How competitive is it to obtain a residency in psychiatry?

[UnicornDemon]

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I'm considering switching to pre-med (currently a junior) and attending medical school to become a psychiatrist. However, I would want to do absolutely no other medical specialty apart from psychiatry. Right now if I was to switch to pre-med, I'd be doing the bare minimum pre-requisites to get into med-school, meaning I won't have the same preparation other kids who took immunology, anatomy etc. in undergrad would have. This puts me at a disadvantage. Anyways, are psychiatry residencies competitive these days or should I be able to land one if I truly want it?

 

[digitlnoize]

I'm considering switching to pre-med (currently a junior) and attending medical school to become a psychiatrist. However, I would want to do absolutely no other medical specialty apart from psychiatry. Right now if I was to switch to pre-med, I'd be doing the bare minimum pre-requisites to get into med-school, meaning I won't have the same preparation other kids who took immunology, anatomy etc. in undergrad would have. This puts me at a disadvantage. Anyways, are psychiatry residencies competitive these days or should I be able to land one if I truly want it?

Its far harder to get into med school (and finish), than to get a psych residency. Psych is currently one of the least competitive fields. This is likely due to many factors.

Go to the pre-med board. Stay focused. Come back in a few years if you're still interested. Have you considered clinical psychology?

 

[UnicornDemon]

I have considered clinical psychology, but I understand the job prospects and salary for psychiatrists are greater than those for psychologists. I am aware of how competitive it is to get into med-school. Thankfully, I have a good GPA (3.98), yet unfortunately I have NO extra-curriculars to put on my resume thus far. I'm willing to spend 2-3 years after undergrad doing volunteer work and other activities to beef up my resume. I've also considered DO school.

 

[NYCMS2]

I'm considering switching to pre-med (currently a junior) and attending medical school to become a psychiatrist. However, I would want to do absolutely no other medical specialty apart from psychiatry. Right now if I was to switch to pre-med, I'd be doing the bare minimum pre-requisites to get into med-school, meaning I won't have the same preparation other kids who took immunology, anatomy etc. in undergrad would have. This puts me at a disadvantage. Anyways, are psychiatry residencies competitive these days or should I be able to land one if I truly want it?

With that goal, you should thoroughly investigate psychology doctoral programs. If you are dead set on psychiatry and no other medical fields, don't bother with med school. Trust me...only go to med school if you have an open mind about medicine.

Also - you are at no disadvantage not taking those classes - I didn't - I took the bare minimum med school pre reqs - it is a non-issue.

 

[V3NOM]

With that goal, you should thoroughly investigate psychology doctoral programs. If you are dead set on psychiatry and no other medical fields, don't bother with med school. Trust me...only go to med school if you have an open mind about medicine.

Also - you are at no disadvantage not taking those classes - I didn't - I took the bare minimum med school pre reqs - it is a non-issue.

Can you develop this? I found this very interesting.

 

[UnicornDemon]

Also - you are at no disadvantage not taking those classes - I didn't - I took the bare minimum med school pre reqs - it is a non-issue.

Do you mean that they make no impact on my admissions decision? Or that knowing anatomy beforehand won't help me get through med-school?

 

[UnicornDemon]

With that goal, you should thoroughly investigate psychology doctoral programs. If you are dead set on psychiatry and no other medical fields, don't bother with med school. Trust me...only go to med school if you have an open mind about medicine.

I would be also be happy doing family practice, which I understand is the least competitive residency to obtain.

 

[NYCMS2]

Do you mean that they make no impact on my admissions decision? Or that knowing anatomy beforehand won't help me get through med-school?

Both. Don't sweat it.

Make As in the pre reqs, make 32+ on the MCAT, and get plenty of volunteer clinical stuff on your resume, and you will be fine for admissions.

 

[NYCMS2]

I would be also be happy doing family practice, which I understand is the least competitive residency to obtain.

I don't know if it is the least competitive or not, but I wouldn't be caught dead in FM. You are approaching this the wrong way.

I don't see how an undergrad can be so certain, or have so many preconceived notions about medical careers, when you haven't done any clinical stuff, or any volunteer stuff.

