Psych becoming an easier match

[calvnandhobbs68]

Do they though? The charting the outcomes for IMGs showed that any IMG with less than a 240 Step 1 had less than a 50% chance of matching. Those with scores above 240 only had a 74% chance of matching. Meanwhile, USMDs with a scores below 210 had a 75% chance of matching, and those with scores below 200 still had a 69% chance of matching. If you look at DOS, the lowest COMLEX scorers (400-450) had a 73.5% chance of matching. So I'd argue that even poor AMGs stand a better chance than foreign grads.

Additionally, total match rates for IMGs was 29.7% while the FMG match rate was 38%. DO match rate was 77.5% and USMD rate was 85%.

I'm not debating that Step scores are of lesser importance for psych. I'm curious how you're defining "good IMG" and "poor AMG" though given the data from the most recent CTO.

I think that definitely shows that most programs (in all fields) must use a pretty firm Step cutoff score to screen out IMGs that they aren't using as harshly for AMGs. Lower scoring AMGs absolutely stand a better chance than lower scoring foreign grads, especially if they're applying broadly. IMGs basically have to apply everywhere just to scrap together a few interviews.

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[VA Hopeful Dr]

But isn't it much different than that? A 5k gives a quantifiable number to be used to rank. Psych don't seem to care much for numbers...

I more meant that as an example of something unexpected, nothing more.

 

[Mad Jack]

To give you an idea, our little program had over 50 US MD applicants per position apply. DOs applied in similarly ridiculous numbers.

 

[blueforest]

To give you an idea, our little program had over 50 US MD applicants per position apply. DOs applied in similarly ridiculous numbers.

Do you even look at IMGs when you have so many US MDs to fill all those spots? Ugh, this is depressing.

 

[TexasPhysician]

To give you an idea, our little program had over 50 US MD applicants per position apply. DOs applied in similarly ridiculous numbers.

That’s possibly a proper correction. Psych low US MD match rates last year were not due to psych being a hard match. They were due to US MD’s concentrating applications at the better programs. If proper safeties are not included, increased supply of US MD’s will catch up to applicants in every field.

It’s in the best interest of applicants to over apply and then decline interviews. A variety of programs helps ensure a match. There is no good reason a US MD without red flags should fail to match this field.

 

[MacDonaldTriad]

30 years ago, we applied and interviewed at 4 or 5 places. I didn't have to fly anywhere. It was unusual to not get an interview where you applied. More than an increase in competitiveness, what has changed is the internet and the electronic application processes. It actually took work to apply places back then. Fax machines were amazing and most of it was typed out on manual typewriters.

 

[Mad Jack]

Do you even look at IMGs when you have so many US MDs to fill all those spots? Ugh, this is depressing.

Our program absolutely does.

 

[TexasPhysician]

Do you even look at IMGs when you have so many US MDs to fill all those spots? Ugh, this is depressing.

Mine does not. Automatic filter.

 

[Horners]

Mine does not. Automatic filter.

What other filters do programs typically use? Past step 1/2 failures? Failed classes? Professionalism violations? Not honoring psych rotation?


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[TexasPhysician]

What other filters do programs typically use? Past step 1/2 failures? Failed classes? Professionalism violations? Not honoring psych rotation?


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Every program is different. Mine filtered all Step failures as well. I doubt any filter failing to honor a single rotation. The more competitive a program, the more filters they will use.

Everyone gets an excess of applications, and you need to quickly narrow it to something manageable. Something you can analyze quickly to begin scheduling interviews with good applicants.

Less competitive programs will even filter out high Step scores unless the applicant calls to provide a good reason as to why they want to interview. Some will filter everyone without a passing Step 3 as they expect to only get non-US applicants, but they will invite those that give a reason that they might attend. Programs don’t want to waste their time.

 

[FFH]

It's all guesswork until after the Match. We don't know any more than you do.

Can you expand on that? What did the pds mention?

How do they know how many programs people are ranking for instance?

That’s possibly a proper correction. Psych low US MD match rates last year were not due to psych being a hard match. They were due to US MD’s concentrating applications at the better programs. If proper safeties are not included, increased supply of US MD’s will catch up to applicants in every field.

It’s in the best interest of applicants to over apply and then decline interviews. A variety of programs helps ensure a match. There is no good reason a US MD without red flags should fail to match this field.

PDs were only speculating too.

The number of residency spots per US grad for Psych is in the normal range for last year. 1.7:1--based on this data alone, as TexasPhysician said, US MD w/o red flag should not have trouble match somewhere.

But the issue that makes it harder for people to match in psych is that most of the programs are small and their capacity of interviewing are equally small--one aPD said they barely could interview half of those in whom they were interested. Because of this, it is impossible to know for sure if one can secure interview at a given place based on the qualification alone. Psych is getting competitive, but it's not THAT competitive like Derm or Ortho. The low match rate for US Senior is probably due to people not aware that they need to apply broadly.

 

[psychattending]

Don't confound invitation to interview with ranking outcomes. They are two different creatures, though similar. I was talking about once you get an interview.

