Applying to psychiatry and a backup specialty?

[Sasaro]

.

---

Members don't see this ad.

 

[ace_inhibitor111]

Hi all, I'm a US MD M4 looking to apply to psychiatry. My stats are below average numerically and above average in other aspects (past experience, research, LORs, etc.). Given the COVID situation this cycle, I have been advised by multiple career advisors and my home psychiatry PD that the match will likely be quite focused on the numerical aspects of applications. This makes sense to me - as there will be no cost of traveling to interviews, it won't be surprising if most people apply to a much greater number of program than usual. This will force PDs to sort applications by Step 1 scores and grades, and my Step1 was sadly quite subpar.

Given how much more competitive psychiatry has become in the past couple of years, I am therefore worried that I may not match. Geography is a very important factor to me for family reasons, and I will be applying outside the region where I attend medical school. Even worse, there are fewer than a dozen psychiatry residencies that are geographically 'good' for me. Sadly, I cannot even show interest in these programs by doing aways this year. In short, the match will be an uphill battle.

As a result, I am strongly considering dual-applying to another specialty, namely EM. I like both specialties equally, and may even have a better shot at EM if I'm honest with myself (but I think I would be ultimately happier in psych). Aside from the obvious extra effort applying to 2 specialties requires, are there any other reasons this is a bad idea? I have been warned by advisors that it would look very bad to be 'caught' by PDs while dual-applying, and they wouldn't take my application seriously if that were to happen. However, I have a hard time seeing how they could possibly 'catch' a dual-applicant this year short of applicants willingly disclosing it. All interviews will be virtual and I doubt that psych and EM PDs communicate much. I also frankly don't see why it is considered 'bad' to apply to 2 specialties - I think it is perfectly reasonable to have multiple interests and aptitudes, and although I prefer psych, I would be happy in either specialty.

Can anyone advise on how to proceed in this situation? I would especially love to hear from anyone involved in residency adcoms, as well as anyone who dual-applied themselves.

They can see your transcript and if you have an EM or psych AI on there, they can call the other department. At least that seems to be the obvious way of doing it, not sure if anyone does though.

 

[Sasaro]

They can see your transcript and if you have an EM or psych AI on there, they can call the other department. At least that seems to be the obvious way of doing it, not sure if anyone does though.

Fortunately I doubt this will be an issue. Everyone at my school is required to do an EM AI, and a bunch of our non-psych people also do psych AIs.

 

[Taddy Mason]

Granted I don’t know what you’re considering “below average”, but if you’re concerned about matching due to being below average number-wise for psych Idk that EM is necessarily the best idea as a “back-up” specialty. That said applying to more than one specialty is completely reasonable.

 

[wolfvgang22]

I don't see anything wrong with this plan. I don't know how competitive EM is compared to psychiatry now, though. In my day a decade ago it was more competitive than psychiatry. Is EM the ideal back up plan to psych? It's great that you like both equally.

I wouldn't volunteer the information about applying to more than one specialty, but if anyone finds out and asks why you are applying to both specialties I'd be straight up honest about it. Your thought process is logical and well thought out and anyone you'd want to work with for 4 years will respect that.

Caution: As you may know, being picky about geographical location is a main reason why many people with less competitive applications fail to match. Life is risk.

 

[TexasPhysician]

What “region” is important here?

 

[Merovinge]

I read your post to say that you are effectively thinking of dual-applying to two mid-tier competitive specialties because you have a very fixed geographical range but may be a below mid-tier applicant so adding a second mid-tier specialty will double your chances to match (if EM=psych for competitiveness). If this is an effective summary of what you are saying then you need to be prepared to not match. The two ways you mitigate this is either A) choose a backup specialty that is less competitive or B) expand your geographical range.

There's a lot missing from your description to give you more exact advice but definitely agree with Taddy and wolf above.

 

[nexus73]

I would interview internal med or family med also, I'd worry about going completely unmatched.

If you matched IM/FM/EM, it wouldn't be unheard of to do one year in one of those specialties then transfer to PGY-2 psychiatry. Who knows you may fall in love with EM and not want to transfer anyhow. Long term, some people will go through a full residency then come to psych as PGY-2 and complete that. Or some people do EM and work for 10 years, get burnt out, then retrain in psych in their mid to late 40's after loans have been paid off. Lots of permutations.

 

[Sasaro]

What “region” is important here?

Does it matter? Not CA if you're asking about competitiveness.

 

[Sasaro]

I read your post to say that you are effectively thinking of dual-applying to two mid-tier competitive specialties because you have a very fixed geographical range but may be a below mid-tier applicant so adding a second mid-tier specialty will double your chances to match (if EM=psych for competitiveness). If this is an effective summary of what you are saying then you need to be prepared to not match. The two ways you mitigate this is either A) choose a backup specialty that is less competitive or B) expand your geographical range.

There's a lot missing from your description to give you more exact advice but definitely agree with Taddy and wolf above.

Makes sense, thanks for the feedback. The career advisors at my school have told me that psych is expected to be actually MORE competitive than EM this cycle. I was also told that I shouldn't have an issue matching EM, and there are many more available EM residencies - many programs have opened up in the last few years, so statistically that would also play in my favor. I don't know how accurate this advice is, unfortunately, but this is why I have been considering EM an 'appropriate' backup.

But you're right that I should also try to expand my geographical range to improve my chances.

 

[TexasPhysician]

Does it matter? Not CA if you're asking about competitiveness.

It matters a lot. You are talking about applying 2 mid-competitive specialties which already isn’t ideal. Add a competitive market and well...you know.

 

[psyguru]

Hi all, I'm a US MD M4 looking to apply to psychiatry. My stats are below average numerically and above average in other aspects (past experience, research, LORs, etc.). Given the COVID situation this cycle, I have been advised by multiple career advisors and my home psychiatry PD that the match will likely be quite focused on the numerical aspects of applications. This makes sense to me - as there will be no cost of traveling to interviews, it won't be surprising if most people apply to a much greater number of program than usual. This will force PDs to sort applications by Step 1 scores and grades, and my Step1 was sadly quite subpar.

Given how much more competitive psychiatry has become in the past couple of years, I am therefore worried that I may not match. Geography is a very important factor to me for family reasons, and I will be applying outside the region where I attend medical school. Even worse, there are fewer than a dozen psychiatry residencies that are geographically 'good' for me. Sadly, I cannot even show interest in these programs by doing aways this year. In short, the match will be an uphill battle.

As a result, I am strongly considering dual-applying to another specialty, namely EM. I like both specialties equally, and may even have a better shot at EM if I'm honest with myself (but I think I would be ultimately happier in psych). Aside from the obvious extra effort applying to 2 specialties requires, are there any other reasons this is a bad idea? I have been warned by advisors that it would look very bad to be 'caught' by PDs while dual-applying, and they wouldn't take my application seriously if that were to happen. However, I have a hard time seeing how they could possibly 'catch' a dual-applicant this year short of applicants willingly disclosing it. All interviews will be virtual and I doubt that psych and EM PDs communicate much. I also frankly don't see why it is considered 'bad' to apply to 2 specialties - I think it is perfectly reasonable to have multiple interests and aptitudes, and although I prefer psych, I would be happy in either specialty.

Can anyone advise on how to proceed in this situation? I would especially love to hear from anyone involved in residency adcoms, as well as anyone who dual-applied themselves.

other back up options for psych are addiction medicine, doing family medicine and doing a 2 year "psychiatry lite" fellowship, doing neuro and then a neuropsychiatry/behavioral neuro fellowship and PMR or Nuero and a BIM (brain injury) fellowship.