Confused and devastated without a match

[psychiatrywhy]

I am so, so devastated that I did not match into psychiatry. I don't know why I didn't match and I'm looking for any advice moving forward.

I am a USMD student from a top 40 school. I honored my psychiatry rotation. 240 step 1, 253 step 2. I had 10 interviews at lovely programs, and I really felt like they went very well... I'm a pretty nice, normal person. I have a longstanding interest in psychiatry going back to college. Never failed any classes. The deans at my school have no idea how this could happen.

This has been the hardest week of my life. SOAP didn't turn out any offers, and I am just beyond terrified that this will happen again. I have a meeting set up with my home PD to discuss, but until then, I'm still panicking. My current plan is to take a research year and reapply. I just want to be a great psychiatrist

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[docksan]

Well, I'm terrified I matched my lowest-ranked program... and I had no idea how well I did in my interviews. Have you tried calling some of the programs to find out what happened? Is that even a thing?

 

[nexus73]

I’m a ways out of residency, but it always seemed like a good idea was to get into an intern year and look for pgy-2 spots. Or get into family med or IM and look for PGY-2 spots.

 

[m2k]

I am so, so devastated that I did not match into psychiatry. I don't know why I didn't match and I'm looking for any advice moving forward.

I am a USMD student from a top 40 school. I honored my psychiatry rotation. 240 step 1, 253 step 2. I had 10 interviews at lovely programs, and I really felt like they went very well... I'm a pretty nice, normal person. I have a longstanding interest in psychiatry going back to college. Never failed any classes. The deans at my school have no idea how this could happen.

This has been the hardest week of my life. SOAP didn't turn out any offers, and I am just beyond terrified that this will happen again. I have a meeting set up with my home PD to discuss, but until then, I'm still panicking. My current plan is to take a research year and reapply. I just want to be a great psychiatrist

Sorry to hear that, I don't know how competitive psyc is this year. Your scores are good. Seems like your med school didn't guide you 1) 10 interviews are a lot but they prefer 15 interviews. If you applied to all top tier programs, you should have a few lower tier 2) They should have spot at there hospital residency program even if that was not your first choice, you can rank them at the bottom and they can rank higher to get you a spot in case you didn't match anywhere else. 3) During soap they should have advised you take prelim spot if you can't secure Psyc spot.

I would prefer to have Prelim over research and try again next year. Also, I would contact programs where you interviewed close to July to see if someone changed his/her mind to do Psyc,

Good luck!

 

[Sushirolls]

Agreed, lock in a PGY-I, hammer out your step III.

1) it shows you are capable of performing at a resident level
2) it shows you passed your step III and are capable of getting an independent license
3) it opens up the fail safe option of doing some sort of cash only option private practice in something if residency isn't in your future
4) Research year makes sense for those who are med students between their year 2 & 3 like you see at places like Cleveland Clinic Lerner school and others. Not so much as this scenario.

 

[IsWhat]

With those scores and no SOAP offers, you need to have someone evaluate your LORs and application. You also need to have someone conduct a practice interview to determine if that is the problem. Something is not right here.

 

[psychiatrywhy]

With those scores and no SOAP offers, you need to have someone evaluate your LORs and application. You also need to have someone conduct a practice interview to determine if that is the problem. Something is not right here.

I got a SOAP offer from a rad onc program. I ended up turning it down because I just don’t know the field at all. Maybe that was dumb of me, but I ultimately couldn’t do it.
Edit- I guess I meant to say “any psychiatry offers” on my OP

 

[m2k]

With those scores and no SOAP offers, you need to have someone evaluate your LORs and application. You also need to have someone conduct a practice interview to determine if that is the problem. Something is not right here.

I agree

 

[caxoo]

Hey OP, was in the same boat as you last year. STEP 1/2 24x/25x, multiple research and stuff -> 7 interviews, no SOAP offers.

Matched into my #4 today

If you got any questions for next steps I'm here for ya

 

[FlowRate]

Other people covered most of it. But also noting things you omitted:

How were your other clerkships aside from psychiatry? What was your class rank?

 

[psychiatrywhy]

Other people covered most of it. But also noting things you omitted:

How were your other clerkships aside from psychiatry? What was your class rank?

Hi, I high passed every rotation aside from psychiatry. I honored two sub-Is in 4th year though. My school does not internally rank.