 

[psychattending]

Do they though? The charting the outcomes for IMGs showed that any IMG with less than a 240 Step 1 had less than a 50% chance of matching. Those with scores above 240 only had a 74% chance of matching. Meanwhile, USMDs with a scores below 210 had a 75% chance of matching, and those with scores below 200 still had a 69% chance of matching. If you look at DOS, the lowest COMLEX scorers (400-450) had a 73.5% chance of matching. So I'd argue that even poor AMGs stand a better chance than foreign grads.

Additionally, total match rates for IMGs was 29.7% while the FMG match rate was 38%. DO match rate was 77.5% and USMD rate was 85%.


I'm not debating that Step scores are of lesser importance for psych. I'm curious how you're defining "good IMG" and "poor AMG" though given the data from the most recent CTO.

I think the data that speed to this the large number of AMGs that did not match into psych. I don't have the figures in front of me but go look at the percentage of AMGs that did not match into psych. I think it was something like 200-300 individuals (out of maybe 1200). If the field was of the belief that IMG/AMG status trumps all, then all those AMGs would have matched and our %IMGs who make up all the interns (not the % of IMGs who applied) would have dropped. Instead you still see a large and somewhat steady number of the slots being filed by IMGs.

 

[Mad Jack]

I think the data that speed to this the large number of AMGs that did not match into psych. I don't have the figures in front of me but go look at the percentage of AMGs that did not match into psych. I think it was something like 200-300 individuals (out of maybe 1200). If the field was of the belief that IMG/AMG status trumps all, then all those AMGs would have matched and our %IMGs who make up all the interns (not the % of IMGs who applied) would have dropped. Instead you still see a large and somewhat steady number of the slots being filed by IMGs.

This could also be an effect of AMGs not applying intelligently, or overplaying their hand. Had a guy with great scores from one of the best schools out there that went unmatched last year because he thought our program was beneath him. And you know, I'm fine with that, because he probably would have been a poor fit. But people are going to have to realign their expectations within reason on the AMG side of things and apply in a less top-heavy manner than before.

 

[yanks26dmb]

This could also be an effect of AMGs not applying intelligently, or overplaying their hand. Had a guy with great scores from one of the best schools out there that went unmatched last year because he thought our program was beneath him. And you know, I'm fine with that, because he probably would have been a poor fit. But people are going to have to realign their expectations within reason on the AMG side of things and apply in a less top-heavy manner than before.

Any advice for someone who applied very broadly (>100 programs) but has interviews at many top 50 (arbitrary I know) programs? Are my odds of matching lower because i'm getting ii from better programs?

 

[Mad Jack]

Any advice for someone who applied very broadly (>100 programs) but has interviews at many top 50 (arbitrary I know) programs? Are my odds of matching lower because i'm getting ii from better programs?

Just rank every program you think you would be willing to go to in a worst case scenario

 

[deleted736562]

This could also be an effect of AMGs not applying intelligently, or overplaying their hand. Had a guy with great scores from one of the best schools out there that went unmatched last year because he thought our program was beneath him. And you know, I'm fine with that, because he probably would have been a poor fit. But people are going to have to realign their expectations within reason on the AMG side of things and apply in a less top-heavy manner than before.

Some programs also have bias for IMGs for program-specific cultural reasons and because they think they would rank them higher. It would take a few years for the system to "equilibrate". I also suspect the flood of AMGs applying are from the lesser competitive pool given the proliferation of US MD schools.

 

[yanks26dmb]

Just rank every program you think you would be willing to go to in a worst case scenario

Plan on it. But should I rank bad programs higher than I'd like?

 

[Mad Jack]

Plan on it. But should I rank bad programs higher than I'd like?

That's not how ranking works. Rank what you want first, there is no way to game the algorithm because it is applicant driven

 

[VA Hopeful Dr]

Just rank every program you think you would be willing to go to in a worst case scenario

People didn't get this mindset when I was applying for residency. It was almost like having too many programs on your list was a mark of shame. I didn't get it.

I ranked everywhere I interviewed because better them than not matching.

 

[clausewitz2]

People didn't get this mindset when I was applying for residency. It was almost like having too many programs on your list was a mark of shame. I didn't get it.

I ranked everywhere I interviewed because better them than not matching.

There was one place I was invited to interview that I think I would not have ranked at the end of the day, but thankfully I found out the very good reasons I would have done this in time to just cancel the interview instead. It should be a very rare occurrence, unless you have very specific circumstances (e.g. a family crisis comes up halfway through interview season that means that a catastrophe will happen in your personal life if you leave a specific geographic area). Now that I think about it most of those circumstances are the kind of thing that might be grounds for a Match waiver.

 

[deleted407021]

That's not how ranking works. Rank what you want first, there is no way to game the algorithm because it is applicant driven

The fact that the process is gameified is pretty irritating

 

[MacDonaldTriad]

Gamified? In what way is this process at all gameified? Rank things in the order you want them and don't rank programs you are unwilling to train in and all will be well. It is set up to honor applicant's wishes. Stop trying to get into program's heads. Stop trying to read into small hints about who says what and who doesn't, there is no secret in this process. I get that you are being pulled by the ring in your nose by a computer, but it is an algorithm that is well thought out and well designed to do what it is supposed to. If this is gamified, please let me know how to play because I haven't been able to play despite thinking about it with very bright people for longer than you have been utilizing oxidative metabolism.

