Chance at top programs in the northeast?

[woof_iamadog]

I am an MS4 who will be applying to psych. To be honest, I feel a lot worse about my residency application than I did about my med school app. I really want to go to a top program in the northeast, but I don't want to apply unrealistically. Give it to me straight.

School: Top 10 school in the NE
STEP 1: 235
STEP 2CK: Didn't take yet
Preclinical: P/F, passed everything
Clerkships: Honors in Neuro and Psych, High Pass in everything else
Research: 1 psych research experience w/ abstract/presentation, 1 non-psych research experience
Extracurriculars: Barely anything. Some psych-related volunteering.
LORs: very solid

I feel like I'm below average for top programs, but would appreciate advice. Specifically curious about my chances at NYU, Cornell, Yale, Mt. Sinai...

Thanks.

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[soporific]

It's worth applying - you have a shot at some interviews at least based on your school, but on paper probably wouldn't be ranked at the top unless you shine in your interviews. If you're open to Boston that would add 4 more programs that meet your criteria.

 

[woof_iamadog]

I'm open to anywhere in the NE and would appreciate suggestions for programs that might be plausible.

 

[Mass Effect]

No one's going to tell you not to apply. It would be foolish not to apply if that's where you want to go. Scores mean next to nothing in regular psych programs. At the top programs, they count only a little more. Knock them dead at the interview and you'll impress them.

 

[box8psych]

I would be curious the reason you are dead set (if you are) on a "top" program? Are you particularly interested in research? Want to eventually take a leadership position in academic medicine? If not, you will get good clinical training at many other programs that are not necessarily considered to be elite. Just a thought.

To answer your question, agree with the sentiment that it won't hurt to apply. You'll likely get yourself at least a couple of interviews at those programs, and then it's just about making the best impression you can to shoot up their rank list (which admittedly will be challenging with Zoom interviews).

 

[Stagg737]

I would be curious the reason you are dead set (if you are) on a "top" program? Are you particularly interested in research? Want to eventually take a leadership position in academic medicine? If not, you will get good clinical training at many other programs that are not necessarily considered to be elite. Just a thought.

This is a good point. If you're gunning for a top research program, your app sounds like it's lacking in that area and that you'd have a difficult time. If you're not gung ho on research, I'd apply to wherever you want. You're not a rockstar, but you sound solid enough that you'd probably have a chance almost anywhere (especially with connections to the area or programs). You won't know if you don't apply though. Apply conservatively and then throw in all your "dream programs". It may cost a little extra, but could also yield very worthwhile results.

 

[clozareal]

What makes you feel like you're below average for NYU, Cornell, Yale, Mt. Sinai?

From what you've shared so far, your application seems pretty on par with the average to slightly above average candidate for those programs. Coming from a top medical school and having a physical location connection to that program/area are probably the biggest factors in your advantage that put you above someone with higher stats coming from elsewhere.

 

[soporific]

I'm open to anywhere in the NE and would appreciate suggestions for programs that might be plausible.

agree with others just apply where you want. Options include columbia, mgh/mclean, cha, bidmc, bwh, penn, pittsburgh, hopkins, brown. Other good programs that may be slightly less competitive like einstein, zucker hillside, BU, uconn, maine, umass, UMD.

 

[kopftonmd]

From what you've shared so far, your application seems pretty on par with the average to slightly above average candidate for those programs. Coming from a top medical school and having a physical location connection to that program/area are probably the biggest factors in your advantage that put you above someone with higher stats coming from elsewhere.

Out of curiosity, what is the "average" candidate for these top tier programs? (If one can even distill the complexities of a whole application into a stereotypical candidate)

 

[reca]

What makes you feel like you're below average for NYU, Cornell, Yale, Mt. Sinai?

From what you've shared so far, your application seems pretty on par with the average to slightly above average candidate for those programs. Coming from a top medical school and having a physical location connection to that program/area are probably the biggest factors in your advantage that put you above someone with higher stats coming from elsewhere.