The first post above advising you to go back to the pre allo threads was spot on. And seriously, with your stated goals of psych or bust, I highly recommend avoiding med school altogether and going the clinical psychology route...save yourself a hell of a lot of grief. I am going into psychiatry, but if I had it to do all over again...

 

[OldPsychDoc]

There is really NO way to predict how competitive or non-competitive psych will be in the 6-7 years between now and you completing medical school, either. We're already building expectations of reduced funding for graduate medical education (=fewer residency positions) while at the same time there are increased numbers of medical school slots, as well as continued increases in offshore medical education. The day may come when medicine is more like law--somewhat less competitive to enter the training, MUCH more competitive to get the post-graduate positions.

Nothing is guaranteed.

 

[deleted307836]

There is really NO way to predict how competitive or non-competitive psych will be in the 6-7 years between now and you completing medical school, either. We're already building expectations of reduced funding for graduate medical education (=fewer residency positions) while at the same time there are increased numbers of medical school slots, as well as continued increases in offshore medical education. The day may come when medicine is more like law--somewhat less competitive to enter the training, MUCH more competitive to get the post-graduate positions.

Nothing is guaranteed.

Well, that's depressing 🙁.

Really, FEWER positions is a possibility being planned for in conjunction with all of the trends you speak of?

I guess that isn't surprising, but excuse me while I cry in the corner...

OPD, if federal funds for residency positions were reduced, could institutions still find alternative ways to maintain current positions? Or do you think it would most likely result in decreased spots? On one hand, I would think that psych residents offer valuable services to hospitals. On the other hand, the cost of teaching, malpractice, etc. are still there.

 

[shan564]

Bottom line - if you can get into med school, you can probably get into psych residency.

If you have a 3.98, you've got a pretty darn good chance of getting into med school, even without a lot of extracurriculars.

 

[OldPsychDoc]

Well, that's depressing 🙁.

Really, FEWER positions is a possibility being planned for in conjunction with all of the trends you speak of?

I guess that isn't surprising, but excuse me while I cry in the corner...

OPD, if federal funds for residency positions were reduced, could institutions still find alternative ways to maintain current positions? Or do you think it would most likely result in decreased spots? On one hand, I would think that psych residents offer valuable services to hospitals. On the other hand, the cost of teaching, malpractice, etc. are still there.

How? If you haven't noticed yet, >85% of residency positions are federally funded via Medicare. What happens to the federal budget is going to affect us--and I don't know of that many deep pocketed foundations or private hospitals that are going to pick up the slack!

We haven't been told to cut positions yet, but my GME office is NOT encouraging requests to expand.

 

[deleted307836]

How? If you haven't noticed yet, >85% of residency positions are federally funded via Medicare. What happens to the federal budget is going to affect us--and I don't know of that many deep pocketed foundations or private hospitals that are going to pick up the slack!

We haven't been told to cut positions yet, but my GME office is NOT encouraging requests to expand.

Yeah, you're right. I was wondering if the funding methods for the ~10% of positions that are not funded via Medicare would work on a more widespread basis, but I can see that that would not be feasible.

I do wonder, though, if there is some way that the system could be restructured to be more sustainable on a long term basis. (Residents billing for services, the proceeds of which go to the hospital? I don't know...) Obviously a tough situation. I speak as someone looking to match in 2020 or so. I don't envy the position this puts programs in, and I can't help but consider how this will affect my cohort of classmates and me.

 

[UnicornDemon]

And seriously, with your stated goals of psych or bust, I highly recommend avoiding med school altogether and going the clinical psychology route...save yourself a hell of a lot of grief. I am going into psychiatry, but if I had it to do it all over again...

That last line is ominous. Do you mind telling me how you would have done things differently if you had the chance to "do it all over again"?

I'll look into clinical psychology further. I will say, though, that upon browsing those forums I came across depressing complaints from people who spent 6+ years of their lives pursuing a PhD in clinical psychology to wind up in a $45,000/year counseling job. The MD just seems to be a far more secure option. Although, as you stated, I'm definitely ahead of myself and should get a fair amount of clinical exposure before making life decisions.

