Unexpected Match Results

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SO2011

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Well, I'm sure this has happened before but I didn't get the match day results I wanted...

Short story: I went for a double specialty match with psych as my preferred specialty and OBGYN as the other specialty. Despite assurances from my home psych instutution, I matched into OBGYN. In the end, psych is a better fit for me. My question is, how do I best position myself to re-match into psych later on? What is the best strategy?

Long story: Early in my 4th year, I still wasn't sure what specialty I wanted. Based on preliminary interest and ability, I somewhat liked OBGYN so I applied when ERAS opened. However, I also got really great reviews in psychiatry and after another awesome rotation in psychotherapy and a few terrible rotations in OBGYN, I started rethinking my choice. Two of the attendings at my home institution were persistant in telling me that I would make a good psychiatrist. I told them I felt it was to late (late Oct.) to apply to psych. Howver, they persuaded me, telling me that my home institution would certainly want me as a resident. So, I applied and got 4 psych interviews in total. At my home institution interview, several more people told me how much the institution wanted me as a resident, and focused on persuading me to rank them high. I followed up with a letter, explaining that I wanted to match to the home institution and was ranking them at the top of my ROL. Then I got a letter in the mail formally stating that my home institution was interested in me and hoped to see me as a resident next year, and reaffirmed their high interest. Imagine my surprise when on match day, I didn't match to my home institution. I also didn't match to the few other psych residency programs. Instead, I matched to one of the OBGYN programs, which I did rank due to the low number of psych interviews. I have done several sub-I's in OBGYN and I am confident psychiatry is a much better fit for me. However, I am not sure I will have enough energy and time to re-apply to psychiatry while also completing a year in a OBGYN residency. How should I proceed if I want to make a switch to psychiatry???

Thanks to all that honestly and respectfully respond
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First, don't get hysterical. But seriously, work really hard in your OBGYN intern year and apply to PGY-2 psych spots. Several larger programs keep open PGY-2 spots for transfers from either 1 year internships or residents switching specialties. And if you find you love OBGYN you can just stay put. The reverse, as in psych to OBGYN, is much tougher.
 
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Thank you! Should I try to network with larger programs prior to the match to see if they will be keeping spots open? If so, how early should I start and how would I approach that in the most professional way? Should I tell the OBGYN program after several months about my situation or is early better? There is a psych program at the institution I matched to, is it best to start there?
 
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SO2011 said:
Thank you! Should I try to network with larger programs prior to the match to see if they will be keeping spots open? If so, how early should I start and how would I approach that in the most professional way? Should I tell the OBGYN program after several months about my situation or is early better? There is a psych program at the institution I matched to, is it best to start there?
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I would start looking for psych spots yesterday.

Personally, I would wait and see what sort of person your OB/GYN program director is over some time before saying anything. You're going to have to feel out the situation carefully. On the one hand, it's nice to give the program plenty of time to plan how many interns they'll need next year. If any open spots in psych become likely for you to obtain, I'd let your program director know rather than he/she find out from a prospective psych program. If you judge your program director to be very supportive and more concerned about you as a resident than who is going to do scutwork and call, you can start at your home institution. But don't do that without telling him or her first.

On the other hand, you don't want anyone to think you are anything less than a dedicated intern. Even if you are a hard working intern, them knowing you are already not interested in staying in OB/GYN may color their perception of you. For me, I would probably just act like I had learned that psych is better fit for me after 6 or 8 months or whenever a really good chance of getting into psych appears and express much appreciation for all I've learned in OB/GYN. I would never complain about anything in OB/GYN, not even once.
 
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Wow I guess this is why they say not to trust programs when they rank you. It will work out, I think much tougher situations have been posted on SDN.
 
FranzLO said:
Wow I guess this is why they say not to trust programs when they rank you. It will work out, I think much tougher situations have been posted on SDN.
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Why? The program made no promise. The OP was fortunate that they have a match. The unmatched numbers were horrendous this year.
 
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OldPsychDoc said:
Why? The program made no promise. The OP was fortunate that they have a match. The unmatched numbers were horrendous this year.
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Yeah, the program didn't say anything guaranteeing anything to the op. There's a world of difference between telling someone they are ranked to match and telling them that you would love to have them at your program -- it's possible the op's program ranked him/her quite highly but people they ranked higher matched instead.

