Psychiatry becoming more competitive?

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Seems like more folks are talking about and wanting to go into it. I have not really seen it in terms of the numbers yet but is anyone else starting to see this?

The number applying doubled at my school in this yr's class and my class already has close to the number that applied this yr.

Is the secret over?

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Look at the past two Charting Outcomes. The average step 1 score for matched applicants when up quite a bit considering the elapsed time is only two years. I think it's becoming more and more recognized as a "lifestyle" specialty, but many students in my experienced are turned off to it because 1) it still retains some degree of stigma, 2) it is significantly different than other fields of medicine in a lot of ways and is quite unlock what you otherwise have been studying for in medical school, and 3) some people just don't want to work with psychotic or otherwise very acutely ill folks.

I don't think there's any "secret." I think the field is sufficiently different enough from the more "traditional" branches of medicine that there will still be a relative paucity of applicants.

But what do I know.
 
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I think it depends on the year. Very variable. I saw match data from my school for past 10 years.

Psych goes something like:

2, 9, 5, 9, 6, 7, 2....

Also I don't think there is a secret (although I'm one to joke about it on here)...pretty much every student rotates through it.

Like Nick alluded to, maybe more lifestyle focus in current cohorts.

Also step scores increased across every specialty with time. Psych only surpasses FM, iirc.
 
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This is a good topic to revisit. Psychiatry is becoming more competitive in terms of the applicants themselves, but this pertains to most specialties (though rads has become significantly less competitive in recent years, though is still much more competitive than psych). Step 1/Step 2 scores are skyrocketing (national avg is approaching 230, about a 10 point increase in about 5 years) because with enough prep/UWorld, it is an outcome people can really control, even for weaker test takers. And since the government isn't putting more funding into more residency programs, yet new medical schools (including ones that get to join the "US Allopathic" club) continuously open, the demand curve is shifting right. Also, regarding psychiatry itself, increasing numbers of MDPhDs are choosing psychiatry (definitely a good thing). But in terms of competitiveness in relation to other specialties... no. Most people enjoy their psychiatry rotation, but medical students tend to cling to things like being a "real doctor," the OR, money, procedures (and no, ECT and rTMS will not sway a proceduralist hell bent on doing central lines, LPs, paras, suturing, abscess drainage, etc), respect from other specialties, respect from the public, etc etc etc. I do not have a problem with this at all though because it means that most people who go into psychiatry REALLY want to do it, the afore mentioned issues notwithstanding. Our specialty will survive even with people who are less scientifically inclined and cling to therapy simply because of their passion for the field. And clinical neuroscience can be taught in residency anyway. Our field will go to **** if we start getting ortho "bros" who don't match ortho or burnouts with >250 step 1 and AOA who decide on derm because they are competitive enough but don't match derm. And truthfully, I am not sure which would be worse...
 
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many students in my experienced are turned off to it because 1) it still retains some degree of stigma, 2) it is significantly different than other fields of medicine in a lot of ways and is quite unlock what you otherwise have been studying for in medical school, and 3) some people just don't want to work with psychotic or otherwise very acutely ill folks.
Agree with everything Nick says here. I will say that on interviews this year I was extremely impressed with the other applicants and it gave me a psychological boost b/c yes I was also kinda worried about my choice to go into psych somewhat at the beginning of 4th year. I was also worried that "only weird/strange people go into psych" and didn't really see myself as meeting that stereotype. I met some really cool, down to earth guys and girls who had many of the same interests that I share. Committing to a specialty (especially psychiatry) is one of the hardest things we face as medical students (for me at least it was). I think there's something about the finality of it all....giving up all the physio, procedures, labs, etc that we've busted our tails off learning and depending on.
 
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Seems like more folks are talking about and wanting to go into it. I have not really seen it in terms of the numbers yet but is anyone else starting to see this?

The number applying doubled at my school in this yr's class and my class already has close to the number that applied this yr.

Is the secret over?

I think there will be more people applying, although that won't necessarily mean its more "competitive." My sense is that there's a pool of candidates that come to medical fairly open-minded, thoughtful and have a general humanistic outlook. They aren't necessarily the super competitive types that had multiple publications, busted their way into AOA and killed the boards, but were engaged and passionate about helping others. In the past, this pool may have gravitated towards internal medicine, maybe peds, and became the wizened, beloved physicians we've all rotated under. The psychiatrists seem to traditionally have been taken from a more alternative crowd. I think that demographic is shifting, and as psychiatry becomes more mainstream and general medicine becomes less humanistic, there is an opportunity to capture those candidates. There's still plenty of space for these people, who are closer to the mean in terms of stats, and are essentially choosing between a mid-tier IM program or upper tier psych.