How long has it been since you applied for residency? Outside of coming from a top school and being from that region, his stats seem well below average for those programs. Step 1 score of 240 seems to be a cutoff for a lot of top programs. I know a lot of people with 230-239 Step 1’s and a lot more research than OP who didn’t get interviews from any of those programs they applied to.

 

[FlowRate]

Out of curiosity, what is the "average" candidate for these top tier programs? (If one can even distill the complexities of a whole application into a stereotypical candidate)

I've reviewed applications for one of these "top" programs, but only at the "already selected for interview" stage. So I don't know what the average applicant is like, but have some sense of the average candidate. It's tempting to remember the really impressive profiles which probably actually only make up 30% of the interview list (max, possibly less) but are memorable because they're competitive for literally any specialty (260-270+ steps, everything Honors, glowing LORs, evidence of research productivity or other leadership etc.). But there were plenty of people with psych-average step scores or even being below-average in clinical grades for their school (but usually those candidates are from highly ranked med schools). Post-interview rank was totally based on interview performance and not everyone at the top was a superstar. A lot were, but one wonders whether that's interviewers being biased by an impressive application or, my theory, that the same attributes which lead to superstar clinical performance are also highly correlated with impressive interview performance.

It's probably also helpful to remember that those 30% are, in the grand scheme of annual psych applicants, a much smaller fraction. Most of that cohort probably interviews at other top institutions. And sometimes they interview at places you wouldn't expect AND choose to go to those places. One of the most impressive applicants I ever interviewed matched in VT. Another chose a somewhat less prestigious program that had a strong psychotherapy focus. The point being that you don't have to be an ultra-superstar to be competitive for most places. Except for maybe McL/Columbia/Cornell.

 

[clozareal]

How long has it been since you applied for residency? Outside of coming from a top school and being from that region, his stats seem well below average for those programs. Step 1 score of 240 seems to be a cutoff for a lot of top programs. I know a lot of people with 230-239 Step 1’s and a lot more research than OP who didn’t get interviews from any of those programs they applied to.

I've also reviewed applications for one of these "top" programs within the past few years and concur with what FlowRate has said. We've had many candidates who made it to the interview stage having failed step 1 the first time, having less than stellar LORs (one was less than 5 sentences), and passing all rotations except for honoring or high passing psychiatry. I've interviewed many candidates with 210s-220s Step 1 score who did a stellar job with their interview and ended up being ranked highly.

On this forum or elsewhere online it may seem like OP has below average stats because of the selection bias of neurotic people online who post to these websites with stellar stats claiming that they are average. The stats look different on the residency program side of things.

To your last point, these top programs consider number of research publications, but it's not the number 1 prioritized part of the application unless you're applying for their research track.

 

[JKinSC]

having less than stellar LORs (one was less than 5 sentences)

Oh, that poor bastard

 

[reca]

I've also reviewed applications for one of these "top" programs within the past few years and concur with what FlowRate has said. We've had many candidates who made it to the interview stage having failed step 1 the first time, having less than stellar LORs (one was less than 5 sentences), and passing all rotations except for honoring or high passing psychiatry. I've interviewed many candidates with 210s-220s Step 1 score who did a stellar job with their interview and ended up being ranked highly.

On this forum or elsewhere online it may seem like OP has below average stats because of the selection bias of neurotic people online who post to these websites with stellar stats claiming that they are average. The stats look different on the residency program side of things.

To your last point, these top programs consider number of research publications, but it's not the number 1 prioritized part of the application unless you're applying for their research track.

And this is at one of those programs?

I'm not basing my view on what I read online, I'm basing it on my own experience and that of people from my school. It's a US MD school in the midwest, pretty middle of the road. The only people in my year and the 2 years before and after me who got interviews from the programs he mentioned are ones who had Step 1's over 240. Not one person with a Step 1 lower than that was given an interview at those programs (and multiple people applied to at least one of them).

