Adviced needed

[Itsarainbow]

Hello guys,

I'm a graduating senior who did not match into anesthsia last year and currently about to start a transitional year. Due to COVID I unfortunately didn't end up having a pysch rotation my 3rd year and decided to go all in all anesthsia because that was my favorite rotation at the time. I plan in using both my elective months to intern in pysch. My question is how feasible is it given my stats? Step 1 226, step 2 224, comlex 1 503, comlex 548. Will having a strong step 3 hel ( I was dealing with a family death during my step 2 date; scored much higher on the practice exam before that) Can I match as a pgy2 or start as a pgy1? Thank you in advance!

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[calvnandhobbs68]

Hello guys,

I'm a graduating senior who did not match into anesthsia last year and currently about to start a transitional year. Due to COVID I unfortunately didn't end up having a pysch rotation my 3rd year and decided to go all in all anesthsia because that was my favorite rotation at the time. I plan in using both my elective months to intern in pysch. My question is how feasible is it given my stats? Step 1 226, step 2 224, comlex 1 503, comlex 548. Will having a strong step 3 hel ( I was dealing with a family death during my step 2 date; scored much higher on the practice exam before that) Can I match as a pgy2 or start as a pgy1? Thank you in advance!

I’d apply pretty broadly if you really want to try to switch to psych and not try to apply anesthesia again. You better have a really good story because it’s going to be super obvious your trying to get into psych as a “backup” to anesthesia since all your 4th year electives are gonna be anesthesia electives and you’ve literally never done an actual psychiatry rotation until now. Your steps are nothing to write home about in the psychiatry applicant pool these days.

I’d actually recommend against it unless you’re dead set on psych now for some reason. It’d make way more sense to try to get into anesthesia or at least pivot to something more related to anesthesia. Why do you want to apply to psychiatry given you’ve never had an actual rotation in it?

 

[nexus73]

Why psych instead of internal medicine for example? You could do IM and be done in three years then three more years for anesthesia. 6 total instead four for psychiatry. And if anesthesia is what you really want to do that’sa longer but possibly reasonable route. And your dual boarded.

 

[Itsarainbow]

It's actually me realizing that I don't want to do anesthsia and how unsatisfied I would feel. I feel pysch would give me a better chance of helping people with their own personal mental health issues having gone through some with me/family recently. Realizing and admitting this to myself this late was a mistake but I'm trying to make the best out of my situation. Any advice would be appreciated.

 

[Psychresy]

It's actually me realizing that I don't want to do anesthsia and how unsatisfied I would feel. I feel pysch would give me a better chance of helping people with their own personal mental health issues having gone through some with me/family recently. Realizing and admitting this to myself this late was a mistake but I'm trying to make the best out of my situation. Any advice would be appreciated.

Don't mention this reason in personal statements or interviews.

 

[Itsarainbow]

Don't mention this reason in personal statements or interviews.

Don't mention this reason in personal statements or interviews.

Can I ask why? And do you have any advice in regards to the PS? Thanks!

 

[Psychresy]

Can I ask why? And do you have any advice in regards to the PS? Thanks!

Program directors generally don't want to bring people on who have their own mental health issues/openly talk about them. Not saying it's right, just saying how it is.

For you, I'd focus mine on why psych isn't really just a backup and why this is what you really feel you're meant to do. Truth be told the ps probably isn't going to make your app, it's just one small piece.

 

[Itsarainbow]

Program directors generally don't want to bring people on who have their own mental health issues/openly talk about them. Not saying it's right, just saying how it is.

For you, I'd focus mine on why psych isn't really just a backup and why this is what you really feel you're meant to do. Truth be told the ps probably isn't going to make your app, it's just one small piece.

Gotcha. That's surprising to hear to be honest. Thanks for the heads up.

 

[Stagg737]

Can I ask why? And do you have any advice in regards to the PS? Thanks!

If you don't have any obvious red flags (other than not matching), mentioning family MH problems is not a complete no-go. You do need to be careful about how you discuss it though, as you want to avoid your own MH problem as much as possible. Avoid talking about your own problems like the plague though. Some PDs can be understanding, but generally avoid personal MH problems unless you've got major red flags that can't otherwise be explained.

For most, PS isn't as important as people think it is. I do think your case is one where it will be important though as you'll need to explain why the 180 switch from anesthesia to psych. Especially when your app seems heavily geared towards anesthesia previously.

 

[Itsarainbow]

If you don't have any obvious red flags (other than not matching), mentioning family MH problems is not a complete no-go. You do need to be careful about how you discuss it though, as you want to avoid your own MH problem as much as possible. Avoid talking about your own problems like the plague though. Some PDs can be understanding, but generally avoid personal MH problems unless you've got major red flags that can't otherwise be explained.

