Does anyone have advice for a stressed 3rd year student?

[musm2008]

Hey everyone- thanks for reading!
I offcially became a 3rd year student today after I found out that I passed step 1 with a 207.
I have always had my heart set on psych, preferably somewhere in New England. I've been hoping to go to some place like UVM, Dartmouth, Maine, or Brown. I live in GA now, but my husband's family lives in Mass, and we'd like to be closer to them during my residency. I love so much about psych, maybe child psych.
Does anyone know anything specific about the competitiveness of these residencies? I have read some threads, but still have questions. Is there anything that anyone would recommend as far as doing well during psych rotations and getting ready for residency? How important do you think iti s to do away rotations at schools of interest?
Well, if anyone has advice, I would love to hear what you have to say!

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[Anasazi23]

There have been quite a few threads on performing well as a psychiatry med student, preparing for residency, and the like. Try a search and see what you come up with.

Be sure to do your psych sub-I where you'd ideally like to do residency.

 

[musm2008]

ok- maybe I could just ask what I was really hoping to hear. Does a 207 on step 1 make it more difficult such that I'll need to perform miracles over the next 2 years to get a residency in the northeast?
thanks for the reply!

 

[Anasazi23]

It depends. There are high end, middle tier, and lower tier residencies in the northeast. Some won't look at you with that number. Others will if you have collateral accomplishments. Some won't be too concerned as long as you passed it without having to take it 3 times.

 

[gardilimo]

In response to Anasazi, I am sure if you do very well on Step 2 you can make up for your Step 1, am I not correct? And of course, do strong work on your clerkships and good LOR's and your chances are good to go to any program if you are coming from an American med school. This is what I have heard from many attendings at least...

It depends. There are high end, middle tier, and lower tier residencies in the northeast. Some won't look at you with that number. Others will if you have collateral accomplishments. Some won't be too concerned as long as you passed it without having to take it 3 times.

 

[Anasazi23]

This is basically correct, except for highly competitive residency programs. For average to below average programs, you might be considered if you do as well or better on Step II.

In psychiatry, like in virtually all specialties, competitive and desirable places are just that...competitive. Meaning, they won't look at you without great numbers and more in most cases.

 

[jane70]

i don't mean to take over, but i have similar questions...i know no one can predict how someone will do on the match, but i've heard the rule of thumb that all residencies in competitive areas are competitive, however how do you know which ones are considered the competitive ones? personally, i only got a 196 on boards and feel like all doors are shutting. i'm looking to move to the western states and not sure which ones would be open to this score and which ones would be not at all.

 

[musm2008]

I have the same exact question. I think step I scores, mine at least, have a lot to do with anxiety. I'm much more comfortable in a clinical setting, so I am hoping to do better on step 2.
If a school has a lot of FMG's does that indicate that it's not highly competitive?

 

[Anasazi23]

If a school has a lot of FMG's does that indicate that it's not highly competitive?

Basically, yeah. But that doesn't mean the program isn't good or even high quality.

Unfortunately, there's no central place which will tell you in any consistent fashion, how competitive residencies are. SDN around application time is a great resource, as there are dozens of threads, usually geographically organized, as to how places seem to be, and how competitive they are.

The other side of the argument is: you can apply to a lot of places through ERAS. It's probabay worth it to apply to a few extras if you feel the need. You never know who's doing the admission screening that day, or if someone simply liked a particular essay of yours, or even a hobby. The point is, like it was for college and med school - have a few 'stars in the sky,' many comfortable places, and a few sure shots just in case.

 

[RustNeverSleeps]

This is basically correct, except for highly competitive residency programs. For average to below average programs, you might be considered if you do as well or better on Step II.

In psychiatry, like in virtually all specialties, competitive and desirable places are just that...competitive. Meaning, they won't look at you without great numbers and more in most cases.

Reading this board makes me sort of confused (and anxious), because people here suggest that psychiatry is much more competitive than other people and sources do. For instance, the residency director at the (competitive) program at my school insists that psych is incredibly easy to match into, and that good boards scores are relatively unimportant. The residency director and other people in psychiatry that I know firmly assert that if you look at the numbers, psych is not becoming more competitive, that it is a myth that has persisted for several years. Yet, posters here say that an American med student with a 207 might be able to get into an average or below average program -- the conflicting reports really don't make sense to me.