But I don't imagine that it will ever have the same appeal as the surgical subspecialties or derm, where you have to commit early on to being competitive.
 
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Look at the past two Charting Outcomes. The average step 1 score for matched applicants when up quite a bit considering the elapsed time is only two years. I think it's becoming more and more recognized as a "lifestyle" specialty, but many students in my experienced are turned off to it because 1) it still retains some degree of stigma, 2) it is significantly different than other fields of medicine in a lot of ways and is quite unlock what you otherwise have been studying for in medical school, and 3) some people just don't want to work with psychotic or otherwise very acutely ill folks.

I don't think there's any "secret." I think the field is sufficiently different enough from the more "traditional" branches of medicine that there will still be a relative paucity of applicants.

But what do I know.

To be fair the step scores have increased substantially across most specialties.
 
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Will more people going into a field due to a desired lifestyle increase the level of care?

Generally speaking: I feel there's a huge difference between someone excited about helping those with mental illness versus someone who wants to be out of work at 4PM and make decent money.
 
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TOur field will go to **** if we start getting ortho "bros" who don't match ortho or burnouts with >250 step 1 and AOA who decide on derm because they are competitive enough but don't match derm. And truthfully, I am not sure which would be worse...

Do you not think there are already plenty of people who go straight into psych because they never even had an outside chance of matching into something like derm?
 
Will more people going into a field due to a desired lifestyle increase the level of care?

Generally speaking: I feel there's a huge difference between someone excited about helping those with mental illness versus someone who wants to be out of work at 4PM and make decent money.

I'm not sure if those with lifestyle as a primary motivator would last very long in the world of psychiatry. It's certainly a nice motivation but IMO it should be secondary to having some passion for the treatment of those with mental illness.

So I think a definite NO to the first question.
 
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As the old saying goes, if you can't do Derm, do Psych.
 
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people say this every year but the general tend has been towards fewer people going into it not more. We have seen many more applicants this year and there do seem to be more people with astronomical board scores etc than before, but a fair chunk of these seem to be people applying to psych as a back up as we discovered. apparently some med schools have been telling students to apply to a backup specialty as things are getting more competitive (which fuels this of course!) but this is a waste of people's time, it's not like we don't know especially when you apply to two specialties at the same institution
 
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M.S4 mom here,taken a year off to spend some time with my child and decide on which speciality i want to persue.Just wanted to share my thoughts,i do hope psychiatry does get competitive and stops being seen as a "less pretigious" field.
Secured 232 on step1 nd 256 on step 2,cs pass on the 1st attempt.Even with just fairly good and not-so impressive scores i've often got that vibe from med students,residents and even attendings,as-if asking me "why considering psych with those scores?".Some directly discourage me from making that choice.
@splik , @OldPsychDoc , @Leo Aquarius :Can you please tell me how often you come across scores above those applying into psych(so that i can feel better)
 
Well, I'll pitch my 2 cents.

I personally know 3 US Citizen IMG Carribean Grads (strong students)

1. Step 1 (230), Step 2 (225): 6 IVs
2. Step 1 (235), Step 2 (230): 3 IVs
3. Step 1 (248), Step 2 (233): 10 IVs

And these IVs are mostly at community programs/low tier univ programs, throughout the country.

So I'm not disregarding your solid scores, but I wouldn't expect to be able to cakewalk into MGH/Columbia either, Psych is definitely no longer a shoe-in to Top 10 programs for US MDs.

Competitiveness is all relative too. I'm pretty sure Psych at Harvard or Cornell is more 'competitive' than a community radiology or anesthesia residency in the midwest. So it depends what you want to achieve academically as well.
 
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Well, I'll pitch my 2 cents.

I personally know 3 US Citizen IMG Carribean Grads (strong students)

1. Step 1 (230), Step 2 (225): 6 IVs
2. Step 1 (235), Step 2 (230): 3 IVs
3. Step 1 (248), Step 2 (233): 10 IVs

And these IVs are mostly at community programs/low tier univ programs, throughout the country.

So I'm not disregarding your solid scores, but I wouldn't expect to be able to cakewalk into MGH/Columbia either, Psych is definitely no longer a shoe-in to Top 10 programs for US MDs.

Competitiveness is all relative too. I'm pretty sure Psych at Harvard or Cornell is more 'competitive' than a community radiology or anesthesia residency in the midwest. So it depends what you want to achieve academically as well.

So all of those examples you have a step 2 score that is lower than Step 1. This suggests a decline in performance as the exams get more clinically relevant. Since an identical performance on Step 2 as on Step 1 with respect to percentile should net a score that is 10-12 points higher on Step 2, I would not characterize these scores as incredibly strong.