About switching specialties, it's totally doable, but I agree that I wouldn't necessarily tell your pd about your plans until you get a feel for things. University of Washington has a few spots explicitly for PGY2 residents -- it would probably be good to find other programs with a similar setup. Spots otherwise open up periodically. My one question is does an ob/gyn year count as an internship for psychiatry?
 
This makes me ecstatic I matched 5 years ago rather than now. It gets harder to match every year. It also gets harder to be a resident every year, with the new bs milestones. I'm honestly not sure I'd have gone into med school/residency these days. I'd have likely ended up in a med school with a lot more debt, and in a worse residency (if I'd have matched at all).

It is really just brutal these days. If I have kids, I'll dissuade them from considering this kind of career.
 
OldPsychDoc said:
The unmatched numbers were horrendous this year.
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Why do you think this is the case?

Being a year out from the match, seeing these stories makes me a bit concerned. Nothing to do but one's best. Game on!
 
Doctor Bagel said:
My one question is does an ob/gyn year count as an internship for psychiatry?
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Frankly, no. You might get the 4 months of primary care credit, and I suppose could apply a few months toward elective time--but it is not going to be equivalent to what most programs require of PGY1s.
 
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OldPsychDoc said:
Frankly, no. You might get the 4 months of primary care credit, and I suppose could apply a few months toward elective time--but it is not going to be equivalent to what most programs require of PGY1s.
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Don't know about this. My program tends to save spots for PDY2 transfers every year. I think the only catch up would have to be a few Neuro rotations missed in the first year. We have someone starting as a PGY2 after an OB-Gyn intern year. If OP does a good job as an intern, she should be able to find a PGY2 spot in Psychiatry.
 
Dharma said:
Why do you think this is the case?

Being a year out from the match, seeing these stories makes me a bit concerned. Nothing to do but one's best. Game on!
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Not matching has been a bad thing at least since I was applying, but the reality still is that almost everyone in psych matches, assuming you're a US grad without significant red flags who picks a decent application strategy. So yeah, take the match seriously and do your best, and chances are you'll be OK.
 
Transferring as a PGY2 seems like the best bet. That way you don't have to apply through ERAS and can tell your PD after you've had time to assess a) whether you can rediscover what you initially liked about OBGYN, and b) how supportive your PD will be if you decide to switch to Psych. The more time your OBGYN PD has to recruit a replacement for you, the more supportive he/she may be. Completely anecdotally: One year (now many years ago), we had a resident come to our PD in November saying he had made a terrible mistake and wanted to pursue a different specialty. Around that same time, a resident from that specialty who had rotated on our service decided that she'd made a terrible mistake and wanted to pursue ours. She'd even gone so far as to apply via ERAS to our program for consideration in the next year's intern class. Our residents had liked her when she was on our rotation. Discussions took place among the respective PDs and DIO...and we ended up just switching the two in January.
 
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Yes, ob/gyn intern year counts as a PGY 1 for psych. You would have to complete two months of neurology once you transfer to psych. There are several programs on the West coast (and likely elsewhere) that have PGY2 spots every year. Don't despair!
 
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Wednesday said:
Yes, ob/gyn intern year counts as a PGY 1 for psych. You would have to complete two months of neurology once you transfer to psych. There are several programs on the West coast (and likely elsewhere) that have PGY2 spots every year. Don't despair!
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How do you go about finding these programs?
 
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Wednesday said:
Yes, ob/gyn intern year counts as a PGY 1 for psych. You would have to complete two months of neurology once you transfer to psych. There are several programs on the West coast (and likely elsewhere) that have PGY2 spots every year. Don't despair!
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Just to clarify, an OB-GYN intern could transfer into a PGY-2 psych slot, but they would have a lot more to make up than just two months of neurology. If the intern year has, for instance, 6 months of inpatient psychiatry, the transferring resident would have to make that up, likely in lieu of elective time later.
 
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Thanks everyone! I feel much more confident now. The news was hard to swallow at first, but I'm adjusted now. I see some of the resources for finding PGY-2 spots like the psych clearinghouse and resident swap. For the program mentioned above that regularly have apply PgY-2 spots, are those accessed through next year's ERAS?
 
I think they are outside ERAS. Contact the programs directly.
 
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