What are my chances?

[Jackofknives]

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[HopeTo99]

Are you serious? 270+ in both steps?

 

[Jackofknives]

Yes, I am serious. I am genuinely seeking for advice.

 

[Bartelby]

Your stats and scholarly work are unreal and should be more than good enough for any program. The only thing that worries me is the idea that you are too 'procedural.' What does that mean? Does that mean that you are abrasive in your contact with patients and peers? Does it mean that you can't really sit down and have a conversation with patients? And does it mean that your clinical evaluations will say that you are a brilliant guy who just can't interact with patients?

At any rate I think your friend is right, sitting down and talking with patients (and people in general) is a skill that can be learned like any other and there is no reason why you can't do it. If your clinical evals suggest that you have good patient interactions I can't imagine that there are many better applicants in the country than you would be. I don't know how being an IMG changes things but based on hearsay getting some US clinical exposure with a rec letter to back up what the rest of your application says about you would help.

Anyhow based on your scores I imagine you are the kind of person who will work hard to make whatever you choose work for you. Good luck, we can always use more good people in psych!

 

[OldPsychDoc]

I'm a little concerned about the "partially to compensate for my own emotional baggage since childhood" part...

 

[notdeadyet]

Your application sounds very strong. I wouldn't worry too much about being focused on one specialty before deciding on psych. I haven't seen the stats, but my guess would be most folks who end up in psych started medical school interested in something else.

The only drawback on your application will be your IMG status, a lack of U.S. clinical rotations, and a lack of U.S. letter of recs. But with the rest of your application looking so strong, I'd have no doubt you'll find a home if you apply broadly. Odds are you'll get nibbles at even the top programs, so I'd include those too if they legitimately interest you.

 

[nitemagi]

I'd leave anything about emotional baggage out of your essay, and come up with an alternative explanatory model for why you want to switch fields.

While some may hope that the psychiatrist reading your essay may be more empathic just by being a psychiatrist, you will never know who reads your essay.

 

[Ron Mexico]

initially, i would have said you would have a shot just about anywhere. but the fact you asked what your chances are makes me think either you are completely dense.

 

[splik]

Hello make sure you have the right motivations for going into psychiatry. Having your emotional baggage is not a good reason you should seek your own therapy if that is a problem not disastrously bring it into the therapeutic encounter. Secondly, if you think psychiatrists study 'human behavior and emotions' you are in for a rude awakening - the vast majority of psychiatrists know very little about that. Psychiatry is the medical specialty that uses a medical framework to assess, diagnose and treat mental illness. You won't learn how to sort out your emotional baggage, and you won't learn that much about human behavior or emotions. You are better off studying literature or psychology if that is your goal.

If you are from Europe and with those scores and publications I would suspect you would get interviews from Duke, Yale, Emory, Mt Sinai, Columbia, Cornell and some other top programs.

It really doesn't take very long to organize an elective (you can do it at a month's notice) and thankfully it is not like psychiatry electives are are full. I would suggest UCLA as they don't charge, but since you have little chance of doing residency in california, you could also consider Harvard (MGH or McLean), Mt Sinai, or Hopkins all of which are usually open to international students but maybe costly and have silly requirements like malpractice insurance, immunization records etc.

You should also consider spending some time doing psychiatric research in the US either during medical school or afterwards. Many IMGs on the interview trail were researchers at Yale. Given your interest in neurosurgery you could see if you could get involved in functional neurosurgery for OCD research at Harvard as is a nice way of making the 'jump'.

You absolutely need US letters of recommendation and doing a US elective (not observership they are mostly useless for top programs and you are obviously a horrendous overachiever so that is what you should go for) will be very helpful. Some IMGs seem to have got by with research however especially if you are working for big names and getting publications.

The main hurdle for you will be the interview. I have come across a few IMGs in psych who have very impressive CVs or astronomical board scores who just come across terribly in person. I have also heard that some people are suspicious of such high scores as many people getting ridiculous scores are almost autistic. You will get interviews but you need to show that you are sociable and likeable during the interview, and be warned some people are a bit suspicious of such ultra high scores.