No idea how much it actually hurts an applicant, but it is not a fillip to an application for sure.
 
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Oh I agree. My point is they have (in my opinion) solid scores, but are not doing damage on the interview trail.

5 years ago a step 1 of 248 would be slicing and dicing through university programs...

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M.S4 mom here,taken a year off to spend some time with my child and decide on which speciality i want to persue.Just wanted to share my thoughts,i do hope psychiatry does get competitive and stops being seen as a "less pretigious" field.
Secured 232 on step1 nd 256 on step 2,cs pass on the 1st attempt.Even with just fairly good and not-so impressive scores i've often got that vibe from med students,residents and even attendings,as-if asking me "why considering psych with those scores?".Some directly discourage me from making that choice.
@splik , @OldPsychDoc , @Leo Aquarius :Can you please tell me how often you come across scores above those applying into psych(so that i can feel better)
Those would be above average scores for our US applicants. Your application will hinge more on how well you can show that you've decided that psych is really the field for you, and making clear that your year off really was for personal and family reasons instead of something possibly nefarious or otherwise concerning.
 
I personally know 3 US Citizen IMG Carribean Grads (strong students)

1. Step 1 (230), Step 2 (225): 6 IVs
2. Step 1 (235), Step 2 (230): 3 IVs
3. Step 1 (248), Step 2 (233): 10 IVs

And these IVs are mostly at community programs/low tier univ programs, throughout the country.
In terms of competitiveness as a class, USMDs > DOs > IMGs/FMGs. This pinch will likely become more and more acute for IMGs/FMGs as the rate at which there are more MD and DO graduates greatly exceeds increased spots in residency. If these three applicants had clinical results, experiences, and letters proportional to the Step scores (not to be assumed) and went to any reputable domestic MD program, they would likely have interviews almost anywhere they applied.
 
So all of those examples you have a step 2 score that is lower than Step 1. This suggests a decline in performance as the exams get more clinically relevant. Since an identical performance on Step 2 as on Step 1 with respect to percentile should net a score that is 10-12 points higher on Step 2, I would not characterize these scores as incredibly strong.
Except for the fact that most people don't take Step 2 nearly as seriously as they do Step 1.

Most program value Step 1 and some use it when they are ranking applicants. Some programs likely look seriously at Step 2 but many do not. My program (and I know of many others) look at Step 2 primarily if they needed reassurance because Step 1 was inconsistent with the rest of their application (you sometimes get applicants who are great overall but bombed their Step 1; if Step 2 is stellar, you are more reassured that Step 1 was a bad-test-day).

Programs that would read much into someone's Step 1 --> Step 2 dropping from the 230's to the 220's or 240's to the 230's would definitely be in the minority.
 
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Psych is for a minority of medical graduates. It interests you or it repels you. I think that is why some people react to psych interested strong students with “why would you do that when you don’t have to”. If you didn’t like your psych rotation well enough to tolerant of such comments, maybe you shouldn’t do it. By the way, most of this bias exists mostly among medical students and residents. Very few psychiatrists are surrounded by these after their training.
 
M.S4 mom here,taken a year off to spend some time with my child and decide on which speciality i want to persue.Just wanted to share my thoughts,i do hope psychiatry does get competitive and stops being seen as a "less pretigious" field.
Secured 232 on step1 nd 256 on step 2,cs pass on the 1st attempt.Even with just fairly good and not-so impressive scores i've often got that vibe from med students,residents and even attendings,as-if asking me "why considering psych with those scores?".Some directly discourage me from making that choice.
@splik , @OldPsychDoc , @Leo Aquarius :Can you please tell me how often you come across scores above those applying into psych(so that i can feel better)

You are in good company Worried-doc. This happened to me and several other Psych residents I know. In med school the prestige bubble bursts, and fizzles once in residency. Nobody measures you by step scores in residency.

I know of a neurosurgeon, a general surgeon, a top internal medicine doctor, an emergency medicine doctor, and a few other specialists who all switched into psychiatry. The neurosurgeon was a mother who got burned out after a few years in practice. You can either cash in your excellent scores for a competitive specialty, only later to switch into psych and then perhaps wonder why you didn't make the switch from the start and spend all those days and nights in agony. Also, you're in good company among strong applicants at competitive programs assuming you are in a US MD.

Take a look at a place like UCSF. Their residents all come from great med schools and have strong step scores and each could pursue any number of specialties based on their resumes. You have to go for what you enjoy. If not, then it will catch up to later and you'll make the switch spending much time and energy in the process.

I also ask you to keep in mind that prestige drops off in importance the further along you are in medical training. Having lots of passion to work hard and be excellent is much more important. If you don't like the specialty you're in, it will show.

