Advice for an M1?

[scruffy821]

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Hey everyone, congrats to everyone who matched! I'm definitely posting here prematurely (my bad), but I am an M1 at an US MD school who is very passionate about pursuing a career as a psychiatrist. I just wanted to ask you guys after you've gone through this intense process - if you could go back, what advice would you give to your M1 self about matching into psych?

I know that matching into psych is generally considered to be less difficult than other specialties, but I'd also love to have a chance at matching at some of the more competitive psych programs! Other than overall national averages that everyone knows about, do you guys have an idea of the range of Step 1 scores of people matching to top-middle tier psych programs? Are there certain extracurriculars or opportunities that I should start pursuing?

I'm doing a psychiatry research fellowship throughout the summer and hoping to learn more about the field/gain some mentorship then, but until then I'd appreciate your feedback!

 

[nitemagi]

This should be in the FAQ sticky.

 

[touchpause13]

Is research at all necessary for matching psych?

 

[notdeadyet]

No. Not unless you're going into research.

Even at the top programs, most people do not come from research backgrounds.

 

[TexasPhysician]

I would:
A) Do my best in all academic aspects
B) Be certain psych makes me happiest
C) Enjoy life.

Other than maybe the top 5-7 programs, the above advice should leave you with good odds of an interview at most top 25 places as a US MD.

 

[shan564]

Sorry to provide advice that sounds vague and generic, but as others have already said, the single most important thing in your application is how good of a med student you were overall. A good med student, on average, is more likely to be a good resident and a good doctor... and that's because the traits that will lead you to be a better med student (work ethic, intellect, interpersonal skills, etc.) are the same traits that are important for a good doctor. The ways to demonstrate that you were a good med student are to get high Step scores, good grades, and good rec letters.

Doing a bit of extra psych stuff in med school is useful, but it will pale in comparison to the amount of psychiatry you'll do after med school, so an extra couple of months of psychiatry as a student will not make you a better psychiatrist, and will therefore not have a large impact on a program's interest in you.

Doing research will be mildly useful for a non-research-oriented program, but it can be very useful for a research-oriented program. If you're aiming for one of the "more competitive programs," then research will definitely be useful, since those programs are usually bigger on research.

But as has already been mentioned, there are only a handful of "more competitive programs." To have a good chance of matching there (MGH, Columbia, Cornell, UCSF, UCLA), you probably need 240+ on Step 1 (higher is better) and some other stuff on your CV to set you apart. It can be hard to understand what that score means when you're an M1, since you're so far away from being ready for Step 1... but on average, people who score 240+ on Step 1 also scored 35+ on the MCAT (of course, it's not a very strong correlation... my Step 1 score was significantly lower than average for people with my MCAT score).

Note that the "more competitive programs" in psychiatry are usually more competitive because of location, not because of quality. Few people would say that those 5 programs are superior to many of the other programs affiliated with "top 15" med schools, but you get an automatic boost in competitiveness if you're located in NYC, Boston, or California. And even if you're not quite able to meet the higher standards expected by those 5 programs, an above-average med student would be competitive at any of the other places affiliated with "top 15" med schools, most of which are just as good as those 5 competitive programs (with a few exceptions, which I won't specify here because of the risk of starting a flame war).

 

[notdeadyet]

Note that the "more competitive programs" in psychiatry are usually more competitive because of location, not because of quality. Few people would say that those 5 programs are superior to many of the other programs affiliated with "top 15" med schools, but you get an automatic boost in competitiveness if you're located in NYC, Boston, or California.

I think most of your advice was spot on, but I'd disagree with this notion here. I think you're doing the mistaking correlation with causation thing.

A lot of the top programs tend to be in places like the above because it's where many people like to live. So folks who have their choice of where to live and settle down often choose places like this, so you keep getting top faculty with top research money settling at places like these, which attracts top quality applicants, etc. etc. etc. I know nothing about Boston, but there are lots of very ho hum programs in NYC and California despite being in awesome locales. The top programs (and I'd add a few to your list) don't develop that reputation because they are in pretty places alone (does anyone pine for moving to New Haven?).

I'd also caution folks to abandon the looking at the undergrad or med school reputation to draw inferences of a psych residencies quality. You mention "top 15" med schools, but this doesn't mean their psych programs are particularly strong, and plenty of fairly middle of the pack med schools have top notch psych residency training.

I'd encourage folks to look into programs and their offerings individually. If you look at a programs with a blindfold on, I think you'll discover that Columbia is an awesome residency because of what it does and how it trains, not the name or location. And the same trick will reveal many truly great and top notch programs are out there whose names wouldn't automatically make most folks top ten list based on name alone. That's why ignoring brands and looking under the hood is time well spent. The Ivy League does not exist in residency training, thank god...

 

[notdeadyet]

Just keep an open mind and open eyes and ears, scruffy. You may wind up falling in love with an altogether unexpected specialty (like some of us did psych), and if you stay in psych you'll be a better doc for good training... Enjoy med school...

 

[touchpause13]

Any advice for someone about start at a DO school and who wants to stay in the Midwest (really MN/IA/ND) for residency?

 

[postbacpremed87]

Any advice for someone about start at a DO school and who wants to stay in the Midwest (really MN/IA/ND) for residency?

I think you would be able to match at a program in one of those states no problem.

 

[scruffy821]

Guys, thanks so much for the advice!

How important do you guys think M1/M2 basic science grades are for matching competitively in psych? My school is on an Honors/Pass/Fail system for the first two years, and I seem to score around average for every exam/haven't honored any classes this year. I hope that wouldn't hold me back in the future, haha.

