3rd Year Interested in Psychiatry - what should I start doing now?

[PS2summerdays]

I'm a third year and I started my clinical rotations recently (US MD school). I think I'm leaning towards psychiatry as my primary option (though admittedly, I've yet to complete most of my rotations).

I just wanted to know if there is anything special I should do (other than focusing on doing well on STEP 2, learning as much as I can etc.) in order to be competitive or well qualified for a residency option. I know a lot of students do research. Though I am not too fond of research, I would be willing to attempt it if it is looked upon favorably. My STEP 1 score is in the middle 230s but I have no other extracurricular activities save for a few volunteering experiences (one in which I counseled young people).

Any advice on what I should do during this year? I'm hoping to match somewhere in NYC. Anywhere in NYC would be fine. Columbia would be really great since I am familiar with that place (I know it's tough to get into!), but location is my top priority overall. Thank you!

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[Bartelby]

Columbia is one of the most competitive programs in the country, so I assume you are aiming high. Your step score is not bad. The most important two items will be clerkship grades (especially in the core rotations) and your step two score. That means this year focus #1 is on learning as much as you can, but also on making sure you keep an impressive track record with your clerkship grades.

The volunteering positions are good, especially if they are memorable. If you are thinking of a place like Columbia, I would recommend adding some scholarly work (this does not have to be bench research). Consider writing up a case report with some psych faculty/residents, or preparing a poster for a conference in a subspecialty area of interest (forensics, addictions, geriatrics, etc.). See what faculty or residents are up to and whether one might be interested in taking on a project with you. Basically have at least something to put down for publications and presentations, and ideally something substantial. It certainly helps if you have other awards/recognition too (Gold society, AOA, recognition for research/teaching/other, and so on). It also doesn't hurt to have interesting hobbies / life experience / something else that makes the reviewer think you would be fun to work with.

If you are coming from a well-regarded school and you can pull off high clerkship grades plus some of the above, you could have a shot at Columbia or similar programs. If you just want to match to a residency (not one of the most competitive), psych remains low on the competitiveness spectrum and fair grades + a mediocre step 2 should get you there.

 

[PS2summerdays]

Columbia is one of the most competitive programs in the country, so I assume you are aiming high. Your step score is not bad. The most important two items will be clerkship grades (especially in the core rotations) and your step two score. That means this year focus #1 is on learning as much as you can, but also on making sure you keep an impressive track record with your clerkship grades.

The volunteering positions are good, especially if they are memorable. If you are thinking of a place like Columbia, I would recommend adding some scholarly work (this does not have to be bench research). Consider writing up a case report with some psych faculty/residents, or preparing a poster for a conference in a subspecialty area of interest (forensics, addictions, geriatrics, etc.). See what faculty or residents are up to and whether one might be interested in taking on a project with you. Basically have at least something to put down for publications and presentations, and ideally something substantial. It certainly helps if you have other awards/recognition too (Gold society, AOA, recognition for research/teaching/other, and so on). It also doesn't hurt to have interesting hobbies / life experience / something else that makes the reviewer think you would be fun to work with.

If you are coming from a well-regarded school and you can pull off high clerkship grades plus some of the above, you could have a shot at Columbia or similar programs. If you just want to match to a residency (not one of the most competitive), psych remains low on the competitiveness spectrum and fair grades + a mediocre step 2 should get you there.

Thank you very much for your input (love your username by the way, if that's a reference to the scrivener). Columbia is an absolute high-reach for me and probably not realistic as I am mostly an average student. My main desire is to remain in NYC since I am very familiar with it. I appreciate the advice about case reports and poster/conference considerations. I think that is something I will look into and pursue, as there are opportunities for that at my school. It is not something I had considered before!

