Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
I have a classmate that is an m4 applying psych. He has 243 step 1, all passes 3rd year (no honors) in a p/f/h system, he's USMD, no red flags, and he's very geographically restricted to like Cleveland and surrounding cities apparently. Can he gauarantee matching there? He's asking my faculty and they said nothing is guaranteed but I didn't think cle was competitive...thoughts?!

Edit: he hasn't taken step 2 ck or cs yet
 

FranzLO

7+ Year Member
Mar 9, 2011
173
67
Status
Medical Student
I will actually be in a similar boat. I am kind of banking on CC or Case but we shall see.
 
  • Like
Reactions: Merely

Bartelby

10+ Year Member
Mar 15, 2007
1,286
537
Status
Attending Physician
I agree with TexasPhysician. Also, make sure your classmate lets programs of interest know how strong his interest is in the program and the location. Training programs want people who really want to be there, so making it clear can help separate him from the crowd.
 
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
Thanks all for advice, my general question tho is cle competitive? I thought it was kinda a not great city so I thought he would be guaranteed since it's like a place no one wants to be, like Idaho lol, like are there a lot of programs he can apply to there and are they like top notch?
 

clausewitz2

10+ Year Member
Oct 13, 2008
1,875
1,982
Status
Resident [Any Field]
If he's anchored to Cleveland by family or SO, it would probably be just at the outer edge of doable to live half way between Cleveland and Pittsburgh and commute to Allegheny or UPMC. F*ing miserable but not literally impossible
 
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
So is cle too competitive for him to get a spot that he needs to go elsewhere?
 

MacDonaldTriad

5+ Year Member
Mar 13, 2013
2,121
3,210
still on the right side of the dirt
Status
Attending Physician
I don't know Cleveland well, but it is respectable on those stupid "reputation" lists and everyone needs to have multiple programs on their rank list. Anyone can screw up an interview. I wouldn't give Idaho such a hard time. They may not have any program, but they have skiing and they don't have lake effect.
 

TexasPhysician

Moderator
10+ Year Member
Sep 1, 2008
4,729
1,865
Status
Attending Physician
So is cle too competitive for him to get a spot that he needs to go elsewhere?
No one can give an answer because it doesn't exist.

I've seen excellent USMG applicants blow interviews to the point of being unranked. All DO's and IMG's were ranked with a better chance despite better stats by this USMG at this average program.
 
  • Like
Reactions: Crayola227
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
Can we assume he doesn't like blow the interview tho he's just a normal guy not a freak, then would he be guaranteed essentially? Also why take step 2 if he has a good step 1?
 

MacDonaldTriad

5+ Year Member
Mar 13, 2013
2,121
3,210
still on the right side of the dirt
Status
Attending Physician
Anyone can blow an interview. No scores or application is a guarantee position. Most med school require step II to graduate so many programs will not rank people without step II. They will interview them, but they will not rank them, risk a fail and therefore a delay in graduation.
 
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
There are lots of guarantees in life lol so saying there aren't is not helpful. For example, a physician could easily drop out and be guaranteed a job at walmart. Now you could be annoying and say "well no not if there are no openings, etc" but that's essentially a guarantee. That's what I'm asking. Assuming nothing crazy happens and he doesn't blow the interview or anything just has a normal interview and such, is cle such a competitive place that he would essentially be guaranteed a spot? The answer seems to be yes, just like the answer to the question, "will the above candidate be guaranteed a spot in psych somewhere in the US?" is yes as well. Now asking if he's guaranteed like harvard or something that's a completely different story but it's not helpful to say there are no gaurantees. Obviously it's not a literal guarantee but more of a 99 percent chance of getting cleveland or something like that.

Feel free to let me know if my thought process is wrong in any way, i'm here to learn im still just a third year that's also very interested in pursuing psych
 

keifernny2

5+ Year Member
Aug 26, 2013
258
159
Status
Attending Physician
There are multiple programs in NE Ohio, and even more if you expand reach to Akron, Columbus, Toledo, and Pittsburgh.

You classmate's chances will be even better if he does a few away rotations in Cleveland and meets the people there.
 