 

[Mad Jack]

The fact that the process is gameified is pretty irritating

It isn't gameified though, it is a very straightforward algorithm in which applicant preference is considered first so there is absolutely no reason to rank programs in any order except the one that you actually prefer, and with programs the same principle applies.

 

[deleted407021]

It isn't gameified though, it is a very straightforward algorithm in which applicant preference is considered first so there is absolutely no reason to rank programs in any order except the one that you actually prefer, and with programs the same principle applies.

By that I mean applicants often perceive it to be a system that can be gamed.

 

[MacDonaldTriad]

The best way to lose is to play the game. War Games, the 1983 movie with Matthew Broderick as a kid.

 

[Shufflin]

After all the extinction, which new species will take over? ... perhaps the bees, probably.

I loved that movie.

 

[Mass Effect]

As someone who is now involved in the process, I can assure you psych is ridiculously competitive. At a small program, we need to rank less than 4 applicants per spot to fill, while we had over 200 applicants per spot. We could easily fill the entire program with US MDs or DOs, but our PD values applicant quality over pedigree. This year is even more competitive than last.

That was my point.

 

[Mad Jack]

That was my point.

I was providing corroboration

 

[Old&InTheWay]

That was my point.

I was providing corroboration

Great, glad we cleared that up.

 

[ridethecliche]

Numbers matter, but the interview is truly make or break. Most of my psych interviews were between two and four hours of solid questions

Wtf were people asking you for 4 hours straight. That sounds awful. Why can't we all just like go bowling or play pool and talk over cigars and scotch while wearing our finest tweed?

PD of the program where I'm at said that step score was used initially to sort out the 1200+ apps they received each year, but at the end of the day, pretty much everyone gets reviewed and it's the non-step part that matters.

I had an attending tell me that they had a candidate that looked fantastic on paper. Great scores, research, etc. When they walked into his office for the interview he hopped on the couch and kicked his shoes up facing the interviewer.

I'm going to take a giant leap and say that I'm guessing that guy didn't get ranked.

Every program is different. Mine filtered all Step failures as well. I doubt any filter failing to honor a single rotation. The more competitive a program, the more filters they will use.
Everyone gets an excess of applications, and you need to quickly narrow it to something manageable. Something you can analyze quickly to begin scheduling interviews with good applicants.
Less competitive programs will even filter out high Step scores unless the applicant calls to provide a good reason as to why they want to interview. Some will filter everyone without a passing Step 3 as they expect to only get non-US applicants, but they will invite those that give a reason that they might attend. Programs don’t want to waste their time.

With so many applications to so many programs, I have a feeling that last minute interview slots are going to be a thing as folks cancel interviews last minute to field other offers and/or interviews will drag out a bit later.

Any advice for someone who applied very broadly (>100 programs) but has interviews at many top 50 (arbitrary I know) programs? Are my odds of matching lower because i'm getting ii from better programs?

Lets think about this for a second... why the hell would programs offer you interviews if they weren't interested in you as a candidate? Like seriously dude, you're doing awesome. They have tons of applicants and limited interview spots. I think they might kinda want you. Go practice your power pose before interviews and go get 'em!

Plan on it. But should I rank bad programs higher than I'd like?

Homes. Chill.
Ish not a game.

 

[Shufflin]

A fun surprise awaits those applicants who glance at the title of this discussion without reading the actual posts.

 

[Heart of Lioness]

Raise the median income to $250k. I'd bet money that even if we all became douche-bags we'd be more competitive

That's my omnipotent fantasy.

I think med students may have a better appreciation of psych if they had more time to observe patients recover. ie. depression can take months to resolve with medications and psychotherapy. They only stick around long enough to see the SI go away and are left with question marks.

We frequently lament over how "uncompetitive" we are compared to other fields. However, there are many challenges in our field that may discourage others from entering it. We deal with all types of character pathology and behavioral disturbances: the intimidating, the threatening, the hostile, the needy, the helpless, the manipulative, the tearful, the angry, the delirious, the psychotic, the manic, the depressed, the anxious, the obsessive, the borderline, the narcissistic....etc. The provider is faced with the challenge of engaging the affective state in an attempt to establish a therapeutic alliance and enhance communication with the medical team. This isn't "easy work" and I can see why it would be an undesirable position for others to take.

Personally, I love the challenges of dealing with difficult patients. Looking at a broken bone on an xray.... doesn't blow my skirt up.

I love seeing a patient who is manic or psychotic become a new person over a week or two. Job satisfaction!

 

[ridethecliche]

PD at a reasonably competitive New England program said at an interview day that they got over 900 applications for 8 spots, tossed about half the applications, and now have 90 folks in for interviews.

I've talked to admins over various interviews that have said 900-1200 applications for programs that have 5-8 spots. A few places said it was about the same or less than last year and others said even more than last year.