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Thought I might make one so that those of us who are applying can connect
Consult Liaison Psychiatry Fellowship Application Thread 2023-2024
- Thread starter movingtopastures
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Just graduated fellow here, happy to answer questions.
Overall this should be the least stressful application cycle you've ever participated in. It's an applicant's market.
Overall this should be the least stressful application cycle you've ever participated in. It's an applicant's market.
Hi! Thanks for posting. So what do you think they typically look for when screening apps? I wonder, do you anticipate any changes now that most prgrms are on eras this year for the first time?
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Since there are so many more spots than applicants (historic fill rate is around 2/3) most programs are just looking for a complete application and you are likely to get invites from nearly all the programs you apply to. Mainly we just want to know people want to do CL.
I really cannot emphasize enough how different this is from residency where programs get buried in literally thousands of applicants. If you don't hear from a program, it's worth shooting them a polite email reiterating your interest just to make sure there wasn't a logistical error somewhere.
When I applied I was pretty annoyed that CL didn't use ERAS mainly bc it put a lot of work on my letter writers to have to email each place individually. I'm really not sure how it will change things this year overall but I doubt it will change the dynamics of the process very much.
I really cannot emphasize enough how different this is from residency where programs get buried in literally thousands of applicants. If you don't hear from a program, it's worth shooting them a polite email reiterating your interest just to make sure there wasn't a logistical error somewhere.
When I applied I was pretty annoyed that CL didn't use ERAS mainly bc it put a lot of work on my letter writers to have to email each place individually. I'm really not sure how it will change things this year overall but I doubt it will change the dynamics of the process very much.
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Oh, if you aren't already planning on it I encourage everyone to go to ACLP if they can! It's a great conference and very useful for meeting people.
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I second the above. Im a PGY4 and I went to ACLP last year, definitely was great to connect with fellowship directors and current fellows. The biggest thing I can say is everyone no matter where in CL has been so welcoming and accommodating.
I ended up applying to 22 programs as I come from a community hospital, but I'm really unsure how competitive my application will be. I do have a couple of CL presentations and papers on my CV
I ended up applying to 22 programs as I come from a community hospital, but I'm really unsure how competitive my application will be. I do have a couple of CL presentations and papers on my CV
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22 is overkill--you'll probably end up needing to turn down a lot of interviews.
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That would be a great problem to have
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Lol in this conversation you've helped me realize that this is likely to be the main thing that is different this year with ERAS. I doubt ANYONE applied to 12+ programs previously--it was too much of a gigantic PITA since every program wanted slightly different documents and everything had to be emailed.
This might elongate the interview cycle if programs do end up inviting applicants who then drop interviews and then make more offers, but since the incentives to apply to fellowship haven't changed at all it will remain a very easy match.
And just to be clear, I did medical school, residency, and fellowship all at big academic centers and all happily interview people who went to community programs, DOs, IMGs, and FMGs for their CL programs. The only times they don't are if there are internal candidates who have the spots on lock.
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I definitely agree that it democratizes the application process, so more people may apply to more places where they necessarily wouldn't have applied to. It's funny though some big-name programs aren't taking ERAS and require the common app. Some places are requiring ERAS and won't accept the common app. So its somewhat of a tossup in applying.
The only thing that holds people back I think is cost, ERAS is such a thief of money and charges so much for doing so little.
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You may be right, my anxiety got the better of me, I've already got 2 so far.
Really!? Didnt it just open five days ago?!
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Yes, it did, but I had all my applications in before it opened
how many programs did you apply to?
Is it advisable to only apply to big name programs?
When did you decide to pursue CL and how do you have to utilize time in residency to prepare for CL (i.e research, connection, conference, etc)
Thanks!
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I applied to about half a dozen programs. It's advisable to apply to programs that you think you want to go to. Everyone has their own reasons and priorities. I'm honestly not sure how to reply to your question about big-name programs. Are you asking if your job opportunities would be limited if you go somewhere other than mgh? Maybe at MGH itself. I don't think anyone else cares. There's a ton of job postings for consult psychiatrists and people looking to hire just through the grapevine.
I decided to pursue CL very early I knew that I probably wanted to do it even as an intern. I don't think that's the most common thing and it's definitely not necessary. There isn't really anything you need to do in residency to prepare other than being a good resident. It's good to have have at least one letter of recommendation from someone who worked with you on consults but your letters can be from other settings too.
I do recommend joining the aclp and going to the aclp annual meeting at least once if you're considering doing a CL fellowship. It's a really good meeting, not too big and not too small, very clinically accessible, and a great way to meet people.
thank you for your reply!