Crayola227

The Oncoming Storm
5+ Year Member
Oct 22, 2013
15,830
17,550
All of Time & Space
don't assume flyover states don't have great programs,
where the lay pop want to live for the weather doesn't always match up with where the medical practice party at

for example, Cincinnati Children's has one of the best peds programs in the country
that wouldn't have been my guess, but there it is

Mayo is excellent and Rochester is the middle of nowhere

Cincinnati overall has excellent programs, and the city is much nicer to live in than most people are aware
same with Indianapolis

in any case, best advice is to make your interests very clear, if you're coming from a coast the one thing is that these programs can be pretty wary about why exactly someone is trying to go from Boston to OKC, if you really are interested and would actually rank them high enough to match and actually move there

I was trying to make a big move geographically to less desirable places and that was the #1 question programs had for me
the "hurdle" was convincing those programs they weren't safeties and I really wanted them
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,231
3,836
57
Left of Center
Status
Attending Physician

3lefts

2+ Year Member
Jun 27, 2016
107
98
Status
Medical Student
I agree with TexasPhysician. Also, make sure your classmate lets programs of interest know how strong his interest is in the program and the location. Training programs want people who really want to be there, so making it clear can help separate him from the crowd.
When should they go about contacting programs? Upfront or if they don't get an interview invite?


Sent from my iPhone using SDN mobile
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,231
3,836
57
Left of Center
Status
Attending Physician
When should they go about contacting programs? Upfront or if they don't get an interview invite?


Sent from my iPhone using SDN mobile
IF they don't have an invite by October 15 (assuming they applied asap), then contact programs and express interest.
 

MacDonaldTriad

5+ Year Member
Mar 13, 2013
2,121
3,210
still on the right side of the dirt
Status
Attending Physician
There are lots of guarantees in life lol so saying there aren't is not helpful.
Feel free to let me know if my thought process is wrong in any way, i'm here to learn im still just a third year that's also very interested in pursuing psych
The number one flaw in your thought process is that you are not listening to what we are saying.

The match is a very fickle and the best defense is being happy with a range of programs because setting your heart on any single place is dangerous. Your friend can make geography his number one priority, but no one who understands the match process is willing to give you a green light to encourage complacency in your friend’s strategy this cycle. He needs to aim at the places in Cleveland, but also look at others that are proximal and a few that are not to be safe.

This cycle, I will chair a selection committee that will be the 30th one I have participated in. I am telling you that resident members of these committees generally don’t give a hill of beans about scores or schools. They look at something subjective they call “fit”. You would be surprised what can come up when you are comparing hundreds of people:

"Can you believe she didn’t know not to mix cheetah and leopard prints, did you see that handbag and scarf?”
“We were talking football and all, and he disparaged my team man!”
“I know he flew across the country just to interview with us, but he just didn’t seem interested.”
“I get that he really really wants to come here, but he seems way too desperate and way too sycophant.”

Selection committees are committees so that such trivial stupid factors are generally ignored, but get two or three people convinced an applicant has a flaw, and it is over. Very few training directors are dumb enough to ram in someone against the wishes of their residents, and applicants don’t want to be where they start without the support of their peers.

You don’t have to believe us, but don’t mess with your friend’s process. If he has a bad outcome, you don't want to be the one who suggested a strategy, and yes, he will probably be fine.
 

alina_s

Senior Member
15+ Year Member
Sep 24, 2001
261
26
Seattle
Visit site
Status
Attending Physician
I graduated from CWRU SOM in 2005, so the data are old. I agree with every thing MacDonald Triad said about the randomness of the process. I had a similar score on step I and had all passes, except for honors in psychiatry, and got invitations to interview everywhere except Cal Pacific, which has a great location but didn't really fit my career plans, and that was pretty obvious in my essay. Cleveland has its pluses and if you've lived anywhere in the Midwest, the climate didn't seem any worse to me. I did my psych rotation at Cleveland Clinic and ended up having minimal contact with the department at CWRU. Their interview process was the least friendly of anyone I dealt with- maybe they knew I didn't really want to stay in Ohio- and I ended up not interviewing. There are actually 3 residencies in Cleveland- CWRU, Cleveland Clinic, and MetroHealth and I don't think that any of them are very competitive, likely because of how most people feel about the Midwest? No judgments, but I don't think that any of the residents at the Clinic were US grads. Metro is the county hospital and pretty public health oriented and I think that the psychiatry department at the Clinic exists to provide a consult-liaison service for the vast medical and surgical units. I liked the faculty at the Clinic but I think it would have been an odd training program because it felt like psych was the ugly stepchild. Not sure, but they may have closed their inpatient unit since I was there. It was tucked away in an old corner of a building and looked comically decrepit compared to fancy décor everywhere else.
 
