Going to DO school in fall, possible to get into competitive psych residencies

[DocTroy]

So the good news is that I am headed to medical school/osteopathic school (Western University) this fall and the school is not too far from my parents so it helps for commuting/home sickness purposes, but I was really gambling on breaking through the waitlist on two MD schools, which didnt fall through.

Although I am still looking at other specialties, psychiatry has been a specialty I have closely followed for the last 5 years. I have heard that a lot of the competitive specialties and that many of the top/prestigious psychiatry residencies have some "bias" against DO applicants. I have heard that PM&R and psychiatry are both DO friendly, but does this also apply to top residencies in psychiatry as well. I am interested in academia psychiatry/academia health care so I heard going to a well known residency is the first step towards that goal.

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[rkaz]

Congrats on your acceptance to medical school! To answer your question: yes, you can get into competitive psychiatry residencies as a DO, presuming you do reasonably well in school. If you don't do so well, you may still likely obtain a psych residency, though the top programs would likely be closed to you. This is how things stand at present - though obviously we don't know if this will still be the case 3 years from now, due to the increasing demand for residency positions (due to the increasing number of medical student matriculants without corresponding residency increases).

If you scroll down through the psychiatry sub-forum, you will see the thread on DO friendly psychiatry residencies. Read through that, as it may give you a perspective. You can also do a search for 'osteopathic' as that should turn up many threads relevant to your question.

(Note to moderators: this recurring question/theme is why we need the DO stickies! Where did that other thread with all of the awesome links for applicants go?)

 

[DocTroy]

thanks for the reply! I saw a couple of forums on DO and psychiatry residency but they were posted a while ago that I figured the dynamics of psych residency application process changed by now.

will check out that thread you mentioned

 

[shan564]

There may be some discrimination at a handful of places - most Ivy League places, Stanford, UCSF, UCLA.

But that doesn't mean that you can't go to a brand-name place. Mayo is definitely DO-friendly and their program director is a DO. There are DOs at my program, WashU, which I think is one of the top programs.

 

[postbacpremed87]

There may be some discrimination at a handful of places - most Ivy League places, Stanford, UCSF, UCLA.

But that doesn't mean that you can't go to a brand-name place. Mayo is definitely DO-friendly and their program director is a DO. There are DOs at my program, WashU, which I think is one of the top programs.

What does it take to get into one of the top programs other than higher USMLE scores and some psych research?

 

[notdeadyet]

What does it take to get into one of the top programs other than higher USMLE scores and some psych research?

- Be professional, compassionate, and motivated on all your clinical rotations. Honoring psych is kind of expected; top programs look at how you do clinically as a whole, not just your psych rotations.m AOA is helpful if you're an allopath.
- Get to know clinicians you work with and give them the chance to get to know you. Good LORs are big, and it helps if they are from people that are know to folks at the programs you want to attend (e.g.: a letter from a known county public health doc in the town of a program you're applying to will likely carry more weight than one from an academic cross country the target program doesn't know). It's also best to go to a school where you can work longitudinally so that your letters aren't limited to folks who've seen your work for only a month (e.g.: if you go DO, try to choose a program that has organized PGY-3/4 years, not ones that have you traveling from site to site in different hospitals for 2 years).
- Find your passion(s) and jump in during medical school. Are you interested in education? Try to write standardized patient cases or curriculum development, not just tutoring here and there. Are you interested in research? Make it a part of your life in med school. Doing lab work between MS1 and MS2 in the summer as a perfunctory box to check doesn't impress anyone, but playing a growing role in projects for years says something about your commitment to research. Are you interested in LGBT, public psychiatry, the justice-involved, veterans health, cross-cultural psych, psychosomatic, or women's health? Explore it with gusto in med school, take a big bite, show some passion that indicates follow through by actually doing work in the area so that you don't name a bunch of interests that you never really explored by the time you apply.
- Top programs get LOTS of apps and they can be choosy. That you are a good med student is a given. But what makes you DIFFERENT? How will you contribute to your residency by being a little different from your peers and help with a different perspective? What in your life experience before, during, or outside of medical school shows this? Does your application and the choices you've made in med school show that you're comfortable inside your own skin and willing to be yourself?
- High USMLE and some research is actually probably a bigger thing at "good" programs. Top programs can look beyond that and look for folks they really feel will make a splash in psych and become future leaders in the field. Figure out how you want to do that in your own personal way and start taking the steps to explore how you want to do that during med school by experimenting with different types of reading, research, volunteering and electives that will help you define ideas of what you hope to do and the type of psychiatrist you'd like to be.