I was recently talking with my CL attending and she's really advocating all her residents to go into big-name (yale, NYU, Penn, etc) fellowships as it will help in the long run with salary negotiation, better reputation if going private, don't lose admin positions to newly grad with big-name fellowship, etc.
She did a CL program near her home due to pregnancy but regrets not taking her offer from yale CL at that time.
Are her claims overly exaggerated or is this really happening?
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I want to be very thoughtful in responding to this, and to caveat that my perspective is one of someone coming from a "brand name" residency and so the exact name of my fellowship felt less important. That being said, I still think the value of what you would call the quote unquote top programs is heavily dependent on what you want your career to look like. If the desire is to be an academic administrative leadership, and definitely if someone wants that to be at these big name institutions, then yes there is some brand name importance. This is also absolutely true if you want a grant funded research career. But if you mainly want to be teaching faculty at a residency program? I am less convinced you are going to be penalized.
At the end of the day consults is a small field with a low supply of boarded physicians. It is also true that the clinical offerings of the different Fellowship programs can vary a lot. For example, when I was looking at programs, MGH was almost entirely inpatient with a small gesture to outpatient consults. If someone wants to explore the possibilities of outpatient oriented consultation liaison careers, there are other Fellowship programs that will give you more time to explore and more outpatient settings.
There is a very strong networking effect in all of Medicine and that is particularly intense in smaller fields. There is a degree to which Fellowship is an audition for faculty position. Some candidates might want to think about their choice of Fellowship more in terms of where they want to be faculty then where they want to train for that year. Another candidate if they did not get particularly robust consult exposure in residency, might need to prioritize high volume intense patient work to gain skills that they do not yet have. I was turned off by one name brand program when I asked if it would be possible to customize my fellowship experience away from emergency psychiatry because I had done an excessive amount of that in residency due to the structure of our call. I was basically told our program is our program. I ended up going somewhere that allowed me more flexibility to customize my experience.
It is also very easy to idealize brand name settings if you have not been in them. And I fully confess that I say this as someone who has spent time there and acquired a certain amount of cynicism.
There is a huge opportunity cost to doing a fellowship in psychiatry. That is why I say that the single most important thing is to have a clear idea in your head of why you with your individual needs want to do the fellowship. If you have a strong sense of that, then it becomes easier to figure out what Fellowship programs you might want to go to.
Given the lack of competitiveness overall and the abundance of spots, and the fact that interviews are virtual now, the investment to do many interviews is fairly low. And so if you feel very uncertain what you are looking for then I would encourage applying maybe to as many as 10 or 12 programs and seeing how you feel after talking with the faculty. To be clear, this number of interviews is strictly for the applicant's benefit. You do not need this many to match.
If you want to DM me I'm happy to chat more.
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One additional thought to what I said above. Just because something is overall not competitive doesn't mean that any one spot is easy to get at a particular time. This is true for both fellowship and faculty positions. If you have your heart set on transplant psychiatry, and your hospital already has a transplant psychiatrist and is not looking for another one, then you may be out of luck there even if transplant Psychiatry jobs in general are in high demand. Similarly, a fellowship might go unmatched one year, and then have an internal candidate that they want to keep the next year. In that case the fellowship is essentially closed and if you want to go there you might not get it. That doesn't mean that overall it is difficult to get that type of position. So there can be this question, is this something that is hard to get in general or is it a matter of bad luck in timing. I'm not saying that's what you're attending experienced specifically, just that it is one aspect to factor in in these conversations.
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Celexa has this completely right. Most fellowships are filled at only about a 60% rate, but that doesn't mean that everyone can waltz into an ivy league position. Even average places can be locally competitive. These fellowships are small and any local interest can fill them. Just understand that broad thinking can almost guarantee getting in. Put all your eggs in one basket and you may fail, be flexible geographically, and it is hard to miss. It is still a buyer's market, but don't go to an art auction with one painting in mind.
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I got to interview at all 4 and these are some of my experiences/thoughts.
Emory- Really like ATL as a city and they offered a classic 3 different training site models (VA, safety, and bougie). Really liked their PD and staff were genuinely great. The one thing I did not like was that you were the only fellow
OSU- great faculty who were very personable and down to Earth.
UCLA- Really liked their model of starting most inpatient then moving to most outpatient. The fellow when I interviewed there was saying that it had an amazing work life balance and that it was lower volume? Not entirely sure that is empirically true, but i do remember he said his residency was brutal.
UPMC- Unique Huntington's clinic experience with robust transplant and psycho oncology experience. Pittsburgh's a great city.
Thank you very much for your insight.