For most, PS isn't as important as people think it is. I do think your case is one where it will be important though as you'll need to explain why the 180 switch from anesthesia to psych. Especially when your app seems heavily geared towards anesthesia previously.

Mine were brief and due to multiple family deaths within a couple of years. I'm back to my old self now but med school was a tough experience mostly due to outside circumstances. I thought maybe talking about the experience and how I was able to get back on my two feet would be a good talking point for a PS. But, I'll take your advice and not mention because I can see how programs can look down on that.

In regards to transitional years, would you recommend using my 2 electives months on pysch? They are in September and October. I was gonna see if I could shadow a nearby psychiatrist during the one month I have off between graduation and starting residency as there won't be much exposure next year besides those electives.

Would a strong step 3 help my cause?

 

[hallowmann]

Mine were brief and due to multiple family deaths within a couple of years. I'm back to my old self now but med school was a tough experience mostly due to outside circumstances. I thought maybe talking about the experience and how I was able to get back on my two feet would be a good talking point for a PS. But, I'll take your advice and not mention because I can see how programs can look down on that.

In regards to transitional years, would you recommend using my 2 electives months on pysch? They are in September and October. I was gonna see if I could shadow a nearby psychiatrist during the one month I have off between graduation and starting residency as there won't be much exposure next year besides those electives.

Would a strong step 3 help my cause?

Discussing grief and how working through it exposed you to more psych than you experienced during your rotations, opening a door to what you truly want is a completely reasonable topic in my opinion. I would not relate it in any way to weaknesses or mistakes in med school though.

I'm gonna disagree that the PS is not important for most people. Often times an interesting PS may get you an interview and at very least says a little something about you. Is it the most important part of your app, no, but it's actually one of the few parts that you can actually show a part of you, which in my opinion is very important regarding fit. That said, this is assuming there are no real red flags and you get to the point where people are actually reading your PS.

Unfortunately, I would generally agree that talking a lot about your own struggle with mental health is problematic, and I've seen some people really overshare making it obvious they either have a personality disorder or really don't understand what psychiatry is. Using an episode of bereavement to briefly describe how your path has changed is different in my opinion.

Strong Level 3 will help. Honestly I wouldn't get hung up on taking Step or even necessarily the score. Most places will care that you can be licensed more than anything else.

I would apply very broadly given the failure to match and being a graduate. Try to make connections internally as well if there is a program where you are doing the transitional year or close by. Apply primarily for PGY1, but you certainly could apply for PGY2. Even if you match PGY1, you could potentially get some credit for some of the TY time, but this is 100% dependent on the program you match to and its PD.

 

[Itsarainbow]

Discussing grief and how working through it exposed you to more psych than you experienced during your rotations, opening a door to what you truly want is a completely reasonable topic in my opinion. I would not relate it in any way to weaknesses or mistakes in med school though.

I'm gonna disagree that the PS is not important for most people. Often times an interesting PS may get you an interview and at very least says a little something about you. Is it the most important part of your app, no, but it's actually one of the few parts that you can actually show a part of you, which in my opinion is very important regarding fit. That said, this is assuming there are no real red flags and you get to the point where people are actually reading your PS.

Unfortunately, I would generally agree that talking a lot about your own struggle with mental health is problematic, and I've seen some people really overshare making it obvious they either have a personality disorder or really don't understand what psychiatry is. Using an episode of bereavement to briefly describe how your path has changed is different in my opinion.

Strong Level 3 will help. Honestly I wouldn't get hung up on taking Step or even necessarily the score. Most places will care that you can be licensed more than anything else.

I would apply very broadly given the failure to match and being a graduate. Try to make connections internally as well if there is a program where you are doing the transitional year or close by. Apply primarily for PGY1, but you certainly could apply for PGY2. Even if you match PGY1, you could potentially get some credit for some of the TY time, but this is 100% dependent on the program you match to and its PD.

Thank you for the response. My biggest issue is that my TY spot doesn't have a home psych program because it's really new but the PD is really supportive. The place itself is pretty small but located near a huge city which could house more opportunities. Is it common to seek experiences outside your own program (eg research/shadowing pyschiarty) in order to boost my app?

 

[Stagg737]

Thank you for the response. My biggest issue is that my TY spot doesn't have a home psych program because it's really new but the PD is really supportive. The place itself is pretty small but located near a huge city which could house more opportunities. Is it common to seek experiences outside your own program (eg research/shadowing pyschiarty) in order to boost my app?