 

[TankTuck]

I am a current fourth year and didn't realize I wanted to do psych about 2/3rds of the way through my third year. Obviously I haven't matched yet so take my advice as is. I would suggest networking and trying to find a psychiatrist that is very willing to teach you, give advice, put in a good word for you at local programs. Basically a mentor. This is hard to do, but can make your med student life so much easier. A little effort can go a long way, and psychiatrists will be ecstatic when you show interest in the field. Really the people you know can help you far more than a few extra points on the step or a research project. Clinical grades and step scores are obviously important, psych is definitely getting more competitive. Start thinking of how you are going to convey a unique and compelling story within your personal statement. Also, maybe the most important thing in my eyes is to socialize. Go out to the bars. Talk to everyone. Listen to your patients histories and try to get a little more out of them. Good luck!

 

[ziggyhope]

I agree that most psychiatrists will be ecstatic when they hear med students taking interest in our field, I certainly am one. However, a few points to consider as you gear up for applications. Keep in mind this is just my personal opinion.
1. Psych is a completely different ball game today compared to when I applied 5 years ago, look at recent SDN posts on the topic and you will get the gist. No the sky is not falling and we are not ortho or derm, but if you read charting the outcomes carefully, competitiveness has shot up significantly in the past 5 years, and will continue to do so.
2. NYC is fairly competitive in general, if I were you I'd apply to all programs there. It is certainly up to you to figure out how important being a psychiatrist is compared to being in NYC. If you find that you are getting too many interviews, you can always cancel and give the spot to someone else.
3. Mentors are good, but if you are trying to find advisors for matching into psych, make sure they are close to the whole process. I've seen too many older psychiatrists give the wrong information (based on their experiences) and the applicant ends up being screwed, usually due to being over confident and not applying broadly enough.
4. You don't have to do research to get into a top program, there are many other ways to demonstrate value. However, it is very important that you do something that you are passionate about. It is much more interesting to converse with someone if they like what they do.
5. In general, psych programs care less about your score so long as you meet a minimum requirement of competence (dependent on program), you won't be screened out of too many places, but once you land the interview, it is everything else that matters. So make sure you have some "everything else" ready.
6. Fortunately, you have some time, a lot can be done in a year. Good luck!

 

[PS2summerdays]

I agree that most psychiatrists will be ecstatic when they hear med students taking interest in our field, I certainly am one. However, a few points to consider as you gear up for applications. Keep in mind this is just my personal opinion.
1. Psych is a completely different ball game today compared to when I applied 5 years ago, look at recent SDN posts on the topic and you will get the gist. No the sky is not falling and we are not ortho or derm, but if you read charting the outcomes carefully, competitiveness has shot up significantly in the past 5 years, and will continue to do so.
2. NYC is fairly competitive in general, if I were you I'd apply to all programs there. It is certainly up to you to figure out how important being a psychiatrist is compared to being in NYC. If you find that you are getting too many interviews, you can always cancel and give the spot to someone else.
3. Mentors are good, but if you are trying to find advisors for matching into psych, make sure they are close to the whole process. I've seen too many older psychiatrists give the wrong information (based on their experiences) and the applicant ends up being screwed, usually due to being over confident and not applying broadly enough.
4. You don't have to do research to get into a top program, there are many other ways to demonstrate value. However, it is very important that you do something that you are passionate about. It is much more interesting to converse with someone if they like what they do.
5. In general, psych programs care less about your score so long as you meet a minimum requirement of competence (dependent on program), you won't be screened out of too many places, but once you land the interview, it is everything else that matters. So make sure you have some "everything else" ready.
6. Fortunately, you have some time, a lot can be done in a year. Good luck!

Thank you very much for your advice. I am somewhat aware of the difficulty of the programs in NYC, but I didn't know that all of them were so competitive. This does worry me a little bit as location is most important to me. I don't have my heart set on Columbia or NYU or anything like that - but I do have my heart set on the city, regardless of the specifics of the program.

I just have one quick question - does the extra "something" we are passionate about have to be medicine/psych related? I know this is probably stupid to ask, as this isn't undergraduate college applications. But the thing with me is that I devote a massive amount of time to my hobby, painting/drawing. It helps me stay sane and I've gotten very good at it over the past decade or so. Yet, it's something extremely removed from the field of medicine and I have no innovative ideas of utilizing art therapy or anything along those lines. I am going to assume that things like volunteering at some sort of counseling center/research would be more appropriate and applicable?

