Anyone freaking out about initial cert boards?

[futuredo32]

Is it too early for anyone else to be totally freaked out? Is anyone studying yet?

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[TexasPhysician]

If you have gotten to this point, take a deep breath and realize your success.

You have reached a point where passing tests is basically optional. You can fail each of the next 3 years and do perfectly well for yourself. A friend of mine has failed twice and has no difficulty finding jobs willing to pay $170/hr for his services.

I barely studied for general and not a minute for child. Study or don’t - you have reached the good life.

 

[futuredo32]

I failed twice. I didn't study enough the first time so I studied my @ss off last summer Clive and Spiegel memorized, BTB. I graduated in 2015 didn't take it that year. I have to pass this year or there will be a good gap where I am not BE next year. I am taking it to pass so my former PD will write a LOR for a 2nd residency in FP. I'm taking Kaufman's class in NY this year, doing focus and the Kaufman neuro questions and a few other question books. I'm freaking out big.

 

[TexasPhysician]

Last I checked, you are BE for 7 years post graduation.

Google shows “Effective January 1, 2012, ABPN will require a physician to become Board certified within seven years following successful completion of ACGME-accredited or ABPN-approved residency training in their primary specialty or ACGME-accredited subspecialty.”

If you graduated in 2015, math gives you until around 2021-2022.

 

[futuredo32]

In Michigan jobs say 5 years. More are saying 3 years. More importantly I want to apply for FP next fall so I can get out of psych. I spent endless hours studying for the board last summer and had I studied any longer I still wouldn't have studied what was on the exam. I emailed a few pds and they said it's hard to match into a 2nd residency even FP due to funding but passing the boards wont matter, but my former PD seriously wont write me a LOR if I don't pass............. I just want out of psych. I miss the rest of medicine and I personally (no offense ) find psych so monotonous. I have tried outpatient inpatient c/l, prison.cmh. I like the variety of FP and there is some psych in FP. I knew I wanted to switch to FP my first year of psych and I kick myself daily for not leaving during my psych residency when I had funding left............
In Mi at least Blue Cross and Medicare will pay in private practice NOW if you are BC or not but who knows how long that will last. I don't want to get stuck in psych forever. It would be one thing if I didn't go to undergrad and didn't go to med school and had a job I hated, but I worked way too hard to have a job I dislike so much.
I'm just hoping and praying there is one FP program no matter how malignant that will see the value of having a psychiatrist as a resident and take me. The ONLY reason I am taking the boards AGAIN is so my former PD will write the obligatory PD letter so I can get out of a field I am so unhappy in.

 

[AD04]

You're beating yourself over this exam for nothing.

Have you tried applying without a PD letter? It's not like you're transferring programs. You've finished a program and are BE which says a lot about you already.

And FM is not competitive (especially if you're applying to DO FM program). Beggar programs can't be choosers.

If that doesn't work, instead of worry about being BC, it may make more sense to work for an institution with FM program. Work as a psychiatrist, do good work, get to know people, and you'll get in based on who you know.

 

[futuredo32]

A PD letter is a must. I am going to fail this year AGAIN.
The only other option I have to the PD letter would be a DME letter from my intern year but that would look kinda odd. But if I don't pass this year I will use that. My chances are super slim anyway............ I will probably apply to PA school. I have the money set aside for that. I don't care if people call me Dr. I just want a job I enjoy and unfortunately psych isn't it.
Thanks

 

[st2205]

I am going to fail this year AGAIN.

Originally I had meant to point out that the test isn’t even for another 3-4 months and how silly this sounds, but then I kept reading...

But if I don't pass this year I will use that. My chances are super slim anyway............ I will probably apply to PA school.

I usually try to keep it tame on SDN but holy ****! Look, you keep talking about PDs not wanting you for this or that reason, of which everyone’s provided reassurance. If I’m a PD and an applicant is a physician who’s backup plan is PA, that’s a huge red flag for seriously impaired judgment that would cause me to pass. Forget that, if I’m an adcom for a PA school, a physician applying is a huge red flag.

 

[PikminOC]

Do DO take the same boards as MD?

 

[st2205]

Do DO take the same boards as MD?

Most people sit for the MD side. There is an osteopathic side, though I’ve never met anyone who’s done it. Not sure if OP considered.

 

[futuredo32]

Do DO take the same boards as MD?

for psych yes

 

[futuredo32]

Most people sit for the MD side. There is an osteopathic side, though I’ve never met anyone who’s done it. Not sure if OP considered.

I graduated from an allopathic psych residency so I take the ABPN boards. I took the COMLEX not USMLE . IF I would have had to take the DO psych boards I would have had to pass the oral so this is actually better........... But I am not holding out any hope of passing. I just kinda wanted someone to freak out with I guess.
Thanks to those who were helpful. I will freak out alone.