I am applying for residency this year also, and in my preliminary information-gathering have glanced over Step 1 criteria for different programs. I have seen a fair number of university programs (not top programs, admittedly) requesting only passing on the first attempt or a score > 190. Maybe people with scores this low don't have a chance of getting an interview, but it suggests that psych programs are relatively understanding when it comes to boards.

I understand that there are some programs that are more competitive than others, but my impression is that these competitive programs are still less selective than comparable programs in other fields.

I am not trying to attack anyone and appreciate reading everyone's contributions, but I truly find the differences in the perceived competitiveness of matching in psych perplexing. I'd appreciate hearing other insights.

 

[Anasazi23]

It's not that psych is hard to match into. Looking at the raw numbers show that there is an overall trend in applicants to psychiatry spots. Matching into the top programs is difficult. It makes no sense that a competitive place is just as easy or nearly as easy to match into as a non-competitive place. By definition, this isn't true.

What a website says about a minimum score is meaningless. Remember medical school. It was the same for that (2.8 GPA required).

Competitive programs have their pick of the litter. For no good reason, they may not offer you an interview. Then again, you might be surprised at the positive response you receive in the application process. Receiving interviews at Hopkins, UCLA, Brown, Yale, and Harvard is great, but those places have around 700 -1200 applicants each, for an average of about 8 spots each. Many of those applicants are as strong or stronger with their board scores, letters, and research experience. Statistically, it's not that easy.

If you're not interested in the top places, you'll likely match. Every year, there is a significant amount of people who fail to match into psychiatry. SDN had such posters looking for scramble spots.

 

[PsychMD2B2006]

I just matched into a great program within the top 20 of the country. And my step 1 scores was below a 207. So to give you some insight, I believe that board scores are not as significant in matching as other specialties. I have heard from a few residency directors (from wonderful programs) that the main focus is not on your board score and gpa but how well you do on clerkship, your LOR's and personal statement. They just wanted to know if you pass step 1. Remember, psychiatry is more about how you are as a person and your ability to interact and treat your patients rather than how well you do on standardized tests. The residency director at my program told me that what held a lot of weight was the attendings' and residents' opinion of my performance when I did an away rotation with them. So my advice is also to go do an away rotation at the school you would like to go to. That is the best way you can shine is by showing how good of a resident you truly can be.

Overall, I definitely still believe that psych is still one of the easier specialties to match into. Don't even consider any doors shutting if you passed step 1 and you are an American graduate.

Please, feel free to ask me any questions

 

[gardilimo]

I, as u can see from my prior response, agree with you...but then again I have not gone thru the residency process yet.

Anyway, where did you find board score criteria for programs?

And I also feel that noone here is emphasizing that there is another step that will make a difference, step 2!!

Also, FREIDA quotes that these 'most competitive' programs offer about 80 interviews per about 8 spots, so I do not think everybody gets an interview...

Reading this board makes me sort of confused (and anxious), because people here suggest that psychiatry is much more competitive than other people and sources do. For instance, the residency director at the (competitive) program at my school insists that psych is incredibly easy to match into, and that good boards scores are relatively unimportant. The residency director and other people in psychiatry that I know firmly assert that if you look at the numbers, psych is not becoming more competitive, that it is a myth that has persisted for several years. Yet, posters here say that an American med student with a 207 might be able to get into an average or below average program -- the conflicting reports really don't make sense to me.

I am applying for residency this year also, and in my preliminary information-gathering have glanced over Step 1 criteria for different programs. I have seen a fair number of university programs (not top programs, admittedly) requesting only passing on the first attempt or a score > 190. Maybe people with scores this low don't have a chance of getting an interview, but it suggests that psych programs are relatively understanding when it comes to boards.

I understand that there are some programs that are more competitive than others, but my impression is that these competitive programs are still less selective than comparable programs in other fields.

