Fm/Psych-how competative

Discussion in 'Combined Residencies' started by medhead1990, Sep 17, 2014.

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  1. medhead1990

    medhead1990 2+ Year Member

    Jun 1, 2013
    Hey question or two for sdn world...

    1. How competitive is Fm/Psych programs? Regarding is there special letters of rec I should consider, should I spend more EC time doing psych or fm during med school, whats the average step score of one of these programs (I keep reading that's its a little more competitive than either FM or Psych alone but both are rather low step1 scores and as such what ends up being a little bit more)?

    2. I am still in the early stages of figuring out what I would want to specialize in as a physician and am apt to change my mind 20 times during med school, however at this point my goal is to go into addiction medicine and open up my own rehabs. I am interested in being able to address both the psych side of addiction as ell as being able to help early recovery type problems such as infections. Is it worth going through the time just to be able to treat both or is it possible to do both from both sides of the fence individually?

    thanks in advance!!
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  3. lizjhu

    lizjhu 2+ Year Member

    Apr 19, 2010
    I am also applying for Psych/FM. I have no clue how competitive it is but I was told by a psych/fm doc to attend the Med Psych conference to make connections. It's in Chicago on Oct 10-11.
    medhead1990 likes this.
  4. MLT2MT2DO

    MLT2MT2DO 7+ Year Member

    Jan 21, 2008
    Applied to 4 of the programs here as well. Also not really sure the op would need the fp portion for what they are describing
  5. medhead1990

    medhead1990 2+ Year Member

    Jun 1, 2013
    thank you good to know... Also from a Step score standpoint what would you say a good target step 1 would be for med psych?
  6. lizjhu

    lizjhu 2+ Year Member

    Apr 19, 2010
    Has anyone heard good news yet? Hoping to meet people on the interview trail!
  7. MLT2MT2DO

    MLT2MT2DO 7+ Year Member

    Jan 21, 2008
    I've heard nothing yet. 2/4 I applied to are in cali, and being a DO without strong connections to cali I'm not surprised by this
  8. hallowmann

    hallowmann 5+ Year Member

    Mar 13, 2012
    Beyond being originally from there, what constitutes strong connections? I'm thinking about heading out there for residency, because my wife is originally from there and all her family is out there. Would that be a "strong connection"? Or should I try to become a state resident out there? (I don't know if I actually want to do that right now).
  9. medhead1990

    medhead1990 2+ Year Member

    Jun 1, 2013
    hey so you guys who are in the cycle right now what were your USMLE-1 scores? Just so i know what ballpark I should be shooting for...
  10. milesed

    milesed 5+ Year Member

    Jun 25, 2011
    Most docs I know who did any sort of combined program ended up just practicing in just one of the fields- all say they wished they'd focused only on one area.
  11. J ROD

    J ROD Watch my TAN walk!! Lifetime Donor 10+ Year Member

    Aug 1, 2005
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  12. Davole


    Sep 17, 2015
    Edit: Didn't realize this was an old thread.

    Anyway, for people applying now, here's some info: I applied to the 3 non-Cali ones. I got an interview from Iowa and haven't heard from Pitt or Cincy yet.
  13. hallowmann

    hallowmann 5+ Year Member

    Mar 13, 2012
    Stats? US MD, DO, IMG?
  14. futuredoctor10

    futuredoctor10 10+ Year Member

    Jan 25, 2007
    The exception being Med/Peds
    WheezyBaby and Mad Jack like this.
  15. medimedimedi


    Nov 4, 2014
    what's the difference between med/peds and family medicine then?
  16. tantacles

    tantacles Lifetime Donor SDN Moderator 7+ Year Member

    Sep 28, 2009
    Physician explains this far better than any of us can.
  17. Mad Jack

    Mad Jack Critically Caring Gold Donor 2+ Year Member

    Jul 27, 2013
    4th Dimension
    Think about the difference between IM and FM. Then the differences between peds and FM. Now combine those differences. Congratulations, you have now discovered the differences between FM and IM/Peds.

    Basically you're much more qualified to specialize and take care of far sicker patients, but not as capable of dealing with Ob/Gyn.
  18. zany_brainy


    Dec 31, 2014
    NMPRA does a great job explaining this on their website, but I can give you a few differences.

    FM: 3 years of training, 4 (?) months of peds, greater emphasis on outpatient, residents rotate through OB and surgery

    Med/Peds: 4 years of training, 24 months of peds, greater emphasis on inpatient and ICU, residents do not rotate through OB or surgery, tons of fellowship options
    AshNiffler, kealaq and futuredoctor10 like this.
  19. medhead1990

    medhead1990 2+ Year Member

    Jun 1, 2013
    Wow. Two years later and this thread has 4600 views with only 16 posts-lots of lurkers. =) With only 10 total spots in the country 4100 is a surprisingly huge number looking at a post about fm/psych.

    For anyone who is interested (namely the lurkers) I recently took the advice from Lizjhu and was at the most recent med-psych conference in chicago just this last weekend. It was an excellent experience and I plan on moving forward in a combo residency, that being said it was surprisingly competitive, and i felt quite intimidated. Relative to the demand there is a miniscule amount of residency spots available for the number of applicants who apply. I believe the numbers are 150 applicants to FM-Psych 50/50 split of UMG and IMG for 10 spots, and a similar breakdown for IM-psych with 250 (ish) applicants for 22 spots.

    I will say in the application process is it seems like they definitely try to screen out those who want to do a combined residency because of ambivalence in deciding one specialty or the other. Naturally the better you can do on the boards the better your chances, however that being said I feel the most salient selling point for getting into a combined program is two part 1. Are you a good fit with our program specifically? 2. Are you a good fit for our tight knit weird combo community? Because you really do have to be a certain kind of weird to want to this type of program.