 

[Sushirolls]

*face palm* take the rad onc, do CME in psych to assist your patients thru their treatments, and be willing to address SSRI starts and referrals.

 

[psychiatrywhy]

*face palm* take the rad onc, do CME in psych to assist your patients thru their treatments, and be willing to address SSRI starts and referrals.

Well, it's too late now. I had 2 hours to make the decision to change my entire career. I can't think about what-ifs at this point. I just wanted to mention that I *did* receive an offer, so maybe I don't have any giant red flags like others are suggesting.

 

[nexus73]

Well, it's too late now. I had 2 hours to make the decision to change my entire career. I can't think about what-ifs at this point. I just wanted to mention that I *did* receive an offer, so maybe I don't have any giant red flags like others are suggesting.

Is it possible you only interviewed at 10 extremely competitive programs?

 

[Mass Effect]

*face palm* take the rad onc, do CME in psych to assist your patients thru their treatments, and be willing to address SSRI starts and referrals.

I don't know, if I wanted psych, I wouldn't become a rad onc. What I might have done is accepted for the intern year experience (what is intern year like in rad onc anyway?) and then transferred as a PGY 2. But that ship has sailed so no use dwelling.

OP, just because you got rad onc doesn't 100% mean there's no red flag. There could have been a red flag specific to psych (for example, if a letter writer/eval wrote you weren't very empathic or you lacked communication skills) or it could be something that rad onc program overlooked because they needed someone. Who knows? But your case is very unusual. I would be tempted to get new letters to add to the ones you already have if at all possible and mix and match which programs get which letters so that you're not sending the same exact mix of letters to every program.

 

[psychiatrywhy]

I don't know, if I wanted psych, I wouldn't become a rad onc. What I might have done is accepted for the intern year experience (what is intern year like in rad onc anyway?) and then transferred as a PGY 2. But that ship has sailed so no use dwelling.

OP, just because you got rad onc doesn't 100% mean there's no red flag. There could have been a red flag specific to psych (for example, if a letter writer/eval wrote you weren't very empathic or you lacked communication skills) or it could be something that rad onc program overlooked because they needed someone. Who knows? But your case is very unusual. I would be tempted to get new letters to add to the ones you already have if at all possible and mix and match which programs get which letters so that you're not sending the same exact mix of letters to every program.

I would have had to scramble for a prelim year somewhere else. They didn’t have an intern position for me.

My psychiatry letter was written by me, so I know it was good. My letter writer asked me to do it. It felt weird but I’ve heard it’s fairly common practice. Of course I don’t know what was in my other letters but I had a great relationship with all of them... but who knows I guess.

 

[psychiatrywhy]

Is it possible you only interviewed at 10 extremely competitive programs?

I didn’t :/ A few were very competitive programs, but some were more middle ranked.

 

[Mass Effect]

Then it all comes down to interview. That's the only other explanation.

 

[m2k]

I don't know, if I wanted psych, I wouldn't become a rad onc. What I might have done is accepted for the intern year experience (what is intern year like in rad onc anyway?) and then transferred as a PGY 2. But that ship has sailed so no use dwelling.

OP, just because you got rad onc doesn't 100% mean there's no red flag. There could have been a red flag specific to psych (for example, if a letter writer/eval wrote you weren't very empathic or you lacked communication skills) or it could be something that rad onc program overlooked because they needed someone. Who knows? But your case is very unusual. I would be tempted to get new letters to add to the ones you already have if at all possible and mix and match which programs get which letters so that you're not sending the same exact mix of letters to every program.

He got 10 interviews. If there were red flags, no one would interview. Also, unclear why only 10 interviews with this kind of score and interest.

 

[deleted1041468]

He got 10 interviews. If there were red flags, no one would interview. Also, unclear why only 10 interviews with this kind of score and interest.

I don’t feel like the OP applied to enough places and broadly. Like I submitted 60 apps for neuro and got half back on interviews. OPs scores are better than mine. Should have matched and should have ranked 15 places minimum with a mix of university and community. I hope you get it figured out you are clearly intelligent. I’d brush up on my interview skills I am sure it matters more in psych than any other specialties and get new letters. Or if you can still land a prelim year get it and kill it.

 

[solitarius]

Agree that any LOR red flags would reduce the likelihood of 10 interviews.
The psych match has been rough the last two years.

