Didn't Match/Nothing in SOAP/HELP!!

[natpsych22]

Hi everyone,

Didn't Match into Psychiatry. Graduated Caribbean 10/2020.
Prior MPH degree and 5 years research/publications.

USMLE STep 1: 220's, Step 2: 245, Step 3: Taking Spring 2021
Letters: 1 Psych Ivy League rotation, 2 psych letters core clerkship, 1 medicine
PS: solid

Ranked: 7
I have no idea what happened besides the most competitive year ever apparently? Disaster.

Tried prelim, IM, FM - nothing so far.

Any ideas for:
1) where to find open spots if not in NRMP: any listserves or facebook groups you can recommend?

2) with my background, how to spend the next year?

3) how to beef up my app this coming year?

THANKS FOLKS

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[wolfvgang22]

You did not rank enough programs. That is why you didn't match, unless you interview poorly. How many did you apply to?

I don't have the answer to your other questions.

 

[Mass Effect]

Hi everyone,

Didn't Match into Psychiatry. Graduated Caribbean 10/2020.
Prior MPH degree and 5 years research/publications.

USMLE STep 1: 220's, Step 2: 245, Step 3: Taking Spring 2021
Letters: 1 Psych Ivy League rotation, 2 psych letters core clerkship, 1 medicine
PS: solid

Ranked: 7
I have no idea what happened besides the most competitive year ever apparently? Disaster.

Tried prelim, IM, FM - nothing so far.

Any ideas for:
1) where to find open spots if not in NRMP: any listserves or facebook groups you can recommend?

2) with my background, how to spend the next year?

3) how to beef up my app this coming year?

THANKS FOLKS

You have a few things against you.

1) You went to the Carrib for med school. Huge mistake. I know you can't change that now, but when you say you don't know what went wrong, I feel inclined to point that out. Psych IS competitive and don't believe anyone who tells you it isn't. Carrib grads get spots, sure, but it isn't at all a sure thing. Did you go to one of the big 4? If not, it's even less likely.

2) You graduated in October 2020. Why? What have you been doing since October? The assumption is that if you graduated in October, you stopped doing clinical work in October. Hopefully that isn't true. But why are you off-cycle? Is your school set up that way and if not, why didn't you graduate in May 2020 or May 2021 like most med students?

3) You ranked 7 programs. Did you interview at only 7? Most people are ranking at least 10 for psychiatry these days.

4) Letters are good, but were these from in-person rotations you did at these places? That matters too.

5) Are you a US citizen? That also matters.

6) How do you know your PS is solid?

7) Every single year we hear that it's the most competitive year ever. And it might be true, but it also means that next year will be "the most competitive year ever" so more competitive than this year. Keep that in mind.

8) If you're a US citizen, I would try like hell to use your connections to get some sort of clinical experience throughout this year. Don't stop working. Do medicine and psych rotations. Collect updated letters. Apply to as many programs as you can afford to. I would apply psych and prelim/transitional spots. Show your PS to no less than 10-20 people. Don't take "solid" as feedback. That isn't feedback. Make them tell you what they liked and didn't like. Does it clearly tell them why you like psychiatry and why you'd be a great psychiatrist?

 

[wolfvgang22]

I am a U.S. citizen "big 4"Caribbean school IMG that matched over a decade ago, with a similarly competitive application, no red flags, and interview well.
I applied to ~180 programs (nearly all of them in the 48 states), eventually received over 50 interview invites. It cost me around $2k. I didn't get a single invite until late November. Yes, I was concerned, when U.S. MDs had already been interviewing for over a month, but the interview invitations finally started rolling in. I interviewed at and then ranked around 30 programs. Another $1.5k cost in travel, living frugally, used my credit card. I only did not rank one or two places I interviewed because they were "malignant" programs far from home. Otherwise, I didn't care about geography, I cared about matching. Luck and hard work meant I matched at my 1st choice at a mid-tier program that was an excellent fit in a city I enjoyed.
Matching into psychiatry is more competitive now than it was then. What I did may have been overkill for me personally looking back, but I didn't believe laxity was prudent, particularly not with 6 figures in student loans.

