **** up job interviews. Why should any organization be forced to hire an intern just because they are in a training program?
 
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WisNeuro said:
It shouldn't be 100% because programs don't do a good job at removing people who should not be in the profession. As someone who has literally reviewed hundreds of internship applications, I can confidently say that a not insignificant portion do not have the credentials to be applying to a clinical internship. Maybe if we did a better job in the front end, sure. But, we don't.
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That speaks to my point. We should be gatekeeping and managing entry to the profession better. It's better to have admissions be low than to have matching be low. And moreover, programs should be showing people the way out when it becomes apparent they are not meant for this line of work.
 
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LAPsyGuy said:
That speaks to my point. We should be gatekeeping and managing entry to the profession better. It's better to have admissions be low than to have matching be low. And moreover, programs should be showing people the way out when it becomes apparent they are not meant for this line of work.
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I wholeheartedly agree. But there are many reasons, some legal, that makes that highly unlikely. Until that happens, though, the match rate should not be 100%
 
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erg923 said:
Because getting the internship is a combination of competencey (which comes from training), and good practical sense. Its a job interiew. Some pople **** up job interviews. Why should any organization be forced to hire an intern just because they are in a training program
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They shouldn't be forced to hire people, but programs should also be managing these skill sets. I know my program does because "good practical sense" sometimes needs to be taught.
 
LAPsyGuy said:
Why shouldn't it be 100%? As a profession we should be planning entry into the profession from beginning to end. Why should we be allowing too many students or too few internships cause havoc in the system?
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The same logic would say that the EPPP pass rate should be 100%. There are a number of hurdles to overcome and there should be. Getting into grad school, IRB approval, clinical competency exams, internship, dissertation defense, oral exams or jurisprudence exams. Some of these will vary in difficulty or weight depending on individual, state, or program. Not everyone can accomplish the goal of becoming a licensed psychologist, nor should they be able to. Whenever any of these become 100% then they no longer serve their purpose.
 
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smalltownpsych said:
The same logic would say that the EPPP pass rate should be 100%. There are a number of hurdles to overcome and there should be. Getting into grad school, IRB approval, clinical competency exams, internship, dissertation defense, oral exams or jurisprudence exams. Some of these will vary in difficulty or weight depending on individual, state, or program. Not everyone can accomplish the goal of becoming a licensed psychologist, nor should they be able to. Whenever any of these become 100% then they no longer serve their purpose.
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Agreed, but if you get to the point of internship and EPPP, and people start failing, there's something wrong with the system. My assumption is that most, if not all students had at least two prac sites and had multiple evaluations of their performance both through those sites and within their program, as well as completing competency exams, and have completed at least a fair amount of work on their dissertations or final projects. If somebody fails to obtain an internship in the first couple of tries, then something was missed in all of those previous experiences and training opportunities. The internship application process should be more about fit than competency given all that comes before it.
 
LAPsyGuy said:
Agreed, but if you get to the point of internship and EPPP, and people start failing, there's something wrong with the system. My assumption is that most, if not all students had at least two prac sites and had multiple evaluations of their performance both through those sites and within their program, as well as completing competency exams, and have completed at least a fair amount of work on their dissertations or final projects. If somebody fails to obtain an internship in the first couple of tries, then something was missed in all of those previous experiences and training opportunities. The internship application process should be more about fit than competency given all that comes before it.
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In med school they have exams all along the way. Maybe we should have a few more of those. I know that I was scared that I might not make one of the hurdles so it motivated me to work extra hard. Studied for EPPP like no other test I ever took, for example. There are students who finish law school but can't pass the bar. Isn't that just the way it is?
 
smalltownpsych said:
In med school they have exams all along the way. Maybe we should have a few more of those. I know that I was scared that I might not make one of the hurdles so it motivated me to work extra hard. Studied for EPPP like no other test I ever took, for example. There are students who finish law school but can't pass the bar. Isn't that just the way it is?
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Very few people get thrown out of medical school, for better or worse, probably because of the very problems we've been discussing. Part of it may be due to more frequent assessment, though the majority is probably because of the same reasons very few psychology doctoral students aren't thrown out (morale, fear of lawsuits, etc.).
 
WisNeuro said:
Should be, sure. But, given the vast differences in quality and amount of training, not all students are competent at this point.
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True enough. Seems like there SHOULD be more curiosity about why they aren't .
 
Psychology left the barn door open, so the only hope they have is corralling the lame and struggling somehow on the back end. I figured a horse analogy is appropriate for a topic that has been beaten to death already.
 
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Therapist4Chnge said:
Psychology left the barn door open, so the only hope they have is corralling the lame and struggling somehow on the back end. I figured a horse analogy is appropriate for a topic that has been beaten to death already.
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What about fixing the system, as opposed to patching it?
 