 

[TexasPhysician]

It may be worth talking to malpractice companies about covering you for a gen med practice. You completed an intern year and are a physician. You could read heavily and treat low-risk gen med issues and refer quickly. You have more training in gen med than new midlevels.

Family medicine residency would certainly be ideal. I wouldn’t have my family treated by someone not residency trained.

Liability risk is higher without residency.

The risks are certainly there, but nothing legally stops you from treating general medical issues with or without mental illness being present. Open an esthetics practice or whatever you want.

If you don’t like the field, you are the only thing stopping you from making changes.

I certainly wouldn’t recommend treating outside the scope of your training. I also wouldn’t recommend keeping a job you don’t like. You decide your own fate, but freaking out over board cert is not the answer.

 

[futuredo32]

Originally I had meant to point out that the test isn’t even for another 3-4 months and how silly this sounds, but then I kept reading...

I usually try to keep it tame on SDN but holy ****! Look, you keep talking about PDs not wanting you for this or that reason, of which everyone’s provided reassurance. If I’m a PD and an applicant is a physician who’s backup plan is PA, that’s a huge red flag for seriously impaired judgment that would cause me to pass. Forget that, if I’m an adcom for a PA school, a physician applying is a huge red flag.

It would have been nice if you kept it tame. This was not helpful in anyway. Fortunately for me you are not a PD or on the admissions committee of a PA school. I don't need the prestige or salary of a physician, I just want a job I like. I need to pass for the required PD letter.

Sometimes the saying "If you can't say anything nice don't say anything at all" is useful. In this case, it would have been useful for you. I hope you are more compassionate toward your patients. I have been reading and posting on SDN since I was a premed 15 or so years ago and the psychiatry forum was always the place where people were nice and supportive..................

 

[futuredo32]

It may be worth talking to malpractice companies about covering you for a gen med practice. You completed an intern year and are a physician. You could read heavily and treat low-risk gen med issues and refer quickly. You have more training in gen med than new midlevels.

Family medicine residency would certainly be ideal. I wouldn’t have my family treated by someone not residency trained.

Liability risk is higher without residency.

The risks are certainly there, but nothing legally stops you from treating general medical issues with or without mental illness being present. Open an esthetics practice or whatever you want.

If you don’t like the field, you are the only thing stopping you from making changes.

I certainly wouldn’t recommend treating outside the scope of your training. I also wouldn’t recommend keeping a job you don’t like. You decide your own fate, but freaking out over board cert is not the answer.

I definitely can't do psych full time forever
. I work minimally. I am pretty darned good at it, but I just don't like it. I don't want to do aesthetics,I want to help people with physical illness and some mental illness. I like medicine. I would be ok with being a PA if a PA program would take me, I know someone who knows someone who does cash only GP who was once in my shoes but I wouldn't want the liability and I have no clue how she gets malpractice. A lot of the population has a job they dislike and if I hadn't worked so hard to get here I guess I wouldn't feel some sense of entitlement to like my job. I like my patients, I like seeing them get better, but I MISS medicine. I want to use motivational interviewing for primary and secondary disease prevention, I want to fix something even if its a UTI. I miss the variety of diseases and the certainty of medicine. I dislike the trial and error of the medications.

We'll see. Maybe I will get a few miracles and pass AND get a second residency. Maybe I can keep doing it part time and volunteer in a free clinic and be "happy enough" I DO pretty much like doing a little therapy somewhat and don't HATE psychiatry with a passion, I just miss medicine. I miss the white coat.

One thing at a time and right now it's the board exam.

Thanks

 

[TexasPhysician]

Why not do inpatient rehab/detox addictions in a smaller town?

This is basically what you want. You handle detox, psych, and gen med issues on the unit. They pay your malpractice. I’ve done this. No issues treating HTN, HPLD, DM, UTI, strep, flu, GERD, seizures, migraines, gout, or whatever presents itself. I refer out anything that seems serious. Chest pain is an automatic send out, etc.

Some of these detox places in smaller towns would love to have you. I find the population rewarding. They can be very high functioning outside of the addiction.

 

[futuredo32]

Why not do inpatient rehab/detox addictions in a smaller town?

This is basically what you want. You handle detox, psych, and gen med issues on the unit. They pay your malpractice. I’ve done this. No issues treating HTN, HPLD, DM, UTI, strep, flu, GERD, seizures, migraines, gout, or whatever presents itself. I refer out anything that seems serious. Chest pain is an automatic send out, etc.

Some of these detox places in smaller towns would love to have you. I find the population rewarding. They can be very high functioning outside of the addiction.