I know that doesn't help you right now OP, but realize others may be reading this forum as I did years ago as a prospective student. We are regularly seeing DO graduates and U.S. MDs not match into psychiatry now. IMGs are second class citizens when it comes to medical education in the U.S. That's a fact.
IMGs: do not screw around. Apply broadly.

 

[kexy]

This may help with questions 2) and 3). A job as a TMS technician, especially at an academic institution, might be a good option to consider. At UCLA, we had two individuals in this role (taking time between MS4 and intern year for various reasons) who both just matched into psych residency yesterday. You would be overqualified for this role, but it has a few advantages: direct patient care, the opportunity to work closely with faculty (and get new LORs, if you are doing well), and the opportunity to help with research (if you are interested) in order to strengthen your application.

The job opening is posted here:

TMS Technician | UCLA Health | Job #12517 | Los Angeles, CA

<div data-field="responsibilities" class="jd-responsibilities">•Responsibilities•<p /><p>The Semel Institute for Neuroscience and Human Behavior is seeking to hire a full-time TMS Technician to join the Transcranial Magnetic Stimulation (TMS) Clinic. Primary duties...

www.uclahealthcareers.org

 

[ayudar]

You have a few things against you.

1) You went to the Carrib for med school. Huge mistake. I know you can't change that now, but when you say you don't know what went wrong, I feel inclined to point that out. Psych IS competitive and don't believe anyone who tells you it isn't. Carrib grads get spots, sure, but it isn't at all a sure thing. Did you go to one of the big 4? If not, it's even less likely.

2) You graduated in October 2020. Why? What have you been doing since October? The assumption is that if you graduated in October, you stopped doing clinical work in October. Hopefully that isn't true. But why are you off-cycle? Is your school set up that way and if not, why didn't you graduate in May 2020 or May 2021 like most med students?

3) You ranked 7 programs. Did you interview at only 7? Most people are ranking at least 10 for psychiatry these days.

4) Letters are good, but were these from in-person rotations you did at these places? That matters too.

5) Are you a US citizen? That also matters.

6) How do you know your PS is solid?

7) Every single year we hear that it's the most competitive year ever. And it might be true, but it also means that next year will be "the most competitive year ever" so more competitive than this year. Keep that in mind.

8) If you're a US citizen, I would try like hell to use your connections to get some sort of clinical experience throughout this year. Don't stop working. Do medicine and psych rotations. Collect updated letters. Apply to as many programs as you can afford to. I would apply psych and prelim/transitional spots. Show your PS to no less than 10-20 people. Don't take "solid" as feedback. That isn't feedback. Make them tell you what they liked and didn't like. Does it clearly tell them why you like psychiatry and why you'd be a great psychiatrist?

Sorry to hijack your thread OP but I had a question myself.

I'm a Caribbean US student currently. I started medical school off-cycle during a spring semester. Just finished my third year of rotations. I am considered off-track as I took an additional 5 months off to pass my STEP 1. And then in the middle of my third year I found a research opportunity where I took another 3 months off. So I took a total of 8 months off. My plan was to bang out the last couple of months of electives I have left so I can finish school by October.

Do you suggest I stretch out my rotations so I can finish after next March? That would be mean I take the minimum amount of clinical rotations in a semester to stretch out my fourth year. My original plan was to wrap up school by October and then continue working part time with a local psychiatrist by home while also obtaining some clinical research experience.

My stats are as follows:
Step 1 232
Step 2CK 254
No failed classes/exams
Bottom of class rank in pre-clinicals
4th quartile in clinicals
Honors in all rotations besides my third year surgery and psych rotations and a cardio elective I took in the COVID downtime. I received a Pass in these rotations.

