Any chances of matching psychiatry?

[BrachialComplexus321]

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[Amygdarya]

What are your clinical grades like? Any significant experiences/extracurriculars in psychiatry? Although your case is more complicated than this and psychiatry is indeed getting more competitive, the specialty is more forgiving about Step scores than many others but evidence of long term interest in psychiatry is very important, especially for someone with less impressive academics. Things that can help you: do well on your clinical rotations and Step 2 (have your score by the time of ERAS submission or as early in the application season as possible), get good letters from psychiatry and another major specialty like medicine, have some significant psychiatry related ECs, applying broadly. Doing well and being likable in away rotations can help at those places. But I won’t lie, it won’t be easy.

You may also find more help in the Psychiatry sub-forum: Psychiatry

 

[gutonc]

Moved to Psych.

 

[tellme_areyoufree]

I have been really interested in Psychiatry since I started medical school( US MD Student ) but my preclinical years have been far from ideal. I have 5 course failures during my preclinical years and passed Step 1 with <200. I have taken the past year off to kind of mentally reset due to my horrible preclinical years and to do some research. I have done research in the past and want to continue to show my commitment to the specialty I know that Psychiatry has been extremely competitive the past could of years and only will get more competitive so I was just wondering if performing well during rotations, on Step 2, and doing aways will give me an okay chance to match? I am geographically flexible as I would graciously accept any opportunity given and I would definitely apply to all 250+ programs! . Just looking towards starting rotations in a couple months and wanted to be realistic in planning out my clinical years for pursuing Psychiatry or whether it would be more realistic to pursue Family Medicine. At the end of the day I just want to practice medicine and would be happy as a psychiatrist or a family physician. Appreciate any input from the SDN community!

From the perspective of an applicant who matched this year, it seems like this year was more competitive than last year, and next year will probably be more competitive still. So I agree with Amygdarya that it may not be easy. That said, I was an applicant with "less than impressive" stats (Step1 210-215) who got interviews at good places, and am happy with how the season went.

Things that I think made a difference for me:

• I could articulate the evolution of my interest in psychiatry very clearly, and I think that was well received in interviews.
• I had a clear vision for my career path, and how each specific residency could help me reach that. I tried to focus applications and interviews I accepted on places that I thought would be good for me in that regard.
  
• I tried to offset my mediocre stats by demonstrating scholarship via writing and publishing. I was fortunate to "grab on" early to a faculty member who published a lot, although in retrospect I wish I had published more specific to psych. Couldn't change my step1 score after it was in, but I could address other things.
  
• I applied broadly. Too broadly, actually, but frankly I'd rather apply too broadly than not broadly enough (sorry PDs and PCs who have to review thousands of applications).
  
• I interviewed broadly, but also adjusted based on interviews I got. I got 25-30 interview invitations out of 50ish applications. I interviewed at "competitive" and "less competitive" programs, but once I had a better sense of who was giving me interviews, I canceled or declined interview offers that were at either extreme of the competitiveness scale. I ultimately went on 16 interviews, ranked 14, and matched at my #3 in the northeast. I think applying broadly would make a lot of sense for you.
  
• I think I interview relatively well. Any help that's offered with interview prep, take it and take it seriously.
• I focused on getting good letters of rec. A psychiatrist I knew well, an internist I worked with and impressed during 3rd year, and a pediatrician I worked closely with and wrote extensively with. Maybe I should've gotten a second psych letter, but I wanted to demonstrate that I wasn't choosing psych because I didn't do well in other fields, that I would not embarrass their program during IM months. I do wish I had gotten a letter from my program chair or PD at my home institution, but frankly I didn't feel like I knew them well and didn't feel comfortable asking. My retrospective advice to self would have been: "suck it up, deal with the awkwardness of asking, and get a letter from them." Ask them for time to get to know them, so they can write you a decent letter. Ask a faculty you're close with to speak on your behalf to that chair person, etc. Just my opinion, PDs may feel otherwise.
• I emailed a couple programs when I didn't get invites from them. That may seem ridiculous since I already had a fair number of invites, but I wanted clustering geographically for personal reasons. Email with PD with PC cc'd, keep it BRIEF, say why you're interested in their program and that you hope they will consider you seriously for an interview invite. This netted me 2 invites to places I wanted to interview, allowing me to cancel 2 interviews at places I didn't want to interview.
• I had Step2 done early. I saw a difference in interviews I got vs interviews a friend got with Step1 ~240. He got interviews much later than I did, and I think it's because I did step2 and CS as early as I could, and he didn't do it until I think November.

Just my reflection on what helped the interview season go well for me as an applicant with mediocre stats. I don't know if that's helpful for not.

I'm sorry it might be rough for you, but it sounds like you are pretty motivated to try your best. Good luck!

 

[tellme_areyoufree]

Thank you also for your response! I really appreciate the breakdown of your journey. I am still staying positive and want to do the best that I can these last 2 years. I really want to make a powerful and effective personal statement and if you do not mind me asking what did you address in your PS? I want to talk a little but about my struggles but also want to address my strengths without it going all over the place. Also, did you do any away electives during your 4th year at the places that you interviewed/ranked? I am scheduling my IM rotation towards the end of 3rd year as I feel like that would be good preparation for me to take Step 2 as soon as possible and submit it with my ERAS. I am definitely going to save your post as I will definitely be looking at it many times these next two years. Thank you again!