Thanks for the suggestion. I appreciate it very much.
I have/ had a lot of people close to me with addictions. STRONG negative counter transference that wouldn't be healthy for me nor the patients and I am not a small town girl. I went to MSU and that is a college town and I thought THAT was a small town .

I am studying and hard, but I studied last year and hard and failed while I think 90 % passed and I don't think they studied as hard or as long. I am also going to an intense in person course and the ABPN is letting me take it over two days, I hope it's Sept 24 and 25 and not sooner because of them letting me take it over two days.......... ( I have ADD and cant take the psychostimulants nor straterra because oooh the side effects and performance anxiety) so thank you to the ABPN for that <3.

I have a great paying weekend moonlighting job once a month, if I got three more weekend jobs like that I could volunteer during the week and be totally happy and make a real doctors salary, BUT I MUST PASS this year or hasta la vista to my moonlighting job.
So back to the books I go. Failing last year after so much work just didn't help my performance anxiety but I have a great therapist/psychiatrist (who couldn't pass the orals and gave up) and he is working with me. So I am going to focus on the boards for now and PRAY for a pass.
Thank you again Texas Physician.

 

[Wilf]

And FM is not competitive (especially if you're applying to DO FM program). Beggar programs can't be choosers.

Wouldn’t family med PDs be hesitant to take someone who has failed psych boards twice? I assume FM boards would be as, or more, difficult and programs like to advertise high pass rates.

And I don’t think PA would necessarily be a bad route for OP. He would be able to practice general medicine.

 

[futuredo32]

Wouldn’t family med PDs be hesitant to take someone who has failed psych boards twice? I assume FM boards would be as, or more, difficult and programs like to advertise high pass rates.

And I don’t think PA would necessarily be a bad route for OP. He would be able to practice general medicine.

I'm a she. I have contacted a few PDs for programs which I have no intention of applying to and they said passing/failing would be irrelevant, it's funding. The psych board last year was total WTF. I do better with straight forward questions, I can't say what the questions were due to the confidentiality thing but............ the questions were not straight forward and ugh the vignettes some had more than 3 right answers. I did well on 3 of 4 of the Prites and got over confident for the first board exam and didn't study enough for the first exam I took my fault , that was IMO a fair exam, but last year was totally WTF, if you read the thread from the board cert I am so not the only one who thinks so. I am really likable in person (I am saying that because my employers like me and when I say I am leaving a job they make all kinds of offers to get me to stay and my attendings for the most part gave me totally awesome evals and my patients love me not because I think I am awesome) and if I could volunteer at a clinic where there was a Dr with a connection to a FP program, I think maybe? Or a program looking for a PGY 2? Or a super malignant program looking for a US grad? Or somewhere really geographically undesirable? Beggars (me) can't be choosers. I dunno it IS unlikely. I might actually take the USMLE Step 1 to bump up my standardized test score. I don't know. But I can't change the past. I can only work on passing THIS years board exam, and then on doing anything and everything to match into FP.

 

[WingedOx]

Or a super malignant program looking for a US grad? Or somewhere really geographically undesirable? Beggars (me) can't be choosers.

Well you're in Metro Detroit I'm assuming. Flint and Saginaw are both up the road and both have programs if I remember right, and from growing up there I can tell you that they are in fact, quite geographically undesirable (though probably not a bad place to learn to do family med).

 

[TexasPhysician]

And I don’t think PA would necessarily be a bad route for OP. He would be able to practice general medicine.

She can already do general medicine.

 

[futuredo32]

Well you're in Metro Detroit I'm assuming. Flint and Saginaw are both up the road and both have programs if I remember right, and from growing up there I can tell you that they are in fact, quite geographically undesirable (though probably not a bad place to learn to do family med).

Applied ......... Denied. I will apply again. I will apply to Alaska the desert, Hell's Kitchen, I don't care. I am in Metro Detroit. I want to end up back here but three years, I will go anywhere.

. But first THE BOARDS I read Mass General. I'm memorizing . Spiegel and Kenny , BTB, Kaufmans Neuro questions, Focus, a DSM5 Q book, Kaufmans review course (it's supposedly interactive I honestly fall asleep if I watch more than one BTB video in a row) and another online q bank I cant think of Kaplan and Sadock question book DSM IV , Stahls Case studies question book, any other suggestions? The Vignettes are hard, neuro and child psych are hard for me.

 

[MedMan80]

Applied ......... Denied. I will apply again. I will apply to Alaska the desert, Hell's Kitchen, I don't care. I am in Metro Detroit. I want to end up back here but three years, I will go anywhere.