ECs:
2 peer-reviewed publications (not first author) in a non-psych field.
1 poster (didn't present) in a non-psych field.
2 psych publications that will be published (hopefully) by September in a peer-reviewed journal.
1 leadership role.
1 work experience and several volunteer opportunities.

---
I understand the Pass in my psych rotation is not impressive at all, but I failed to impress one attending but was able to obtain strong letters from the other two attendings I worked with. The game plan was to complete a sub-i, and a CL elective to see if I can obtain stronger letters and show my devotion to the specialty. And then complete a sub-i in internal med afterwards and take the required electives by my school to wrap up my education.

And I know taking 8 months of off time during my medical school career is only a detriment for me. I was not anywhere near passing range for my step 1, even after 6 weeks of dedicated. I needed that time to at least score average there.

Now I'm worried if graduating off-cycle will make me look even worse.

I would greatly appreciate your critique on my plan.

 

[wolfvgang22]

Sorry to hijack your thread OP but I had a question myself.

I'm a Caribbean US student currently. I started medical school off-cycle during a spring semester. Just finished my third year of rotations. I am considered off-track as I took an additional 5 months off to pass my STEP 1. And then in the middle of my third year I found a research opportunity where I took another 3 months off. So I took a total of 8 months off. My plan was to bang out the last couple of months of electives I have left so I can finish school by October.

Do you suggest I stretch out my rotations so I can finish after next March? That would be mean I take the minimum amount of clinical rotations in a semester to stretch out my fourth year. My original plan was to wrap up school by October and then continue working part time with a local psychiatrist by home while also obtaining some clinical research experience.

My stats are as follows:
Step 1 232
Step 2CK 254
No failed classes
Bottom of class rank in pre-clinicals
4th quartile in clinicals
Honors in all rotations besides my third year surgery and psych rotations and a cardio elective I took in the COVID downtime. I received a Pass in these rotations.

ECs:
2 peer-reviewed publications (not first author) in a non-psych field.
1 poster (didn't present) in a non-psych field.
2 publications that will be published (hopefully) by September in a peer-reviewed journal.
1 leadership role.
1 work experience and several volunteer opportunities.

---
I understand the Pass in my psych rotation is not impressive at all, but I failed to impress one attending but was able to obtain strong letters from the other two attendings I worked with. The game plan was to complete a sub-i, and a CL elective to see if I can obtain stronger letters and show my devotion to the specialty. And then complete a sub-i in internal med afterwards and take the required electives by my school to wrap up my education.

And I know taking 8 months of off time during my medical school career is only a detriment for me. I was not anywhere near passing range for my step 1, even after 6 weeks of dedicated. I needed that time to at least score average there.

Now I'm worried if graduating off-cycle will make me look even worse.

I would greatly appreciate your critique on my plan.

If it were me, I would stay in school through March and do research during that time, but that's only preference. I think sub-i rotations are fine as long as you can explain why you are doing them.

If you choose to finish in October, which is not a very bad thing, consider registering for Step 3 immediately upon graduation and tell prospective programs when you are to take the exam. Programs will see you are a go-getter and have one less resident to worry about not passing step 3 after intern year.

It is unlikely your basic sciences class rank matters much, or not honoring psych or other rotations. USMLE is king, at least for now. Letters do have an impact.

 

[Mass Effect]

Sorry to hijack your thread OP but I had a question myself.

I'm a Caribbean US student currently. I started medical school off-cycle during a spring semester. Just finished my third year of rotations. I am considered off-track as I took an additional 5 months off to pass my STEP 1. And then in the middle of my third year I found a research opportunity where I took another 3 months off. So I took a total of 8 months off. My plan was to bang out the last couple of months of electives I have left so I can finish school by October.

Do you suggest I stretch out my rotations so I can finish after next March? That would be mean I take the minimum amount of clinical rotations in a semester to stretch out my fourth year. My original plan was to wrap up school by October and then continue working part time with a local psychiatrist by home while also obtaining some clinical research experience.