The interview is paramount. Unlike IM or whatever, the intangibles that make a great psychiatrist are not adequately reflected in board scores or in clinical grades. More than the other specialties, this is one where someone with a 21x / 22x with all Ps can be ranked higher than a 25x with multiple Hs.

I also have no doubt that support from your home program during the critical phase of the rank list is also pretty important. Calls are made.

 

[deleted1041468]

Agree that any LOR red flags would reduce the likelihood of 10 interviews.
The psych match has been rough the last two years.

The interview is paramount. Unlike IM or whatever, the intangibles that make a great psychiatrist are not adequately reflected in board scores or in clinical grades. More than the other specialties, this is one where someone with a 21x / 22x with all Ps can be ranked higher than a 25x with multiple Hs.

I also have no doubt that support from your home program during the critical phase of the rank list is also pretty important. Calls are made.

I agree I saw people in my class with lower scores than this by far. Everyone in the match thread is claiming it’s the most competitive ever. I don’t buy it. I think people with higher scores aren’t interviewing as well as they want and in a field where human relationship is paramount you got to interact well.

 

[asdf123g]

Agreed, lock in a PGY-I, hammer out your step III.

1) it shows you are capable of performing at a resident level
2) it shows you passed your step III and are capable of getting an independent license
3) it opens up the fail safe option of doing some sort of cash only option private practice in something if residency isn't in your future
4) Research year makes sense for those who are med students between their year 2 & 3 like you see at places like Cleveland Clinic Lerner school and others. Not so much as this scenario.

usually its said score doesnt matter, you just need to pass. In this instance, would your score matter?
Do DO's have to take the Step III in addition to their COMLEX III? Or is the DO equivalent fine?

 

[asdf123g]

Hey OP, was in the same boat as you last year. STEP 1/2 24x/25x, multiple research and stuff -> 7 interviews, no SOAP offers.

Matched into my #4 today

If you got any questions for next steps I'm here for ya

Do you think having high Step scores and/or lots of research screened you out a lot of programs? (either for being seen as applying only psych as back up or low chance you'd actually attend the program, etc etc)

 

[asdf123g]

Agree that any LOR red flags would reduce the likelihood of 10 interviews.
The psych match has been rough the last two years.

The interview is paramount. Unlike IM or whatever, the intangibles that make a great psychiatrist are not adequately reflected in board scores or in clinical grades. More than the other specialties, this is one where someone with a 21x / 22x with all Ps can be ranked higher than a 25x with multiple Hs.

I also have no doubt that support from your home program during the critical phase of the rank list is also pretty important. Calls are made.

Nevermind the potential bad interviewing. Why did OP not receive more interviews than 10 with such a strong app? Could it be due to post #24?

The grades and boards do show however, a hardworker. If that's the case, the process is more favorable to those who don't kill themselves studying and instead focus on having a good time.

I agree I saw people in my class with lower scores than this by far. Everyone in the match thread is claiming it’s the most competitive ever. I don’t buy it. I think people with higher scores aren’t interviewing as well as they want and in a field where human relationship is paramount you got to interact well.

In psych, if competition cannot self-select based on academic metrics which leads to a much smaller number of people who actually apply (as in say derm, ortho, etc) then its more competitive since now 'everyone' is competitive. You cannot distinguish yourself with hardwork from the crowd. Instead, it may be a disservice to yourself. Networking, connections, being fun to be around, etc seem more important. Shame in a way.

 

[TexasPhysician]

I didn’t :/ A few were very competitive programs, but some were more middle ranked.

Define a few middle ranked.

 

[psychiatrywhy]

Hey all. I reached out to a program I interviewed with and they got back to me. Basically, they said that they were shocked I didn’t match. I was apparently 2 below the last person who matched at the program (and they usually match below my rank # on their list)... they said I interviewed well, the residents liked me, I’m well suited for the field, and that they would interview me again next year. I also reached out to my LOR writers who said they wrote excellent letters.

I think what may have hurt me with number of interviews is that I didn’t have my CK score until mid-November. I suddenly got a few more interviews after I submitted it.

I am keeping an open mind that I may have something wrong with my application, but I’m starting to think that sometimes people just get screwed by the algorithm. It sucks and it’s scary for those of us who want to be psychiatrists. But I have a little more confidence now that this was basically a fluke. I *will* of course do everything I can to strengthen my application with research and practice interviews, but I’ve been getting really positive feedback so far.