. But first THE BOARDS I read Mass General. I'm memorizing . Spiegel and Kenny , BTB, Kaufmans Neuro questions, Focus, a DSM5 Q book, Kaufmans review course (it's supposedly interactive I honestly fall asleep if I watch more than one BTB video in a row) and another online q bank I cant think of Kaplan and Sadock question book DSM IV , Stahls Case studies question book, any other suggestions? The Vignettes are hard, neuro and child psych are hard for me.

What can I say Futuredo, I hope you pass. May try your best to associate passing with moving on and doing something you love, keep reminding yourself of this fact. You need to do what you love and you've established that this love is not psych. keep it up!

 

[st2205]

It would have been nice if you kept it tame. This was not helpful in anyway. Fortunately for me you are not a PD or on the admissions committee of a PA school. I don't need the prestige or salary of a physician, I just want a job I like. I need to pass for the required PD letter.

Sometimes the saying "If you can't say anything nice don't say anything at all" is useful. In this case, it would have been useful for you. I hope you are more compassionate toward your patients. I have been reading and posting on SDN since I was a premed 15 or so years ago and the psychiatry forum was always the place where people were nice and supportive..................

You're talking about going from being a licensed physician to entering a PA training program. That's not an appropriate avenue to pursue for a physician for a whole host of reasons that I won't get into, none of which include medical hierarchy. I'm always open for debate, discussion, and being flexible, as very little of what we do is as concrete and rigid as we make it appear. This is not one of those situations. Before you invest in spending money on this kind of pathway, I'd contact a large sampling of PA programs and try to get some honest feedback of how your application will appear when it comes across their desk. Should you go to PA school, I'd try to envision what happens after that when you interview for jobs, when they inquire about how you're a physician and why you went to PA school. You may be getting feedback that feels supportive now, but at the very least I'd prepare yourself for how you'd handle that scenario if/when this road becomes a lot more rocky than you're imagining it. You may not appreciate what is being said and may resent me for how it's said, but this will not be the last time it comes up, and would be in the setting of explaining this to someone who has a lot more influence over your career possibilities than an anonymous person on a message forum.

 

[SilverHawk]

I am surprised you are a psychiatrist. You seem like you would be better suited to be a radiologist or forensic pathologist. So 1. If you don't have anything nice to say don't say anything at all number two you know what they say about assumptions what does that make out of you?

Perhaps you should try following your own advice before casting stones.

 

[futuredo32]

What can I say Futuredo, I hope you pass. May try your best to associate passing with moving on and doing something you love, keep reminding yourself of this fact. You need to do what you love and you've established that this love is not psych. keep it up!

What can I say Futuredo, I hope you pass. May try your best to associate passing with moving on and doing something you love, keep reminding yourself of this fact. You need to do what you love and you've established that this love is not psych. keep it up!

Thanks.

 

[futuredo32]

Silverhawk agree. I didn't realize there was an ignore feature. Never needed it before.

 

[AD04]

I don't agree with going back to PA school, but I respect your decision.

It seems you are more comfortable following established structures:

- I need to go to FM residency to practice medicine
- PD will write me a letter for residency only if I pass the boards
- I need to pass the boards

It is very possible to get into FM residency in your situation without the boards / PD letter. (An ophthalmologist got tremors in his 50's couldn't practice anymore. So he went back to do a second residency. At his age, the PD must have been long gone.)

It is very possible to practice medicine as a GP without residency. (FM resident transferred in as a second year. After 1 year, he dropped out of residency because the cost outweigh the benefits. He made good money as a GP before -- $150 / hr -- and went back to the same job.)

But those solutions most likely don't fit your temperament.

As a bonus for going back to PA school, it offers a structure that may better fit your temperament. It is much easier to switch specialties without the hoops of residency. And someone else gets to make the major decisions / take on the major risks. You may be much happier as a PA. And the pay isn't terrible.

Wouldn’t family med PDs be hesitant to take someone who has failed psych boards twice? I assume FM boards would be as, or more, difficult and programs like to advertise high pass rates.

Her main issue is funding. There are programs that don't rely on Medicare for funding so she would not be at a disadvantage there. There are programs that don't fill and they may very well take half funding and get a warm body to generate revenue vs having nothing. If a program wants you enough, funding will not be an issue. Again, beggar programs can't be choosers.

 

[futuredo32]

I don't agree with going back to PA school, but I respect your decision.

It seems you are more comfortable following established structures:

- I need to go to FM residency to practice medicine
- PD will write me a letter for residency only if I pass the boards
- I need to pass the boards

It is very possible to get into FM residency in your situation without the boards / PD letter. (An ophthalmologist got tremors in his 50's couldn't practice anymore. So he went back to do a second residency. At his age, the PD must have been long gone.)

