Away Rotations at Top Psych Programs

[imatelllisa]

I am an MS3 very interested in the top psych programs (MGH/McLean, Columbia) and trying to decide whether it’s worth applying for an away Sub-I to strengthen my chances of interviewing/matching there. More about me:

Step 1: 250+
Clinical Grades: Mostly Honors
Medical School: Mid-Tier
Pre-Clinical Grades: Mostly Honors
AOA: don't know yet
Research: Nothing much

I know away rotations can be a double-edged sword, so I only want to do one if the top psych programs are truly a "reach" for me. Is it worth the risk?

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[TexasPhysician]

I wouldn’t.

 

[dl2dp2]

I disagree. I think it'll help. I would do one at MGH and one at Columbia.

These programs are getting increasingly competitive, and typically go after MD/PhDs and others with significant research background, or people with other degrees (i.e. MBA) that carry a cachet. You have very little to lose by doing an away, especially your grades suggest you are a high quality med student (i.e. friendly, conscientious, etc), and likely will do well at aways. I discourage people from doing aways if they are bad students to begin with and will likely f it up.

You don't want to be like, come match day, and end up at X program, and be all like, huh i wonder if i did do that away if i'd end up at MGH. Your numbers are likely still better than the vast majority of applicants, but likely the top programs will prefer someone with slightly lower numbers but lots of other desirable traits.

I would also start looking at doing a small research project this summer, and develop a "narrative" of your application to prepare for your interviews.

 

[Amygdarya]

Great stats, but I agree with sloux that for places like Columbia and MGH stats alone are not enough. However, I would argue that research is not absolutely necessary for this kind of places - rather, they look for a passion, a significant involvement with something, hopefully psychiatry related, which can be research but can also be significant leadership activities like founding a homeless outreach program etc. Which are not the kind of things (same goes for any kind of decent research) that can be done in the 8 months between now and ERAS submission. In which case doing strong aways at these and hopefully getting letters from them is a good way to get noticed.

 

[psychattending]

If you are AOA, it is probably not worth it, especially if all you want to get out of a sub-I is an invitation to interview. Just send the program a nice email come next September indicating why you are really interested in their program.

 

[imatelllisa]

Thanks to all for the very helpful thoughts and feedback! The goals of the away sub-I would be 1.) to increase the chances of getting an interview and 2.) to hopefully be ranked more highly by the program as a result of being a "known quantity."

Even though stats alone may be enough to get the interview, I get the impression that a significant percentage of the current residents (especially at MGH) are PhDs, Ivy Leaguers, or have something else that makes them uniquely compelling. Since I have none of these, I am wondering if establishing a relationship with the program would be my best shot.

 

[Amygdarya]

Thanks to all for the very helpful thoughts and feedback! The goals of the away sub-I would be 1.) to increase the chances of getting an interview and 2.) to hopefully be ranked more highly by the program as a result of being a "known quantity."

Even though stats alone may be enough to get the interview, I get the impression that a significant percentage of the current residents (especially at MGH) are PhDs, Ivy Leaguers, or have something else that makes them uniquely compelling. Since I have none of these, I am wondering if establishing a relationship with the program would be my best shot.

Top programs like MGH and Columbia looking for applicants who "have something else that makes them uniquely compelling" is a great way of putting it. Think about it this way: these programs want to produce *future leaders of psychiatry* and, since past success is the best predictor of future success, they look for people who have a track record of significant involvement with something (which can be but doesn't have to be research). You have an impressive academic track record, but what are you going to bring to their table, ie what is your passion? You may already have something like this already, I dunno; I recommend thinking about it. Having a coherent story of why you want to go into psychiatry and what you want to achieve there helps with your residency application in general, and especially for top programs.

Which leads me to a question: Why do you want to go to these programs specifically? What is it that you expect to get from them that other "simply top" programs can't give you other than the marginally higher prestige? Think about it, too.

On a different note, if anything, doing away rotations at top programs can be a good educational experience. I haven't done any aways myself but have heard people having great experiences at their MGH aways specifically (though they don't necessarily end up matching at MGH).

 

[surfguy84]

Top programs like MGH and Columbia looking for applicants who "have something else that makes them uniquely compelling" is a great way of putting it. Think about it this way: these programs want to produce *future leaders of psychiatry* and, since past success is the best predictor of future success, they look for people who have a track record of significant involvement with something (which can be but doesn't have to be research). You have an impressive academic track record, but what are you going to bring to their table, ie what is your passion? You may already have something like this already, I dunno; I recommend thinking about it. Having a coherent story of why you want to go into psychiatry and what you want to achieve there helps with your residency application in general, and especially for top programs.

Which leads me to a question: Why do you want to go to these programs specifically? What is it that you expect to get from them that other "simply top" programs can't give you other than the marginally higher prestige? Think about it, too.