I really like Psychiatry, and am doing a fellowship to become specialized into a subfield I'm passionate about and can't stop learning enough about. Psych and her sister branches are deep for sure.
 
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The head of Critical Care medicine gently balked when I told him I'm going into psychiatry, and asked why would I do a thing like that and then asked why I didn't want to go into Critical Care (I did really well on my clerkship). So I feel your hesitation. It will pass if you listen to your gut.
 
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These threads about psych competitiveness that are popping up lately are scaring the heck out of me:

Lets say someone from a low tier US MD... 200-210 on step1... 210-220 on step 2 and pass CS ... All on first attempt. No other red flags. Will that person be able to match somewhere in the country? assuming he/she applies to 60+ low tier community programs.

I decided to go to med school just to become a psych physician (or maybe a FM doc)... I am not a strong student (around 3rd quartile in class rank) and these threads are starting to scare me a lot...
 
These threads about psych competitiveness that are popping up lately are scaring the heck out of me:

Lets say someone from a low tier US MD... 200-210 on step1... 210-220 on step 2 and pass CS ... All on first attempt. No other red flags. Will that person be able to match somewhere in the country? assuming he/she applies to 60+ low tier community programs.

I decided to go to med school just to become a psych physician (or maybe a FM doc)... I am not a strong student (around 3rd quartile in class rank) and these threads are starting to scare me a lot...

The answer is yes. You know this. You have read it here on multiple threads, if you have been following the threads that you post in.
 
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Just have to pop in and say something, please do not limit your application to low tier community programs if you are interested in academic programs too...you have a chance. Being an allopathic MD gives you a huge boost.
 
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Just have to pop in and say something, please do not limit your application to low tier community programs if you are interested in academic programs too...you have a chance. Being an allopathic MD gives you a huge boost.
Are there other kinds of MDs? ;)
 
Just have to pop in and say something, please do not limit your application to low tier community programs if you are interested in academic programs too...you have a chance.
I agree with this.

W19- You are an allopathic grad with no red flags. Given that you are in a lower quartile at a lower tier medical school and have a below average Step 1, I probably wouldn't apply to MGH and the like, but I'd still apply to academic programs (if they interest you). There are many academic programs and not all are particularly competitive and would definitely give your application a serious look.
 
I agree with this.

W19- You are an allopathic grad with no red flags. Given that you are in a lower quartile at a lower tier medical school and have a below average Step 1, I probably wouldn't apply to MGH and the like, but I'd still apply to academic programs (if they interest you). There are many academic programs and not all are particularly competitive and would definitely give your application a serious look.

Sorry if my post was not clear... I am a MS2 so I have not taken the steps yet... The numbers I used were just a hypothetical situation based on my class performance so far. I have done a lot better in 2nd year (top 1/3 in my class so far), but it's hard to make up for my dismal 1st year...

I am going to study my b... off to score 230+ in step 1/2, but I have to prepare for the worst case scenario... That's why I used these low(ish) numbers.
 
As someone involved in the admissions at a top tier program (MGH/Cornell/Columbia/UCLA-level), I want to make some clarifications and dispel some myths posted in this thread from my experience (which is only one point of view from a specific setting):

1) A very large percentage of those interviewed by us have board scores in the 230's and way on up, but this does not mean that some with lower scores will not be ranked highly. The whole package matters in psychiatry. A chunk of applicants could have matched into the most competitive specialties (assuming they had done the necessary research for those fields). The desirable candidates in the applicant pool with lower scores have other important factors (great performances on visiting rotations, important clinical or research experience that is exceptional, applying from a top 10 medical school, solid to great grades in clinical clerkships, personal recommendations from trusted people known to the admissions committee, genuinely likable personality). There is some magic in the process, where someone who doesn't have the strongest numbers still charms everyone with their persona and story and ends up higher on our list. A step failure or barely passing, severe academic issues (failing, having to take time off for academic problems) are at least yellow and usually red flags. With these problems you might make the cut for an interview, but you'll have a more difficult time in the ranking unless you have an exceptional story that can explain these issues in a compelling way.

2) There may be some who are using psychiatry as a backup, but they are easy to detect in an interview. You can tell when someone is truly passionate about the field, is able to talk intelligently about their clinical experiences, and seems somewhat interested in your program. There are many people with amazing records, from top medical schools, who want to go into psychiatry. They will be sought after by many programs, but they are distinct from someone who is a gunner using psychiatry as a backup specialty.

3) I can't comment on whether the specialty is getting more competitive or not, but I can say that we are enormously impressed by the vast majority of candidates we interview. By and large, they are energetic, charismatic people who seem to have a more humanistic streak than average medical students. The old stereotype of the creepy, socially awkward psychiatrist is by far the exception, not the rule. Makes me feel excited about the future of our field.

