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12+ Interviews and No Match or SOAP, How to strengthen application for next cycle?

Discussion in 'Psychiatry' started by @gainstAllOdds, Mar 14, 2019 at 6:52 PM.

  1. @gainstAllOdds

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    Hey Guys,

    Congrats to all those who Matched Monday and will find out where tomorrow. Unfortunately, I was not as lucky. I had 12+ Interviews and all went GREAT (or so I thought) and ranked every single one but no luck. My stats are as follows:

    Osteopathic Medical Student
    Step 1: 218
    COMLEX 1: 539
    COMLEX 2: 559
    COMLEX 2 PE: Pass
    All board exams passed on first attempt

    President of PsychSIG on Campus
    A lot of community service and volunteering with award from city mayor, while in medical school.
    I have good LORs, decent ECs
    Research with 2 publications (1 psych, 1 non-psych)
    1 book review accepted for publication

    Red Flags:
    -Took a leave of absence after 1st year of medical school due to family emergency (for 1 year)
    -No other red flags

    In your opinion what are some of the best ways for me to strengthen my application for next cycle? I cannot see myself going into any other field. I love Psych!

    Some high yield things I'm thinking are given my below average Step 1 score, to take the Step 2 exam and do well, also thinking of becoming a Mental Health First Aid Instructor and give courses in my local community to raise awareness of mental health issues, Not sure if I should go ahead and take COMLEX 3 in this year, also thinking of networking by attending various Psych conferences, etc.

    If there is anything else you think that may help me, please do let me know. I would really appreciate and constructive feedback. Thanks all!
     
  2. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
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    All of the above sound good. After the dust clears, contact a couple of programs where you felt you had the best rapport and ask for feedback, and what they would like to see from you in a subsequent cycle.
     
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  3. Mass Effect

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    I think taking Step 2 is a waste of time. If you're itching to take a test, take Comlex Level 3. But even that isn't your issue. Given what you've shared, you need help with interview.
     
  4. TexasPhysician

    Moderator Physician Verified Expert 10+ Year Member

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    Where did you interview? Is it possible you chose too many “reach” programs?
     
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  5. Merely

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    You need to interview better. You got 12 interviews meaning you have a good app. You need to apply to community programs next cycle and find a trusted friend/advisor and ask them why you’re bad at interviewing. Good luck.
     
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  6. Stagg737

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    Knock Level 3 out. Score doesn't matter, just pass. It'll just be one less thing programs will be questioning you about next round.
     
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  7. Crayola227

    Crayola227 50 Shades of Green
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    Not sure I agree that the Level 3 score won't matter. I wouldn't approach it that way. Especially with a below average Step 1. Doing well on Step 3 is an opportunity, especially when you're not busy with clinicals. Some programs might wonder why you didn't do better on the test given that you had ample time (from their standpoint) on it.

    Not to mention if you're not a fresh grad it can be one way to show that despite being out of practice for a year, that your knowledge base was strong fairly recently, or at least on the last test you took. I get that psych intern year doesn't draw on general medicine heavily, but still, you want to show you will struggle in as few areas as possible. Last thing you want is a psych resident you're worried won't do well on rotations off the psych service, I would imagine.

    From what I can tell, the advice to "just pass" Step 3 really only applies to those who are Matched/in training. Common wisdom is that the unmatched seeking to better their app, need to try to do better than just pass.

    I know this is true in gen med but can't speak for psych, there is an eye for the step scores in selecting candidates, not just for who will have a good knowledge base for residency, because the correlation there could be questionable in some eyes, but the correlation between Step scores and passing boards is real. I know from a PD telling me to my face on an interview, that eventual board passage ability, is being considered even at the interview invite and ranking stage, at least in some fields. I don't know how predictive Step 3 is for anything, except that we know being good at multiple choice tests about medical topics is predictive of being good at multiple choice tests about medical topics. Which matters somewhere for many.