On a different note, if anything, doing away rotations at top programs can be a good educational experience. I haven't done any aways myself but have heard people having great experiences at their MGH aways specifically (though they don't necessarily end up matching at MGH).

Any idea if prior careers are taking into consideration when assessing for that "something else that makes them uniquely compelling"?

I don't have research or heavy academic accolades (aside from good grades/board scores in med school). I did however spend some years between UG and med school as CEO of a successful tech start up. Not sure how much this will carry me in residency interviews...

 

[Amygdarya]

Any idea if prior careers are taking into consideration when assessing for that "something else that makes them uniquely compelling"?

I don't have research or heavy academic accolades (aside from good grades/board scores in med school). I did however spend some years between UG and med school as CEO of a successful tech start up. Not sure how much this will carry me in residency interviews...

Yes, especially if your prior experience somehow fits into your future plans in psychiatry.

 

[TexasPhysician]

Top programs like MGH and Columbia looking for applicants who "have something else that makes them uniquely compelling" is a great way of putting it. Think about it this way: these programs want to produce *future leaders of psychiatry* and, since past success is the best predictor of future success, they look for people who have a track record of significant involvement with something (which can be but doesn't have to be research). You have an impressive academic track record, but what are you going to bring to their table, ie what is your passion?

That’s also a reason to not do an away. The applicant has excellent scores and likely AOA. Odds are pretty good about getting an interview. That leaves only 1 day of needing to prove/fake your value.

If you dedicate 1 month there, there is plenty of time to prove you are something special or disappoint.

An away at MGH would appear to make more sense for someone with a step 1 of 225 and 8 first author publications. The average step 1 could go overlooked or filtered out.

Just my thoughts though.

 

[Mass Effect]

Are you better in person than you are on paper? If not, don't do it.

In my case, I likely wouldn't have even gotten an interview where I ultimately matched if I hadn't done an away. I perform MUCH better than my med school record would imply, so doing aways helped me. I know some people who screwed up their aways though and ended up not even getting interviews at some places they rotated, despite decent grades/scores.

 

[uhmocksuhsillen]

Are you better in person than you are on paper? If not, don't do it.

In my case, I likely wouldn't have even gotten an interview where I ultimately matched if I hadn't done an away. I perform MUCH better than my med school record would imply, so doing aways helped me. I know some people who screwed up their aways though and ended up not even getting interviews at some places they rotated, despite decent grades/scores.

I see this a lot; are you better on paper than in person, etc but not sure what to make of it. I think my exam scores and grades are better than I am clinically. That said, I'm pretty outgoing and generally well liked...I seem to get along with almost all my attendings and nurses.

Should I shoot for an away or will I just expose my weak points, i.e. clinical skills.

 

[Evidence Based]

I see this a lot; are you better on paper than in person, etc but not sure what to make of it. I think my exam scores and grades are better than I am clinically. That said, I'm pretty outgoing and generally well liked...I seem to get along with almost all my attendings and nurses.

Should I shoot for an away or will I just expose my weak points, i.e. clinical skills.

Think it really is 6 one way, half a dozen the other with away rotations. I would be inclined to slightly advise you against, but you really seem to want to do them. Given what looks like an impressive application already, I doubt an away would substantially increase your chances of interviewing, but it could. Given it seems like you do well clinically, I doubt it would decrease your chances either, but if you happen to rotate with an attending you don't jive with then it might.

Which leads me to a question: Why do you want to go to these programs specifically? What is it that you expect to get from them that other "simply top" programs can't give you other than the marginally higher prestige? Think about it, too.

Still wondering about this question. What is it about Columbia or MGH that makes you want to go there? Aways do come with significant cost (in time, energy, and money), so I would strongly advise against doing these rotations just because you want to get into a "top program" just for the sake of doing so. You might spend two months doing aways, go on interviews, and realize that you actually want to go to UCSF, Penn, or Hopkins (or God forbid any number of equally strong or stronger programs that aren't at "famous" places).

tl;dr sounds like you'll do super well in the application process, I doubt an away will really add much unless you have a really compelling reason to want Columbia or MGH that's not just wanting to go to a big name program.

 

[MacDonaldTriad]

If in parallel universes, you do a sub-I somewhere and don't get in and you don't do a sub-I at the same place and you do get in, would you want to be there? If after a month of exposure you are judged to be inferior, or some faculty or resident is really annoyed by your presence? I would move on anyway. Only do Sub-Is at clinical experiences you want, what this does to your chances of getting in is to sharpen the picture for both sides, but this is more fate than free will.

 

[chajjohnson]

Could be worth it so see if you really want to go somewhere. You can't get an honest look at a program from one interview day.