It is very possible to practice medicine as a GP without residency. (FM resident transferred in as a second year. After 1 year, he dropped out of residency because the cost outweigh the benefits. He made good money as a GP before -- $150 / hr -- and went back to the same job.)

But those solutions most likely don't fit your temperament.

As a bonus for going back to PA school, it offers a structure that may better fit your temperament. It is much easier to switch specialties without the hoops of residency. And someone else gets to make the major decisions / take on the major risks. You may be much happier as a PA. And the pay isn't terrible.



Her main issue is funding. There are programs that don't rely on Medicare for funding so she would not be at a disadvantage there. There are programs that don't fill and they may very well take half funding and get a warm body to generate revenue vs having nothing. If a program wants you enough, funding will not be an issue. Again, beggar programs can't be choosers.

I don't agree with going back to PA school, but I respect your decision.

It seems you are more comfortable following established structures:

- I need to go to FM residency to practice medicine
- PD will write me a letter for residency only if I pass the boards
- I need to pass the boards

It is very possible to get into FM residency in your situation without the boards / PD letter. (An ophthalmologist got tremors in his 50's couldn't practice anymore. So he went back to do a second residency. At his age, the PD must have been long gone.)

It is very possible to practice medicine as a GP without residency. (FM resident transferred in as a second year. After 1 year, he dropped out of residency because the cost outweigh the benefits. He made good money as a GP before -- $150 / hr -- and went back to the same job.)

But those solutions most likely don't fit your temperament.

As a bonus for going back to PA school, it offers a structure that may better fit your temperament. It is much easier to switch specialties without the hoops of residency. And someone else gets to make the major decisions / take on the major risks. You may be much happier as a PA. And the pay isn't terrible.



Her main issue is funding. There are programs that don't rely on Medicare for funding so she would not be at a disadvantage there. There are programs that don't fill and they may very well take half funding and get a warm body to generate revenue vs having nothing. If a program wants you enough, funding will not be an issue. Again, beggar programs can't be choosers.

What programs don't rely on government funding? That'd work as long as it's not military I am a girly girl.
I knew a PA who worked essentially as a physician. She had phone c omtact but didn't use it. I've seen PAs who did llttle. I prefer the former. I just don't care about the title or money. But my pd is alive and well so i need the lette4. But here's hoping I pass. Either third times the charm or 3 strikes and you're out hoping for the charm.

 

[michaelrack]

Why not do inpatient rehab/detox addictions in a smaller town?

This is basically what you want. You handle detox, psych, and gen med issues on the unit. They pay your malpractice. I’ve done this. No issues treating HTN, HPLD, DM, UTI, strep, flu, GERD, seizures, migraines, gout, or whatever presents itself. I refer out anything that seems serious. Chest pain is an automatic send out, etc.

Some of these detox places in smaller towns would love to have you. I find the population rewarding. They can be very high functioning outside of the addiction.

If you aren't opposed to inpatient psych, Many hospitals will allow you to handle similar medical issues on general psych or senior care units.

 

[futuredo32]

If you aren't opposed to inpatient psych, Many hospitals will allow you to handle similar medical issues on general psych or senior care units.

Except for weekend moonlighting I don't like inpatient psych and I kinda like that because the nurse's are fun and nice and well it pays awesome. Outpatient private practice is pretty lonely. . I like the long term doctor patient relationship in any field . But ty. Unfortunately where I moonlight they just want me to do psych. They have IM docs for any physical complaint. Outpatient therapy is the most enjoyable it doesn't pay well but it's the best I like and I've done prison inpatient CMH C/L and outpatient med management only. I would even consider part time private practice with therapy and part time FP. That was actually the original plan. I think the thought of being locked in psychiatry makes thar currently less appealing . BUT IF I CAN GET 13 MORE QUESTIONS RIGHT OUT OF THE 450 they keep maybe FP could happen or like I said moonlighting all weekends and volunteer in a free FP clinic. I know a few amazing doctors who couldn't pass the boards- my psychiatrist is one. He passed the written not the orals due to a combination of poor patient selection and performance anxiety. He's one of the two best psychiatrists I know from eithet training or being a patient. But i have one day less than 3 months plenty of study material and maybe the in person review class and being able to take it over 2 days will help me pass. If not I can at least say I gave it my all two years in a row and figure life out ftom there but for now I'm going to study and try the best I can and pray too. Thanks much to all who have been kind supportive and helpful. Any hints or pearls of wisdom on how to pass or study more effectivly appreciated.

