Chances for derm/psych?

[whataremychancesdermpsych]

Hi, I could really use some help right now. I'm a 4th year medical student (T25-ish school) who recently decided not to pursue a surgical subspecialty. I was wondering whether I had a chance at dermatology or psychiatry. It's late in the cycle and I would have to complete a dermatology sub-i this month if it was a possibility for me to match, if not I'll apply for psychiatry. I would honestly be very happy in either one.

Clinical grades: P/HP/H. P in peds/IM/surgery. HP in most other clerkships. No H, resulting in bottom quartile on MSPE (but with positive comments) This would be my big red flag for dermatology. However, I worked hard to improve and have performed very well in my surgical sub-internships in my fourth year.
USMLE step 1/2: 253/263
1 first author article publication, 1 first author case report, 3 or 4 second author publications, all in surgical subspecialty unrelated to dermatology.

I think that based on my clinical grades (bottom quartile) and relatively low research publications outside of dermatology, it would be unlikely that I would match. If I had a chance, I would definitely try. Dermatology is the reason I went to medical school, I just had trouble finding research and found a surgical subspecialty research lab instead, then decided last minute after sub-i's that it wasn't for me.

I would really appreciate some advice/guidance!

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[operaman]

Yours is the situation for which research years were made. I think you’re right that derm chances are low and it’s very last minute. Take a year and do derm research somewhere, rock some sub-Is and you might have a shot.

Psych would be more of a sure thing though given your scores. Derm would still carry some risk of not matching for anyone even after a research year.

 

[LeaveNoTrace]

I don't know about derm; however, you should get psych interviews if you have decent LORs and a realistic application list. Don't just apply to Ivy League programs and you're good there. Good luck. Interview at and rank some community programs to cover your flank.

 

[mrbreakfast]

You match to derm either with strong letters/ties or with a strong academic CV, and it doesn't seem like you would necessarily have either. If you want to do derm, a extra year (or even two) might be helpful.

 

[GoSpursGo]

I agree, this late in the game if you want to switch to derm you need to take a year to get field-specific research and make connections.

You can match psych, no doubt.

 

[Taddy Mason]

Psych isn’t unreasonable but you should apply broadly and have a solid explanation for “why psych?” which is going to be heavily scrutinized at many programs, especially if your app and research is heavy with derm and/or whatever surgical specialty you had been planning for.

 

[voxveritatisetlucis]

Depends on what T25 means. If it’s Harvard JHU UCSF etc then good shot for derm but if it’s like UVA tier then probably not (nothing against UVA)

 

[FalconSlice]

Even though I agree with the advice above that if you have your mind dead set on derm, doing a research year is compulsory for you, I have my reservations:

1. Even with a killer research year, your chances are still very low for derm given your other info.

2. Sounds like you’re NOT dead set on derm but rather a cush lifestyle (assuming that’s why you’re deciding between derm and psych) which is OK.

TLDR: what I would do if I were you: do psych, have a (relatively) stress-free mind, and enjoy your life.

 

[Taddy Mason]

…2. Sounds like you’re NOT dead set on derm but rather a cush lifestyle (assuming that’s why you’re deciding between derm and psych) which is OK….

Lifestyle as the primary motivating factor, implicit or explicit, is going to be a red flag for many psych programs, which is why OP needs to have a convincing explanation for “why psych?” and not rest his/her laurels on Step scores and unrelated research.

 

[GoSpursGo]

Depends on what T25 means. If it’s Harvard JHU UCSF etc then good shot for derm but if it’s like UVA tier then probably not (nothing against UVA)

I actually disagree. We all know that the most prestigious schools really help students match, but you still have to do the steps necessary to prove your commitment to the field and make connections. If you do those things AND come from a top school your chances of matching are much higher than other schools, but prestige by itself isn’t a substitute for doing the usual steps needed to secure a competitive specialty

 

[esob]

Without a convincing "why psych" PS, your scores alone might not get you interviews at desirable psych programs.

 

[Hzreio]

Without a convincing "why psych" PS, your scores alone might not get you interviews at desirable psych programs.

Lol just do a few electives and get some letters. High board scores arent prohibitive from psych...

 

[deleted1168269]

How are you a 4th year with a scored step 1? Did your school do an accelerated MS1 year and you took Step 1 before Jan 2022?

 

[collegestud2013]

Based on Step scores alone and 2022 Charting the outcomes data, your probability of matching are around 76-80% for dermatology and 99% for Psychiatry.

For Psych, as long as you have done at least one rotation and have at least one Psych LOR, and you apply broadly you should likely match somehwere.

However, for dermatology I suspect the chances will be lower than what what your Step scores alonepredict, given the lack of derm-specific research and being 4th quartile on your MSPE. Would not even bother to go for derm at this point if you haven't done a rotation yet and have no related research. Even after a research year, you chances would still be somewhat uncertain unless you make significant connections with the institution you end up doing research at, and they have an in-house dermatology program that will take you. Keep in mind that your research year would be after you already graduated from med school, and you would be applying as a USMD graduate instead of a senior (which in itself hurts chances slightly).

Hopefully, your reasons for wanting dermatology are not the superficial reasons for which derm gets a lot attention among med students (eg high pay per hour and good lifestyle with minimal call responsibilities).

 

[esob]

Based on Step scores alone and 2022 Charting the outcomes data, your probability of matching are around 76-80% for dermatology and 99% for Psychiatry.

For Psych, as long as you have done at least one rotation and have at least one Psych LOR, and you apply broadly you should likely match somehwere.

However, for dermatology I suspect the chances will be lower than what what your Step scores alonepredict, given the lack of derm-specific research and being 4th quartile on your MSPE. Would not even bother to go for derm at this point if you haven't done a rotation yet and have no related research. Even after a research year, you chances would still be somewhat uncertain unless you make significant connections with the institution you end up doing research at, and they have an in-house dermatology program that will take you. Keep in mind that your research year would be after you already graduated from med school, and you would be applying as a USMD graduate instead of a senior (which in itself hurts chances slightly).

Hopefully, your reasons for wanting dermatology are not the superficial reasons for which derm gets a lot attention among med students (eg high pay per hour and good lifestyle with minimal call responsibilities).

Many psych programs require two psych LORs, so the OP should be shooting for two or they will have a substantially smaller pool of programs. The NRMP psych match results for 2023 demonstrate an 86% match rate for US MD applicants. Having been through the process and currently discussing "what makes a good applicant" with colleagues, the "why psych" will more significantly impact many adcoms than high board scores or a bottom quartile on your MSPE.






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[Taddy Mason]

Many psych programs require two psych LORs, so the OP should be shooting for two or they will have a substantially smaller pool of programs. The NRMP psych match results for 2023 demonstrate an 86% match rate for US MD applicants. Having been through the process and currently discussing "what makes a good applicant" with colleagues, the "why psych" will more significantly impact many adcoms than high board scores or a bottom quartile on your MSPE.






.

Having been on interview committees at two different residency programs and a fellowship program, I’ve encountered more than a handful of people with 250-270 Step scores, AOA, etc., who were pretty superficial as to why psych in their PS and/or interviews and either had to SOAP or matched at the very bottom of their rank list and were extremely bitter about it, causing performance issues and morale and interpersonal issues with co-residents and faculty.