You are not really switching from neurosurgery you are only a medical student. I would downplay this and instead explain your interest in neurosciences, and how you considered neurosurgery, but realized it was rather crude and you would not be happy assaulting an organ as wonderful as the brain and you are more interested in higher functions and disorders of memory, mood, emotion, and so on rather than motor and sensory disorders, that your are fascinated by the brain function more than its structure, and you are more interested in excavating the psyche than the cerebellum etc.

When I was a medical student the neurosurgeons tried to 'recruit me' to the dark side, but I was only ever interested in functional neurosurgery and it is for the most part pretty depressing and most patients do pretty poorly.

 

[Leo Aquarius]

...I have come across a few IMGs in psych who have very impressive CVs or astronomical board scores who just come across terribly in person. I have also heard that some people are suspicious of such high scores as many people getting ridiculous scores are almost autistic.

The psychiatry director at my institute mentioned one day that very high board scores are actually red flags, and they take a cautious look at such applicants. Are you SURE you want a career where direct communication with patients is of utmost importance instead of the scalpel (or drill in your case)?

 

[Jackofknives]

OK, thanks for the replies. I will give it some more thoughts.

 

[psychphan]

The psychiatry director at my institute mentioned one day that very high board scores are actually red flags, and they take a cautious look at such applicants. Are you SURE you want a career where direct communication with patients is of utmost importance instead of the scalpel (or drill in your case)?

Well that may be the single dumbest thing I have ever heard. Of course there is way more to being a good doctor than board scores but calling it a red flag is pretty silly. It's essential downgrading applicants who do well on the least subjective measure stick. Since its super bowl Sunday, let me use an analogy. It's like saying, "I'm not going to draft anyone with a very good 40yar dash time because they are probably too fast to be a good football player."

 

[OldPsychDoc]

Well that may be the single dumbest thing I have ever heard. Of course there is way more to being a good doctor than board scores but calling it a red flag is pretty silly. It's essential downgrading applicants who do well on the least subjective measure stick. Since its super bowl Sunday, let me use an analogy. It's like saying, "I'm not going to draft anyone with a very good 40yar dash time because they are probably too fast to be a good football player."

But a pure sprinter isn't going to get drafted if they have hands of concrete, or the inability to see how their pure speed fits into an overall offensive scheme, or how to adapt to different coverages and get open so they can catch the ball. (Enough analogies for you?) And if they're a diva in the locker room, they're not going to become a treasured teammate, either.

There are plenty of highly trained memorizers out there who will be LOUSY psychiatrists if they can't see how those facts fit into the whole psychosocial picture, or if they are too socially stilted to engage in a therapeutic relationship.

 

[Leo Aquarius]

I trust my director - there seems to be a correlation between super high exam achievers and social skills. Don't take my word for it. Look around you. In fact, if I just look at the top exam achievers in my class, they are all gunning for those ultra competitive specialties and care not about having therapeutic extended dialogues with patients. And frankly, I wouldn't want them to try.

 

[psychphan]

But a pure sprinter isn't going to get drafted if they have hands of concrete, or the inability to see how their pure speed fits into an overall offensive scheme, or how to adapt to different coverages and get open so they can catch the ball. (Enough analogies for you?) And if they're a diva in the locker room, they're not going to become a treasured teammate, either.

There are plenty of highly trained memorizers out there who will be LOUSY psychiatrists if they can't see how those facts fit into the whole psychosocial picture, or if they are too socially stilted to engage in a therapeutic relationship.

Of course all those things you said are true, and as I mentioned in my first post there is plenty more to being a good doctor than good board scores. But just because you run a 4.2 doesnt mean you can't catch, run routes, learn offensive schemes, etc. Thats why I said its ridiculous to consider high board scores as a negative red flag.

I trust my director - there seems to be a correlation between super high exam achievers and social skills. Don't take my word for it. Look around you. In fact, if I just look at the top exam achievers in my class, they are all gunning for those ultra competitive specialties and care not about having therapeutic extended dialogues with patients. And frankly, I wouldn't want them to try.