I didn't do any aways.

My PS talked about being surprised by my love for psychiatry, but in retrospect my work experience before medical school set me up to be interested in the field. After considering other fields, deciding that psychiatry was the best choice for me and would best allow me to meet my career goals. Embracing the excitement I felt for the field, yada yada.

I tried not to talk about weaknesses. They'll already know your weaknesses. I wasn't convinced it would be best to keep the reader's mind focused on my poor performance on Step1, for example. Instead I used the PS to focus on my excitement for the field and why I thought I'd be a good candidate and ultimately a good resident.

That said, our circumstances are different and MacDonaldTriad makes a very good point below about addressing a major weakness, while I was thinking more about a soft weakness. (I think their advice is better than mine, having just read their response)

 

[MacDonaldTriad]

Any advice that gaps and major weaknesses not be addressed in a PS is very bad advice. Don't leave programs wondering what happened, our imagination will paint a worse picture than reality in most cases. It is one thing to not point out a passing score that was below average, it is an other to repeat multiple preclinicals and then take a year off without a MPH, or MBA, or a significant research project. You should at least build up your research year as something you really wanted to take advantage of did so. A lot of students struggle in preclinicals and end up shining in clinicals. This is your goal now. I'm a little surprised a school can fail someone on 5 courses and not require a year to be repeated. This is often what happens for 3 or 4 course failures. Unless you have identifiable life circumstances that would preclude jumping back in, you need to stop "regrouping" and get going and do your best. Your school may be minimizing the impact of becoming less and less traditional in your path through school, but these are about the only concrete facts that programs are given in your packet to judge you by. Be regrouped and go kick tail, preclinical performance isn't all that it takes to be a good doctor. Good luck.

 

[splik]

I am also of the opinion that things that might otherwise go unnoticed should not be the focus on your personal statement. Most people do not spend much time glancing over your preclinical performance. I am mainly going to look at your clerkship grades. It would a mistake imho to focus on negatives in your personal statement that we might otherwise gloss over, particular if the rest of your application is otherwise solid. There are obviously some things that must be discussed in the personal statement (like if you had to repeat a year, if you were kicked out of medical school, multiple step failures. But I would probably not realize someone had multiple preclinical course failures nor care much unless they drew attention to it.

I do however agree with MDT that you cannot just take a year off without addressing it. Taking a year off to "mentally reset" would be a massive red flag, and should not be mentioned. You need to have a very productive year off and make it appear the year was taken off with clear goals in mind that enhance your professional development. If it does not look convincing, I will assuming you are lying about why you took the year off, which is the kiss of death. I remember an applicant who made up an unconvincing reason for having taken time off and I knew he was lying; we did not rank him, and he did not match into psychiatry at all.

 

[psychattending]

I am also of the opinion that things that might otherwise go unnoticed should not be the focus on your personal statement. Most people do not spend much time glancing over your preclinical performance. I am mainly going to look at your clerkship grades. It would a mistake imho to focus on negatives in your personal statement that we might otherwise gloss over, particular if the rest of your application is otherwise solid. There are obviously some things that must be discussed in the personal statement (like if you had to repeat a year, if you were kicked out of medical school, multiple step failures. But I would probably not realize someone had multiple preclinical course failures nor care much unless they drew attention to it.

I do however agree with MDT that you cannot just take a year off without addressing it. Taking a year off to "mentally reset" would be a massive red flag, and should not be mentioned. You need to have a very productive year off and make it appear the year was taken off with clear goals in mind that enhance your professional development. If it does not look convincing, I will assuming you are lying about why you took the year off, which is the kiss of death. I remember an applicant who made up an unconvincing reason for having taken time off and I knew he was lying; we did not rank him, and he did not match into psychiatry at all.

I would disagree with splik. I do look at pre-clinical grades. Even 1 failure gives me pause. While pre-clinical failures do not weigh as heavily as clinical ones, in today's environment such failures would take on a even greater importance. I would want to see this addressed in the personal statement.

 

[Mad Jack]

Give it a shot, but I would definitely have a backup plan

 

[Desired Member]

This makes me kind of sad because I feel like there is nothing wrong with needing a year to “mentally reset.” How could a psych professional not support a person needing to take time off for mental health reasons? I feel like the medical field is a toxic environment

 

[MacDonaldTriad]

Medical students are students. Residents are employees. Employers don't want to hire anyone who will need a year off to "mentally reset". Mentally resetting would be called quitting and finding a new job when you return. Granted, taking time off as a student isn't a crime, but employers do see the past as a predictor of the future and there are a lot of fish in the sea to pick from. We could make all programs take an oath not to discriminate against anyone who takes time off, but no matter what, all things being equal, taking time off will be viewed as not as good as not taking time off.

Like all highly desirable stable high paying professions, there is a lot of competition in medicine and that does make it a "toxic environment". The same can be said of investment banking and working in the stock market. I'm sure even kings and captains of the cat food industry have to perform or perish. Rules and laws can mitigate overt bad behavior, but the selection process remains cloaked under very subjective standards. "They shouldn't" and "it should be OK" will always have shoulds. Historically, there have been lots of rules aimed at mitigating these things, but they have been either ineffective or untenable for the most part.