 

[ziggyhope]

Thank you very much for your advice. I am somewhat aware of the difficulty of the programs in NYC, but I didn't know that all of them were so competitive. This does worry me a little bit as location is most important to me. I don't have my heart set on Columbia or NYU or anything like that - but I do have my heart set on the city, regardless of the specifics of the program.

I just have one quick question - does the extra "something" we are passionate about have to be medicine/psych related? I know this is probably stupid to ask, as this isn't undergraduate college applications. But the thing with me is that I devote a massive amount of time to my hobby, painting/drawing. It helps me stay sane and I've gotten very good at it over the past decade or so. Yet, it's something extremely removed from the field of medicine and I have no innovative ideas of utilizing art therapy or anything along those lines. I am going to assume that things like volunteering at some sort of counseling center/research would be more appropriate and applicable?

I am not the most familiar with NYC programs, I don't think all of them are competitive, I think there are 16-17 programs in the city? So you will probably be fine if location is all you care about. I don't think it is necessary that your activities be related to psych or medicine, but it should be something that is in service of others, to indicate you are a caring human being. Again, you mentioned Columbia, so I am giving you advice based on what I know of the top tier programs. YMMV.

 

[Stagg737]

The best information to look at for this question is likely the PD survey conducted by the NRMP (links for 2016 and 2018 at end). If you look at those, many programs don't care about your board scores, just that you passed. The most important factors for getting an interview were: not being flagged for a match violation, demonstrating professionalism and ethics, and "perceived commitment to the field". Once interview is obtained, by far the most important factors are interpersonal skills and how well you interacted with faculty and residents during your interview.

Imo, the best ways to convey professionalism, ethics, and perceived commitment to the field in your app is through your MSPE and LORs as those are the places where these traits can really stand out (as both very good or very bad). These were also the parts of my application that PDs and faculty consistently mentioned when I was interviewing last year. I also had a couple interviews at reaches for my stats where I was specifically told my LORs and MSPE caught the PD's eye, so I feel fairly confident stating that you should prioritize strong LORs.

I think there are many ways to demonstrate commitment to the field. Research is the obvious one and as previously stated doesn't need to be bench work. Getting involved with community mental health groups like NAMI and groups raising awareness about mental health is another great way to show you're really trying to get involved. Even politics and advocacy through legislation and local papers helps. Splik has a great thread on ways to strengthen your app here: how med students can beef up their psychiatry applications

The past few years have gotten more competitive, but psych is still very obtainable if you're realistic about your application and cater your app to the field. Here's the links to the PD surveys if you want a more detailed breakdown:

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf
http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf

 

[PS2summerdays]

The best information to look at for this question is likely the PD survey conducted by the NRMP (links for 2016 and 2018 at end). If you look at those, many programs don't care about your board scores, just that you passed. The most important factors for getting an interview were: not being flagged for a match violation, demonstrating professionalism and ethics, and "perceived commitment to the field". Once interview is obtained, by far the most important factors are interpersonal skills and how well you interacted with faculty and residents during your interview.

Imo, the best ways to convey professionalism, ethics, and perceived commitment to the field in your app is through your MSPE and LORs as those are the places where these traits can really stand out (as both very good or very bad). These were also the parts of my application that PDs and faculty consistently mentioned when I was interviewing last year. I also had a couple interviews at reaches for my stats where I was specifically told my LORs and MSPE caught the PD's eye, so I feel fairly confident stating that you should prioritize strong LORs.

I think there are many ways to demonstrate commitment to the field. Research is the obvious one and as previously stated doesn't need to be bench work. Getting involved with community mental health groups like NAMI and groups raising awareness about mental health is another great way to show you're really trying to get involved. Even politics and advocacy through legislation and local papers helps. Splik has a great thread on ways to strengthen your app here: how med students can beef up their psychiatry applications

The past few years have gotten more competitive, but psych is still very obtainable if you're realistic about your application and cater your app to the field. Here's the links to the PD surveys if you want a more detailed breakdown:

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf
http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf

I appreciate you taking the time to post these links! I don't feel as lost anymore. Very helpful!! Thanks 🙂