 

[imatelllisa]

Great question. As an MS3, I obviously have very limited knowledge of programs besides what I hear through the grapevine. So I am really in no position to decide which programs I like or dislike.

My major concern is keeping doors open. Honestly, I think I'm strong enough on paper that if I fall in love with another reputable program (Hopkins, for example), I will have a solid chance of matching there (provided the interview goes well).

However, I'm not sure whether this is the case with MGH and Columbia, since they seem to be even more competitive than the rest- hence my question about whether an away rotation would be worthwhile. I want to make sure I have a shot at matching to one of those programs, in case one of them does turn out to be the best fit for me.

Still wondering about this question. What is it about Columbia or MGH that makes you want to go there? Aways do come with significant cost (in time, energy, and money), so I would strongly advise against doing these rotations just because you want to get into a "top program" just for the sake of doing so. You might spend two months doing aways, go on interviews, and realize that you actually want to go to UCSF, Penn, or Hopkins (or God forbid any number of equally strong or stronger programs that aren't at "famous" places).

tl;dr sounds like you'll do super well in the application process, I doubt an away will really add much unless you have a really compelling reason to want Columbia or MGH that's not just wanting to go to a big name program.

 

[notdeadyet]

I would recommend an away.

OP- You have awesome stats, and I have no doubt you'll match somewhere amazing (assuming you cut as great an impression in person as you likely do on paper.

But you're looking at the tippiest top programs like MGH and Columbia. The top 8 or so psychiatry residencies get the same 100 applicants who apply to most of theses programs. They all vie for them. Then they rank them. You'll likely be ranked by every program you interview at, but the question is whether or not you will be ranked high enough to match.

How does that get determined? Well, it varies by program, but they will basically look at the gestalt of your application and then compare you against peers. How much you'll move up the rank ladder depends on how much folks will push for you in Admissions Committee. And people will almost ALWAYS push harder for people they know.

At even the greatest of programs, administrations have been burned by someone who looked great on paper and then turned out to be a "problem child" on arrival. This is why programs really like individuals who have been "field tested." How do they work under pressure? How do they get along with the residents, faculty, nurses, administrative staff? Do they act professional and get their work done on time?

Your background will make for an interesting talking point (and maybe more if you are going to leverage your professional experience and can show you've done so in medical school). You have an amazing Step 1. How much this will help varies by program, but at many places, they consider anything above 230 or so great and then don't quibble the points because they don't really matter. Your medical school is "mid-tier" which will knock you down a few pegs at some programs because places like MGH and Columbia are not going to be totally devoid of snobbery.

So if your question is whether you need to do audition rotations to match somewhere great, the answer is a resounding "no." If your question is whether you should do audition rotations at MGH and Columbia if you want to match at those two programs, the answer is "yes." And that's advice I'd give to anyone, regardless of stats. Let them get to know you.

 

[Amygdarya]

And whatever you decide, keep in mind that even a good away rotation doesn't guarantee a match at that place. I know people who were strong applicants from prestigious med schools who did aways at MGH and loved their experiences but matched elsewhere. Somewhere very very good but not MGH.

Basically, as notdeadyet said, if you're personable, with your academic achievements you'll match somewhere great, though you cannot be guaranteed a match at MGH or Columbia.

 

[psychattending]

My gut tells me that you are seriously underselling yourself (as are a lot of the posters).

If you are AOA, there will probably be something like 30-50 such individuals going into psych. Per NRMP in 2016 https://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf there were 46. Your Step 1 will also likely put you in the top 10% of next year's class. People like that will go to their top ranked program barring some major problem. You guys are also seriously overcalling the ability of top programs to get MD/PhDs. There are probably something like 20-40 of those individuals each year. In 2016 there were 29. The top major academic institutions will each on average get their fair share of such people. Thus the top programs will each only get 1-3 of these individuals each year. Go look at MGH's website. The number of MD/PhDs in their classes are: PGY1s (1); PGY2s (1); PGY3s (2); PGY4s (2). That is out of a yearly class size of 16. Thus, 14-15 of the people at MGH each year do not have a PhD (most also do not go on to do research for a career). The biggest thing they have in common is that most are from the East coast (even from mid-tier places). That is not a reflection of MGH preferring such people but applicants from the East coast wanting to stay on the east coast.

Programs know that where somebody grew up and went to medical school are two of the big (if not biggest) factors that determine where top people go. The perverse problem programs face then (especially when applicants are applying to obscenely large number of places) is that if a top-notched person is not likely going to rank the school number one, then that program is by the odds better served not inviting that person for an interview but rather going for a weaker individual. Thus, the problem for really strong people is not matching at their top ranked place but rather getting an interview at places. There will be some places that choose to not offer an interview to strong people just because they suspect that they are really #10 on that person's list.

 

[Monocles]

OP don't do it. Your stats are rockstar and the odds are against you and here's why.