 

[oracle2]

I'm probably headed to a DO program and also interested in psych. My concerns are more about attracting clients in the "real world", especially in markets where there are plenty of psychiatrists to choose from (aka, desirable urban markets... just because people aren't always educated on what a DO is and only look at the letters, not the training program the doctor attended. I seriously think the "letters" issue is one of the only reasons Carib med schools attract students.

I'd love if someone could speak on that. It seems like DO's might have an easier time building up a client base when they are mixed into an MD practice and are preliminarily "assigned" patients, but so many psychiatrists just practice solo.

 

[postbacpremed87]

I'm probably headed to a DO program and also interested in psych. My concerns are more about attracting clients in the "real world", especially in markets where there are plenty of psychiatrists to choose from (aka, desirable urban markets... just because people aren't always educated on what a DO is and only look at the letters, not the training program the doctor attended. I seriously think the "letters" issue is one of the only reasons Carib med schools attract students.

I'd love if someone could speak on that. It seems like DO's might have an easier time building up a client base when they are mixed into an MD practice and are preliminarily "assigned" patients, but so many psychiatrists just practice solo.

It looks like everyone will be doing Psychiatry by 2018

 

[notdeadyet]

This likely won't cause many challenges for you, unless you are planning on doing a high price cash only practice in an urban area.

And if you do that, it's kind of hard to set up a business targeting a demographic rife with snobs and then complain of snobbery…



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[DocTroy]

wow a lot of great responses. thanks.

so I have a fiance working in Vegas and the plan was to stay in CA after I graduate and get married during residency. CA has more applicants than other states so I wanted to know how much of a disadvantage I am putting myself being geographically limited, we might look into the NV residencies but her requires her to be in CA in the future. notdeadyet mentioned a good list but what step 1 score should I aim for if I want to stay in CA since I figure there will be more applicants than compared to the AZ/NV residencies.

 

[OldPsychDoc]

I'm probably headed to a DO program and also interested in psych. My concerns are more about attracting clients in the "real world", especially in markets where there are plenty of psychiatrists to choose from (aka, desirable urban markets... just because people aren't always educated on what a DO is and only look at the letters, not the training program the doctor attended. I seriously think the "letters" issue is one of the only reasons Carib med schools attract students.

I'd love if someone could speak on that. It seems like DO's might have an easier time building up a client base when they are mixed into an MD practice and are preliminarily "assigned" patients, but so many psychiatrists just practice solo.

That really depends on where you are. The image of solo practice is likely over-represented on this forum, but I think that shortage conditions and group practice is the norm (yes, I need to see the numbers...) in much of the nation. And with the call to increase our presence in integrated care (see thread a bit down the page), etc., I think that you're unlikely to have a problem filling a practice in very short measure.

 

[postbacpremed87]

That really depends on where you are. The image of solo practice is likely over-represented on this forum, but I think that shortage conditions and group practice is the norm (yes, I need to see the numbers...) in much of the nation. And with the call to increase our presence in integrated care (see thread a bit down the page), etc., I think that you're unlikely to have a problem filling a practice in very short measure.

Give me a 210-220k employed job where I can leave the administrative stuff up to someone else so I can go pick my son or daughter up from practice after school.

 

[OldPsychDoc]

Give me a 210-220k employed job where I can leave the administrative stuff up to someone else so I can go pick my son or daughter up from practice after school.

Can do--call me in 4 years.

 

[EMDO2018]

It looks like everyone will be doing Psychiatry by 2018

I doubt it, chill

 

[whopper]

Don't let yourself feel you are second rate because you have a DO. Some places might be prejudicial. If so-screw them. You got plenty of opportunities. If you're good, it's their loss.

 

[postbacpremed87]

I doubt it, chill

I was joking...

 

[DocTroy]

wow a lot of great responses. thanks.

so I have a fiance working in Vegas and the plan was to stay in CA after I graduate and get married during residency. CA has more applicants than other states so I wanted to know how much of a disadvantage I am putting myself being geographically limited, we might look into the NV residencies but her requires her to be in CA in the future. notdeadyet mentioned a good list but what step 1 score should I aim for if I want to stay in CA since I figure there will be more applicants than compared to the AZ/NV residencies.

any advice on this post. advice appreciated. what type of Step 1 score should I aim to try to aim for if I am looking at CA. how many residencies do most apply to?