 

[MacDonaldTriad]

I just had the same conversation with an unmatched applicant. Some really good people didn't match.

 

[deleted1041468]

Hey all. I reached out to a program I interviewed with and they got back to me. Basically, they said that they were shocked I didn’t match. I was apparently 2 below the last person who matched at the program (and they usually match below my rank # on their list)... they said I interviewed well, the residents liked me, I’m well suited for the field, and that they would interview me again next year. I also reached out to my LOR writers who said they wrote excellent letters.

I think what may have hurt me with number of interviews is that I didn’t have my CK score until mid-November. I suddenly got a few more interviews after I submitted it.

I am keeping an open mind that I may have something wrong with my application, but I’m starting to think that sometimes people just get screwed by the algorithm. It sucks and it’s scary for those of us who want to be psychiatrists. But I have a little more confidence now that this was basically a fluke. I *will* of course do everything I can to strengthen my application with research and practice interviews, but I’ve been getting really positive feedback so far.

That’s a good attitude I commend you on that. Get after it next year.

 

[kopftonmd]

I just had the same conversation with an unmatched applicant. Some really good people didn't match.

Thoughts on why? Vagaries of the process and the algorithm, or some other reason?

 

[Sushirolls]

usually its said score doesnt matter, you just need to pass. In this instance, would your score matter?
Do DO's have to take the Step III in addition to their COMLEX III? Or is the DO equivalent fine?

Step III, level III, what ever you need for your degree to get an independent license.

 

[meow1985]

I am so, so devastated that I did not match into psychiatry. I don't know why I didn't match and I'm looking for any advice moving forward.

I am a USMD student from a top 40 school. I honored my psychiatry rotation. 240 step 1, 253 step 2. I had 10 interviews at lovely programs, and I really felt like they went very well... I'm a pretty nice, normal person. I have a longstanding interest in psychiatry going back to college. Never failed any classes. The deans at my school have no idea how this could happen.

This has been the hardest week of my life. SOAP didn't turn out any offers, and I am just beyond terrified that this will happen again. I have a meeting set up with my home PD to discuss, but until then, I'm still panicking. My current plan is to take a research year and reapply. I just want to be a great psychiatrist

These days it’s not just about grades and scores. It’s about club/society leadership, independent projects, and spearheading various do-gooder initiatives most people don’t have time for because they are actually acquiring the knowledge to be a doctor. You have to be a freak of nature and basically study and do other things. Publications are also somewhat helpful. Oh, and ask people for honest opinions about whether you have any off putting habits or mannerisms you don’t realize you have. One awkward word or behavior at an interview can sink you — that, and just being plain old boring. I’ve been part of these ranking discussions.

Not that I think any of the above is fair or right. The bottom line is the US needs more residency slots yesterday. That’s the real problem here. But until then, you have to play the game and stand out by means of “intangibles.”

 

[TexasPhysician]

Thoughts on why? Vagaries of the process and the algorithm, or some other reason?

Applicants have a poor understanding of how competitive many places have been for years. There are programs that aren’t top 10 in name that are fantastic at selling themselves come interview time. They match the same qualify applicants as top 10 programs. Mid-tier programs are not appropriate safeties.

Many med student advisors still believe the process is similar to what it was 25 years ago when matching was easy.

 

[usoggyojimbo]

Applicants have a poor understanding of how competitive many places have been for years. There are programs that aren’t top 10 in name that are fantastic at selling themselves come interview time. They match the same qualify applicants as top 10 programs. Mid-tier programs are not appropriate safeties.

Many med student advisors still believe the process is similar to what it was 25 years ago when matching was easy.

As someone who will be applying next year with stats that are similar to OPs, I feel nervous because of comments like this and trying to square it with the sentiment that I've heard that low to mid tier places might not want to interview someone with higher than average stats because they don't want to be someone's back up. I guess, overall, I feel uncertain where I should apply in order to have a broad application. I also wonder how much I can trust the opinions of my admin.

 

[Mad Jack]

As someone who will be applying next year with stats that are similar to OPs, I feel nervous because of comments like this and trying to square it with the sentiment that I've heard that low to mid tier places might not want to interview someone with higher than average stats because they don't want to be someone's back up. I guess, overall, I feel uncertain where I should apply in order to have a broad application. I also wonder how much I can trust the opinions of my admin.