Without doing an away, statistically someone with your app will get an interview from those top programs.

However, if you do an away --
1) It goes well -- doesn't help you that much because they were probably going to interview you anyway
2) It goes poorly -- during some sort of internal meeting/email, some resident that you didn't along with will probably say "I remember imatelllisa! That kid's hair was stupid/liked a different sports team than me/gave off weird vibes" and all it takes is for one random resident to give arbitrary negative feedback to the PD and your app can be sunk.

Not to echo the other posters too much but with your stats you can hurt yourself much more than you can help yourself.

Also as an anecdote -- friends of mine from my state school (midwest) with MUCH worse stats than yours, 230/240s, nothing stellar in terms of extracurriculars have interviewed at MGH without problems.

 

[notdeadyet]

Thus, the problem for really strong people is not matching at their top ranked place but rather getting an interview at places. There will be some places that choose to not offer an interview to strong people just because they suspect that they are really #10 on that person's list.

A place like MGH or Columbia is not going to not interview someone out of fear they'll be ranked poorly. Middle tier psych programs may play those kind of games, but "s/he's too good for us" is not something that's going to cross the mind of folks at the programs the OP is talking ab out.

 

[notdeadyet]

Not to echo the other posters too much but with your stats you can hurt yourself much more than you can help yourself.

Ouch. This is the kind of advice that costs a lot of great applicants their top choice.

The advice to strong applicants of don't-audition-at-your-dream-program-lest-you-screw-it-up may be fair advice for gaming interview chances; if someone is pretty toxic and it doesn't show on LORs, they may torpedo a chance to get an interview at Acme by doing an away at Acme.

But the point of the interview is to lead to a match. And many great people who might have matched at a program did not because they ended up in a lot of Ad Com deliberations of "A and B are both great, but we know A..." You don't have to be flawless on an away, the point is for them to see you fit in well and will be a good resident.

I struggle to find a good reason for a strong applicant without obvious characterological defects to not do an audition rotation at a top 5 program, other than the obvious ones like cost and time. From the AdCom perspective you can only advocate so strongly for someone you don't know.

 

[3lefts]

Also, don’t think you need to have perfect social skills to shine at an away rotation. I nearly talked myself out of a very enjoyable and educational opportunity because I was under this impression. You just have to be pleasant to work with. Of course, it could hurt you if you’re needy or a know-it-all, and it could help you if you are funny or fun to work with. But I’m quite shy, and I’m pretty sure I don’t exude quiet confidence, so it was a benefit to have a month to get to know residents and attendings. I think that in the end it was easier for me to come off as warm and thoughtful over the course of my away rotation than it was on one-day interviews.

 

[MacDonaldTriad]

Ouch. This is the kind of advice that costs a lot of great applicants their top choice.

The advice to strong applicants of don't-audition-at-your-dream-program-lest-you-screw-it-up may be fair advice for gaming interview chances; if someone is pretty toxic and it doesn't show on LORs, they may torpedo a chance to get an interview at Acme by doing an away at Acme.

But the point of the interview is to lead to a match. And many great people who might have matched at a program did not because they ended up in a lot of Ad Com deliberations of "A and B are both great, but we know A..." You don't have to be flawless on an away, the point is for them to see you fit in well and will be a good resident.

I struggle to find a good reason for a strong applicant without obvious characterological defects to not do an audition rotation at a top 5 program, other than the obvious ones like cost and time. From the AdCom perspective you can only advocate so strongly for someone you don't know.

This.

 

[FlowRate]

I overall agree with lots of the earlier sentiments. Candidates who manage to get excellent clinical grades are not likely to be bad with people. That's just not how the core clinical year works at most places--the most important thing is whether people liked you. For an already strong applicant, I really think aways should be thought of as a mutual experience of goodness-of-fit. It could help you or hurt you and either outcome is likely to be the right thing for both parties.

 

[psychattending]

A place like MGH or Columbia is not going to not interview someone out of fear they'll be ranked poorly. Middle tier psych programs may play those kind of games, but "s/he's too good for us" is not something that's going to cross the mind of folks at the programs the OP is talking ab out.

My experience indicates that you are incorrect in your statement.

 

[MacDonaldTriad]

The highest rejection sensitivity coefficients cloister in the tallest ivory towers. It is a logical defense strategy.

 

[clausewitz2]

The highest rejection sensitivity coefficients cloister in the tallest ivory towers. It is a logical defense strategy.

What good is being all the way up on that shining alabaster spire if you cannot bask in the adulation of the lumpenproletariat below? How now shall you live if the enthusiasm of their praises should wane?

 

[TexasPhysician]

I struggle to find a good reason for a strong applicant without obvious characterological defects to not do an audition rotation at a top 5 program, other than the obvious ones like cost and time. From the AdCom perspective you can only advocate so strongly for someone you don't know.