 

[MLT2MT2DO]

any advice on this post. advice appreciated. what type of Step 1 score should I aim to try to aim for if I am looking at CA. how many residencies do most apply to?

You should aim for a 270. If you fall below that so be it. Do your best to acclimate yourself to med school the first year, then work yourself like you've never worked yourself before in your 2nd year to obtain as high of a board score as possible. If you follow this formula at very least you'll walk away knowing you gave it your all.

Going to a D.O. school I think the one thing I would encourage is to seek out research and if it comes available snatch it up. I passed on a research opportunity early 2nd year and haven't been able to find anything since. Now as I sit here filling my CV out my CV for the match, it is a definite gaping hole and I'm guessing I will be ranked lower or screened out of some CA schools because of it. A major disadvantage of many DO schools to MD is our lack of access to research.

 

[notdeadyet]

Most psych applicants, allopathic or otherwise, do not have research. Even at top programs, unless you're research track, many matriculants will not have research. It's a nice-to-have, but its absence will not be a deal killer in an otherwise strong applicant. Even for top CA programs.


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[Elisabeth Kate]

There may be some discrimination at a handful of places - most Ivy League places, Stanford, UCSF, UCLA.

But that doesn't mean that you can't go to a brand-name place. Mayo is definitely DO-friendly and their program director is a DO. There are DOs at my program, WashU, which I think is one of the top programs.

Also, not all Ivy League places are discriminatory. There are DOs at both Dartmouth and Harvard in psych and yes, there are a lot of brand-name places that are very DO friendly, even if you didn't take the USMLE.

You should aim for a 270. If you fall below that so be it. Do your best to acclimate yourself to med school the first year, then work yourself like you've never worked yourself before in your 2nd year to obtain as high of a board score as possible. If you follow this formula at very least you'll walk away knowing you gave it your all

I'll agree with this, but I will say don't feel as if you are required to take the USMLE to match psych. You are not (but you should). This is very important -- take practice NBME exams before you sit for it. I know of a few classmates who did fairly well on the COMLEX, but failed the USMLE and all three were shut-out of places they probably would have interviewed at had they not taken the USMLE at all. A failed USMLE is much worse than no USMLE.

Going to a D.O. school I think the one thing I would encourage is to seek out research and if it comes available snatch it up. I passed on a research opportunity early 2nd year and haven't been able to find anything since. Now as I sit here filling my CV out my CV for the match, it is a definite gaping hole and I'm guessing I will be ranked lower or screened out of some CA schools because of it. A major disadvantage of many DO schools to MD is our lack of access to research.

Granted, CA wasn't a destination for me and I only applied to 2 programs out there, but sincerely, the vast majority of applicants in psych match without any research. Of all the things to worry about for your application, this should be at the bottom. The most important thing for psych is third year evals in ALL fields, not just psych, your grade in your psych clerkship, and letters of recommendation. Right after that comes board scores and personal statement/reason for wanting psych. Somewhere after that comes research. Focus on the others before you fret about research.

 

[Igor4sugry]

I have heard that PM&R and psychiatry are both DO friendly, but does this also apply to top residencies in psychiatry as well.

All low competition residencies are DO friendly. PM&R keeps showing up on this "DO friendly list", but its becoming quite a competitive specialty. In any case, do well in med school, take at least USMLE Step I, and apply only to MD residencies.

 

[shan564]

Also, not all Ivy League places are discriminatory.

That's why I said "most" and not "all."

 

[Elisabeth Kate]

All low competition residencies are DO friendly. PM&R keeps showing up on this "DO friendly list", but its becoming quite a competitive specialty. In any case, do well in med school, take at least USMLE Step I, and apply only to MD residencies.

PM&R being on the DO friendly list has nothing to do with it being competitive or non-competitive. As you said, it is becoming quite competitive. However, it will always be DO friendly because the OMM component in DO education lends itself brilliantly to the fundamental concepts of PM&R. That's why a lot of DOs want to do it and why the field has been relatively open to DOs.

That's why I said "most" and not "all."

I meant to add on to your post, not disagree with it.

 

[Leo Aquarius]

According to the NRMP, the following specialties took the most DO students this past year 2014:

"For students and graduates of osteopathic medical schools (“Osteo”), the largest numbers were matched to:
 Internal Medicine (categorical) (444)
 Family Medicine (394)
 Pediatrics (categorical) (290)
 Anesthesiology (categorical, advanced, and physician positions) (185)
 Emergency Medicine (177)
 Psychiatry (categorical and physician positions) (160)
 Obstetrics-Gynecology (131)
 Physical Medicine & Rehab (categorical, advanced, and physician positions) (114)"

Regarding PM&R, the average Step 1 score isn't high for this specialty. So I was baffled wondering what could make it a tad competitive. Looks like there are very few residency positions each year - around 391 in total. That's fewer than Derm's 414. Very interesting.