Sure, if you're coming from a top school, programs will be more lenient with stats. But I find it hard to believe that while psychiatry has gotten more competitive in the past few years, these programs have relaxed their criteria.

Speaking from my own personal experience, I had a Step 1 of 239, very good LOR's, lots of ec's and did not get an interview at Yale, Cornell, or Sinai. I know many peers with similar stats who had the same experience.

 

[Taddy Mason]

And this is at one of those programs?

I'm not basing my view on what I read online, I'm basing it on my own experience and that of people from my school. It's a US MD school in the midwest, pretty middle of the road. The only people in my year and the 2 years before and after me who got interviews from the programs he mentioned are ones who had Step 1's over 240. Not one person with a Step 1 lower than that was given an interview at those programs (and multiple people applied to at least one of them).

Sure, if you're coming from a top school, programs will be more lenient with stats. But I find it hard to believe that while psychiatry has gotten more competitive in the past few years, these programs have relaxed their criteria.

Speaking from my own personal experience, I had a Step 1 of 239, very good LOR's, lots of ec's and did not get an interview at Yale, Cornell, or Sinai. I know many peers with similar stats who had the same experience.

Anecdotally, between co-residents and med students affiliated with my residency I’m aware of >15 people with sub 240s step scores, little to no research, and who were from “mid/low” tier schools who interviewed at those programs. Someone in the class above me in med school (no name, middle of nowhere school) interviewed at all the Harvard programs, Yale, NYU, Cornell, Mt. Sinai, and Columbia and matched into one of those NY programs with no research, 220s/230s steps, and no connections. Yes, Psych is getting more competitive but “top” programs aren’t off limits to applicants who aren’t in the upper echelon.

 

[asdf123g]

You go to a top 10 program...the top programs all like to recycle their own in the Top 40 or so. I wouldn't worry too much unless there is some red flag you forgot to mention. Seriously you'll have so many interviews you won't know what to do.

 

[Lexanoob]

I'm at one of these programs and have some friends at other "top" programs. To be honest, I'm not even really sure what it means to be "top" except maybe w/r/t having more research funding and people doing this kind of stuff, which is something to think about in deciding whether or not you want to go to what of these programs, as that might be more so the emphasis in what they might be looking for in residents. For example, to describe one culture of these one of these programs, do you want to be at a program where all of your co-residents are doing research and the 'successful' resident looks like someone that has published a bunch of research papers in XYZ field and going to start a lab? Would you feel OK/ supported in this environment if you didn't have the slightest interest in bench work, and "just" wanted to be a great clinician?

Anyway, to get back to your question, as mentioned above, I think there's really less of an emphasis on grades and measurable metrics, and more so an emphasis on intangibles and whether or not they might see you become a part of their academic pipeline as a "leader" of some sort, whether it be in research, education, social justice, public education/media, etc. For my particular program, from what I hear, we're recruiting for people with a demonstrated interest in something that the department hopes to grow in (keeping it as vague as a can for to remain anonymous, but I hope this gets the point across) + great interpersonal skills.

Therefore, I think it's hard to assess your competitiveness, or rather anyone's, because of this, since I think there's this logic that we use to think about applying to psychiatry as similar as applying in internal medicine or other fields where there is more of an emphasis on these measures, and where being "more competitive" equates to scoring higher on these metrics, and what's easier to communicate and summate who are as an human being than your step scores, clerkship scores and # of papers you got ? not throwing any shade, as we take what we can get. But, I also think this thinking also might be a reason why we hear terrible stories of people who score 250+, apply only to top programs, and don't match. It's not all about numbers, especially in psychiatry.

In the end, I think it's really all about fit, and if what you present in your application, essay and interview happens to be what the program wants/ matches the culture. Just be yourself, reflect on what you want, and show it to the program, and I'm hopeful you'll end up where you fit/will be the most happy!