 

[michaelrack]

It took me 5 years.... I aced written, then failed oral 3x, then aced written again, failed orals, and then finally passed fifth time... beat the boards made a lot of $ off me. You got to keep on trying. Luckily for me, I had my IM and sleep boards to fall back on, and my career didn't suffer much

 

[michaelrack]

Keep on retaking as long as you are eligible is my advice

 

[clausewitz2]

Except for weekend moonlighting I don't like inpatient psych and I kinda like that because the nurse's are fun and nice and well it pays awesome. Outpatient private practice is pretty lonely. . I like the long term doctor patient relationship in any field . But ty. Unfortunately where I moonlight they just want me to do psych. They have IM docs for any physical complaint. Outpatient therapy is the most enjoyable it doesn't pay well but it's the best I like and I've done prison inpatient CMH C/L and outpatient med management only. I would even consider part time private practice with therapy and part time FP. That was actually the original plan. I think the thought of being locked in psychiatry makes thar currently less appealing . BUT IF I CAN GET 13 MORE QUESTIONS RIGHT OUT OF THE 450 they keep maybe FP could happen or like I said moonlighting all weekends and volunteer in a free FP clinic. I know a few amazing doctors who couldn't pass the boards- my psychiatrist is one. He passed the written not the orals due to a combination of poor patient selection and performance anxiety. He's one of the two best psychiatrists I know from eithet training or being a patient. But i have one day less than 3 months plenty of study material and maybe the in person review class and being able to take it over 2 days will help me pass. If not I can at least say I gave it my all two years in a row and figure life out ftom there but for now I'm going to study and try the best I can and pray too. Thanks much to all who have been kind supportive and helpful. Any hints or pearls of wisdom on how to pass or study more effectivly appreciated.

Given the number of attempts and the sheer volume of resources you report having used, what pearls or tips could possibly help you at this point? Something more fundamental is holding you back not going to pretend that I know what it is for sure despite mt hypotheses, but this is going to keep causing you problems.

 

[futuredo32]

Keep on retaking as long as you are eligible is my advice

Keep on retaking as long as you are eligible is my advice

Thanks for sharing that it took you more than once. I am honestly drained from last year. I spent 4 5 months and 12 to 16 hours a day 5 days a week. I'm surprised I'm going for it this year. It may be funny to someone that I start early but I have ADD and performance anxiety not a great mix for the boards. I can't tolerare any of the ADD meds. I have other aspirations than career. Im just going to try my best for the next 3 months and hope I pass this year. One step at a time. But honestly that was really nice of you to post that. I remember as a premed when everyone posted they got an almost perfect score on the MCAT. Can I ask did you do psych/Im or is psych a second residency for you? Beat the boards now lets you keep taking their course for free until you pass. But I am giving the ABPN lots of money as well as lots of books and the Kaufman class in NY. Not only an expensive class but an expensive trip. I could never pass the oral noards. I passed in residency because it was obvious I was extremely nervous and the attendings were just kind. I was a good resident actually and did well on 3 of 4 PRITES. Too bad I can't substitute my prite scores for the boards... But i am just going to hope pray and work hard this summer for now.

 

[futuredo32]

Given the number of attempts and the sheer volume of resources you report having used, what pearls or tips could possibly help you at this point? Something more fundamental is holding you back not going to pretend that I know what it is for sure despite mt hypotheses, but this is going to keep causing you problems.

First time I was cocky because I had done well on the Prites 3x. I have ADHD no meds and performance anxiety. I struggle tons with the last right answer on the vignettes but I think I am lacking efficient study skills and test taking skills. That's my best guess. I scored low on all of the COMLEX exams. I don't know. I think my diagnoses and something I'm lacking in efficient studying or test taking. I wish I knew whar it was. 90% I think passed last year. I wasn't one of them. Hope the outcome is different this year.

 

[Bartelby]

If you are willing to go PA you are willing to take a substantial income cut after factoring in the salary decrease and the opportunity cost (new school debt + missed earning time). That opens some doors. Maybe:

-start a primarily therapy-based practice, even if you take a financial hit
-work 2-3 days a week (half-time psychiatry work is likely to earn you a PA's salary) and spend the rest of your time doing something you love
-work like crazy for a few years and retire early (see online communities like "Mr. Money Mustache" for the kind of thing I'm talking about)
-consider CL, you could land a job without a fellowship (and quite possibly without board certification / eligibility)
-inpatient (detox or locked) as mentioned above could also work in more exposure to general medicine, and you might learn to like it with time
-geri-psych

At any rate I hope you pass this year and and land somewhere you will enjoy! If you are sure that retraining in family medicine would make you happy, then that is a reasonable option; still, consider why you chose psych in the first place, and make really sure it's worth it to you.