 

[MLT2MT2DO]

I'll agree with this, but I will say don't feel as if you are required to take the USMLE to match psych. You are not (but you should). This is very important -- take practice NBME exams before you sit for it. I know of a few classmates who did fairly well on the COMLEX, but failed the USMLE and all three were shut-out of places they probably would have interviewed at had they not taken the USMLE at all. A failed USMLE is much worse than no USMLE.

Regardless, you should attempt to shoot for the stars, not settle on an arbitrary number like 230. Additionally UCSF won't interview anyone until they have Step 1 and Step 2 USMLE under their belt.

Granted, CA wasn't a destination for me and I only applied to 2 programs out there, but sincerely, the vast majority of applicants in psych match without any research. Of all the things to worry about for your application, this should be at the bottom. The most important thing for psych is third year evals in ALL fields, not just psych, your grade in your psych clerkship, and letters of recommendation. Right after that comes board scores and personal statement/reason for wanting psych. Somewhere after that comes research. Focus on the others before you fret about research.

While this may be true at many schools, I had UCSD in mind when writing this. They are known for being very research oriented.

 

[Elisabeth Kate]

Regardless, you should attempt to shoot for the stars, not settle on an arbitrary number like 230. Additionally UCSF won't interview anyone until they have Step 1 and Step 2 USMLE under their belt

As I said in my other post, I just didn't want anyone thinking that they had to take the USMLE in order to match into psych. Also, a lot of people shoot themselves in the foot by taking it without taking practice exams and end up failing or getting a 195 or something.

 

[Atom bum]

Regardless, you should attempt to shoot for the stars, not settle on an arbitrary number like 230. Additionally UCSF won't interview anyone until they have Step 1 and Step 2 USMLE under their belt.

Out of curiosity, how do you know this to be true? One school I am looking at has this

• We do NOT accept COMLEX Scores in place of USMLE Scores
• Trainees must pass USMLE Step 1, Step 2CK, and Step 2CS prior to commencing their Duke postgraduate training

right on their application website. When I called them, however, I was informed that they do take COMLEX scores.

 

[MLT2MT2DO]

Out of curiosity, how do you know this to be true? One school I am looking at has this

right on their application website. When I called them, however, I was informed that they do take COMLEX scores.

That is quite ridiculous Duke would put that on their website if they accept the COMLEX. If you call UCSF let me know what you find out.

 

[Leo Aquarius]

PM&R being on the DO friendly list has nothing to do with it being competitive or non-competitive. As you said, it is becoming quite competitive. However, it will always be DO friendly because the OMM component in DO education lends itself brilliantly to the fundamental concepts of PM&R. That's why a lot of DOs want to do it and why the field has been relatively open to DOs.

Makes sense but I don't feel it's the right explanation. I wonder why did the least number of DOs match into PM&R, and I wonder why so many DOs entered a procedure-dominated non-holistic field like anesthesiology?

Multiple choice question:
Which field matched the most DOs in 2014?
a. Psychiatry
b. Emergency Medicine
c. Anesthesiology
d. PM&R

90% of respondents would pick A, with the remaining 10% picking PM&R. But the answer is C. I think no matter MD or DO, most students jump for the high-paying good-lifestyle specialty, or at least what's perceived to be that way.

 

[Atom bum]

That is quite ridiculous Duke would put that on their website if they accept the COMLEX. If you call UCSF let me know what you find out.

I was actually surprised when they told me that. To be honest I am going to call back at some point to verify. Perhaps the person I spoke with was mistaken.

 

[Elisabeth Kate]

Makes sense but I don't feel it's the right explanation. I wonder why did the least number of DOs match into PM&R, and I wonder why so many DOs entered a procedure-dominated non-holistic field like anesthesiology?

Multiple choice question:
Which field matched the most DOs in 2014?
a. Psychiatry
b. Emergency Medicine
c. Anesthesiology
d. PM&R

90% of respondents would pick A, with the remaining 10% picking PM&R. But the answer is C. I think no matter MD or DO, most students jump for the high-paying good-lifestyle specialty, or at least what's perceived to be that way.

