Child Fellowship Question Competitiveness?

[SaiyanSammy]

I'm curious to anyone who is familiar with the competitiveness of the fast-track Child Psychiatry Fellowship process. How competitive is it? I know it's not as competitive as most other things in medicine, but is it to the point that most people with decent stats get their top choice? Is it easy to get a "prestigious" fellowship program if that's what you want? Is there any reason to be stressed, or does every qualified applicant match where they want to?

Also, what makes an applicant competitive for child? I've heard it's just "having a pulse" and being in psych residency, but is that actually true or are there more ways to prepare (my program has pretty weak child psych rotations)?

Thanks.

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[Celexa]

Sometimes programs fill entirely internally, or majority internally. So you arent guaranteed your top choice and there's an element of pure luck in terms of what year you apply. But overall, it is not competitive and there are many spots available after the match, so getting a position is not difficult and most people match high on their list.

 

[kelminak]

In a similar position applying this upcoming cycle. I've dug through a LOT on the internet, and to summarize: If you want to get in *anywhere*, you are guaranteed to find a position. It is LEAGUES easier than matching residency. A lot of programs don't even fill at all. However, if you want to match a big-name program, then you need to step up a bit and check the typical boxes that you would for residency.

My program is weak as well and I want to go somewhere better too. If you put out enough applications, you're almost guaranteed to get into a nice program as long as you're willing to be flexible on geographics, cost of living, etc. I'm not sure that I'm flexible with that, so my options might be more limited.

 

[comp1]

It's probably the most competitive of the psych fellowships, right? I know forensics has some sites that are competitive, but I think child still beats it. Of course that's still not saying much, just that it's harder to get into than many programs like CL that regularly don't fill for years and years.

 

[TexasPhysician]

The competitiveness is highly variable from year to year. The same program can take anyone with a pulse 1 year and impossible the next. Programs highly prefer internal applicants. It doesn’t matter what your CV may be, an internal applicant will likely trump you.

Let’s say a program has 6 child spots. If 8 internal residents want those spots (fast track or not), you have almost no chance. They may not even interview outside candidates. Everyone has their own interests that they develop during residency. If the same program has 0 internal applicants, they know they will struggle to fill and will likely start interviewing everyone. English proficiency becomes optional.

Most applicants don’t want to move elsewhere for 2 years for fellowship. Local preferences thus determine competitiveness. Harvard could have called me up personally and offered a spot without interviewing for 3x the pay, and I wouldn’t have been interested.

 

[SaiyanSammy]

The competitiveness is highly variable from year to year. The same program can take anyone with a pulse 1 year and impossible the next. Programs highly prefer internal applicants. It doesn’t matter what your CV may be, an internal applicant will likely trump you.

Let’s say a program has 6 child spots. If 8 internal residents want those spots (fast track or not), you have almost no chance. They may not even interview outside candidates. Everyone has their own interests that they develop during residency. If the same program has 0 internal applicants, they know they will struggle to fill and will likely start interviewing everyone. English proficiency becomes optional.

Most applicants don’t want to move elsewhere for 2 years for fellowship. Local preferences thus determine competitiveness. Harvard could have called me up personally and offered a spot without interviewing for 3x the pay, and I wouldn’t have been interested.

Are you implying that even Harvard might have trouble filling?

 

[Bartelby]

Are you implying that even Harvard might have trouble filling?

I don't think that's it. Big-name highly competitive programs usually have more interest than spots, and will usually fill.

The point is more that because many fellowships are small they can fluctuate in competitiveness. For example one year maybe there are no internal applicants and outside applications are pretty weak, making the program an easy match. Next year they have enough good internal applicants to fill and are fully committed to them, making that same program an impossible match. So whether most program are "competitive" has a lot to do with luck of the draw with the small sample of applicants who are interested that year.

 

[TexasPhysician]

Are you implying that even Harvard might have trouble filling?

I don’t yearly analyze the Harvard child program, so maybe the top 5 well known programs are exceptions. It isn’t a guarantee that Harvard will fill all of its psych fellowships in general. I have also known some Harvard fellows that were probably bottom 5% of all residency graduates in knowledge. Harvard would rather have someone than not fill, like the vast majority (if not all) of programs.

Fellowships in general are significantly less competitive than gen psych. If you want a specific program, it can be impossible due to internal applicants, but finding a highly regarded program in general is significantly easier.

 

[Merovinge]

As above, smaller numbers make for more variation outside of your control. You will get a spot but you cannot predict an exact program and chances for any given year. It's actually a great reminder about the role of chance, 1 year earlier or later could be the difference between Harvard and Ohio, life or death, finding the perfect partner or the worst relationship from Hell.

 

[comp1]

As above, smaller numbers make for more variation outside of your control. You will get a spot but you cannot predict an exact program and chances for any given year. It's actually a great reminder about the role of chance, 1 year earlier or later could be the difference between Harvard and Ohio, life or death, finding the perfect partner or the worst relationship from Hell.

I mean yeah, but ultimately you'll still be practicing child and making (relative to the area) the same amount of money regardless of where you match in the end. I'd probably never rank both (or either, snow, ew) Harvard and Ohio together. Instead, I'd advise people to primarily limit it by the geography of where you want to live, likely for the rest of your life. The majority of your week should not be work, even in fellowship and the majority of your life is certainly not fellowship. The big consideration is that you're statistically extraordinarily likely to stay where you last trained, even if it's not your current intent. On the plus side, there are a lot of child fellowships out there so applicants could probably find one geographically appropriate that doesn't autofill with internals. Chance has a part here, but I think less than a lot of other places in life.