4) It will not be a cakewalk for someone going into this field for purely lifestyle reasons to get into a top program. They have a high chance of getting an interview, but they will be smoked out and ranked lower than someone with true passion for the field who has solid but less stellar scores. I'm not saying it would be impossible for them to match at one of the most competitive programs, but unless they are an exceptionally smooth sociopath who can lie about themselves convincingly, they are not going to be at the top of the list.
 
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Don’t panic about not getting into psychiatry. With only one or two exceptions, if you can’t get into psychiatry, you will not have any luck with other specialties. My gosh, we should be careful about these posts because if we scare away MDs who haven’t failed anything we are really shooting ourselves in the foot. If you graduate with a pulse, you will get in. The only question is where not if.
 
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Sorry if my post was not clear... I am a MS2 so I have not taken the steps yet... The numbers I used were just a hypothetical situation based on my class performance so far. I have done a lot better in 2nd year (top 1/3 in my class so far), but it's hard to make up for my dismal 1st year...

I am going to study my b... off to score 230+ in step 1/2, but I have to prepare for the worst case scenario... That's why I used these low(ish) numbers.
No one is going to care about your first year. Smoke Step 1!
 
Don’t panic about not getting into psychiatry. With only one or two exceptions, if you can’t get into psychiatry, you will not have any luck with other specialties. My gosh, we should be careful about these posts because if we scare away MDs who haven’t failed anything we are really shooting ourselves in the foot. If you graduate with a pulse, you will get in. The only question is where not if.

Correction: "If you graduate with a pulse from a US allopathic program, you will get in."

I'm going through the application process right now so I can share my experience. I have long been interested in psychiatry and it comes through in my application and personal statement. I'm a Caribbean grad (top 3 school) with below average board scores in the 210-220 range with pass on Step 2 CS on the 1st attempt.

I consider myself a strong psych applicant (at least I used to!) despite my board scores, mostly due to my genuine interest in the field, breadth of relevant extracurricular involvements, strong interpersonal skills and very positive evaluations received during my clerkships. I also have 2 strong LORs from psychiatrists and applied on Sept. 15th. I currently have 4 interviews all from community programs with questionable reputations, 2 of which are brand new programs and 1 is outside the match. By mid-October, I applied to a number of IM programs because of the fear of not matching and now have 2 medicine interviews as well (both from places where I've rotated). One of the medicine programs is at a great quality hospital with a great reputation, happy residents, etc. who have also expressed interest in me.

All this to say that my application season has been disappointing because I may have to give up my goal of pursuing psychiatry for a better residency program in internal medicine, simply because my psychiatry interviews are at highly undesirable locations with poor track records. Having done my research and spoken to many residents in various programs, yes, I would say things are more competitive than in the recent past.
 
Correction: "If you graduate with a pulse from a US allopathic program, you will get in."

I'm going through the application process right now so I can share my experience. I have long been interested in psychiatry and it comes through in my application and personal statement. I'm a Caribbean grad (top 3 school) with below average board scores in the 210-220 range with pass on Step 2 CS on the 1st attempt.

I consider myself a strong psych applicant (at least I used to!) despite my board scores, mostly due to my genuine interest in the field, breadth of relevant extracurricular involvements, strong interpersonal skills and very positive evaluations received during my clerkships. I also have 2 strong LORs from psychiatrists and applied on Sept. 15th. I currently have 4 interviews all from community programs with questionable reputations, 2 of which are brand new programs and 1 is outside the match. By mid-October, I applied to a number of IM programs because of the fear of not matching and now have 2 medicine interviews as well (both from places where I've rotated). One of the medicine programs is at a great quality hospital with a great reputation, happy residents, etc. who have also expressed interest in me.

All this to say that my application season has been disappointing because I may have to give up my goal of pursuing psychiatry for a better residency program in internal medicine, simply because my psychiatry interviews are at highly undesirable locations with poor track records. Having done my research and spoken to many residents in various programs, yes, I would say things are more competitive than in the recent past.

On the flip side. If you where to rank Psychiatry higher, chance of you matching is a lot higher this season. Last interview, PD asked how many interviews I'm going to. He mention, because he notice a lot of his applicants had 20+ booked. So.... That's something that eases my mind, that programs might have to go further down lists.
 
Correction: "If you graduate with a pulse from a US allopathic program, you will get in."

I'm going through the application process right now so I can share my experience. I have long been interested in psychiatry and it comes through in my application and personal statement. I'm a Caribbean grad (top 3 school) with below average board scores in the 210-220 range with pass on Step 2 CS on the 1st attempt.