Psych residencies are very well aware that they have higher quality applicants than they would have in the past applying. The strength of applicants is going through the roof, even at many community programs

 

[TexasPhysician]

As someone who will be applying next year with stats that are similar to OPs, I feel nervous because of comments like this and trying to square it with the sentiment that I've heard that low to mid tier places might not want to interview someone with higher than average stats because they don't want to be someone's back up. I guess, overall, I feel uncertain where I should apply in order to have a broad application. I also wonder how much I can trust the opinions of my admin.

Mid-tier programs don’t think that way. They grab great applicants, just may not fill with them.
Lower tier programs may want to see a reason to interview you. Places like NYC sometimes feel the city is a big enough draw in itself. Home programs and nearby programs likely assume you want to stay regional. If you want an interview in El Paso, TX and you come from Harvard, you may need to call the PD and have a really good reason why you are worth their time.

 

[FatherPsychiatry]

These days it’s not just about grades and scores. It’s about club/society leadership, independent projects, and spearheading various do-gooder initiatives most people don’t have time for because they are actually acquiring the knowledge to be a doctor. You have to be a freak of nature and basically study and do other things. Publications are also somewhat helpful.

Lets be honest here - the pool is so competitive that many (most?) people have the time to both successfully "acquire the knowledge to be a doctor" while also doing a bunch of "do-gooder initiatives".

Oh, and ask people for honest opinions about whether you have any off putting habits or mannerisms you don’t realize you have. One awkward word or behavior at an interview can sink you — that, and just being plain old boring. I’ve been part of these ranking discussions.

Agreed 100%. I guess mock interviews would be the way to handle this. I imagine an applicant can ask the residents or the PD at their med school if they're willing to do so. Be honest and humble. I don't think most people are boring or annoying intentionally. Again - be humble and willing to listen to feedback, which has the potential for hurting you at your core.

 

[psychiatrywhy]

As someone who will be applying next year with stats that are similar to OPs, I feel nervous because of comments like this and trying to square it with the sentiment that I've heard that low to mid tier places might not want to interview someone with higher than average stats because they don't want to be someone's back up. I guess, overall, I feel uncertain where I should apply in order to have a broad application. I also wonder how much I can trust the opinions of my admin.

I’d suggest over-applying. Trust me, it’s worth the money to avoid going through this hell. The lower tier programs I applied to did not invite me to interview. The programs that got back to me were mid- and higher tier programs. Apply to the lower tier programs too, but they probably won’t even extend an interview.

As an aside, many of my classmates who matched into psychiatry this year fell waayyyy down their rank lists. My home program screwed over many of us who ranked them highly. It’s really unusual for psych applicants at my school.

 

[MacDonaldTriad]

Thoughts on why? Vagaries of the process and the algorithm, or some other reason?

I really don't know. Supply and demand I suppose. A local small medical school had 25% of their graduates go into psychiatry.

 

[hallowmann]

I got a SOAP offer from a rad onc program. I ended up turning it down because I just don’t know the field at all. Maybe that was dumb of me, but I ultimately couldn’t do it.
Edit- I guess I meant to say “any psychiatry offers” on my OP

Why use some of those 45 apps in the SOAP for RadOnc if you don't know the field at all?

I know this is in the past, but maybe there's something there about how you applied or the programs you applied to. I don't know if you were very selective regionally or if you applied to non-, competitive programs in competitive areas, but something doesn't add up.

Maybe it was just the lack of Step 2 though.

usually its said score doesnt matter, you just need to pass. In this instance, would your score matter?
Do DO's have to take the Step III in addition to their COMLEX III? Or is the DO equivalent fine?

If you don't have a categorical program, score matters. Barely any DOs take Step 3 (like 1% of them), Level 3 is all they need. What people really want to see is that you do well and won't have trouble getting licensed.

These days it’s not just about grades and scores. It’s about club/society leadership, independent projects, and spearheading various do-gooder initiatives most people don’t have time for because they are actually acquiring the knowledge to be a doctor. You have to be a freak of nature and basically study and do other things. Publications are also somewhat helpful. Oh, and ask people for honest opinions about whether you have any off putting habits or mannerisms you don’t realize you have. One awkward word or behavior at an interview can sink you — that, and just being plain old boring. I’ve been part of these ranking discussions.