 

[Merovinge]

I mean yeah, but ultimately you'll still be practicing child and making (relative to the area) the same amount of money regardless of where you match in the end. I'd probably never rank both (or either, snow, ew) Harvard and Ohio together. Instead, I'd advise people to primarily limit it by the geography of where you want to live, likely for the rest of your life. The majority of your week should not be work, even in fellowship and the majority of your life is certainly not fellowship. The big consideration is that you're statistically extraordinarily likely to stay where you last trained, even if it's not your current intent. On the plus side, there are a lot of child fellowships out there so applicants could probably find one geographically appropriate that doesn't autofill with internals. Chance has a part here, but I think less than a lot of other places in life.

Yes this is the right take. I just saw the question about getting someone's top choice. That clearly is not happening for all applicants and trying to point out why. Glad my pick of Ohio as an "ew" state came out right, although the state is better than people give credit for, particularly when it comes to medicine.

 

[SaiyanSammy]

So what are the "most competitive" fellowships and which ones have the best resources for learning?

My guess is: Harvard-BCH, Harvard-MGH, Yale, New York Presby, UCLA-DG, UCSF. I can't find a lot about the quality of programs in general nor rankings.

 

[comp1]

It's kind of ironic how people are directed to focus on their own personal geographic needs, but then immediately jump to competitiveness or some intangible quality aspect. That gunner mentality just will not die...

 

[SaiyanSammy]

It's kind of ironic how people are directed to focus on their own personal geographic needs, but then immediately jump to competitiveness or some intangible quality aspect. That gunner mentality just will not die...

I'm single and unattached and have no geographic preferences because I've lived in places with 4 seasons and I've lived in a desert. My current program has no child psych fellowship and little guidance. It's tough to go through every single program in the U.S. and half the websites don't have much info. It does help to streamline the process.

 

[kelminak]

I'm single and unattached and have no geographic preferences because I've lived in places with 4 seasons and I've lived in a desert. My current program has no child psych fellowship and little guidance. It's tough to go through every single program in the U.S. and half the websites don't have much info. It does help to streamline the process.

It helps to make a spreadsheet with all the programs and narrow it down that way. A lot of upfront time to get it set up, but that's how my wife did it and we've had much more success getting it to a reasonable amount. It's ultimately going to come down to preference because your options are a lot wider if you're not constrained geographically.

 

[Merovinge]

I'm single and unattached and have no geographic preferences because I've lived in places with 4 seasons and I've lived in a desert. My current program has no child psych fellowship and little guidance. It's tough to go through every single program in the U.S. and half the websites don't have much info. It does help to streamline the process.

I have yet to meet someone ending adult residency with no geographic preference. You don't care if it's a huge city or a tiny spot surrounded by cornfields (and I do have a lot of respect for Iowa for the record). You don't envision yourself living in a part of the US? Because where you do fellowship will greatly improve the odds of landing a superior job in that area. The East coast is a lot different than So Cal which is a lot different than the South which is a lot different than the midwest etc. I would try to really get some idea where you might like to live and use that to get a 10-20 programs and then go from there.

 

[SaiyanSammy]

I have yet to meet someone ending adult residency with no geographic preference. You don't care if it's a huge city or a tiny spot surrounded by cornfields (and I do have a lot of respect for Iowa for the record). You don't envision yourself living in a part of the US? Because where you do fellowship will greatly improve the odds of landing a superior job in that area. The East coast is a lot different than So Cal which is a lot different than the South which is a lot different than the midwest etc. I would try to really get some idea where you might like to live and use that to get a 10-20 programs and then go from there.

Like most of us, I've been in school and in-training for so long that I feel like I could survive two last years of training even if it was at the University of Solitary Confinement and be fine with it as long as the training was good and made me feel prepared. So geographically, even if it's a place I don't want to be in, I'll be *okay* with it. I don't expect life to be exciting. I just want good training to prepare me for what's to come and to have all doors open when I'm finished. That said, you bring up a really good point about landing a job where you train and if that's true that's definitely something that deserves more thought. So I'm hearing put more thought into where I want to be in 2 years from now.

 

[Merovinge]

Like most of us, I've been in school and in-training for so long that I feel like I could survive two last years of training even if it was at the University of Solitary Confinement and be fine with it as long as the training was good and made me feel prepared. So geographically, even if it's a place I don't want to be in, I'll be *okay* with it. I don't expect life to be exciting. I just want good training to prepare me for what's to come and to have all doors open when I'm finished. That said, you bring up a really good point about landing a job where you train and if that's true that's definitely something that deserves more thought. So I'm hearing put more thought into where I want to be in 2 years from now.

Yes and honestly the data on this stuff is pretty wild. You are dramatically more likely to work in the city you complete training in. You will also enjoy the time more if the city fits you as a person, and when you are happier you learn better and practice better medicine. You are also more likely (in my opinion based on no studies that I can cite) to find a good fit for a partner when you are happier. I'm an average looking chap on a good day but I have a deep and true joy for my work and somehow that's always helped me punch up a bit in the mating pool.

 

[comp1]

I think the OP needs to develop a geographic preference. It's really that simple. The training just doesn't matter that much. Where you are extremely likely to spend the entirety of the rest of your life does. You should not be thinking about where you're okay staying for two years. You should be thinking about where you want to live the entirety of the rest of your life because statistically, that's really what is at stake. As others have said, you DO have preferences, you just need to lay them out. Do you want to live in a big city or rural? Do you want to be near a coast? Can you tolerate snow? Can you tolerate humidity? Are you completely and utterly estranged from all family so that there's no chance you could ever rekindle any sort of relationship and thus it REALLY doesn't matter where they are? Do you have no friends anywhere in the country? These sort of things might not matter at all for 2 years (although I would personally disagree), but they sure as heck matter a lot when considering the rest of your life and honestly, each one matters more than the training variation between child programs.