I consider myself a strong psych applicant (at least I used to!) despite my board scores, mostly due to my genuine interest in the field, breadth of relevant extracurricular involvements, strong interpersonal skills and very positive evaluations received during my clerkships. I also have 2 strong LORs from psychiatrists and applied on Sept. 15th. I currently have 4 interviews all from community programs with questionable reputations, 2 of which are brand new programs and 1 is outside the match. By mid-October, I applied to a number of IM programs because of the fear of not matching and now have 2 medicine interviews as well (both from places where I've rotated). One of the medicine programs is at a great quality hospital with a great reputation, happy residents, etc. who have also expressed interest in me.

All this to say that my application season has been disappointing because I may have to give up my goal of pursuing psychiatry for a better residency program in internal medicine, simply because my psychiatry interviews are at highly undesirable locations with poor track records. Having done my research and spoken to many residents in various programs, yes, I would say things are more competitive than in the recent past.
I don't thing things are legitimately that much more competitive (besides the general increase across the board in all specialties). There's a huge log jam with folks holding onto to too many interviews out of fear, leaving folks like yourself (who deserve more) with the leftovers and crumbs.
 
I agree with this. Hyper applying has created a parallel process with the programs. In the past applicants were told to be sure and broaden the “tiers” of programs so they don’t only apply to “reaches”. Now programs have to be sure not to only interview superstars because most of them can fill their dates with only outstanding candidates. I’m predicting that some very sold programs may go unfilled if they are caught off guard with this change in applicant behavior.
 
Thankyou all for your valuable insight.After reading a lot of posts throughout this forum,i can't help but think that the n.r.m.p. score statistics might be misleading.I've come across non-u.s. i.m.gs in residency presently and i've heard quite a few high numbers(indians especially)way! above the limit of the ones in the n.r.m.p. match data plotted these past few years.I figured this might be a case for f.m.gs(for whatever reason),now i'm learning that a LOT of u.s. citizen grads(u.s. seniors) and foreign u.s. grads(independent applicants) have scores above n.r.m.p. data upper limits for those categories too.Is this simply because of in-acurrate data or are there reasons behind this charting outcome release.
Also,i personally know a carribean IMG who barely passed the qualifying percentile in his mles, didnot seem to have any exceptional qualities(i don't mean to judge him) and has a thick accent which definitely can be a drawback i would think,applied for 3 consecutive years and then got into a fairly ok program.I couldnot help wonder if psychiatry is one of those residency spots to fall back on if everything else fails.I donot mean ANY disrespect to this wonderful field which i will most likely want to persue.This might be an exceptional case but i heard it very frankly from himself:"i couldn't get into any residency so i applied into psychiatry after doing 2 electives and then got in.You dont get into anything,there's always psychiatry".
There must be more to his profile that must have favoured his application and such candidates might certainly be present in other fields too(for instance i came across a surgery resident with below average scores from india who's uncle or somebody was something senior in some academic institution),but the higher prevalance in psychiatry does make my heart sink because i dont want to be known as being in a field that is a last resort settle for a residency applicant.Offcourse realistically speaking it's how competant and successful one is than the title he/she is known by.
This whole scene confuses me about where psychiatry stands as a competitive field after considering "the whole package" an applicant brings to the table.I'm just looking at the practical picture.It's already being seen as a less prestigious field, the n.r.m.p. statistics make it look lesser.It's disappointing to one who loves the field and sways him/her from persuing it(i know that those should be secondary concerns for someone who truely loves any field)Just saying what's on my mind. I hope psychiatry becomes competitive scores-wise too and gets it's deserved respect.I dint do pre-med and go through 4 years of greuling med school to be called an "half md" or "not a real doc" or any of those silly,non-sense labels.
 
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Well, I'll pitch my 2 cents.

I personally know 3 US Citizen IMG Carribean Grads (strong students)

1. Step 1 (230), Step 2 (225): 6 IVs
2. Step 1 (235), Step 2 (230): 3 IVs
3. Step 1 (248), Step 2 (233): 10 IVs

And these IVs are mostly at community programs/low tier univ programs, throughout the country.

So I'm not disregarding your solid scores, but I wouldn't expect to be able to cakewalk into MGH/Columbia either, Psych is definitely no longer a shoe-in to Top 10 programs for US MDs.

Competitiveness is all relative too. I'm pretty sure Psych at Harvard or Cornell is more 'competitive' than a community radiology or anesthesia residency in the midwest. So it depends what you want to achieve academically as well.
Would you know that although they are strong students as you said,what was lacking in their c.vs that dint get them interviews at better,more reputed programs?
Does clerkship at one instution get more credit than another?Or is it how potentially good they seem through the way their l.o.rs are written?
I assumed good scores and l.o.rs from any good elective program would atleast get one invited to an interview at those better,more reputed programs where performance during the interview will decide if he/she is a suitable pick.
 
