Got a TY offer in SOAP, didn't match into Psych

[Puckisagod]

Hi everyone,

Thanks for reading this.

So I'm really conflicted as to what to do here. My apps were delayed a few weeks in the fall due to a late LOR and I ended up not matching into Psych. I got a TY in SOAP and I know I should be grateful for that, but so far the program does not seem great. They've changed the location I was assigned to, their website has no information and the staff has been unresponsive to my emails. They're not affiliated with a psychiatry residency either. The only people I know from my school who did a TY and matched into Psych, did a TY at our home school and matched into the same program. I've been told I should do away rotations in the fall, similar as a MS-4, but I don't even know how to go about doing that. PD's I've spoken to said the only problem with my app was my step 2 score, as it dropped. Step 1 was average. One also recommended I do some more research, if I can. I have a master's degree in Neuroscience, so I'm not interested in getting another one. I'm still pretty shocked I didn't match, as my top 2 programs basically told me 'see you in the summer,' and I knew one of them from work I did during my master's.

To get reimbursed by the TY for taking step 3 (which would be nice), I can't schedule it or even buy the test until after July 1st, which means it probably won't be out in time for the 9/15 app date. My school is not being helpful with the guidance on how to go about all of this. Is doing the TY a good idea? Should I be delaying graduation instead and just get a clinical research job? Or graduate and take a year off? Any advice from someone who's been there would be awesome, because I feel like I'm running blind here, thanks.

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[mbgr2014]

For starters, I'm sorry you're going through this

If you SOAPed into a TY, my understanding is you are contractually obligated to work at least the first 45 days or something like that. That's true for all NRMP matches. So you can't just delay graduation or take a year off, you have to start when scheduled this summer. It would be a match violation, and a contractual violation for you to not do your transitional year.

Edit: And obviously with that context, you should really just complete the full TY as planned and do the best you can to get a Psych residency the following year.

 

[Sushirolls]

Full steam ahead. Graduate, Get your degree, get your step 3 done and finish that TY. Keep your eyes peeled for PGY-II openings in psych and apply to ALL psych programs for PGY-I next year.

Worst case scenario at end of TY if unmatched, you'll be able to get an independent license in most states and do cash only in some capacity to pay the bills.

 

[psychattending]

Agree with the point that you are required to show up at the program on July 1. If you don't you would have a match violation and would likely not be allowed into the Match the next year. I would also encourage you to finish the entire yet (instead of dropping out after the required time to not have a Match violation), as it will be obvious in your application that you did not finish your TY, which would be a very big negative.

 

[DokterMom]

Try to reframe your thinking onto the positives. You got a TY residency that will allow you to practice medicine after completion of your year. Focus on the positive aspects of the program you SOAPed into -- the locale, multiple training sites, people who believed in you enough to choose you. Don't let the administrative SNAFUs get into your head; those happen at many top programs also. And first and foremost, plan to complete the year there! Start strong and treat your TY as Job One -- because it is.

The timing on your STEP 3 is fine. Getting your score back after 9/15 but before February allows you to release your scores early if they're good, late if they're OK, or retake if you fail. That's actually a good thing.

And finally, you've got enough time to research and plan how to get back into the Psych game. If your school can't help you, SDN can. And if you work hard and maintain a great attitude, your TY program probably can and will as well. You can still absolutely get there from here.

 

[MacDonaldTriad]

You really have to show up and start the TY program. You can try to write the NRMP for an exception to get out of the contract but it will take more than "because I don't want to do it". If you train for 45 days and find a PGY-I mid year in psychiatry it would be safe to jump, but this is hard without the cooperation of your current PD. If you drop out of TY after 1.5 months and reapply, you will have a difficult time I fear.

 

[Puckisagod]

Ok, so yea after some research, definitely going to do the TY in it’s completion. But how do I go about getting away rotations like you do as a 4th year during my elective time?

 

[Crayola227]

Ok, so yea after some research, definitely going to do the TY in it’s completion. But how do I go about getting away rotations like you do as a 4th year during my elective time?

Most interns don't have "elective" time. I remember even selectives being pretty limited in quantity and range, and not being until after intern year. Maybe TY get a month, I dunno.

 

[MacDonaldTriad]

Ok, so yea after some research, definitely going to do the TY in it’s completion. But how do I go about getting away rotations like you do as a 4th year during my elective time?

Stop obsessing about away rotations. You are about to enter post graduate education. Your current PD will summarize your performance during real MD training and this will generally trump most of your medical school record unless there is something very funky that happened during med school. If you do well, you might get a PGY-II position. If you do averagely well, you will be a safer bet for a PGY-I position than most untested MS4s.

You started this post with "So I'm really conflicted as to what to do here." The reality is that you made that decision when you soaped into a contract. Your last post seems to indicate that this reality has set in some, but then asking how you can do more medical school rotations shows that the reality of your graduating from being a med student still hasn't sunk in.