    Also, given that they didn't match, and may need to even consider slots outside psych (ie may need to SOAP to prelim/transitional or something else next year, or apply outside psych in general), the advice to do well on Step 3 may be even more applicable.

    I'm not saying a great or mediocre Step 3 score is going to make or break this applicant. But when you're literally scrambling to save your career, don't you want to grasp at every straw you can control?

    Just, an unmatched grad should never squander the opportunity to do well on Step 3. Passing it isn't a bad idea. Doing well is even better.

    ETA: Level III, Step 3, you get my drift. Although it's come up that it's questionable how much PDs outside of AOA are adept at interpreting COMLEX scores, even at ACGME residencies that are DO friendly (they could just be selecting for those with Steps as well as COMLEX). Do you have to take Step 2 CK and CS, in order to be eligible for Step 3? I can't say what exactly an unmatched DO student should do as far as, is it worth doing all your COMLEX's and then bothering to take all the Steps. But the advice to do well on any test that could be looked at when you are an unmatched grad, still stands imho
     
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  8. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
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    We're fine with COMLEX, and OP's are above average--but I'll just say that "average" may not be good enough anymore. Was amazed at how many 600+s and even a 700 I saw this cycle.
     
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  9. Stagg737

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    Fair point. I don't think it would have a huge impact with OP as they don't seem to be someone who would be at risk of failing it anyway. From the PDs I've talked to a lot of them like to see a passed Step/Level 3 for those who don't match because there was a red flag that made them question if they could pass. OP doesn't seem to fit that category, which is why I believe it would be a nice box to be able to check, but nothing that's going to make or break them next time around. Obviously, the higher the score the better, but I've never talked to a PD or anyone involved in the academic aspect of residency who cared about the actual Step/Level 3 scores. ITE exams on the other hand...
     
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  10. OP
    OP
    @gainstAllOdds

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    No one itches to take any test bro. lol. My thought process for wanting to take the STEP 2 is that this year was the last separate AOA match. Going forward, everything will be just ACGME and MD students will be able to apply to dually accredited program with STEP 1 and STEP 2 scores. Since everything going forward will be ACGME, to me it makes sense to take STEP 2 and do well in it to show I can compete with fellow MD students on an equal ground. Once I take Step 2, if I have time, I can also take Level 3 (1st day of level 3 is very similar to Step 2 questions as far as I know). So that is my thought process.

    In terms of interviewing, I interview well to the point where my first interview, the doctor told me "you did a great job." So to me, interviewing is not an issue. I am not awkward, more like life of the party. I can carry a good conversation. Thank you for your input though. :)
     
  11. OP
    OP
    @gainstAllOdds

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    UT Austin
    Penn State
    Drexel (both adult, and combined child)
    U Albany
    Baystate
    JPS (fort worth, tx)
    Uni. Buffalo (both adult, and combined child)
    Morehouse
    Palm Beach Consortium
    Nassau University med ctr
    NYCOMEC-NY

    I am not sure how many "reach programs" are on this list, if any. lol
     
  12. OP
    OP
    @gainstAllOdds

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    Sounds reassuring. But I thought psych was about the holistic approach to the entire applicant, lol and not just scores. Problem is every student is applying to hundreds of programs so programs spend less and less time on each app, unfortunately.
     
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  13. samac

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    you can’t take level 3 without being in a program anymore.
    “Beginning with the 2018-2019 test cycle for the two-day COMLEX-USA Level 3, eligibility will require an attestation from an American Osteopathic Association (AOA) or Accreditation Council for Graduate Medical Education (ACGME) accredited graduate medical education program director that the Level 3 resident/exam candidate is in “good academic and professional standing” meeting the professional requirements of the residency program and is eligible to continue as a resident in the program.“

    I wish you the best luck. And also, you’ve scared me for my future. Thanks lol.
     