Aug 7, 2013
4
2
Status
Medical Student
Hey, I'm a resident at one of the NE Ohio programs, so I can offer some insight. Like people are saying, nothing is guaranteed. At our program, this candidate would certainly be asked to interview. Beyond that, all bets are off. If he has a decent interview but it's an exceptional year, he might get ranked low and not match. If he bombs his interviews, he might not match. If he annoys someone, he might plummet down the list and not match. Is NE Ohio uber-competitive? No, of course not. But this process is very uncertain, and even less-desireable locales are inundated with applications from great candidates. Program directors love high board scores, but they know very well that they don't assure a good resident, and so that's not how they pick residents, and that's why your friend is not "guaranteed" anything in the match.

He should make sure to express interest to these programs, let them know that he has strong geographical ties, and do his best at nailing his interviews. That's really all you can do.
 
  • Like
Reactions: Crayola227
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
Hey, I'm a resident at one of the NE Ohio programs, so I can offer some insight. Like people are saying, nothing is guaranteed. At our program, this candidate would certainly be asked to interview. Beyond that, all bets are off. If he has a decent interview but it's an exceptional year, he might get ranked low and not match. If he bombs his interviews, he might not match. If he annoys someone, he might plummet down the list and not match. Is NE Ohio uber-competitive? No, of course not. But this process is very uncertain, and even less-desireable locales are inundated with applications from great candidates. Program directors love high board scores, but they know very well that they don't assure a good resident, and so that's not how they pick residents, and that's why your friend is not "guaranteed" anything in the match.

He should make sure to express interest to these programs, let them know that he has strong geographical ties, and do his best at nailing his interviews. That's really all you can do.
If he has a decent interview he still won't match?
 
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
If it is an exceptional year. You really need to get checked for presbycusis. :smack:
That's still outrageous...a 243 step 1 can't make it into a mid tier psych program with a decent interview....this is not derm lol idc what kind of year it is still seems fishy
 

clausewitz2

10+ Year Member
Oct 13, 2008
1,875
1,982
Status
Resident [Any Field]
That's still outrageous...a 243 step 1 can't make it into a mid tier psych program with a decent interview....this is not derm lol idc what kind of year it is still seems fishy
See I think rolling up to an interview day with that in your head is a really good way to not have a decent interview.
 
  • Like
Reactions: Dharma

st2205

Attending
10+ Year Member
Oct 29, 2006
1,832
1,098
Status
Attending Physician
That's still outrageous...a 243 step 1 can't make it into a mid tier psych program with a decent interview....this is not derm lol idc what kind of year it is still seems fishy
I think you're missing the mark here. Psychiatry by and large isn't competitive. When we say "competitive," this often refers to things on paper such as class rank, board scores, research, etc. While psychiatry isn't really competitive (relatively) in those terms, there are plenty of other variables that can make it harder or easier to match, but we don't typically classify those elements as 'competitive' simply because as a medical culture we've come to synonymize competition with easily measured benchmarks (board scores, class rank, publications, med school reputation, etc.)

You can match into psychiatry much easier, but that doesn't mean that you're a shoe-in (is that even how it's spelled?) for any particular program. The program I graduated from was not "competitive." We weren't huge, academic or in a nationally recognized city. We had 5 spots. That leaves a lot of variability. We had a year where we went nearly to the bottom of our list. Two of the past three years we matched our top 5. There were a lot of other people wanting to match there but since the top people also wanted us, it didn't really leave room for anyone else. There also wasn't any correlation amongst the top of our list with regard to board scores or med school -- that's just the way it is. We've had people who were AOA at very well regarded programs interview who had 250+ step 1s and end up getting ranked in the mid or lower end of our list -- not because they were bad or that anyone didn't like them, just simply that there were a lot of other people we felt would fit better, who all on paper would be outmatched by these folks. This doesn't mean that being good on paper is bad, it just means that it's not as tightly correlated with matching at any particular program.

An analogy would be if you were a CEO of a Fortune 500 company and were seeking a mate. You likely wouldn't have any shortage of possibilities, but that isn't necessarily the same as assuming that any one particular person would love to have you, or that everyone would be dying to be your mate, despite having many more options than the rest of us.
 
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
I think you're missing the mark here. Psychiatry by and large isn't competitive. When we say "competitive," this often refers to things on paper such as class rank, board scores, research, etc. While psychiatry isn't really competitive (relatively) in those terms, there are plenty of other variables that can make it harder or easier to match, but we don't typically classify those elements as 'competitive' simply because as a medical culture we've come to synonymize competition with easily measured benchmarks (board scores, class rank, publications, med school reputation, etc.)