 

[Bartelby]

I'm willing to spend 2-3 years after undergrad doing volunteer work and other activities to beef up my resume. I've also considered DO school.

Yikes! That's a master's degree and on the way to a PhD, you should avoid spending 2-3 years spent just doing extracurriculars and volunteer work unless we are talking Peace Corps or something similar (and you do it because you want to do it)! If you have a year or two left in school find maybe one intersting club or research activity to get involved with and accomplish something (leadership position, publication, whatver) within it. Far more important will be that 3.98 GPA, A's in your prereqs, and a solid (30+, 35+ even better) MCAT score especially if your heart is not set on Hopkins or Harvard.

Anyhow, as others have said psychiatry is not that competitive. You will, however, need to make it through four years of medical school (where about 90% of time is dedicated to other medical specialties) and an intern year that about half medicine and neurology before getting to all psych, so weigh the cost of that against the better job prospects. If you think you could enjoy those things psychiatry could be a good route.

 

[NYCMS2]

Yikes! That's a master's degree and on the way to a PhD, you should avoid spending 2-3 years spent just doing extracurriculars and volunteer work unless we are talking Peace Corps or something similar (and you do it because you want to do it)! If you have a year or two left in school find maybe one intersting club or research activity to get involved with and accomplish something (leadership position, publication, whatver) within it. Far more important will be that 3.98 GPA, A's in your prereqs, and a solid (30+, 35+ even better) MCAT score especially if your heart is not set on Hopkins or Harvard.

Anyhow, as others have said psychiatry is not that competitive. You will, however, need to make it through four years of medical school (where about 90% of time is dedicated to other medical specialties) and an intern year that about half medicine and neurology before getting to all psych, so weigh the cost of that against the better job prospects. If you think you could enjoy those things psychiatry could be a good route.

No kidding! So add that 3 years onto the 2 years of remaining college for the OP, plus 4 years med school, 4 years residency...umm, 13 years? You have to be joking, OP.

Med school is some measure of hell for all but a few people, but it is particularly hellish for those who really aren't motivated to be something other than a shrink. Internal medicine, surgery, ob/gyn, peds - the heart of the med school experience - were hell on earth for me. I am just starting MS4, and I am dreading critical care and the medicine sub-I, and I am also dreading intern year.

If I had it all to do over again, I would have found a different path than med school to a career as a mental health care provider.

 

[MacDonaldTriad]

Don’t be too discouraged about the future of graduate medical education if you plan on attending a US allopathic school. Interest in psychiatry has been flat since the hay days in the 70s. Only half of the current psychiatry residents are domestic grads. There is a lot of room for contraction before domestic grads get squeezed much.

While this monopoly would seem threatening to undergraduates, it is also the reason for your stated interest in psychiatry over psychology. The field of psychology has done a poor job of quality control. There are very fine educations, but there are non-accredited on line PhDs as well. Psychology is much more like law school than medical school in terms of jobs and opportunities. Many are saturated and graduates can struggle.

Your biggest hurdle will be getting into medical school. Get through medical school, and there will be training in psychiatry for you. Mind you, getting through medical school is no walk in the park, and the financial obligations make this an all-in or all-out adventure. I can tell you that if you make it, you will be rewarded for doing it. There are a lot of other ways to be in behavioral health, MFTs, LCSWs, PhDs, but psychiatry should be and generally is the leader of care on multidisciplinary teams.

 

[SmallBird]

How? If you haven't noticed yet, >85% of residency positions are federally funded via Medicare. What happens to the federal budget is going to affect us--and I don't know of that many deep pocketed foundations or private hospitals that are going to pick up the slack!

We haven't been told to cut positions yet, but my GME office is NOT encouraging requests to expand.

My understanding at my own program is that medicare makes up rather a small portion of our funding. We have a lot of time funded by the VA, some funding through research grants, and then three different third year sites which each fund the residents who choose to go there (the univeristy health service, community health center and the VA). Not a typical situation I am sure but it does show that there are other options for funding.