Do the applicants with character defects know it?

I’ve seen it go both ways. A poor applicant got into my program on the strings of an awesome audition rotation. I’ve seen a great applicant on paper alienate residents to the point that the residents helped to keep the applicant off the rank list. This applicant had no idea.

 

[notdeadyet]

Do the applicants with character defects know it?

I’ve seen it go both ways. A poor applicant got into my program on the strings of an awesome audition rotation. I’ve seen a great applicant on paper alienate residents to the point that the residents helped to keep the applicant off the rank list. This applicant had no idea.

Ah, that's the rub, isn't it?

I would hope, that as a budding psychiatrist, someone would have enough observational ability to recognize that they typically don't get along well with others (even if they lack the insight to understand why). These folks should probably avoid audition rotations. And consider a research career...

For the vast majority though, I think that auditions do you a favor. If you're a strong applicant and rub everyone wrong on the away, it's probably not a good fit (and you will have PLENTY of better fitting options). No program is so strong as to justify a bad fit because much of the value of the residency is the doors kicked open by the folks you work for and work with; having a bad reputation at an MGH is much weaker sauce than having a good reputation at a program three or four slots down.

Sigh... insight...

 

[freakusmcgee]

Bumping this thread to get some advice, as I'm also wondering if I should do away rotations.

My stats aren't as impressive as the OP's but I am an MD/PhD student with a strong research portfolio relating to psychiatry. I did my PhD in psychology and should have two pubs in mental illness / fmri research (fingers crossed for current revision), have received several competitive grants including an F30 from NIMH, 10-15 conference presentations, competitive travel awards to psychiatry conferences, etc. My grades are not stellar but I should be in the second quartile (50-75%) by the end of third year. I have strong clinical evals and LORs but my shelf scores took a hit after 5 years of PhD. My Step 1 score is 248. I will definitely *not* be AOA!

All in all I suspect I will be pretty competitive at academic research-focused programs. I would like a shot at the top 10 programs but I'm not in love with any particular program, and I care more about quality of research and "fit" than I do about reputation. I really don't have any geographic preferences. I'm coming from a mid-tier school in the midwest though I have lived on the East Coast. I'm told that away rotations matter because, e.g., California schools "won't even interview" someone who didn't at least do an away in California, but I have no idea how true that is or if it's true for MD/PhD students. I'd rather not do an away rotation because of the expense and the time I could be spending here, on research projects and/or just enjoying my last months of free time. But if I really thought it would make or break my application to, like, an ENTIRE geographic region, I would do it.

Any and all thoughts are welcome, as I don't really know anyone in my situation so I don't have much recourse for advising here!

 

[OldPsychDoc]

Your PhD portfolio should open all the doors for you that an away rotation would.
I'd be very surprised if you don't get interviews at at least 9 of your top 10--whatever those are.

 

[clausewitz2]

Bumping this thread to get some advice, as I'm also wondering if I should do away rotations.

My stats aren't as impressive as the OP's but I am an MD/PhD student with a strong research portfolio relating to psychiatry. I did my PhD in psychology and should have two pubs in mental illness / fmri research (fingers crossed for current revision), have received several competitive grants including an F30 from NIMH, 10-15 conference presentations, competitive travel awards to psychiatry conferences, etc. My grades are not stellar but I should be in the second quartile (50-75%) by the end of third year. I have strong clinical evals and LORs but my shelf scores took a hit after 5 years of PhD. My Step 1 score is 248. I will definitely not be AOA!

All in all I suspect I will be pretty competitive at academic research-focused programs. I would like a shot at the top 10 programs but I'm not in love with any particular program, and I care more about quality of research and "fit" than I do about reputation. I really don't have any geographic preferences. I'm coming from a mid-tier school in the midwest though I have lived on the East Coast. I'm told that away rotations matter because, e.g., California schools "won't even interview" someone who didn't at least do an away in California, but I have no idea how true that is or if it's true for MD/PhD students. I'd rather not do an away rotation because of the expense and the time I could be spending here, on research projects and/or just enjoying my last months of free time. But if I really thought it would make or break my application to, like, an ENTIRE geographic region, I would do it.

Any and all thoughts are welcome, as I don't really know anyone in my situation so I don't have much recourse for advising here!

I was a MD/PhD from a mid-tier no-name med school with weaker Step 1, lower preclinical grades, and a less robust CV than yours. My interview invite:application ratio was well over 90%. The work for you will be to figure out your preferences, not getting your foot in the door.

That said, I don't know you. Maybe it is painful to talk to you in person, I don't know. I would talk on a lower tier but still respectable academic program or two to be safe. my home program made it clear I would match there if I wanted to, but that they did not really expect this. Maybe yours is similar?