Not that I think any of the above is fair or right. The bottom line is the US needs more residency slots yesterday. That’s the real problem here. But until then, you have to play the game and stand out by means of “intangibles.”

I got to be honest, when we saw our categorical residents this year, they all seemed crazy on paper. They had done amazing things in their lives and did very well academically. My app had a lot of unique things on it, but I was a non-traditional applicant and had a lot of random time. In this kind of climate, I wonder if I would have matched even just a few years later.

 

[solitarius]

• Solid comments all around.
• 10 interviews this year is pretty solid, I would say.
• Compare the match lists from this year to the same say five years ago. Brutal.
• Some places will only interview superstar applicants. Other places take DOs/IMGs/regional candidates/niche applicants.
• Applying to 60 programs may help with your mental sanity, and that is likely a good enough reason to do it. Nonetheless, a shotgun approach may yield one or two interviews at best, or none at all.
• I would avoid aways if at all possible. Nonetheless, some people may have no choice.
• Good luck to everyone applying in the next few years. May The Force Be With You.

 

[Piebaldi]

Well, it's too late now. I had 2 hours to make the decision to change my entire career. I can't think about what-ifs at this point. I just wanted to mention that I *did* receive an offer, so maybe I don't have any giant red flags like others are suggesting.

Not to pile on you in your moment of suffering but that was stupid. Rad onc is a pretty amazing field, not to mention selective - that you would have gotten a rad onc soap offer, with never having had applied to rad onc normally, with no research in rad onc - dude if that's not some sort of Heavenly intervention i don't know what is. Sigh. I'm even regretting this for you. Sigh x10000. Not only would you have had an amazing option but it would have potentially have saved you from another year of applying, etc. Sorry dude not the right decision. I realize nothing you can do about it now but sigh.

 

[Oedipa Maas]

Not to pile on you in your moment of suffering but that was stupid. Rad onc is a pretty amazing field, not to mention selective - that you would have gotten a rad onc soap offer, with never having had applied to rad onc normally, with no research in rad onc - dude if that's not some sort of Heavenly intervention i don't know what is. Sigh. I'm even regretting this for you. Sigh x10000. Not only would you have had an amazing option but it would have potentially have saved you from another year of applying, etc. Sorry dude not the right decision. I realize nothing you can do about it now but sigh.

Actually, I have seen a number of SDN and reddit threads cautioning applicants about Rad Onc in this day and age. Apparently the field is very saturated right now and underwent rapid expansion of residency programs without a similar sized expansion of rad onc attending jobs. It sounds like salaries *in general* are not what they used to be and leave a lot to be desired. Many of the places hiring are not where most people want to live. I also saw a lot of talk about malignant rad onc programs. It sounds similar to what I've heard about law school - the cream of the crop that go to the best programs get their pick of primo jobs, but it's not so prime for everyone else. Maybe OP actually dodged a bullet.

 

[asdf123g]

• Solid comments all around.
• 10 interviews this year is pretty solid, I would say.
• Compare the match lists from this year to the same say five years ago. Brutal.
• Some places will only interview superstar applicants. Other places take DOs/IMGs/regional candidates/niche applicants.
• Applying to 60 programs may help with your mental sanity, and that is likely a good enough reason to do it. Nonetheless, a shotgun approach may yield one or two interviews at best, or none at all.
• I would avoid aways if at all possible. Nonetheless, some people may have no choice.
• Good luck to everyone applying in the next few years. May The Force Be With You.

I disagree.

 

[Piebaldi]

Actually, I have seen a number of SDN and reddit threads cautioning applicants about Rad Onc in this day and age. Apparently the field is very saturated right now and underwent rapid expansion of residency programs without a similar sized expansion of rad onc attending jobs. It sounds like salaries *in general* are not what they used to be and leave a lot to be desired. Many of the places hiring are not where most people want to live. I also saw a lot of talk about malignant rad onc programs. It sounds similar to what I've heard about law school - the cream of the crop that go to the best programs get their pick of primo jobs, but it's not so prime for everyone else. Maybe OP actually dodged a bullet.