I am not trying to attack anyone and appreciate reading everyone's contributions, but I truly find the differences in the perceived competitiveness of matching in psych perplexing. I'd appreciate hearing other insights.

 

[RustNeverSleeps]

I, as u can see from my prior response, agree with you...but then again I have not gone thru the residency process yet.

Anyway, where did you find board score criteria for programs?

And I also feel that noone here is emphasizing that there is another step that will make a difference, step 2!!

Also, FREIDA quotes that these 'most competitive' programs offer about 80 interviews per about 8 spots, so I do not think everybody gets an interview...

I guess my post must have been very unclearly written -- I apologize for that. I do not think that everyone who applies to a program will be interviewed, obviously. Also, in no way was my post limited to top schools; I was referring to applying to psychiatry in general. The reason I responded was someone's post saying that an American student with a 207 might be able to get into a mediocre psych program, which sounded harsh and anxiety-provoking to me. The gist of my post was that, according to psych faculty and residency directors to whom I have spoken, if you are an American med student, matching in psych is relatively easy, particularly compared to other specialties. I am not saying matching at a top program is easy, just to be clear. However, I still do believe that matching at a top psych program is easier than matching at a top program in most other specialties (ex. IM, general surgery) -- I did write this in my previous post, and I believe it got misinterpreted.

One other factor that has not yet been mentioned is the strength of your medical school. I have been told (again by my residency director) that the strength/reputation of your medical school is still meaningful in psychiatry, especially compared to other specialties. I am not saying that is the most important factor, but take it for what it's worth.

 

[outofhere]

Last year, when I was involved with interviewing lots of applicants, I had a long discussion about board scores with my PD. He is much less interested in the 3 digit score that we are discussing. He is interested in the percentile (2 digit score) and he uses that as a screening tool. He wants that number to be above 80, because under 80, he is concerned about that future resident's ability to pass step 3. He said he has known a few residents unable to progress in residency programs because they can't pass step 3. If an applican'ts number is >80, then the screening is done. I think my program is top notch, we routinely match students from 'famous' medical schools, whatever that means, and we have had 50% residents go on to do child fellowships in the recent years, to 'famous' institutions.

At the same time, I can think of 2 students with AWESOME board scores, two digit score in the mid 90s, that we DID not rank. So, go figure.

 

[musm2008]

This is all good news and what I was hoping to hear- that there is reason to hope! Thanks, everyone!

 

[Mr.Tweed]

He is interested in the percentile (2 digit score) and he uses that as a screening tool. He wants that number to be above 80, because under 80, he is concerned about that future resident's ability to pass step 3.

As far as I know, the 2 digit score is not a percentile. Your point is still valid. Just wanted to point that out.

 

[bobmarley77]

What are the "highly competitive residency programs?" Is there a list of them somewhere? I'm interested in California, Washington, Texas, North Carolina, Virginia, Florida, DC, Chicago, or New York...hoping my low step 1 board scores won't keep me out of these states....

 

[Anasazi23]

What are the "highly competitive residency programs?" Is there a list of them somewhere? I'm interested in California, Washington, Texas, North Carolina, Virginia, Florida, DC, Chicago, or New York...hoping my low step 1 board scores won't keep me out of these states....

See Doc Samson's post:
http://forums.studentdoctor.net/showthread.php?t=297870

 

[Doc Samson]

See Doc Samson's post:
http://forums.studentdoctor.net/showthread.php?t=297870

Not sure if you're referring to the US News and World Report List, or my post of biological vs. psychotherapeutic programs on that thread, Sazi. Either way, I wouldn't call either a definitive list of the most competitive programs. The US News list is based on reputation of hospital, not training program... so it includes University of Maryland (which is a fine place, but probably not in the top 10 most competitive programs in the country), Austen Riggs (which to my knowledge doesn't have a residency), but completely excludes well-respected university based programs that don't have a tie to one massive hospital (e.g. Brown, Cambridge, Harvard Longwood). Maybe we could run our own version of the US News list, since we have a fair amount of info on which to base a rational opinion...