LAPsyGuy said:
True enough. Seems like there SHOULD be more curiosity about why they aren't .
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I think there is plenty of curiosity. Plenty of us would like to see diploma mills corralled and APA accreditation standards for graduate programs tightened considerably. Just have to get some good leaders at the help for once to perhaps make some positive change.
 
LAPsyGuy said:
What about fixing the system, as opposed to patching it?
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I'd love to fix it, but that would take a lot of heavy lifting w. tightening APA-acred standards, changes in state laws (huge hurdle), and fighting off the $$ that comes from Argosy, Alliant, et al.

WisNeuro said:
I think there is plenty of curiosity. Plenty of us would like to see diploma mills corralled and APA accreditation standards for graduate programs tightened considerably. Just have to get some good leaders at the help for once to perhaps make some positive change.
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I'm hoping Dr. Puente can tackle some of this if he is elected to APA president. He received the most nominations (by a wide margin) and has a strong backing from neuropsychologists who tend to vote and be vocal...so that is promising.
 
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Therapist4Chnge said:
I'm hoping Dr. Puente can tackle some of this if he is elected to APA president. He received the most nomination (by a wide margin) and has a strong backing from neuropsychologists who tend to vote and be vocal...so that is promising.
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I hope so to. Hopefully there are still enough people in APA who still care, after all those dropped their memberships for various reasons within the past couple decades.
 
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smalltownpsych said:
It is an imbalance, correct, and a few businesses that put out 100's of students per year ensures that it will stay unbalanced. There can never be a perfect matched system, but the one we have now is truly broken when only 64% match to an accredited site.

Hey, doesn't your internship start soon? An exciting and stressful time! Good luck with everything.
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Thanks :) I begin on Wed. Getting nervous!
 
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OneNeuroDoctor said:
Most of the physician are dually specialized in Psychiatry and Neurology. The Board exams are easier and generally both are considered easier specializations.

Many psychiatrist\neurologist I have worked with wanted to specialize in other areas but failed board exams and had to do residencies in other areas. I worked with a psychiatrist who wanted to be a cardio/heart surgeon but he did poorly on the board exams and did not match with surgery sites.

He was in his forties and switched to psychiatry\neurology. He dedicated several years to specialize in heart surgery but had to switch to less intensive specialization and use his empathy skills rather than his fine motor skills. Another situation I know off was a physician who was in a surgery residency but was not recommended to continue, so she had to reapply for the match and was selected into an ophthalmologist residency.
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The Board exam in Psychiatry is very difficult. There are two parts. The written has to be passed before taking the oral exam. The oral exam, which I was one of the last classes to take, had a poor pass rate. I don't have the link.
When I was doing orientation for the oral board exam, the head of the ABPN, Larry Faukner, needed security as the physicians who had failed previous exams were accosting him.
 
AcronymAllergy said:
I'd be surprised if there weren't surveys available regarding physicians' opinions of the various specialties. I don't have any available to cite off hand, though.
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Like any field, including psychology, there is a hierarchy. But it doesn't matter at all. It is fluid.
Depends on what you are measuring when you make the list. If you are talking about money, prestige, hours, etc those are all different lists..
 
In terms of the match, don't forget, some medical students shoot too high and don't have a back up in case they don't match. Some people apply to fields they are not a good fit for.
I matched in anesthesia and did 2 years of residency in that.
Then I changed by mind.


Regarding the accreditation, it would be great if psychology had standardized and accredited training in all locations. That would help a great deal. But it is expensive and difficult to do.
Medical school and residency has both set up by the ACGME.

In psychology, do you need an internship to practice? Does it have to be accredited?
 
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WisNeuro said:
I think there is plenty of curiosity. Plenty of us would like to see diploma mills corralled and APA accreditation standards for graduate programs tightened considerably. Just have to get some good leaders at the help for once to perhaps make some positive change.
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Exactly right. Why aren't the leaders doing this?
Are their pockets being lined by the diploma mills?
Follow the money..
 
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smalltownpsych said:
In med school they have exams all along the way. Maybe we should have a few more of those. I know that I was scared that I might not make one of the hurdles so it motivated me to work extra hard. Studied for EPPP like no other test I ever took, for example. There are students who finish law school but can't pass the bar. Isn't that just the way it is?
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It's a lot more than just "exams along the way". There is standardization of almost everything in US medical schools. I studied for every exam in medical school like no other test I ever took. Every one of them. And there were a lot.

Law school is suffering from a glut. I don't even know if they are all accredited as there are so many pop up schools.
 
GroverPsychMD said:
In psychology, do you need an internship to practice? Does it have to be accredited?
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Yes, you need an internship to become licensed, but it does not have to be accredited. Generally, licensing boards will accept (a) either proof of completion of an accredited internship or (b) evidence that an unaccredited internship met a set list of criteria deemed "equivalent" to those required of accredited internships. However, not attending an accredited training program or internship will make it difficult if not impossible to find a job in some settings.