Not sure how common, but certainly would not hurt your app. To clarify a few things above, strong Step 3 may not be a game changer unless programs are really concerned you couldn't pass. A pass will certainly help though. as that's one less things for programs to worry about. PS are hit or miss. Most of the time when they stand out they do so for the wrong reason. As I said above, I think your situation is a bit different as your have things that need to be explained to convey "why psych?" So you should certainly try and make your PS as strong as possible as it will likely be scrutinized more than most others' will.

Mine were brief and due to multiple family deaths within a couple of years. I'm back to my old self now but med school was a tough experience mostly due to outside circumstances. I thought maybe talking about the experience and how I was able to get back on my two feet would be a good talking point for a PS. But, I'll take your advice and not mention because I can see how programs can look down on that.

This is a very different situation from most people when they talk about their own MH problems. Major depressive episodes, severe anxiety, mania/psychosis are all things to leave out. Acute stress disorders or 1-time adjustment disorders d/t deaths in the family is a whole different category. Many physicians I talk to don't even consider acute stress reactions to be pathological and consider them to be normal cognitive responses to extreme stressors (I'm of the same opinion). If you had a very stressful several months d/t sudden deaths, this could be a good topic for a personal statement IF written the right way. If you developed a more chronic issue because of this which you still struggle with at times, then may be best left out.

I'm sorry you're in the situation you're in. As someone who took multiple tries to get into med school, I can empathize. Only you can really know your situation and how to frame it. My best advice is to try and make your application as cohesive as possible, explain what needs to be explained but avoid putting a spotlight on the negatives, and be as organized and proactive as possible (without being obnoxious).

 

[Itsarainbow]

Not sure how common, but certainly would not hurt your app. To clarify a few things above, strong Step 3 may not be a game changer unless programs are really concerned you couldn't pass. A pass will certainly help though. as that's one less things for programs to worry about. PS are hit or miss. Most of the time when they stand out they do so for the wrong reason. As I said above, I think your situation is a bit different as your have things that need to be explained to convey "why psych?" So you should certainly try and make your PS as strong as possible as it will likely be scrutinized more than most others' will.




This is a very different situation from most people when they talk about their own MH problems. Major depressive episodes, severe anxiety, mania/psychosis are all things to leave out. Acute stress disorders or 1-time adjustment disorders d/t deaths in the family is a whole different category. Many physicians I talk to don't even consider acute stress reactions to be pathological and consider them to be normal cognitive responses to extreme stressors (I'm of the same opinion). If you had a very stressful several months d/t sudden deaths, this could be a good topic for a personal statement IF written the right way. If you developed a more chronic issue because of this which you still struggle with at times, then may be best left out.

I'm sorry you're in the situation you're in. As someone who took multiple tries to get into med school, I can empathize. Only you can really know your situation and how to frame it. My best advice is to try and make your application as cohesive as possible, explain what needs to be explained but avoid putting a spotlight on the negatives, and be as organized and proactive as possible (without being obnoxious).

Thank you for your reply. Yeah I'm really uneasy about this whole situation. I'm really not sure where my career is going and sucks not having a permanent position. I just hope to have better luck next year.

 

[Itsarainbow]

Not sure how common, but certainly would not hurt your app. To clarify a few things above, strong Step 3 may not be a game changer unless programs are really concerned you couldn't pass. A pass will certainly help though. as that's one less things for programs to worry about. PS are hit or miss. Most of the time when they stand out they do so for the wrong reason. As I said above, I think your situation is a bit different as your have things that need to be explained to convey "why psych?" So you should certainly try and make your PS as strong as possible as it will likely be scrutinized more than most others' will.




This is a very different situation from most people when they talk about their own MH problems. Major depressive episodes, severe anxiety, mania/psychosis are all things to leave out. Acute stress disorders or 1-time adjustment disorders d/t deaths in the family is a whole different category. Many physicians I talk to don't even consider acute stress reactions to be pathological and consider them to be normal cognitive responses to extreme stressors (I'm of the same opinion). If you had a very stressful several months d/t sudden deaths, this could be a good topic for a personal statement IF written the right way. If you developed a more chronic issue because of this which you still struggle with at times, then may be best left out.

I'm sorry you're in the situation you're in. As someone who took multiple tries to get into med school, I can empathize. Only you can really know your situation and how to frame it. My best advice is to try and make your application as cohesive as possible, explain what needs to be explained but avoid putting a spotlight on the negatives, and be as organized and proactive as possible (without being obnoxious).

Thank you for your reply. Yeah I'm really uneasy about this whole situation. I'm really not sure where my career is going and sucks not having a permanent position. I just hope to have better luck next year.

 

[gyngyn]

This thread can be followed here: Failed to match a advance spot. Not sure what to do. Need advice