You can match into psychiatry much easier, but that doesn't mean that you're a shoe-in (is that even how it's spelled?) for any particular program. The program I graduated from was not "competitive." We weren't huge, academic or in a nationally recognized city. We had 5 spots. That leaves a lot of variability. We had a year where we went nearly to the bottom of our list. Two of the past three years we matched our top 5. There were a lot of other people wanting to match there but since the top people also wanted us, it didn't really leave room for anyone else. There also wasn't any correlation amongst the top of our list with regard to board scores or med school -- that's just the way it is. We've had people who were AOA at very well regarded programs interview who had 250+ step 1s and end up getting ranked in the mid or lower end of our list -- not because they were bad or that anyone didn't like them, just simply that there were a lot of other people we felt would fit better, who all on paper would be outmatched by these folks. This doesn't mean that being good on paper is bad, it just means that it's not as tightly correlated with matching at any particular program.

An analogy would be if you were a CEO of a Fortune 500 company and were seeking a mate. You likely wouldn't have any shortage of possibilities, but that isn't necessarily the same as assuming that any one particular person would love to have you, or that everyone would be dying to be your mate, despite having many more options than the rest of us.
Well put doc, I understand now thanks
 

MacDonaldTriad

5+ Year Member
Mar 13, 2013
2,121
3,210
still on the right side of the dirt
Status
Attending Physician
I've gone to the last person on my list and I've filled half way through the top quartile. I never know what will happen and it can exclude a 243. This unpredictable process can lead to a lot of magical thinking, but my conclusion is that it isn't dependent on anything I can do.
 
  • Like
Reactions: OldPsychDoc

FranzLO

7+ Year Member
Mar 9, 2011
173
67
Status
Medical Student
Not trying to hijack the tread but while I am not 100% sure I want to be in NE Ohio I am heavily leaning towards it. I know more about CC and Case than I do about Metro and even Akron/Summa so if anyone can comment on those I would appreciate it too.
 

uname943

10+ Year Member
Jun 28, 2008
78
55
Status
Just out of curiosity I looked up the MetroHealth residency website. It's interesting that ALL the residents are IMG/FMGs, except for one who graduated from Harvard med school.
 

Blitz2006

10+ Year Member
Nov 20, 2006
1,560
374
Status
That's still outrageous...a 243 step 1 can't make it into a mid tier psych program with a decent interview....this is not derm lol idc what kind of year it is still seems fishy
I agree with this. I'm one of the few cheerleaders for psych on this forum, but even I'm a bit shocked at this thread, that someone with a Step 1 of 243 is concerned about matching into NE Ohio!!?

Of course, obviously if the applicant bombs the interview, then he/she is not a shoe-in. But thats irrelevant. Most people WON'T bomb the interview, so I think we can assume the applicant, while may not be the most charismatic, will probably be around average in interviewing.

So a 243 with no red flags and gunning for Ohio shouldn't be a problem. And this person is US MD...even IMG with a 243 step 1 shouldn't have a problem matching into Ohio...I mean, a 243 should have you locked up in the coasts...unless you act like a complete prick in your interview.
 
OP
Merely

Merely

5+ Year Member
7+ Year Member
Jul 12, 2012
1,371
1,271
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
I agree with this. I'm one of the few cheerleaders for psych on this forum, but even I'm a bit shocked at this thread, that someone with a Step 1 of 243 is concerned about matching into NE Ohio!!?

Of course, obviously if the applicant bombs the interview, then he/she is not a shoe-in. But thats irrelevant. Most people WON'T bomb the interview, so I think we can assume the applicant, while may not be the most charismatic, will probably be around average in interviewing.

So a 243 with no red flags and gunning for Ohio shouldn't be a problem. And this person is US MD...even IMG with a 243 step 1 shouldn't have a problem matching into Ohio...I mean, a 243 should have you locked up in the coasts...unless you act like a complete prick in your interview.
Yeah I agree thanks for this post. I think the other posters were just being extra pedantic and saying that literally nothing is guaranteed but...I think he's going to be fine
 

MacDonaldTriad

5+ Year Member
Mar 13, 2013
2,121
3,210
still on the right side of the dirt
Status
Attending Physician
Well put doc, I understand now thanks
No you don't. I did say he will probably be fine. Operative word is probably. He needs to hedge all bets in this game. Every unmatched applicant I have met regrets the way they played this.
 
  • Like
Reactions: Crayola227
Aug 7, 2013
4
2
Status
Medical Student
Just out of curiosity I looked up the MetroHealth residency website. It's interesting that ALL the residents are IMG/FMGs, except for one who graduated from Harvard med school.
I actually met that resident last year...she said she needed a visa sponsor, and even going to Harvard doesn't make that problem go away.