I plan on doing research and am pretty involved at our school, so I think I'll be okay there, unless there are specific extracurriculars you guys think would be worth exploring. I scored a 34 on the MCAT, so I'm hoping that I'm at least capable of doing somewhere in the 230s/240s on Step 1, even though they obviously aren't completely correlated!

Sorry for all the questions, you guys are great!

 

[notdeadyet]

How important do you guys think M1/M2 basic science grades are for matching competitively in psych? My school is on an Honors/Pass/Fail system for the first two years, and I seem to score around average for every exam/haven't honored any classes this year.

I wonder if any programs actually look at performance in the first two years. If they do, they are definitely in the minority.

The main benefit of any kind of grades in the pre-clinical years are to keep people studying so that the Step 1 doesn't take them by surprise. Their only other benefit I can think of is that some schools may use it for class rank (which programs sometimes look at in terms of top quartile vs. middle-of-the-pack candidate) or AOA (which no program expects but is nice to see).

 

[scruffy821]

I wonder if any programs actually look at performance in the first two years. If they do, they are definitely in the minority.

The main benefit of any kind of grades in the pre-clinical years are to keep people studying so that the Step 1 doesn't take them by surprise. Their only other benefit I can think of is that some schools may use it for class rank (which programs sometimes look at in terms of top quartile vs. middle-of-the-pack candidate) or AOA (which no program expects but is nice to see).

Okay, that's good to hear. And yeah that makes sense, hopefully I'm getting the main concepts down, I just try not to worry too much about memorizing every irrelevant detail that some professors randomly test on.

To be honest, I'm not sure if our school releases a class rank like that, my understanding is that they might do so but that it's based off the M3/M4 clerkship grades (which are graded like normal classes). I think they do use M1/M2 grades for junior AOA, in that you have to at least be in the top 50% of the class for those grades and also score in the top 5-10% on Step 1. My chances of getting AOA seem pretty low if that's the standard anyway, hopefully competitive psych residencies wouldn't be too concerned about it!

 

[notdeadyet]

My chances of getting AOA seem pretty low if that's the standard anyway, hopefully competitive psych residencies wouldn't be too concerned about it!

The year I matched (and I can't imagine it's changed much) there were a total of 34 folks who were AOA that ended up matching into psych. So the vast majority of folks who match at competitive psych residencies are not AOA. It's most definitely not a requirement.

 

[shan564]

A lot of the top programs tend to be in places like the above because it's where many people like to live. So folks who have their choice of where to live and settle down often choose places like this, so you keep getting top faculty with top research money settling at places like these, which attracts top quality applicants, etc. etc. etc. I know nothing about Boston, but there are lots of very ho hum programs in NYC and California despite being in awesome locales. The top programs (and I'd add a few to your list) don't develop that reputation because they are in pretty places alone (does anyone pine for moving to New Haven?).

I usually choose my words carefully, and I think you're conflating my use of "most competitive" with the word "top" - I said "most competitive" instead of "top" specifically because Yale is known to be less competitive than the other 5, but few would argue that it's inferior in any way. I was also careful to avoid saying that these programs have this reputation (again, the reputation for being "more competitive", not "top") because they're in pretty places "alone," but rather that they get a "boost in competitiveness" due to location. Even the ho-hum programs in these locales are more competitive than the ho-hum programs in other locales. And the great programs in the less-attractive locales are less competitive than the great programs in the more-attractive locales.

I'd also caution folks to abandon the looking at the undergrad or med school reputation to draw inferences of a psych residencies quality. You mention "top 15" med schools, but this doesn't mean their psych programs are particularly strong, and plenty of fairly middle of the pack med schools have top notch psych residency training.

That's why I said "many top 15 med schools" instead of "all of the top 15 med schools." And then I specifically said that there are some exceptions to that trend, and that I won't mention which ones because I didn't want to start a debate about which programs are better than which. But since you made this comment, I'll give a specific example - I think that MUSC has a better psych program than UChicago. I also wanted to avoid giving a biased opinion because I think that my program is one of the best and is not as competitive, but I didn't want to specifically say that.

I'd encourage folks to look into programs and their offerings individually. If you look at a programs with a blindfold on, I think you'll discover that Columbia is an awesome residency because of what it does and how it trains, not the name or location. And the same trick will reveal many truly great and top notch programs are out there whose names wouldn't automatically make most folks top ten list based on name alone. That's why ignoring brands and looking under the hood is time well spent. The Ivy League does not exist in residency training, thank god...

I agree completely, as you'll see based on many of my prior posts as well as the advice that I'm about to give another person below. I think we can all agree that this is the general consensus on this forum. I was trying to give the OP tailored advice because he/she specifically asked about how to be competitive at the "more competitive" programs. He/she is not currently trying to choose a program, just trying to figure out how to be a good applicant. And that's why my advice was tailored to competitiveness, not to quality.

Any advice for someone about start at a DO school and who wants to stay in the Midwest (really MN/IA/ND) for residency?

Be a competent med student and you'll reach your goal. Luckily for you, psychiatry in MN/IA/ND is probably one of the less competitive specialty/location combinations, and these states nevertheless offer several programs that are probably among the best.
Personally, I think that U.Iowa has one of the best programs around, especially if you're more interested in biological psychiatry. U.Minnesota and Mayo are also great if you have a biological leaning, and Mayo is definitely DO-friendly, since the program director is a DO. Hennepin in Minneapolis is also a very well-respected community program on these boards, and this will continue to be the case for at least as long as the program director sticks around. Honestly, you're lucky - Minnesota and Iowa are a goldmine of psychiatry.