Question about possible gap year after medical school

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mohi

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I'm a US allopathic school senior and decided to switch to Psych a week or so before applications were due.
However, my question is about doing a Prelim intern year OR a gap year next year.
This might get a little complicated, so please bear with me.
I'm a non traditional med student, 230 on step 1, 4rth quartile first two years, 3rd quartile after 3rd year. Between 2nd and 3rd year I took a LOA for 1.5 years. The LOA was for medical reasons (surgery, recovery etc), and its addressed in my PS and Deans letter. I have 1 Psych LOR so far and will be getting more Psych letters after rotations in the Spring. (Other letters are Medicine and EM).
My husband was going to apply to dental residency this cycle, but due to some unforeseen circumstances he had to delay his application till next cycle. There is no dental-medical couples match, but they match in January and I was planning on applying very broadly and hoping to narrow my match list based on where he goes. This is not a sure fire way I know, but its the best we could come up with. We have been long distance for the last 6 or so years (excluding the time during my LOA); so matching in a place where we can be in relatively close proximity to each other is quite important at this point.
He (like me) will be doing a dental prelim year next year, and this way we would both apply to categorical spots next cycle.
My application to Prelim spots was quite late given all of this (even more so because I was stupid enough to overlook assigning my step 1 score till yesterday :(. I applied to 30 prelim/TY programs and only have an interview from my home institution.
I'm worried at this point. I don't want to spend another year (especially a medicine intern year) away from my husband. I know its just a year, but with all the years adding up its really started to take a toll on both of us. Although we are both passionate about what we are going into, I think we are getting to a point where we are beginning to lose our drive and motivation because we aren't able to live a half way normal personal/family life.
My question is, how badly will I be hurting my Psych application for next year if in case I don't match into a Prelim spot where he will be, and instead of SOAPing chose to do something else that year ( like research with the Psych department wherever my husband will be)? I realize this is probably not a good option given that I already took 1.5 years off in med school. I have no problem with doing a prelim year; and I suppose if we have to be apart for another year, we will make it work; but I'm trying to see if I can save us the heart ache and possibly still be okay with apps. I'd appreciate any thoughts. Thanks!

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Psych is a categorical match, not a prelim/intern year.
Yes, but I'm not planning on applying to categorical spots until next year for reasons stated. I am applying for prelim medicine spots so as to be doing something next year.
 
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I think you should do a psych research year instead of spending another yr away from your husband. The main reason to do a prelim year would be financial (since you might have to do a research year without pay), but if you had a productive year and got a great letter I don't think that would look significantly "worse" than doing a prelim year. This is just my inkling, I'm a fellow applicant and not a PD.
 
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Bit of a gamble, but possibly intermediate plan would be to go into the match with a blank list and see if the SOAP gives you anything near your husband. This may be a long shot, but it depends on your husband’s city. I suspect the SOAP could be wild this year in terms of open positions in some previously unlikely places. I also predict that you could be a competitive person among those in the SOAP as everyone is applying to so many places, unmatched AMGs will be rarer. This may be a long shot, but at worst, you do research and at best you get into a PGY-I psych spot and don’t have to repeat any training.
:shrug:
 
Bit of a gamble, but possibly intermediate plan would be to go into the match with a blank list and see if the SOAP gives you anything near your husband. This may be a long shot, but it depends on your husband’s city. I suspect the SOAP could be wild this year in terms of open positions in some previously unlikely places. I also predict that you could be a competitive person among those in the SOAP as everyone is applying to so many places, unmatched AMGs will be rarer. This may be a long shot, but at worst, you do research and at best you get into a PGY-I psych spot and don’t have to repeat any training.
:shrug:

Thank you for your input @MacDonaldTriad. I chose not to apply to psych this year because I didn't want to be in a position where Im committed to a place for 4 years in the instance that my husband doesn't match where I was. This is why I chose to delay match for a categorical 4 year spot so we are both applying to categorical positions in the same cycle.
I guess what I didn't explain well is that he is applying to a competitive specialty and does not know where he will end up after his prelim year next year. He does have an idea about where he can do Prelim year ( which for them isn't part of the match). So I've directed my Prelim applications accordingly.
Do you think I can do what you've suggested for prelim spots though?
Also, would a research year be more/less/same as a medicine year in terms of how I'm perceived the next cycle for psych?
Thank you!
 