 

[futuredo32]

If you are willing to go PA you are willing to take a substantial income cut after factoring in the salary decrease and the opportunity cost (new school debt + missed earning time). That opens some doors. Maybe:

-start a primarily therapy-based practice, even if you take a financial hit
-work 2-3 days a week (half-time psychiatry work is likely to earn you a PA's salary) and spend the rest of your time doing something you love
-work like crazy for a few years and retire early (see online communities like "Mr. Money Mustache" for the kind of thing I'm talking about)
-consider CL, you could land a job without a fellowship (and quite possibly without board certification / eligibility)
-inpatient (detox or locked) as mentioned above could also work in more exposure to general medicine, and you might learn to like it with time
-geri-psych

At any rate I hope you pass this year and and land somewhere you will enjoy! If you are sure that retraining in family medicine would make you happy, then that is a reasonable option; still, consider why you chose psych in the first place, and make really sure it's worth it to you.

PAs make a lot more tham I do. I work very little. I'm guessing the co manager of a fast food restaurant made more than I did last year. Therapy doesn't reimburse well. I work in an area that has the supet rich and the super poor next door. I think Medicare pays 80 for 45 min and I waive copays for those who are struggling financially. I might break even at best with my little private practice theres a pretty big tax for a solo business malpractice rent the biller etc. I do that a day or two a week. I do evals and meds in a clinic one day a week and moonlight in a hospital inpatient and c/l once a month. Geri psych would break my heart. Dementia is the cruelest disease. I mentioned before why not substance abuse and cl is hard. I am so close to the medicine but so far. I see the white coat and stethoscope that I so want. I can read about their renal failure or CHF but that's not my purpose. Therapy I like enough to do a day or two a week but with patients I pick. I currently have everyone mashed into one 8 hour day. I am taking a ton of those single days off to study. I work an hour from home because malpractice is far less expensive in this county. The drive sucks.
I inherited some money from an Uncle in residency. I have that to pay for PA school if needed.
I thought I was going into psych because i loved it but i just had a fun attending and psych was novel. I knew my first yeat in residency I wanted out and regret not leaving while I still had funding. But thanks. I hope I pass too.

 

[michaelrack]

I did a 5 year medicine psych combined residency followed by a 1 year sleep fellowship. In the old beat the boards course for the old oral boards you paid each time plus paid extra for supplementary extra patient interviews

I also grand fathered into the psych consult boards, so despite my multiple previous failures I am now quadruple certified

 

[michaelrack]

Here is a tip from my recent recertification: memorize the basics stone cold..... one of my sources was the introductory textbook of psychiatry (black and andreason)

 

[splik]

1. as a board-eligible psychiatrist/physician it is not realistic for you to go to PA school. Being a US trained physician who has completed residency is basically an exclusion.
2. you could however go to NP school (I know of a psychiatrist who knew he was going to lose his medical license and retrained as a psych NP before doing so...)
3. Your old PD cannot refuse to write you a letter if you don't pass the boards. If he refuses to write you a letter that reflects your clinical skills and professional attributes, then you should complain to the GME/DIO at the institution who should compel him to do his job. You may wish to seek legal advice/action but it is completely inappropriate for him to do that, unless there is some other reason. Whether you have passed the boards has nothing to do with whether you were in good standing. All they need to document is you satisfactorily completed your training, whether there were any professionalism issues, whether you faced any disciplinary actions or were on probation etc.
4. Hopefully you have other people who are able to write you positive LoRs including non-psychiatrists. while the PD letter would ideally more than perfunctory and sing your praises, all you really need is for them to sign off on your not being a liability.
5. FM is not competitive and if you are willing to be flexible about where you go, you should be able to find somewhere. There are quite a few FM residencies funded by the states or local counties or through FQHCs which means your lack of GME funding would not be an issue at such programs.
6. If you are struggling to pass the psych boards, there is a very good chance you would also struggle with the FM boards.

 

[hamstergang]

3. Your old PD cannot refuse to write you a letter if you don't pass the boards. If he refuses to write you a letter that reflects your clinical skills and professional attributes, then you should complain to the GME/DIO at the institution who should compel him to do his job. You may wish to seek legal advice/action but it is completely inappropriate for him to do that, unless there is some other reason. Whether you have passed the boards has nothing to do with whether you were in good standing. All they need to document is you satisfactorily completed your training, whether there were any professionalism issues, whether you faced any disciplinary actions or were on probation etc.

This is the part I never understood about OP's story.