So, name your top 10 most prestigious residency programs, we can collate them into a master list at the end. Don't have to assign a rank, just your top 10 names.

Mine (ordered solely based on geographic proximity):

MGH/McLean
Harvard Longwood
Cambridge
Brown
Yale
Columbia
NYU
Penn
UCSF
UCLA-NPI

Totally subjective, totally idiosyncratic, and based on uncertain evidence (just like the US News list), but I think we have enough geographic diversity among us to get something like a reasonable sample of national opinion.

 

[musm2008]

Not sure if you're referring to the US News and World Report List, or my post of biological vs. psychotherapeutic programs on that thread, Sazi. Either way, I wouldn't call either a definitive list of the most competitive programs. The US News list is based on reputation of hospital, not training program... so it includes University of Maryland (which is a fine place, but probably not in the top 10 most competitive programs in the country), Austen Riggs (which to my knowledge doesn't have a residency), but completely excludes well-respected university based programs that don't have a tie to one massive hospital (e.g. Brown, Cambridge, Harvard Longwood). Maybe we could run our own version of the US News list, since we have a fair amount of info on which to base a rational opinion...

So, name your top 10 most prestigious residency programs, we can collate them into a master list at the end. Don't have to assign a rank, just your top 10 names.



Mine (ordered solely based on geographic proximity):

MGH/McLean
Harvard Longwood
Cambridge
Brown
Yale
Columbia
NYU
Penn
UCSF
UCLA-NPI .

Are these school places where people go if they are interested in research? Is that what makes a "top school?" I'd like to have some reasonably good school like that in the possibility list (Brown has some interesting program options that I'd like to learn more about,) but I'm really not interested in doing research. Does anyone know what exatly makes these programs "top?"

 

[Doc Samson]

Are these school places where people go if they are interested in research? Is that what makes a "top school?" I'd like to have some reasonably good school like that in the possibility list (Brown has some interesting program options that I'd like to learn more about,) but I'm really not interested in doing research. Does anyone know what exatly makes these programs "top?"

Again, that list is just my personal opinion (hopefully we'll be able to gather some other opinions), but to me those programs each stress excellent clinical training in both biological and psychotherapeutic approaches to patients; provide a broad spectrum of patients both in terms of SES and psychopathology; provide exposure to well-known top-of-their-field faculty; and the opportunity (but not the expectation) for research. When I was interviewing, the programs that expected you to do research made me very uneasy... they didn't really seem all that keen on teaching clinical skills - so they didn't make my list.

 

[maranatha]

Back to the orginal postings: Nobody has mentioned anything about the interview...I would think that would be a strong component of the application, especially in psychiatry!

Also, unless my PD is out of his mind, I was told with a Step I score of 202 on first attempt, honors in psych, some research experience in neurology and psych (nothing too spectacular), being an officer in the psych club, and otherwise very "averge" grades in everything else, would almost assure me a spot in one of the top 15 programs in the US. Of course, he never told me I was a shoe-in for Harvard or Hopkins, but that I would get into a very good program. Based on some of the responses on this post, I should be worried about getting into a middle or lower tier program! Is my PD just confused?

 

[musm2008]

Back to the orginal postings: Nobody has mentioned anything about the interview...I would think that would be a strong component of the application, especially in psychiatry!

Also, unless my PD is out of his mind, I was told with a Step I score of 202 on first attempt, honors in psych, some research experience in neurology and psych (nothing too spectacular), being an officer in the psych club, and otherwise very "averge" grades in everything else, would almost assure me a spot in one of the top 15 programs in the US. Of course, he never told me I was a shoe-in for Harvard or Hopkins, but that I would get into a very good program. Based on some of the responses on this post, I should be worried about getting into a middle or lower tier program! Is my PD just confused?

I think you are right about the interview thing. That makes a lot of sense, since a VERY BIG part of psych concerns your abilities to communicate with people.

 

[raspberry swirl]

as a clueless 4th year starting out this ERAS nonsense, im interested to see other people's personal top ten lists, like doc samson's ...

 

[bobmarley77]

bump

 

[jjbmsiv]

most pointless. bump. ever.