 

[RocknRhoLim]

OP, I obviously can only advise you about med school admissions but with your gpa there is no need to spend any extra time taking classes before med school. Take your MCAT, get some volunteering ec's under your belt and apply widely to MD schools. If your score is solid (30-32+) you should not need to apply to DO schools. The path to clinical psych is much more variable and vague and demands nearly as much time as med school. Also, the salary for clinical psychologists is dropping as others such as social workers are doing therapy as well. As others have mentioned, the only caveat with psychiatry is that you must be willing to study non-mental health stuff for the majority of medical school. Depending on how you look at it, this can be a good thing because you will be able to treat your psych patients medically and mentally and be well-rounded.

 

[tobi44]

I have considered clinical psychology, but I understand the job prospects and salary for psychiatrists are greater than those for psychologists. I am aware of how competitive it is to get into med-school. Thankfully, I have a good GPA (3.98), yet unfortunately I have NO extra-curriculars to put on my resume thus far. I'm willing to spend 2-3 years after undergrad doing volunteer work and other activities to beef up my resume. I've also considered DO school.

Just try to keep your GPA as high as possible in your pre-med classes (Only As and Bs). And do well on the MCAT ie +30. These 2 thing are by far the most important thing on the application. If I had to put a number on it I would say they make up 75% of how your application is handled.

As for extracurriculars, research is more impressive to adcoms then volunteering. Do a research project in anything medical related (including psych) and you put yourself over the top.

For volunteering I would suggest to keep it light, clinical and with the underserved ie volunteering at free clinic 1x per month, 1 time service trip abroad, translate Spanish at a hospital a few times a month. Doing something like that will help a lot with writing your secondaries many of which ask questions on how you affect your community as a doc. As well as exposing you to different facets of medicine.

 

[UnicornDemon]

No kidding! So add that 3 years onto the 2 years of remaining college for the OP, plus 4 years med school, 4 years residency...umm, 13 years? You have to be joking, OP.

Well, unfortunately, I've taken absolutely none of the pre-requisite courses for med-school, and I still need to graduate on time with some degree (probably my original major, accounting, since I'm so far into it). I go to a private school and my scholarship runs out within 4 years. If I don't finish on time I start paying $50,000+ a year. I can squeeze in a few pre-reqs but it will be demanding since they are weed-out courses and I still have to do volunteer work on the side and sweet talk my way into a leadership position for some charity club.

So, post-graduation I'll have to finish my pre-requisites at a local college near home. I can probably do that during the summer and fall. And then once I finish my pre-reqs I'll be prepared to take the MCAT in the Spring. And then I'll send out my applications and have yet another gap year as I wait for responses and hope I get in somewhere.

So... I'm looking at at least two years post-grad before I manage to get into med-school. It's a bit upsetting, but then again I'd rather give up two years now then waste the rest of my life working as an accountant.

 

[digitlnoize]

I still have to do volunteer work on the side and sweet talk my way into a leadership position for some charity club.

FYI: I didn't volunteer or lead a charity club and am now a doctor. Just saying.

It helps if you have an interesting background or story. That can take the place of some of the padding that more traditional students have to do.

I'd do something MEDICAL though. Something that shows that you know what the clinical side of medicine is like and what you're getting yourself into. Shadowing, ER scribe, volunteering at a clinic, whatever. Clinical stuff.

 

[SteinUmStein]

I really don't know that I would recommend medical school to someone ONLY interested in psychiatry. What a slog that would be. I don't think it's worth it. Look into PA programs if you really love the clinical/medical side of treating mental illness, otherwise clinical psychology or social work are likely to be more satisfying.

 

[NYCMS2]

I really don't know that I would recommend medical school to someone ONLY interested in psychiatry. What a slog that would be. I don't think it's worth it. Look into PA programs if you really love the clinical/medical side of treating mental illness, otherwise clinical psychology or social work are likely to be more satisfying.

This.

 

[Bartelby]

Well, unfortunately, I've taken absolutely none of the pre-requisite courses for med-school, and I still need to graduate on time with some degree (probably my original major, accounting, since I'm so far into it). I go to a private school and my scholarship runs out within 4 years. If I don't finish on time I start paying $50,000+ a year. I can squeeze in a few pre-reqs but it will be demanding since they are weed-out courses and I still have to do volunteer work on the side and sweet talk my way into a leadership position for some charity club.