 

[futuredo32]

1. as a board-eligible psychiatrist/physician it is not realistic for you to go to PA school. Being a US trained physician who has completed residency is basically an exclusion.
2. you could however go to NP school (I know of a psychiatrist who knew he was going to lose his medical license and retrained as a psych NP before doing so...)
3. Your old PD cannot refuse to write you a letter if you don't pass the boards. If he refuses to write you a letter that reflects your clinical skills and professional attributes, then you should complain to the GME/DIO at the institution who should compel him to do his job. You may wish to seek legal advice/action but it is completely inappropriate for him to do that, unless there is some other reason. Whether you have passed the boards has nothing to do with whether you were in good standing. All they need to document is you satisfactorily completed your training, whether there were any professionalism issues, whether you faced any disciplinary actions or were on probation etc.
4. Hopefully you have other people who are able to write you positive LoRs including non-psychiatrists. while the PD letter would ideally more than perfunctory and sing your praises, all you really need is for them to sign off on your not being a liability.
5. FM is not competitive and if you are willing to be flexible about where you go, you should be able to find somewhere. There are quite a few FM residencies funded by the states or local counties or through FQHCs which means your lack of GME funding would not be an issue at such programs.
6. If you are struggling to pass the psych boards, there is a very good chance you would also struggle with the FM boards.

I don't know why you think being a Dr precludes you from becoming a PA. I did reach out to 2 PA schools in MI and both were really understanding. My former PD is no longer a PD. She left the program. We are FB friends. That's my only current connection to her. It's her replies to my comments about wanting to do FP and not passing the psych boards that spell it out. I emailed and called a few FP programs I have zero intention of applying to and they said the boards were irrelevant it was all about funding. She thinks the programs would be looking for a pass on the boards. And as for the comparison between me passing the FP boards vs psych I think I would do better on FP because it's straight forward from what I have heard if you took last years exam you know what I mean and I am the typical ADHD person. I can read about medicine topics no problem. I like it. Psych I have to force myself. I read the latest and greatest in psychiatry to keep up with meds but I read all I can about the rest of medicine. I guess if I had to I could ask the DME from my DO intern year to write me a letter. She's no longer at the hospital but keeps in touch.
I applied to 30 some programs in MI 2 interviews and nada. I interview well. But for the next 3 months the focus is on passing the board exam. After that a non work related goal and then I guess look into non government funded FP programs and talk more to the 2 PA programs I reached out to. But for now the boards.

 

[futuredo32]

Here is a tip from my recent recertification: memorize the basics stone cold..... one of my sources was the introductory textbook of psychiatry (black and andreason)

Thanks. I skimmed the Mass General book I will spend more time on it.

 

[hamstergang]

My former PD is no longer a PD. She left the program. We are FB friends. That's my only current connection to her.
...I guess if I had to I could ask the DME from my DO intern year to write me a letter. She's no longer at the hospital but keeps in touch.

You don't need to have personal connections to these people for the letter. If your program still exists, it can attest to your satisfactory completion of it, right?

 

[TexasPhysician]

You don't need to have personal connections to these people for the letter. If your program still exists, it can attest to your satisfactory completion of it, right?

That’s my understanding too. Why do we care about the now retired PD?

 

[futuredo32]

You don't need to have personal connections to these people for the letter. If your program still exists, it can attest to your satisfactory completion of it, right?

I have a diploma that says that. I can get a glowing letter from her. My CV looks awful I took time off during med school to care for my Grandma among other things. But I was a really good resident. I need her to sell me. The 2 interviews I got were because the PDs knew her. I didn't get a spot but at least an interview.

 

[MacDonaldTriad]

You are putting up a lot of barriers up that aren't real, and you are going in a direction that isn't rational. A diploma shows you finished a residency, but a letter that includes a summary of your performance over the last 4 years is very different. Your file will have 8 semiannual review summaries in it to build a picture of your value as a resident no matter who the director is now. Drop the PA nonsense and apply to family medicine if that is what you want to do. There are many practicing psychiatrists out there that don't have boards. You are now licensed. You are fully qualified to supervise a PA for gosh sakes.

 

[futuredo32]

You are putting up a lot of barriers up that aren't real, and you are going in a direction that isn't rational. A diploma shows you finished a residency, but a letter that includes a summary of your performance over the last 4 years is very different. Your file will have 8 semiannual review summaries in it to build a picture of your value as a resident no matter who the director is now. Drop the PA nonsense and apply to family medicine if that is what you want to do. There are many practicing psychiatrists out there that don't have boards. You are now licensed. You are fully qualified to supervise a PA for gosh sakes.

Msucom reads your letters to you or at least they used to. Her letter made me sound like the world's best resident on planet earth. This has gotten so off topic and way more personal than intended. My CV has a lot of red flags my low board scores on the Comlex my fault. I'm not going to get into thr rest. Thanks so much for the helpful and thoughtful advice. Congratulations to all who have passed the boards and best of luck to those who are taking it this year.

 

[MacDonaldTriad]

Good luck and I hope you pass as well.