Yeah, but you're responding to my lesser point. The point I was going for was why PM&R is so DO friendly. PM&R PDs are more open to DOs because of the training DOs have in the musculoskeletal system. At least, that's what I've been told by many MDs in the PM&R field.

 

[Leo Aquarius]

I agree and I was just taking the opportunity to add my extra point following your point. PM&R does jive well with the DO mantra.

 

[Leo Aquarius]

To answer the OP's question, you can get to a reasonably competitive residency as a DO graduate apparently because I've seen them at some better-known California programs. Not many of them, but some.

 

[MacDonaldTriad]

Makes sense but I don't feel it's the right explanation. I wonder why did the least number of DOs match into PM&R, and I wonder why so many DOs entered a procedure-dominated non-holistic field like anesthesiology?

Multiple choice question:
Which field matched the most DOs in 2014?
a. Psychiatry
b. Emergency Medicine
c. Anesthesiology
d. PM&R

90% of respondents would pick A, with the remaining 10% picking PM&R. But the answer is C. I think no matter MD or DO, most students jump for the high-paying good-lifestyle specialty, or at least what's perceived to be that way.

If you think anesthesia isn’t very in line with the DO mantra, what about psychiatry?
DO applicant: “I could have gone to an allopathic school, but I think the OMM skills are important skills to have if I’m going to help people.”
Psych attending: (Humm… Does this applicant realize that this is a psychiatry interview?)

 

[rkaz]

If you think anesthesia isn’t very in line with the DO mantra, what about psychiatry?
DO applicant: “I could have gone to an allopathic school, but I think the OMM skills are important skills to have if I’m going to help people.”
Psych attending: (Humm… Does this applicant realize that this is a psychiatry interview?)

I brought up my interest in holistically-0riented medicine and drew parallels between both osteopathy and psychiatry in a few of my residency interviews , and I don't think I was being disingenuous at all. Maybe my MD interviewers were rolling their eyes internally at my spiel... but I truly meant what I said.

 

[Elisabeth Kate]

I brought up my interest in holistically-0riented medicine and drew parallels between both osteopathy and psychiatry in a few of my residency interviews , and I don't think I was being disingenuous at all. Maybe my MD interviewers were rolling their eyes internally at my spiel... but I truly meant what I said.

I simply said I applied all over, both MD and DO, and went to the school I liked the best that also liked me. It happened to be a DO school.

 

[rkaz]

I simply said I applied all over, both MD and DO, and went to the school I liked the best that also liked me. It happened to be a DO school.

I was responding to Macdonaldtriad, not to anything that you wrote.

 

[Elisabeth Kate]

I was responding to Macdonaldtriad, not to anything that you wrote.

I know. I was just adding on to your post and saying that I got that question of why, as a DO, did you pick psychiatry. I didn't bother to make any parallels, as you did. It still worked out. But I do like that you intertwined them.

 

[MacDonaldTriad]

I brought up my interest in holistically-0riented medicine and drew parallels between both osteopathy and psychiatry in a few of my residency interviews , and I don't think I was being disingenuous at all. Maybe my MD interviewers were rolling their eyes internally at my spiel... but I truly meant what I said.

I admit I don’t know much about OMM, and I’m sure your interest in holistic approaches was not disingenuous (sorry about the weird double negative, “was ingenuous” sounds wrong), I just assume that some of the OMM stuff would be inappropriate to apply in psychiatry. If there is a literature on OMM and psych, I would love to be educated. No one would argue that holistic approaches are bad.

On a somewhat related, but new subject; if you are a D.O. applicant being interviewed by an ACGME program, most interviewers will not make you defend your choice of education, unless they are being jerks. When D.O. applicants are pushed towards the defensive, they sometimes sound like they are inferring that allopathic schools are closed minded and anti-holistic in their approach. Not a good place to go so be careful how you make such arguments. Statements akin to “my education has so many wonderful things that your MD training is lacking”, lead to traps like: “so why are you not going for AOA training?” If someone asks this, I suggest discussing fellowship opportunities, the wider variety of locations, or something like that. I guess the AOA/ACGME distinctions are going to melt away soon anyway.

 

[rkaz]

I know. I was just adding on to your post and saying that I got that question of why, as a DO, did you pick psychiatry. I didn't bother to make any parallels, as you did. It still worked out. But I do like that you intertwined them.

Ahh, gotcha... that makes more sense, as I read your last post wrong. I like your response to being asked about going to a DO school.