You need a year of bio, a year of physics, a year of chemistry, and a year of organic chemistry. You have to take gen chem before orgo. You also need (for many schools, check requirements where you are applying) some math and an English/writing class or two.

So in two years you could do:
Year one: gen chem + biology
Year two: physics + orgo

Splice in any other requirements as tolerable. If you do not have a ton of difficult stuff left to do in your accounting major this would help you have only one gap year (not bad at all), save you money, and look better than taking all your prereqs at an easier school.

Of course maintaining the GPA is key and you know how much you can handle when also doing some volunteering or research on the side. It'll be a busy couple of years, but to be honest it'll be a busy decade if you go down this route. Just an option to consider.

 

[NYCMS2]

You need a year of bio, a year of physics, a year of chemistry, and a year of organic chemistry. You have to take gen chem before orgo. You also need (for many schools, check requirements where you are applying) some math and an English/writing class or two.

So in two years you could do:
Year one: gen chem + biology
Year two: physics + orgo

Splice in any other requirements as tolerable. If you do not have a ton of difficult stuff left to do in your accounting major this would help you have only one gap year (not bad at all), save you money, and look better than taking all your prereqs at an easier school.

Of course maintaining the GPA is key and you know how much you can handle when also doing some volunteering or research on the side. It'll be a busy couple of years, but to be honest it'll be a busy decade if you go down this route. Just an option to consider.

I did a one year formal post bacc and took all of the science pre reqs over the course of one summer and 2 semesters, so it is possible to knock all of this out in one calendar year. And...I maintained my high GPA from undergrad (3.9+), and this is key. I did not take any extra science classes, and I believe it is a total non issue assuming you nail all the pre reqs with As (I made one B+). Don't go in thinking you can make a 3.5 in your pre reqs - go in guns blazing.

I still would advise going another route to mental health pro than med school. Med school is hell when you are in classes and in rotations you really can't stand, and you can never let down your guard - you are tested constantly, have pressures to do well on the standardized tests, have pressure to get glowing comments from attendings - the pressure never freaking lets up.

I found at my med school that even the hard charging gunners start to burn out in 3rd year. I was NOT a gunner - I just wanted to do well, get through it in one piece - and I am accomplishing that - but it has been stressful as hell to me, and I believe a large part of the stress is because I disliked so many of the rotations. I intensely disliked surgery and ob/gyn...sheer misery.

 

[NYCMS2]

FYI: I didn't volunteer or lead a charity club and am now a doctor. Just saying.

It helps if you have an interesting background or story. That can take the place of some of the padding that more traditional students have to do.

I'd do something MEDICAL though. Something that shows that you know what the clinical side of medicine is like and what you're getting yourself into. Shadowing, ER scribe, volunteering at a clinic, whatever. Clinical stuff.

All of my clinical exposure was through volunteering. I did very little shadowing - it was not a widely accepted practice where I lived, lots of HIPAA concerns were always raised, so I quit even trying to arrange shadowing.

A great place to volunteer: the ER. You can often get long shifts (4 to 8 hours) and even get to do stuff - I got to staple some wino's scalp as a pre-med. It was "watch one, do one" in action.

Curious, digit: other than shadowing, what are examples of non volunteer clinical activities? I am drawing a blank on this...

Oh, and club activities are total BS. Don't even bother...charity work is fine, but no substitute for clinical.

 

[michaelrack]

So in two years you could do:
Year one: gen chem + biology
Year two: physics + orgo

To the OP: this may seem tough to you, but you should be able to do this, add in any miscellaneous med school requirements, plus complete your accounting major in your remaining 2 years (plus have some time for a few extracurriculars).
This will be difficult, but much less difficult than med school. Assuming you don't have a job during the school year, if you can't handle this, you can't handle med school.

 

[UnicornDemon]

I did a one year formal post bacc and took all of the science pre reqs over the course of one summer and 2 semesters, so it is possible to knock all of this out in one calendar year. And...I maintained my high GPA from undergrad (3.9+), and this is key. I did not take any extra science classes, and I believe it is a total non issue assuming you nail all the pre reqs with As (I made one B+). Don't go in thinking you can make a 3.5 in your pre reqs - go in guns blazing.