My stats are as follows:
Step 1 232
Step 2CK 254
No failed classes/exams
Bottom of class rank in pre-clinicals
4th quartile in clinicals
Honors in all rotations besides my third year surgery and psych rotations and a cardio elective I took in the COVID downtime. I received a Pass in these rotations.

ECs:
2 peer-reviewed publications (not first author) in a non-psych field.
1 poster (didn't present) in a non-psych field.
2 psych publications that will be published (hopefully) by September in a peer-reviewed journal.
1 leadership role.
1 work experience and several volunteer opportunities.

---
I understand the Pass in my psych rotation is not impressive at all, but I failed to impress one attending but was able to obtain strong letters from the other two attendings I worked with. The game plan was to complete a sub-i, and a CL elective to see if I can obtain stronger letters and show my devotion to the specialty. And then complete a sub-i in internal med afterwards and take the required electives by my school to wrap up my education.

And I know taking 8 months of off time during my medical school career is only a detriment for me. I was not anywhere near passing range for my step 1, even after 6 weeks of dedicated. I needed that time to at least score average there.

Now I'm worried if graduating off-cycle will make me look even worse.

I would greatly appreciate your critique on my plan.

Do some research and prolong graduation. Do some sub-Is and blow them away. How are you in the 4th quartile in clinicals if you've honored all but three?

Good luck in the match.

I do want to add for anyone reading who's a pre-med, do NOT go to the Caribbean. Just don't do it. It isn't an easy route to becoming a doctor. Even if it takes you 5 tries to get into a US MD or US DO school, it's worth it. The match isn't going to get less competitive. Even if you think you'll be happy with FM in BFE, don't take the chance because in the end, even FM in BFE may not take you.

 

[ayudar]

Do some research and prolong graduation. Do some sub-Is and blow them away. How are you in the 4th quartile in clinicals if you've honored all but three?

Good luck in the match.

I do want to add for anyone reading who's a pre-med, do NOT go to the Caribbean. Just don't do it. It isn't an easy route to becoming a doctor. Even if it takes you 5 tries to get into a US MD or US DO school, it's worth it. The match isn't going to get less competitive. Even if you think you'll be happy with FM in BFE, don't take the chance because in the end, even FM in BFE may not take you.

Thank you both of you for your responses. I really do appreciate it. After some googling and speaking to some of my peers who matched this year (but in other specialties) I think the better option is to delay my graduation and spend time doing research along with my elective rotations. But, I will still sit on it though and think some more about it before I rush to make a decision.

To answer your question regarding being placed in the fourth quartile, I have taken my core rotations (5) of which I honored 3. And during COVID when all students were pulled from rotations, we were given options to take online electives or take a leave of absence. I honored 3 of the 4 electives that were offered. Of course not all rotations are weighted equally as my internal medicine rotation was 3 months whereas my psychiatry rotation was 6 weeks. With each rotation, we also have to complete NBME shelf exams, where I have scored consistently on the higher side (besides surgery), which I think added to having a "boosted" overall grade.

 

[natpsych22]

This may help with questions 2) and 3). A job as a TMS technician, especially at an academic institution, might be a good option to consider. At UCLA, we had two individuals in this role (taking time between MS4 and intern year for various reasons) who both just matched into psych residency yesterday. You would be overqualified for this role, but it has a few advantages: direct patient care, the opportunity to work closely with faculty (and get new LORs, if you are doing well), and the opportunity to help with research (if you are interested) in order to strengthen your application.

The job opening is posted here:

TMS Technician | UCLA Health | Job #12517 | Los Angeles, CA

<div data-field="responsibilities" class="jd-responsibilities">•Responsibilities•<p /><p>The Semel Institute for Neuroscience and Human Behavior is seeking to hire a full-time TMS Technician to join the Transcranial Magnetic Stimulation (TMS) Clinic. Primary duties...

www.uclahealthcareers.org

This is very helpful, and kind of you, thank you!