  14. Piebaldi

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    sorry I have to ask - when did Psych get competitive? Have Psych salaries really gone up or something?I find it crazy that people with 19, 12 interviews would not have matched. Just curious!
     
  15. IsWhat

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    Did you do any aways/sub-is? And if so, where did you rank them?
     
  16. bobby pen

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    Here’s my advice. Find a preliminary year either Med, surgery, or transitional preferably at an academic institution . Make connections with the psych PD there. Do well on your rotations, and have the psych PD send you open pgy2 openings that are advertised on addprt( this is very important). Also UW, Cornell, u Maryland and several others keep open spots for pgy2s. Pass level/step 3. The 2 spots are competitive despite what others
    On this forum will say (you’ll be competing against in house applicants, ortho, optho, etc residents looking to transfer out of their specialty). You will need a person to vouche for you Bc unfortunately you have a red flag( the year off and it will always raise eyebrows regardless of totally valid circumstances). I don’t mean to discourage but it will be tough. However, if you really want to be in psych you can do it. If you have other questions feel free to IM me.
     
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  17. Amygdarya

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    Psych is still less about numbers and more about the holistic approach (based on the range of scores of applicants interviewed at my fairly prestigious program). That said, with the number of applications rising, it's just so easy to filter some of them out based on score cutoffs. I agree with you that it's very unfortunate.
     
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  18. Mass Effect

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    Step 2 is a gigantic waste of time. I stand by the fact that you interview poorly, regardless of what some doctor told you. The problem is not with your application. If it was, you wouldn't have gotten 12 interviews. I've been a part of recruitment season, I've interviewed applicants, I've had input, I've sat in on rank meetings. Trust me when I say in psych, by the time you make it to the interview, a below average interview will kill you more than anything else (besides a criminal record).
     
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  19. Amygdarya

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    Being overconfident during your interviews can actually be a bigger turnoff than shyness and awkwardness in psychiatry interviews.
     
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  20. TexasPhysician

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    I’d say about 1/2 were a reach which may have been part of the issue.
     
  21. Taddy Mason

    Taddy Mason 30 Helens agree
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    OP, also leaving a negative impression with residents during the interview dinner and lunch can be almost as damning as a bad interview.
     
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  22. Drrrrrr. Celty

    Drrrrrr. Celty Osteo Dullahan
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    Not to hijack this thread. But I have a similar outcome. Except that I matched into a categorical IM program.
    I had a 24x, 26x and COMLEX 1,2 >700. I went on interviews to pretty strong programs and almost every one of my 12 ranks was at an academic university hospital.
    Based off this thread going to assume that my personal statement sucked because I only started getting a lot of interview invites around mid October. And I'm going to assume interviewers thought that I was an alien who had hijacked a human being or something and thus thought I didn't play well.

    Well in either case, aside from correcting the above. What is next for me? 90% of me is just saying stick with IM and forget Psych. I mean let's be honest here, the average match rate for Psych is going to be abysmal this year ( 2300 US grads applied for 1600 spots) and it won't be better next year. But another part is saying, whats the worst that can happen if I give applying another shot.

    What am I supposed to do now and until September 15th? Should I be looking for PGY2 transfers and if how? Will my applying to psych programs shatter my relationship with my current program and make them hate me? And what happens if again I don't match psych? Will they terminate me as someone who doesn't really believe or want to invest in psychiatry?
     
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  23. neworleans8

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    I understand that psych is holistic in giving out interviews. What I would be more curious about is are they as holistic when creating rank lists? I don’t believe that all applicants are on the same level pre-interview. I’m sure having a terrible interview would kill your ranking. At the end of the day though, most people are ‘average’ interviewers. Therefore it seems the rank list would mostly be determined by objective factors such as scores and school name. Maybe an ‘excellent’ interview would bump you up a few spots but how much that matters depends on your starting point. This is just speculation, so if I’m wrong, would love to hear from the other side.