I still would advise going another route to mental health pro than med school. Med school is hell when you are in classes and in rotations you really can't stand, and you can never let down your guard - you are tested constantly, have pressures to do well on the standardized tests, have pressure to get glowing comments from attendings - the pressure never freaking lets up.

I found at my med school that even the hard charging gunners start to burn out in 3rd year. I was NOT a gunner - I just wanted to do well, get through it in one piece - and I am accomplishing that - but it has been stressful as hell to me, and I believe a large part of the stress is because I disliked so many of the rotations. I intensely disliked surgery and ob/gyn...sheer misery.

Seems like we've got a bit in common. I hope you don't mind me asking you a few questions to help shed perspective on my own life. How old were you when you began med-school? What was your undergraduate degree in? What prompted you to return to school? Did you go into school knowing you wanted to do psychiatry and only psychiatry?

I know there are other fields in mental health, but psychiatry is definitely the most respectable, well-paid, and secure. I know I have the aptitude to get into med-school. I know this sounds a bit arrogant and I don't mean it to be so, but I feel as though I'd be selling myself short getting a Master's in mental health and working a job as a guidance counselor. I know med-school will be hell, but I've always been interested in a career in psychiatry and I don't want to have a mid-life crisis at 50 and regret not going for it.

Just endure through it. I know you're going through hell now, but if you truly have a passion for mental health at least you'll find your psych residency to be somewhat enjoyable. Just remember, when it's and all said and done you'll be working a stable, 40-hour work-week rocking six-figs.

 

[FrasierMD]

I have to say I totally disagree with this but have heard it said a lot. I knew I wanted to be a psychiatrist since I was 19. I came to medical school with 100% certainty that I would never do any other specialty and I was afraid of the rotations that are considered to be far from psych, eg surgery. What I quickly realized, though, was that EVERY patient experience contains elements of psychiatry. On OB clinic, I sought out opportunities to follow pts with postpartum dep; on surgery I was exposed to steroid induced mania; on internal med not one pt left my sight without a PHQ depression screening! By the end of many rotations, attendings would ask my thoughts on what I would rec for their patients psychotropics.

Clinical psychology is no doubt a rewarding and vitally important career, but I could never see myself having traded a future in psychiatry for clinical psychology. Personally, I am fascinated by psychopharmacolgy which requires a medical training to practice. Some rotations can be grueling in 3rd year, but they are crucial to be being a great psychiatrist. 8 weeks of surgery hours and taking biochemistry are small prices to pay for the privilege of practicing psych. Now in my 4th year and largely focusing on psych, I couldnt be happier with my decision....that i made at 19 !

So I encourage you to stay focused, take prereqs and do everything that you'll read about in premed section. The hard work and hours will be worth it!

 

[FrasierMD]

I have to say I totally disagree with this but have heard it said a lot. I knew I wanted to be a psychiatrist since I was 19. I came to medical school with 100% certainty that I would never do any other specialty and I was afraid of the rotations that are considered to be far from psych, eg surgery. What I quickly realized, though, was that EVERY patient experience contains elements of psychiatry. On OB clinic, I sought out opportunities to follow pts with postpartum dep; on surgery I was exposed to steroid induced mania; on internal med not one pt left my sight without a PHQ depression screening! By the end of many rotations, attendings would ask my thoughts on what I would rec for their patients psychotropics.

Clinical psychology is no doubt a rewarding and vitally important career, but I could never see myself having traded a future in psychiatry for clinical psychology. Personally, I am fascinated by psychopharmacolgy which requires a medical training to practice. Some rotations can be grueling in 3rd year, but they are crucial to be being a great psychiatrist. 8 weeks of surgery hours and taking biochemistry are small prices to pay for the privilege of practicing psych. Now in my 4th year and largely focusing on psych, I couldnt be happier with my decision....that i made at 19 !

So I encourage you to stay focused, take prereqs and do everything that you'll read about in premed section. The hard work and hours will be worth it!