    There are some very specific things that combined training are good for and if you are interested in those than it is the perfect place for you. I personally am interested in pain/addiction/correctional medicine as well as integrative primary care delivery. If you are interested in the field because you want to be a psychiatrist but "don't want to hang up the stethoscope" (as has been said in other sdn posts)- or on the other hand want to do FM/IM but still really enjoyed your psych rotations and don't want to let that go, combo training is probably not the place for you. You can still apply but that underlying mind set will probably be picked up along the way in your application process (remember they are psychiatrists). One of the biggest tragedies with so few spots in the country is for a program to take someone on and then come year 3 or 4 they drop out. PD's are very intent on making sure that does not happen. To put it plain they don't want people who have interests in both fields, they are interested in people who want to practice combined medicine.

    Disclaimer this is my take on it, I could be totally off base here but this was the vibes I got.

    Hope this helps! =)
    olderbrooklyndoc likes this.
  20. OrangeOrange

    OrangeOrange SDN Gold Donor Gold Donor

    Mar 29, 2016
    When applying FM-Psych, do most people apply for categorical psych as a backup, or categorical IM as a backup? Do programs care?
  21. medhead1990

    medhead1990 2+ Year Member

    Jun 1, 2013
    yes you can /no they dont care. This was asked both at the conference back in November and the other week during a conference call put on by the AMP student outreach committee. Yes most people apply to categorical programs as well. All the PD's understand the situation your in when there is only 10 spots total in the country for fm-psych. Its even acceptable to apply to the categorical programs at the same program as well. However you have to be very straightforward in your interview that this is the case.
  22. nashki

    nashki 2+ Year Member

    Feb 8, 2013
    Yeah, while everyone seems to think that you're only practicing one field with combined training, the truth is that in most cases that's too simplistic. I would also argue that FM-psych is a combination that inherently goes together, because psych is such a huge part of primary care.

    Even the docs that only work in one type of setting are utilizing their training and it changes how they practice with a clear emphasis on both fields. Many combined docs have explicitly said that they don't wear two hats that they switch between, they wear one that just happens to combine both fields.

    In any case, I thought I'd refresh this thread. In terms of numbers, you should at least be competitive for FM and psych respectively. The biggest thing that gets you invites though is networking, meeting people, and having a very targeted application. You need to go to AMP. You need to have a PS that explicitly describes why you want combined training and how you'll use it in the future. You need LORs from each field (i.e. at least one from FM and one from Psych, plus others), and at least some of those LORs should mention combined training. You need to network and stay in contact with combined residents, because its a small community, and you'll be seeing them for years to come.

    There's only five programs, and each one is a bit unique:

    UCD - Strong and established PD in AMP community, agricultural community with a lot of migrant workers, unique combination of city and nearby agriculture, requires 4 LORs and a supplemental application that's on their website

    UCSD - Large university, incredible continuity clinic at St. Vincent de Paul, where you are caring for the homeless population, lots of traveling and issues with parking according to residents, but also lots of opportunities to do a lot of different things in the city

    Iowa - Strong emphasis on primary care, PD and some other faculty made up of combined trained docs from the program or the IM-Psych program, IMP program in-house, heavy VA psych curriculum, psmaller University town with a very family friendly atmosphere

    Cincy - Very detailed FM curriculum with modules and regular "quizzes", strong emphasis on global health, FM at community hospital, PD is well known in the AMP community and is a psych trained doc

    UPMC - Large university system, newest program, huge and incredible Psych hospital (WPIC), PD is a foreign (UK) trained psychiatrist that also worked as a GP, global health emphasis, features two settings for FM training, an unopposed inpatient heavy program in a middle-upper class community (StM) and a hospital with an in-house IM residency in a severely economical depressed/underserved area (McK)

    Obviously you can get more from the individual websites and talking to residents. One thing repeatedly said by the residents from all programs is that all the remaining programs are the strongest and all will provide excellent training. It's more a matter of finding where you fit best.

    You have to apply to a backup. Everyone does. There's only 5 FMP and 11 IMP programs. Some people do FM/IM, some do psych, and some do both. Each year is different, but this year seemed like more people were applying to psych to me. The programs know and understand this.
  23. medhead1990

    medhead1990 2+ Year Member

    Jun 1, 2013
    Awesome post thank you! I really don't want to be either categorical counterpart but rather the "one hat" blend as you put it, which is a hard concept to explain to others outside of the combo community.

    I think what you said near the end is probably the most important part of it all. If you are going to be going somewhere for 5 years you should really make sure it has the right feel for your personality. If you don't get invited somewhere a good way to look at it is, that the program didn't think you were a right fit for them, so it would be safe to say in turn that they probably won't be the right fit for you.

    One of the positive points to applying to the combined programs is that in order to have a combo program in the first place you have to have strong categorical programs to support it. I've decided that I will be getting great training no matter where I go, the trick is now to find where myself and my family will be most happy.

    Application season is coming up i'm curious to see how many SDN'er are thinking about putting their hat in the combo cycle (both FM and Im psych)? If your reading this put up a quick post. =)
  24. Lets Get Free

    Lets Get Free Big Member 7+ Year Member

    Aug 30, 2009
    Thousand Oaks, CA
    CA MS4 here, going to apply to FM-Psych and FM
  25. medhead1990

    medhead1990 2+ Year Member

    Jun 1, 2013
    Hey! Glad to hear another one is on the boat with me. You looking to apply to the CA programs or all 5 Fm-psych's?

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