 

[Beepboop]

I’m also going to join the bandwagon of asking for away rotation advice and would appreciate any help!

I have much worse stats than the previous posters and am wondering about what type of away I should apply to. I’m a DO student at a well reputed DO school. My step 1 is a 231, I hope to do a lot better on step 2 (but I know everyone says this lol). Preclinically I was in the top 15% of my class and I’ve gotten honors in all of my clinical blocks so far with good evals and strong LORs. I’ve done some addiction research but I don’t have any publications. I do have a lot of psych based volunteer work and EC leadership activities though.

Basically, I’m wondering if I should do an away at a top program that I would have no chance of getting into so that I could get a strong LOR that would open more doors for me or if I should focus on doing aways at places that would actually accept me.

Sorry to hijack this thread!! Any advice would be appreciated as my school is of no help at all!!

 

[dl2dp2]

My stats aren't as impressive as the OP's but I am an MD/PhD student with a strong research portfolio relating to psychiatry. I did my PhD in psychology and should have two pubs in mental illness / fmri research (fingers crossed for current revision), have received several competitive grants including an F30 from NIMH, 10-15 conference presentations, competitive travel awards to psychiatry conferences, etc.

Do you plan to continue a career in academia? If so, you should do away rotations. Not in terms of enhancement of matching, but for creating network for research. Relationship is the most important in academia.

While you'll most likely be interviewed by all the top programs at the end of the day, whether you get ranked by any particular program depends on your relationship with insiders, as well as the quality and nature of the pool of MD/PhDs of that particular year.

 

[Celexa]

I’m also going to join the bandwagon of asking for away rotation advice and would appreciate any help!

I have much worse stats than the previous posters and am wondering about what type of away I should apply to. I’m a DO student at a well reputed DO school. My step 1 is a 231, I hope to do a lot better on step 2 (but I know everyone says this lol). Preclinically I was in the top 15% of my class and I’ve gotten honors in all of my clinical blocks so far with good evals and strong LORs. I’ve done some addiction research but I don’t have any publications. I do have a lot of psych based volunteer work and EC leadership activities though.

Basically, I’m wondering if I should do an away at a top program that I would have no chance of getting into so that I could get a strong LOR that would open more doors for me or if I should focus on doing aways at places that would actually accept me.

Sorry to hijack this thread!! Any advice would be appreciated as my school is of no help at all!!

You sound like a strong applicant.

I can only speak to my knowledge of my home program (very well-respected academic, but not in the top 5-10 programs by anyone's definition) which does take a small number of DOs...away rotations go a long way here and absolutely contribute to DOs matching here. Whereas based on what he's told me I doubt a big name LOR would do much from our PDs perspective. That would lead me to recommend that you focus on programs that have at least a few DOs among their residents, but YMMV.

 

[freakusmcgee]

Thanks everyone! Yeah, I am going to apply widely, including state schools, mid-tier schools, all over the country. I have a strong research network already from conferences and many years of training, lol. But I'm not really in love with any particular place, and I'm not sure how much an away rotation will give me research connections as much as clinical connections at that particular institution. It would be a no-brainer if I really wanted to go to a specific school, but I'm just not sure. Maybe Stanford? McLean? I dunno.

 

[Armadillos]

I haven’t read all the responses, but I had slightly better application than you and got tons of advice on SDN not to risk doing an away. I think this is due to SDN overemphasizing board scores and the fact that majority of posters aren’t at “top 5” programs so may underestimate how competitive they are. Ultimately I did not match at my top choice.

Now that I’m heavily involved in admissions several years down the road, I see how important doing aways can be. Someone can have a 260+ and 2 publications and sort of blur from memory. But someone who did an away will have residents and attendings knocking on our door advocating for them.

 

[dl2dp2]

I'm not sure how much an away rotation will give me research connections as much as clinical connections at that particular institution. It would be a no-brainer if I really wanted to go to a specific school, but I'm just not sure. Maybe Stanford? McLean? I dunno.

Why don't you do one at Stanford and one at McLean?

 

[Amygdarya]

Thanks everyone! Yeah, I am going to apply widely, including state schools, mid-tier schools, all over the country. I have a strong research network already from conferences and many years of training, lol. But I'm not really in love with any particular place, and I'm not sure how much an away rotation will give me research connections as much as clinical connections at that particular institution. It would be a no-brainer if I really wanted to go to a specific school, but I'm just not sure. Maybe Stanford? McLean? I dunno.

1. It's programs, not schools. Residency is a job - apprenticeship if anything - not a school. You'll be a grown up, start thinking like one.

2. Medical school ranking/prestige doesn't always reflect the presumed quality/prestige of the corresponding psychiatry (or any other specialty) residency. In other words, I don't understand the appljcants' obsession with Stanford (unless your specific research interest alighn with their faculty). If anything, UCSF has a much stronger reputation in psychiatry.