I’m predicting that some very sold programs may go unfilled if they are caught off guard with this change in applicant behavior.
This. I think there will be a bigger SOAP this year with some unexpected strong programs on the list.


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i can't help but think that the n.r.m.p. score statistics might be misleading. I've come across non-u.s. i.m.gs in residency presently and i've heard quite a few high numbers(indians especially)way! above the limit of the ones in the n.r.m.p. match data plotted these past few years.

Some of what you see as nrmp data errors is because not all psych programs are in the match and therefore not in the data. I really think you should stop worrying about who else is doing what and just be sure you get good training and be sure you become good at what you want to do. There are good and bad physicians in all specialties, and there are lots of people practicing in fields that aren’t their first choice because they didn’t get into something else. The exceptions may be derm, optho and plastics, but other than that, there are a lot of GI people who wanted cards, and general surgeons who wanted ortho, and so on. These pecking orders will always exist in some environments, but not so much out in the real world. Your peers at your high school reunion will be judging you for how much money you make, not for how you make it.

Rich contractor: “So Bob, I hear you are some kind of doctor.”
Dr. Bob: “Yes, I’m now an associate professor at the University’s School of Medicine”
Rich contractor: (associate what?...) “That’s great, what kind of car do you drive?”
 
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On the flip side. If you where to rank Psychiatry higher, chance of you matching is a lot higher this season. Last interview, PD asked how many interviews I'm going to. He mention, because he notice a lot of his applicants had 20+ booked. So.... That's something that eases my mind, that programs might have to go further down lists.

Honestly I feel tired just from reading that someone is going on 20 interviews.
 
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At the end of the day we are all speculating and can only make informative and assertive analysis once we get the match stats in March.

But based on the interviews from this year vs. last year, I have to say I am far more impressed with the quality of applications this year. Plus the number of IMGs we interviewed this year are much lower to last year. So I suspect the %US MD in Psych will go from 57% to around low to mid 60s. Educated guess, lets see.

While the inflation in psych applicants could very well be due to more people 'backing up with psych', but I honestly think that genuine interest is going up. I find it also interesting that this is the first year in over 15 years where there is a DECREASE in US MDs applying to IM.

https://www.aamc.org/services/eras/stats/

and this is a big deal for a specialty that usually sees an increase of 200-300 applicants/year (US MD)

So perhaps people going into Derm are backing up with psych instead of IM? Maybe. But it is 'interest', which is something I will advocate on this board.
 
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Would you know that although they are strong students as you said,what was lacking in their c.vs that dint get them interviews at better,more reputed programs?
Does clerkship at one instution get more credit than another?Or is it how potentially good they seem through the way their l.o.rs are written?
I assumed good scores and l.o.rs from any good elective program would atleast get one invited to an interview at those better,more reputed programs where performance during the interview will decide if he/she is a suitable pick.

I think the only thing that is 'lacking' is the fact that they are IMGs.

That was the point of my post, to illustrate that competitiveness has gone up in psych, and therefore IMGs are feeling the brunt. 3-5 years ago, IMGs with those stats would have no problem muscling solid univ. programs, and now its becoming an uphill battle. So essentially my point is that it is a ripple effect. US MDs are still safe obviously, and should not worry about matching anywhere. But if this trend continues for the next 3-5 years, this will continue to impact first the DOs, then the low tier US MDs....etc.

I have to re-emphasize what LeoAquaris said about prestige. Its very. I remember as a college student, I thought getting into medical school would increase my prestige, and then again increase after getting into residency.

Not true.

My friends are still the same from highschool/college, I still eat the same food, wear the same type of clothes since college, date the same type of girls, etc.. Nothing really has changed after becoming an MD/Resident, so I highly doubt my life would be dramatically better right now if I was a neurosurgery resident at UCSF. People in the hospital don't really care what you do, they care more about how well you do what you do. And as a resident, I'm sure once you become an attending you are even more secluded in the working world and no one gives a crap about "prestige", but moreso on the type of work you are doing. It becomes even more moot if you are hidden in the private practice jungle. I'm sure attendings on this forum can back me up on this.

As I have said many times before, I am sure a pediatrician at CHOP or a psychiatrist at MGH or a Hospitalist at Hopkins commands more "prestige" (if that is what you are after), than a dermatologist in a community setting or an ophthalmologist in a community program (no slam towards community docs, but thats just how society perceives individuals, by their association to 'name brands').

So just do what you want to do, and if its prestige you are after, than be the best at what you are doing.