Medical education is more standardized in every possible way, from admissions standards to exit requirements. One reason (of many) for this is that psychology is foremost an academic discipline, and psychologists differ in how they align with the roles of scientist and practitioner. Some clinical psychologists leave the lab setting for exactly one year to do an internship and then head straight back to academia for the remainder of their careers, whereas others have little meaningful first-hand experience in a full-time research setting. The Psy.D. training model was introduced as a more practice-oriented counterpart to the research degree model, but it didn't solve the fundamental issues of professionalism and training standards among psychologists.
 
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GroverPsychMD said:
Exactly right. Why aren't the leaders doing this?
Are their pockets being lined by the diploma mills?
Follow the money..
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Oh, this is no secret. Alliant and Argosy have been big sponsors of APA in the past. One of the reasons I dropped my membership. Many of us have been pushing for stricter standards for some time. It's why I'd rather give my money to a couple neuropsychological organizations who do a good job of advocacy and push for board certification as an additional check on competence.
 
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GroverPsychMD said:
It's a lot more than just "exams along the way". There is standardization of almost everything in US medical schools. I studied for every exam in medical school like no other test I ever took. Every one of them. And there were a lot.

Law school is suffering from a glut. I don't even know if they are all accredited as there are so many pop up schools.
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My bad, I meant standardized exams that have discriminant validity. Also, you were right on the money with your comment about "follow the money" for why we have a number of weaker programs with lower standards cranking out too many grads. I think another factor that plays into that is that psychologists tend to have bought into the "everyone wins a prize for trying" mentality that has been permeating our society more than the MDs. You guys compete all day long all the way through your training. The only time I really competed head to head during the doctoral training was when a supervisor and I would see who could get the most info from difficult patients on an inpatient unit and that helped make it one of my best training experiences. I do compete head to head now and it is for real because if I don't do a good job, my schedule isn't full and I make less money.
 
WisNeuro said:
Oh, this is no secret. Alliant and Argosy have been big sponsors of APA in the past. One of the reasons I dropped my membership. Many of us have been pushing for stricter standards for some time. It's why I'd rather give my money to a couple neuropsychological organizations who do a good job of advocacy and push for board certification as an additional check on competence.
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They were massive donors in IL to push for prescribing as well, IMO.

Diluting the field is not working.
 
WisNeuro said:
Massive money on both sides, but a different issue with it's very own thread.
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Not really as the original point I was making and you all were agreeing with is that Argosy/Alliant are diluting the field.
That's another reason at least I was very against the bill. If the education was more standardized and heading in that direction, that at least would have been good. But they are diluting the field and then donating money to increase the responsibility. Seemed like much more of a money grab than really trying to increase quality and help patients in IL. Didn't make sense. IMO.
 
WisNeuro said:
That particular bill, yeah, it was garbage, But, I imagine the AMA will oppose any bill in that direction. We can debate that to our hearts content in the RxP thread.
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I am specifically referring to Argosy/Alliant diluting the field. And the APA being lined with money from them. Which doesn't really benefit psychologists who want more standarized training. IMO.
 
I believe most of their revenue if from licensing fees, royalties, and copyrights. While I think they do receive some bias, I think it plays out more in accreditation of programs rather than specific legislation. So, yes, in a way, potential for bias is there. We'll see what happens in the coming year if Puente gets the presidency, but I don't hold out too much hope for wrangling of Argosy/Alliant from the APA. There's a better chance of hurting them by lawsuits from prior students.
 
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WisNeuro said:
I believe most of their revenue if from licensing fees, royalties, and copyrights. While I think they do receive some bias, I think it plays out more in accreditation of programs rather than specific legislation. So, yes, in a way, potential for bias is there. We'll see what happens in the coming year if Puente gets the presidency, but I don't hold out too much hope for wrangling of Argosy/Alliant from the APA. There's a better chance of hurting them by lawsuits from prior students.
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They are making money hand over fist in IL. I don't know if lawsuits will impact them much at all.
 
If the lawsuits are big enough, maybe. But, money is a way of life in medicine. Just look at other disciplines. The other APA, psychiatry, gets over a quarter of its annual operating budget from the pharma industry.Money and industry have a much bigger influence than actual patient outcomes in all of healthcare than most would like to admit.
 
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WisNeuro said:
If the lawsuits are big enough, maybe. But, money is a way of life in medicine. Just look at other disciplines. The other APA, psychiatry, gets over a quarter of its annual operating budget from the pharma industry.Money and industry have a much bigger influence than actual patient outcomes in all of healthcare than most would like to admit.
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Including the APA psychology, which is what we are discussing in this portion of the thread. Psychology today is full of pharma ads as well. Follow the money, you don't think pharma is pushing this as well?
 
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