3. More to the point, since you may be strongly interested in a research career, look for strong research tracks (there was a thread recently - writing from my phone, can't look up) and what kind of research is done at any program of your interest. From what I gather (as someone with significant research experience who interviewed for research tracks as well as "regular" tracks), alignment of research interests between the program and the applicant goes a long way.

 

[OldPsychDoc]

Thanks everyone! Yeah, I am going to apply widely, including state schools, mid-tier schools, all over the country. I have a strong research network already from conferences and many years of training, lol. But I'm not really in love with any particular place, and I'm not sure how much an away rotation will give me research connections as much as clinical connections at that particular institution. It would be a no-brainer if I really wanted to go to a specific school, but I'm just not sure. Maybe Stanford? McLean? I dunno.

Use that network. Who can they help you connect to? Where are the psych-oriented research labs you'd like to potentially end up doing research fellowships with? Who would you identify as potential mentors to start your academic career? These are more important and more specific questions that apply to a residency search for MD/PhD types.
(Also frankly, as a PD at a supposedly 'mid-tier' program, if I saw someone with your CV applying, particularly one with no visible geographic reason to apply here, I'd be inclined to assume that you really aren't specifically interested in us, and I would rather extend the interview to someone who more fits the profile of a future community clinician.)

 

[Amygdarya]

(Also frankly, as a PD at a supposedly 'mid-tier' program, if I saw someone with your CV applying, particularly one with no visible geographic reason to apply here, I'd be inclined to assume that you really aren't specifically interested in us, and I would rather extend the interview to someone who more fits the profile of a future community clinician.)

I had this experience from the applicant side of things, even within my geographic region. I.e. my advisor, surprised by me not getting interviews from my presumed "safeties", reached out to some of these programs and heard back that I'd been passed on because of my research background and the assumption that I'd be interested in a academic career (which is very true).

I'd also like to add to OPD's great suggestion to reach out to your research contacts that it's not unusual for research applicants to "cold" email PDs, research program directors and individual faculty if your research interests strongly align with them.

I'm sure that with your research accomplishments you'll have great success with your residency application.

 

[MacDonaldTriad]

"don't risk taking step II", "don't do an away rotation, they may not like you", these are all good advice if you are deficient in IQ and come across as a jerk. Most of you should not listen to this. PDs are risk aversive and paranoid. Hiding data from them makes our imagination go to much darker places than what the reality normally is. Go ahead and do an away, they may like you. You may even find out that you don't like them, even better to learn.

 

[MacDonaldTriad]

by the way, like most other PDs, on Tuesday I took 3 people off my list because I looked at ERAS and they didn't post step II. If you fail step II, you don't graduate. With hundreds of applicants, why take that chance?

 

[psychattending]

Bumping this thread to get some advice, as I'm also wondering if I should do away rotations.

My stats aren't as impressive as the OP's but I am an MD/PhD student with a strong research portfolio relating to psychiatry. I did my PhD in psychology and should have two pubs in mental illness / fmri research (fingers crossed for current revision), have received several competitive grants including an F30 from NIMH, 10-15 conference presentations, competitive travel awards to psychiatry conferences, etc. My grades are not stellar but I should be in the second quartile (50-75%) by the end of third year. I have strong clinical evals and LORs but my shelf scores took a hit after 5 years of PhD. My Step 1 score is 248. I will definitely *not* be AOA!

All in all I suspect I will be pretty competitive at academic research-focused programs. I would like a shot at the top 10 programs but I'm not in love with any particular program, and I care more about quality of research and "fit" than I do about reputation. I really don't have any geographic preferences. I'm coming from a mid-tier school in the midwest though I have lived on the East Coast. I'm told that away rotations matter because, e.g., California schools "won't even interview" someone who didn't at least do an away in California, but I have no idea how true that is or if it's true for MD/PhD students. I'd rather not do an away rotation because of the expense and the time I could be spending here, on research projects and/or just enjoying my last months of free time. But if I really thought it would make or break my application to, like, an ENTIRE geographic region, I would do it.

Any and all thoughts are welcome, as I don't really know anyone in my situation so I don't have much recourse for advising here!

Agree with OPD you will get a lot of interview invites and will likely end up at your top ranked program.

 

[psychattending]

I’m also going to join the bandwagon of asking for away rotation advice and would appreciate any help!

I have much worse stats than the previous posters and am wondering about what type of away I should apply to. I’m a DO student at a well reputed DO school. My step 1 is a 231, I hope to do a lot better on step 2 (but I know everyone says this lol). Preclinically I was in the top 15% of my class and I’ve gotten honors in all of my clinical blocks so far with good evals and strong LORs. I’ve done some addiction research but I don’t have any publications. I do have a lot of psych based volunteer work and EC leadership activities though.