    Plus, just like we interview at safety schools, they must interview safety candidates (maybe the lower scoring ones, but that’s just a guess?)
     
    #23 neworleans8, Mar 15, 2019 at 11:19 PM
    Last edited: Mar 15, 2019 at 11:25 PM
  24. splik

    splik Professional Cat at Large
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    Sorry, but "you did a great job" is code for you were a mess and they are trying to reassure you. No one would ever say "you did a great job" if the interview went well. For the med school admissions interview committee, we are specifically told to tell applicants who are croaking it "you're doing great" etc
     
  25. Old&InTheWay

    Old&InTheWay MS4 >>> Psychiatry (Matched!!)
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    Doesn't that kind of do a disservice to interviewees? Wouldn't it be better to say "hey, you seem like a great candidate, but you stink at interviewing....you should probably work on that a bit."
     
  26. drkurapika

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    I would do what the above poster said and email ALL of the PDs. Sometimes really nice ones have connections to other PDs and maybe know about new programs etc. Maybe email sooner than later since you want to try to get a spot this year if you can. If not its good to get their feedback and maybe reapply with a backup specialty next year. Psych has gotten brutally competitive but not scorewise. More unpredictable
     
    #26 drkurapika, Mar 16, 2019 at 12:51 AM
    Last edited: Mar 16, 2019 at 12:59 AM
  27. IsWhat

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    Unless it’s follwed up with, “...and I hope to see you here next year.” Then you’re good.
     
  28. PlasticBag

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    I'm really sorry you're in this position. I agree with others that interviewing must have been your issue. It is very hard to have insight about our own performance, especially if it conflicts with our self-concept ("life of the party" comment). For example, I've been getting great feedback on my sub-Is and great evals from all my clinical rotations, and yet one of the places I did a sub-I at decided not to interview me at all. The residents reassured me how "everyone loved me". I think of myself as a generally likable and clinically competent med student, but clearly I was lacking in some regard. I'm still not exactly sure where I went wrong. Maybe it just wasn't the best fit (see, my defense mechanisms are rock solid!). Either way, as uncomfortable as it is, you might want to seek feedback on your interviewing style.
     
  29. Mad Jack

    Mad Jack Critically Caring
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    The trouble is many psych programs are interviewing far more applicants than they need- perhaps interviewing 10:1 when they barely break 4:1 in the match. This leaves marginal candidates with many interviews and no match, or so it seems from the people in the PD side I've talked with.
     
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  30. TexasPhysician

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    You did a great job at securing your future with a categorical IM spot, but this is not ideal if you want to transfer. Cat IM locks your full funding into 3 years. Psych as you know is a 4 year field. A prelim IM spot would have left you with full funding (my understanding) and in a better position to transfer. Prelim spots do not have a guaranteed future though.
     
  31. Drrrrrr. Celty

    Drrrrrr. Celty Osteo Dullahan
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    Yah. None of this process actually makes sense or otherwise. I only found out about funding as a whole a couple days into the soap. But honestly after this year of applying I absolutely have little desire to have another go at it. I only wish that someone had told me to apply to more midwestern and low tier programs. The vast majority of people in my program matched community psychiatry programs or midwestern programs. I applied mainly East coast due to geographical desire.

    Oh well. I'm going to go and try to get a decent fellowship and figure out how to go from there. My only regret is really that when I came into medical school it was because I wanted to be a psychiatrist. I worked my butt off and got stellar boards so I could be picky about location. And well I got neither.
     
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  32. Piebaldi

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    I would be surprised if you can't get a Psych position. I am also surprised Psych is more competitive now. Used to be people's safety specialty.
     
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  33. Drrrrrr. Celty

    Drrrrrr. Celty Osteo Dullahan
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    This year at my program we had like maybe 5 or 6 ppl match university programs and all in the midwest. The rest matched into pretty much low tier programs.

    This also makes my apprehension for the situation go up for reapplying.
     