Although that can certainly be the case, it is not a hard and fast rule, thus using it as a red flag seems like poor judgment on your directors part. My board scores were what I consider to be very good, and I still feel that my ability to interact with people is my strong suit. Likewise, I know a few other people who crushed the boards and are what I consider to be some of the most cool, normal, down to earth people I have met in med school. To me, its just silly to consider a positive objective parameter to be a negative.

 

[deleted432032]

Chances are NO GOOD. Abandon All Hope and apply for a Psychiatry residency instead

 

[Bartelby]

Although that can certainly be the case, it is not a hard and fast rule, thus using it as a red flag seems like poor judgment on your directors part. My board scores were what I consider to be very good, and I still feel that my ability to interact with people is my strong suit. Likewise, I know a few other people who crushed the boards and are what I consider to be some of the most cool, normal, down to earth people I have met in med school. To me, its just silly to consider a positive objective parameter to be a negative.

That's an interesting point, I wonder if there is any research data out there linking outlier SAT/LSAT/MCAT/Step scores (or other major aptitude tests) with social ability? To me board scores that high suggest that a person is very driven to achieve, which may or may not stem from a need for validation from that success. So maybe unfairly I would pay more attention to social skills in an interview with a super high achiever, but if they seemed to be okay I would be really glad to have them as a colleague.

I also just noticed the OP deleted his post. I guess we have given him or her enough food for thought for the time being!

 

[Salpingo]

There are plenty of highly trained memorizers out there who will be LOUSY psychiatrists if they can't see how those facts fit into the whole psychosocial picture, or if they are too socially stilted to engage in a therapeutic relationship.

I think there are a lot of different ways you can score high on the boards outside of having photographic memory (although that helps). There are people who are just passionate about medicine, who are legitimately eager to pick up a book and read. There are people who already have extensive hands-on experience with medicine either through research or jobs they did before school. There are people who are great analytical readers, who can burn through a passage in a couple of seconds and glean all the important information out of it. And there are donkeys who just want to get their personalized "BONEMD" plates on their Bugatti as soon as possible.

I trust my director - there seems to be a correlation between super high exam achievers and social skills. Don't take my word for it. Look around you. In fact, if I just look at the top exam achievers in my class, they are all gunning for those ultra competitive specialties and care not about having therapeutic extended dialogues with patients. And frankly, I wouldn't want them to try.

Except that the people who publicize their ultra high exam scores happen to be douche bags. You don't know the socially skilled high achievers because they don't make it a point to bring up their Step 1 score while waiting for the bus. For us, there were a couple of real surprises when the AOA list was announced, people who were so chill that they didn't really fit the mold of gunner. I talked to upperclassmen, and that was the case for a lot of them too. A lot of them end up in pediatrics or primary care tracks.

tl;dr - Stop the reverse exam discrimination

 

[Leo Aquarius]

True true. Perhaps the more accurate correlation is between self-aggrandizing over-achievers who voice it, and less-than-desirable social skills.

While I do trust my director (I attend a program in the South), I have to admit I was surprised by the statement. There isn't a necessary correlation, just an incidental one perhaps. Anyhow, I like to encourage any medical student who is interested in psychiatry to look into it.

 

[billypilgrim37]

If you have a high board score and are an otherwise affable, clinically skilled medical student, you're probably only going to be interviewing at about 8-10 of the top 15 programs in the country anyway. That means only maybe 20 programs are ever going to see people with scores of 260+ who aren't weirdos.

So for most programs, the correlation is probably true. If you're not a top 15-20 program, and somebody is interviewing with a 265, they must either have local ties or some serious human defects, otherwise they wouldn't be bothering with your program.

 

[psychphan]

So for most programs, the correlation is probably true. If you're not a top 15-20 program, and somebody is interviewing with a 265, they must either have local ties or some serious human defects, otherwise they wouldn't be bothering with your program.

Or they are a DO, and thus won't get interview offers at some of those top 15 places so they apply more broadly.

 

[billypilgrim37]

Or they are a DO, and thus won't get interview offers at some of those top 15 places so they apply more broadly.

What part of serious human defect didn't you...

No, seriously, I'm kidding.

 

[psychphan]

touche, haha