Basically, I’m wondering if I should do an away at a top program that I would have no chance of getting into so that I could get a strong LOR that would open more doors for me or if I should focus on doing aways at places that would actually accept me.

Sorry to hijack this thread!! Any advice would be appreciated as my school is of no help at all!!

DOs can be trickier in that I am not sure how many programs treat them the same as a MD. If there is a specific program that you want to get into, then doing a rotation there could help you get in there. Doing an away rotation for the reason that you give (getting a good LOR so that you can get an interview elsewhere) is probably not a fruitful strategy and might instead decrease the likelihood of you getting invited to other places. It is likely going to be a rare program that will allow you to do an away rotation there with the intent of not inviting you for an interview. If they believe you are not strong enough for them, then they are not likely going to allow you to do a rotation there as it is just more work for them.

 

[psychattending]

I had this experience from the applicant side of things, even within my geographic region. I.e. my advisor, surprised by me not getting interviews from my presumed "safeties", reached out to some of these programs and heard back that I'd been passed on because of my research background and the assumption that I'd be interested in a academic career (which is very true).

I'd also like to add to OPD's great suggestion to reach out to your research contacts that it's not unusual for research applicants to "cold" email PDs, research program directors and individual faculty if your research interests strongly align with them.

I'm sure that with your research accomplishments you'll have great success with your residency application.

This is one of the ways in which the personal statement can be important. You should be telling the programs what you are interested in doing. When I find an applicant whose interests align with our strengths, then I am more likely to invite that applicant.

 

[MacDonaldTriad]

I'm not very involved in undergraduate medical education, but my peers that are complain that there is very little information about potential sub-I performance to judge who should get a rotation and who shouldn't. Schools tell us that everyone is above average.

 

[freakusmcgee]

(Also frankly, as a PD at a supposedly 'mid-tier' program, if I saw someone with your CV applying, particularly one with no visible geographic reason to apply here, I'd be inclined to assume that you really aren't specifically interested in us, and I would rather extend the interview to someone who more fits the profile of a future community clinician.)

Is that just because you're a community-oriented program, not a research program? I'm assuming that because I am a strong research candidate, a program that I don't have a geographical link to but make a strong case for my research interest in (Stanford is a good example of this) would be more inclined to invite me for an interview. I can't imagine why having spent a month at Stanford would necessarily help me out at UCSF or UCLA, although I have heard this argument before - "prove that you have an interest in that geographical region with an away rotation." Okay, I guess so?

I mean I'm well aware of the importance of networking, reaching out to PDs, having my advisor reach out if necessary. I'm also well aware of research fit as a concept, and doing my homework and selling my research compatibility with a program in my personal statement. This is how I got into grad school in the first place and frankly, research fit is my main motivator anyway. Given all that I'd be surprised if a PD at a program looked at my personal statement where I make the case that I'm a strong research fit and said "eh but you've never lived in Southern California / Portland / Texas / wherever so therefore you could not possibly be interested in our program bye." An away seems like a good thing to do if I'm in love with ONE place, but right now I don't have one top choice.

I know the cost of an away pales in comparison to med school and application costs, but I'm not in debt and I've lived on a stipend for 8 years. It really is a factor for me.

 

[OldPsychDoc]

Is that just because you're a community-oriented program, not a research program? I'm assuming that because I am a strong research candidate, a program that I don't have a geographical link to but make a strong case for my research interest in (Stanford is a good example of this) would be more inclined to invite me for an interview. I can't imagine why having spent a month at Stanford would necessarily help me out at UCSF or UCLA, although I have heard this argument before - "prove that you have an interest in that geographical region with an away rotation." Okay, I guess so?

I mean I'm well aware of the importance of networking, reaching out to PDs, having my advisor reach out if necessary. I'm also well aware of research fit as a concept, and doing my homework and selling my research compatibility with a program in my personal statement. This is how I got into grad school in the first place and frankly, research fit is my main motivator anyway. Given all that I'd be surprised if a PD at a program looked at my personal statement where I make the case that I'm a strong research fit and said "eh but you've never lived in Southern California / Portland / Texas / wherever so therefore you could not possibly be interested in our program bye." An away seems like a good thing to do if I'm in love with ONE place, but right now I don't have one top choice.

I know the cost of an away pales in comparison to med school and application costs, but I'm not in debt and I've lived on a stipend for 8 years. It really is a factor for me.

Exactly--if you're presenting yourself as a strong research candidate, they will be FAR less concerned about geography, but as a community PD I'd be inclined to wonder why this exceptionally overqualified person wanted to train in my program. OTOH--if you came to me with a reason for why you think we're a good fit for each other, then by all means I'd want to interview you.