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  34. Piebaldi

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    Interesting. I don't think that it's that Psych has gotten more competitive I think as usual, that there are simply more applicants. It was the biggest match in history - I think over 38,000 applicants.
     
  35. Mass Effect

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    There are a lot of places that may consider scores in the ranking, especially when all else is equal (interview, likability, resident feedback). However, I think many still base it on the factors I mentioned. The reason is because in psych, more than any other field, a good interview is key. Communication skills are what you use to examine and help patients, particularly when doing psychotherapy. Having good insight into your own skills and abilities is also key. Psych cares about these things more than other fields and definitely more than scores, unless they're judging between two candidates who are equally good. That's also why it's important, in my opinion, to do away rotations in psych. It's no longer a safety field. If you want to make an impact on a program, do a rotation with them, let the residents get to know you (don't discount resident say; it's important and also heavily weighed at rank meetings), let them see how you communicate with residents, nurses, staff, and faculty, let them see that you're likable and easy to work with. That will go a long way when they're trying to decide where to place you on the rank list.

    Yes, that's true, because they have to. But someone who interviewed at 12 places and didn't match to do their own analysis of why. Among the likely reasons is too many reach programs and interview/lack of rapport with interviewers, residents, and staff. Just plain bad luck is further down on the list of likely reasons.

    If you really want to be a psychiatrist, don't settle for doing something else. Work is going to suck if you don't enjoy it. Yes, funding may be an issue, but there are still programs that will take you. You need to reach out to the ones you applied to, ask what went wrong. I would apply again and this time, I would apply to as many programs as you can afford. I would be honest with your IM program if you decide to do this (and try to tell them soon) because you'll need time off for interviews, so maybe they can put you on elective months during October/November.
     
  36. Drrrrrr. Celty

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    I don't want to burn bridges with my program and end up getting terminated. To me that sounds a hell of a lot more risky and dangerous. In either case, I loved mainly working with pts who were depressed, anxious, and were non-psychotic. I think I'll happily see a lot of these.
     
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  37. Mass Effect

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    Except it's been this way the past few matches. It used to be that there were many more psych spots left in the old scramble/soap. Since around 2016ish, there are many, many less. Also, the credentials you see for psych has also gone up. As you said, it used to be a safety specialty, but now people who could get into any other specialty are applying psych because they want to match psych. This has been confirmed by 3 program directors I've talked to.
     
  38. Mass Effect

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    Wait, I'm under the impression you SOAPed. Is that not true? Because if you SOAPed into your program, they have to know they weren't your first choice already.

    Also, most program directors are not vindictive types who will intentionally evaluate you tougher and terminate you just because you don't love their specialty. Most are reasonable individuals who understand that someone may not love IM as much as another specialty. That said, it will be difficult for them to be one person down PGY 2 year, so you need to be aware of that. I think that aProgramDirector here on SDN is in IM (could be wrong). You might want to message him and ask what thinks about your options/situation.
     
  39. Drrrrrr. Celty

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    Yes. I soaped. Obviously they understand I'm not in IM as a first choice. And probably at least half of my class may be finding themselves in a similar position. Either way as of right now I feel exhausted from this season. The idea of reapplying sucks.
     
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  40. ridethecliche

    ridethecliche Meep Meep Meep
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    More people for the same number of spots is the literal definition of increased competition....
     
  41. Piebaldi

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    I don't view it that way. EVERY specialty has more applications. The relative competitiveness of specialties has not changed much. For example, Derm and Ortho, Ophtho, Rads, and Gas are still far more competitive than Psych. They have more applications also, but in relative terms they are far more competitive. Every year, people say that specialty x or y has gotten more competitive. That's not truly the case. There are simply more people in the match. And that will happen every single year.
     