You need to look up radical acceptance and move on. This ship has sailed and the train has left the station. You are about to move, go to orientation by late June and then do 12 life changing months as a medical intern. It will not be easy, but if you steel yourself up to the task and do well, you will be a desirable applicant. The alternative is to show up in disbelief like a deer in headlights and look for a way out that is unlikely to happen without significantly damaging your chances of getting into a residency. Program directors hate it when new trainees show up irritated with being in their program. You need some enthusiasm going into this or it will start poorly and probably get worse. Again, radical acceptance. Buck up and show us how good you can be and how steep your learning curve is and all will end well. I'm pulling for you, but you need to get your head around this.

 

[psychattending]

Most (all?) programs will have zero expectation of you being able to do an away rotation. They know that you are being paid to work/learn in your TY program. In general it will be very difficult administratively to do an "away rotation" as you are no longer a student but a doctor who has a new role to fulfill with its own set of training requirements. If you do well and get good letters, that will help your application immensely since it will show that you can function as a doctor. The thing that you need to be asking time off for are interviews during interview season. You might need to be prepared to use your vacation time for that.

 

[puahate]

is this the future for psych applicants?

 

[MacDonaldTriad]

I don't think so, but it is somewhat dependent on what kind of applicant you are. I think the lesson here is not to hold up your application because of one LOR. Try to get it in on 9/15. If it isn't complete 9/15, put in what you have and hurry with the rest. I know it can be hard to pressure faculty to get your LOR done when they are doing you the favor, but realistically you may need to ask them if they can do it before 9/15 because if they can't, you will need to ask someone else. In late August, I remind our faculty how high stakes this is for MS4s and doing it late can be worse than refusing to do it.

 

[mbgr2014]

I don't think so, but it is somewhat dependent on what kind of applicant you are. I think the lesson here is not to hold up your application because of one LOR. Try to get it in on 9/15. If it isn't complete 9/15, put in what you have and hurry with the rest. I know it can be hard to pressure faculty to get your LOR done when they are doing you the favor, but realistically you may need to ask them if they can do it before 9/15 because if they can't, you will need to ask someone else. In late August, I remind our faculty how high stakes this is for MS4s and doing it late can be worse than refusing to do it.

I agree on this bit. I also recommended to the class below me that they aim to have 5-6 letter writers so they have some room for error for less consistent faculty. In addition I emphasized the importance of Sept 15 to letter writers, although mine were pretty on top of it.

 

[Sushirolls]

One positive is that by doing a TY this allows a second review of "what do I want to do?" and the OP could maybe apply for gen surg, or rads, or PM&R or what ever else. Granted, this change of heart will have to happen before fall, narrow window to make such a change.

 

[psychattending]

I think it is gross overkill to be asking 5-6 faculty to write letters. I will only accept three or four and I don't hold it against an applicant if they are not in yet as I know it is out of the control of the applicant. Letters have minimal impact on one's ability to get a residency slot. As indicated above don't hold up submitting your application if letters are not done yet. Send it in when all of your work is done. The Dean's letter and the LOR will come on their own later. As many of us have said in the past, applicants are getting way too concerned about things. Yes things are more competitive than in the past but they are still not what other some of the other specialties deal with. The ones who are not matching tend to have some type of red flag or poor interpersonal skills during the interview process.

 

[raisinbrain]

I think it is gross overkill to be asking 5-6 faculty to write letters. I will only accept three or four and I don't hold it against an applicant if they are not in yet as I know it is out of the control of the applicant. Letters have minimal impact on one's ability to get a residency slot. As indicated above don't hold up submitting your application if letters are not done yet. Send it in when all of your work is done. The Dean's letter and the LOR will come on their own later. As many of us have said in the past, applicants are getting way too concerned about things. Yes things are more competitive than in the past but they are still not what other some of the other specialties deal with. The ones who are not matching tend to have some type of red flag or poor interpersonal skills during the interview process.

Agreed.

Please don’t go asking 6 faculty to write letters for you, especially if you plan on not even using some of them. Many letter writers do in fact take their role seriously and put effort into thinking about what to say (no, not everyone does, but worth keeping in mind). And note that the more people you ask, the more ‘stress’ you’re placing on your institutions faculty members as a whole. Could mean a wasted 25% of all letters.

I do agree though in identifying 5-6 people that you would be happy getting letters from. Ask them EARLY, and clarify your expected time you would like it done (do not give them your submission deadline, but a month or two early), and remind them often. Most importantly ask if they feel they can produce a positive letter in this time frame. Ask in person. Any hesitancy, then reconsider...

 

[mbgr2014]

I think it is gross overkill to be asking 5-6 faculty to write letters. I will only accept three or four and I don't hold it against an applicant if they are not in yet as I know it is out of the control of the applicant.

In my case, I asked for 5 letters and got 5. I obviously only turned in 4 because that is all ERAS lets you do. But I had a fallback in case I wasn't confident my attending from my Sub-I would write a strong letter. I don't think that's unreasonable. Especially with all the horror stories of students being completely GHOSTED by their letter-writers after having the feeling they'd get a strong letter.

 

[scrapy]

Could we get a 5 point range for the step score?