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I get it; your husband is going to get to do this again in one year.

I’m not an expert in transitional year positions, but I do know that there are a lot of surgery prelim spots in SOAP vs. Prelim medicine (like 11 vs 3).

I’m not sure what would do better, research or Prelim. I guess that would depend on the quality and productivity of the research. My personal view is that an extra medicine year does make one a better doctor.
 
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My thoughts on options:

Medicine prelim year in match: pluses better doctor, you have an outside but not non zero chance of finding a pgy2 spot in psych next year, a good letter as an intern can't hurt. Minuses: it might be hard to interview broadly like you plan. If you match to a medicine prelim year, you'll only ever have three years of full dgme payments, so for half of psych you'll be worth half $ to you're program. Probably ndb to VA heavy places, but maybe a PD could weigh in and say if they consider this. A surg prelim would give you all five years of dgme, but probably not worth the hell and not as helpful for psych. (Yes, this is an idiotic rule… but worth a thought... Really interested to know the PD perspective).

soap: chance to grab prelim program, or maybe psych. If psych, you might have a non zero chance to transfer near your husband next year/better than if prelim im, he can definitely rank places by you highest vs. you trying to follow him.

Research: flexibility to interview, you can maybe do something that could maybe make you look better. Not dgme issues for sure. You have a reasonable reason IMO. Possibly more time with husband. Cons: probably won't actually make you much money or help much with making you a better doctor. No garuntee that you get enough interviews to match that close to him. If he doesn't find out till Jan... It's probably to late to send "I'm interested because my hubby matched here" letters and get extra interviews. I guess this applies for all the options.

Good luck.
 
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My thoughts on options:

Medicine prelim year in match: pluses better doctor, you have an outside but not non zero chance of finding a pgy2 spot in psych next year, a good letter as an intern can't hurt. Minuses: it might be hard to interview broadly like you plan. If you match to a medicine prelim year, you'll only ever have three years of full dgme payments, so for half of psych you'll be worth half $ to you're program. Probably ndb to VA heavy places, but maybe a PD could weigh in and say if they consider this. A surg prelim would give you all five years of dgme, but probably not worth the hell and not as helpful for psych. (Yes, this is an idiotic rule… but worth a thought... Really interested to know the PD perspective).

soap: chance to grab prelim program, or maybe psych. If psych, you might have a non zero chance to transfer near your husband next year/better than if prelim im, he can definitely rank places by you highest vs. you trying to follow him.

Research: flexibility to interview, you can maybe do something that could maybe make you look better. Not dgme issues for sure. You have a reasonable reason IMO. Possibly more time with husband. Cons: probably won't actually make you much money or help much with making you a better doctor. No garuntee that you get enough interviews to match that close to him. If he doesn't find out till Jan... It's probably to late to send "I'm interested because my hubby matched here" letters and get extra interviews. I guess this applies for all the options.

Good luck.

Thankyou everyone for your response and @downwithDTB for the breakdown. I didn't even know about the prelim medicine vs surgery difference. This was super helpful. I really wasn't considering a research year as strongly, but it seems like I should.
Thank you!
 
Psych is a categorical match, not a prelim/intern year.

I mean, I trust you, but I always heard it could be both. My home program is categorical, but I've heard others are advanced and require intern years.
 
There are some programs with built in PGY-II positions that are in ERAS.
 
There are some programs with built in PGY-II positions that are in ERAS.
Was also going to add this. A good number of places have 1-2 "extra" PGY-2 spots.

Personally, I'd vote for research year, especially if you can delay graduation and get funding. If you can't do that, prelim would work, but you may not end up with your husband and applying into PGY-2 psych spots will further limit your choices.
 
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