Just my 2 cents.
 
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The % of US applicants filling Psychiatry residency spots (one measure of competitiveness) jumped up this year. For the past 4 years its hovered around 51% to 55%, crept up to 57% last year.

61.4% in 2016. I sense a trend.
 
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The % of US applicants filling Psychiatry residency spots (one measure of competitiveness) jumped up this year. For the past 4 years its hovered around 51% to 55%, crept up to 57% last year.

61.4% in 2016. I sense a trend.


Yep. I called it way back last summer.

And it's not like all specialties are going up in US MD mathes. IM saw a decrease, as did Peds and Gas. Gen Surg is stable, etc.

US MD % For Comparison

IM 47%
FM 45%

Gas 67%
Rads 69%

So psych is closing in on those 2 specialities. Give it 3 years.

Psych is the only specialty that is seeing a significant increase. 690 to 775 to 850 US MD in just 2 years. Impressive. These are 10% annual increases. But of course only time will tell if the psych market is gonna overheat like the Chinese stock market.

But, I've said this before, and I'll say it again, I suspect by 2018ish psych will be middle of the road competitive like gen surg or IM. No longer will it be in the bottom 3.

Exciting present, and an even more exciting future for psychiatry.
 
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Yep. I called it way back last summer.

And it's not like all specialties are going up in US MD mathes. IM saw a decrease, as did Peds and Gas. Gen Surg is stable, etc.

US MD % For Comparison

IM 47%
FM 45%

Gas 67%
Rads 69%

So psych is closing in on those 2 specialities. Give it 3 years.

Psych is the only specialty that is seeing a significant increase. 690 to 775 to 850 US MD in just 2 years. Impressive. These are 10% annual increases. But of course only time will tell if the psych market is gonna overheat like the Chinese stock market.

But, I've said this before, and I'll say it again, I suspect by 2018ish psych will be middle of the road competitive like gen surg or IM. No longer will it be in the bottom 3.

Exciting present, and an even more exciting future for psychiatry.

I could be totally wrong and am just speculating but I get the impression that psych can have a somewhat bimodal spectrum of applicants. I feel like a lot of people interested in psychiatry have a decent idea that is what they want to do even from the beginning of medical school. Some proportion of these people are going to be very competitive applicants and would be for many/most specialties come match day. On the other side of things, you may get a bunch of less competitive people for whom psych is the coolest option of those they have left. For some people, psych is the only realistic opportunity to be a specialist of any sort, so if they don't like generalist medicine of one form or another, they wind up in psych.

I wonder how much of the increase is just random ebb and flow, though. I mean, even if it's a large percentage increase, given the relatively low number of med students interested in psych to begin with, an increase of 80-150 people spread out across all the med students in the country still winds up being a difference of, on average, recruiting an extra student or so from each given class, or an average of an extra 0.5-0.9% of grads. In any case, the data I'm looking at indicate that in 2 years, there has been an overall total increase of about 4% for matched U.S. allopathic seniors, so at least some of the increase is not unique to psych.
 
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I could be totally wrong and am just speculating but I get the impression that psych can have a somewhat bimodal spectrum of applicants. I feel like a lot of people interested in psychiatry have a decent idea that is what they want to do even from the beginning of medical school. Some proportion of these people are going to be very competitive applicants and would be for many/most specialties come match day. On the other side of things, you may get a bunch of less competitive people for whom psych is the coolest option of those they have left. For some people, psych is the only realistic opportunity to be a specialist of any sort, so if they don't like generalist medicine of one form or another, they wind up in psych.

I wonder how much of the increase is just random ebb and flow, though. I mean, even if it's a large percentage increase, given the relatively low number of med students interested in psych to begin with, an increase of 80-150 people spread out across all the med students in the country still winds up being a difference of, on average, recruiting an extra student or so from each given class.
I agree with you 100%. But the point is that people, specifically US MD, are now at least choosing psych compared to FM/IM. 5 years ago "low competitive" applicants were still deciding against psych, and therefore leaving a lot of spots for IMGs. So the fact that they choose psych over generalist in medicine is still progress.

We can't expect the interest in psych to become ortho or derm overnight. It will take 5-10 years to achieve middle level competitiveness, let alone ROAD competitiveness.

But these past 2 years is a good start, and hopefully the start of continual progress in psychiatry. It's just like how radiology starting crashing in 2009 and continued yearly until this year's match.

So if radiology can see a decline for 6 years, why not the opposite effect for psych.

An increase in 80-100 students is huge, considering there are only 1400 psych spots. Look at the other specialties, that have over 1000 spots, yet only an increase or decrease of 50 or so students (e.g. peds, IM, obgyn, gen surg, anesthesia)

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