  42. Piebaldi

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    You never know, you might like IM. Be grateful that you HAVE a spot. Many people would like to be in your position vs theirs - aka - no spot. So please I encourage you not to go into your intern year with the idea of - this sucks, I matched IM vs Psych. We don't want to have you be the person we are giving you advice on "Oh I am being put on probation or at risk of being terminated" for not putting in enough work, or whatever. Be grateful. Sometimes things don't work out for a reason - sometimes we find ourselves in something we never thought we would like. I NEVER thought i would pursue what I ended up in. But I feel given my personality and my views on Medicine, life, goals, etc. it's really the perfect field for me. I probably would have never picked had things not worked out the way they did.

    So please - take a break now, go spend time with family or something and be grateful that you have a job, a position come next July. And yes it's always possible to change. Don't let anyone tell you it's not. Even in my own program we had a number of people switch. Regroup and then after some time in your new program, reassess. You might actually end up liking IM.
    I had a classmate who switched from Rads - IM.
     
  43. Old&InTheWay

    Old&InTheWay MS4 >>> Psychiatry (Matched!!)
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    You are not alone in your surprise that psych has become more popular as a field, but it actually has and I think there are a bunch of reasons for it:

    - Decreased stigma associated with being a Psychiatrist (and mental health in general)
    - Increased awareness of need
    - Personal wellness as part of med school curriculum has a lot of people really looking at their quality of life. Psychiatry (as opposed to some other specialties) seems to actually create space for personal wellness
    - Psych has a pretty great pay:hours worked ratio
    - Psych is the probably only field in medicine in which you can actually run a solo practice.
    - Realization that getting to spend time talking to patients is more meaningful than sticking instruments in their orifices.
     
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  44. Drrrrrr. Celty

    Drrrrrr. Celty Osteo Dullahan
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    Sigh. you're correct. And I am going to be happy to be in this position sooner than later.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
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  45. Piebaldi

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    I disagree sorry. Every specialty has seen an increase in the number of spots. My field - PM&R - has seen for the past 2 or 3 years EVERY spot filled in the match, 100% filling in the match. My program - last time I checked - got close to 600 applications I believe or so ballpark. So is PM&R more competitive than Ortho, Derm, etc? No. There are just so many more people in the match. And qualifications for everything has gone up. You look at med school applicants and they are stellar too - many of us probably would not get into med school today in relative terms with new classes' competitiveness.
     
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  46. Mass Effect

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    Why are you comparing? No one on this thread said anything about psych being more competitive than derm. Whether or not it's more competitive than derm literally has nothing to do with the fact that psych is more competitive now than it was years ago and no longer a safety specialty.

    Also, what are you basing your opinion on? What numbers are you looking at when judging the match rate in psych and where?
     
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  47. Piebaldi

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    I'm providing examples. Again I don't believe that Psych is more competitive in relative terms, it's more competitive because of increased people in the match. That's the example I'm trying to exemplify. Every year there will be more "competition" per se for the positions - for every specialty. That's what I am trying to convey. Don't become defensive. It's a poor defense mechanism. No one is saying anything bad about Psych. Psych is a fine field. Relax.
     
  48. Mass Effect

    7+ Year Member

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    Not sure why you think questioning your post = becoming defensive or not being relaxed. I notice you used that as a distractor rather than actually backing up your opinion with numbers. I guess that alone answers my question though.
     
  49. Piebaldi

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    I'm not going to go back and forth with a medical student. You think you know best, that's fine. I would be cautious about having this attitude with your attendings in residency. Best of luck.
     
  50. raisinbrain

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    Then you might really enjoy outpatient practice and having your clinic colleagues ‘refer’ you the anxious and depressed mild mental illness comorbidities, and you take on more of those as initial complaints. Lots of IM or FM docs that I talked to said they would love having a partner who would offload some of that for them. No, you won’t get as much specific training in that during an IM residency, but you can seek out extra training, and easily work with lots of people in that category. As long as you remember to refer out when things get complicated.
     

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