Everything is saturated in bigger cities, where people want to be. Lots of jobs in places where no one wants to be -that's for every specialty. The overexpansion happens in every specialty every so often - it happened in Rads, etc. Rad onc obviously tends to be attached to major academic centers, and obviously one rad onc is able to treat many patients so there isn't a need of a ton of rad oncs. This is true. And salaries in every field in Medicine are taking hits - nevertheless, I would say rad onc is a pretty fantastic field, and generally speaking very well compensated. So I don't think OP dodged a bullet. Psych is a perfectly fine field, but with lots of midlevel encroachment -

 

[TexasPhysician]

Actually, I have seen a number of SDN and reddit threads cautioning applicants about Rad Onc in this day and age. Apparently the field is very saturated right now and underwent rapid expansion of residency programs without a similar sized expansion of rad onc attending jobs. It sounds like salaries *in general* are not what they used to be and leave a lot to be desired. Many of the places hiring are not where most people want to live. I also saw a lot of talk about malignant rad onc programs. It sounds similar to what I've heard about law school - the cream of the crop that go to the best programs get their pick of primo jobs, but it's not so prime for everyone else. Maybe OP actually dodged a bullet.

My N-2 is that rad onc makes crazy money with a great lifestyle. That said, the biggest mistake is missing the intern year. My understanding is that rad onc requires an intern year. You can apply to PGY-2 psych spots and not lose any time. Some intern will gladly take that rad onc spot later.

 

[PsychApp777]

Everything is saturated in bigger cities, where people want to be. Lots of jobs in places where no one wants to be -that's for every specialty. The overexpansion happens in every specialty every so often - it happened in Rads, etc. Rad onc obviously tends to be attached to major academic centers, and obviously one rad onc is able to treat many patients so there isn't a need of a ton of rad oncs. This is true. And salaries in every field in Medicine are taking hits - nevertheless, I would say rad onc is a pretty fantastic field, and generally speaking very well compensated. So I don't think OP dodged a bullet. Psych is a perfectly fine field, but with lots of midlevel encroachment -

Psych has a MUCH better job market than rad-onc (which appears to be circling the drain by many accounts).

 

[Piebaldi]

Psych has a MUCH better job market than rad-onc (which appears to be circling the drain by many accounts).

Every specialty has its ups and downs, rad onc makes excellent money even if they currently have a tigh tjob market. more and more psych positions are being done by PA/NPs, or one psychiatrist is managing multiple NPs. where my mom works for example - she's a mental health counselor - all the psychiatrists were let go, and instead replaced by NPs. that is happening more and more.

 

[deleted1041468]

Every specialty has its ups and downs, rad onc makes excellent money even if they currently have a tigh tjob market. more and more psych positions are being done by PA/NPs, or one psychiatrist is managing multiple NPs. where my mom works for example - she's a mental health counselor - all the psychiatrists were let go, and instead replaced by NPs. that is happening more and more.

That’s true it is happening in a lot of primary care specialties. That is going to eventually backfire because patients receive extremely bad care most of the time.

 

[caxoo]

Do you think having high Step scores and/or lots of research screened you out a lot of programs? (either for being seen as applying only psych as back up or low chance you'd actually attend the program, etc etc)

No. Looking at the Psych spreadsheet, there were multiple people with high scores getting plenty more interview invites than me. There is no hard data on this, and everything I think might be completely wrong, but these are the factors I believe impacted me:

- Too few extra-curriculars and leadership positions during medical school. My application may read boring, and a person with lower STEP scores but more experiences they can talk about could be seen as a better candidate
- TX applicant, who may have a reputation for staying in TX (foolishly enough, I only applied to a few TX programs the first time around because I actually wanted somewhere new)
- My school isn't particularly well known (Yes, it's MD. Talking to my DO friends, they definitely have "more to prove" to a lot of residencies during application process, keep this in mind if you're DO)
- Applying to too many places that are "hard to reach" (West Coast and NY). However, I applied to a lot of places that I thought were within my range, and did not get interviews from many of them either

Just to give more clarification on the numbers:
- first time around, applied 45. Plenty of "mid tier" programs (whatever that means, I'll loosely define it as everyone that's not top 20), 7 interviews. Admittedly, almost none of these were in cities with populations much shyer than 1 million.
- second time around, applied 80. Plenty of places I didn't consider the second time around, purely because of location, including a lot of TX places. Got 15 interviews for psych, including 6 out of state