Interested in psych but not sure where to apply?

[justletithappen]

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So I'm an M3 at a smaller school in the northeast. I've always been interested in Psych and just finished my psych rotation...and loved it! So now that I know for sure I want to do this I"m starting to look at places that offer residency (I"m an M3) but I"m lost. I've seen the lists and read which programs people regard highly on this board. However I don't know how competitive those programs are (programs like MGH/McLean, Columbia).

I did decent on step 1 I got a 240. My preclinical grades are all passes, and my clinical grades have so far all been pass with honor in psychiatry, medicine and surgery. I don't have any psychiatry specific research or publications, but 2 poster presentations non psych related. I'm not sure if I should even look at those top programs. I know psychiatry as a whole isn't very competitive but I assume those programs which everyone regards highly are.

Any advice on the competitiveness of those programs? I had a hard time finding any data. Thanks!

 

[notdeadyet]

Have you talked to your school's psychiatrists?

 

[vistaril]

So I'm an M3 at a smaller school in the northeast. I've always been interested in Psych and just finished my psych rotation...and loved it! So now that I know for sure I want to do this I"m starting to look at places that offer residency (I"m an M3) but I"m lost. I've seen the lists and read which programs people regard highly on this board. However I don't know how competitive those programs are (programs like MGH/McLean, Columbia).

I did decent on step 1 I got a 240. My preclinical grades are all passes, and my clinical grades have so far all been pass with honor in psychiatry, medicine and surgery. I don't have any psychiatry specific research or publications, but 2 poster presentations non psych related. I'm not sure if I should even look at those top programs. I know psychiatry as a whole isn't very competitive but I assume those programs which everyone regards highly are.

Any advice on the competitiveness of those programs? I had a hard time finding any data. Thanks!

it's not looking good....you may be able to scramble into Maimonides or Nassau if you have connections.

Seriously, just apply and see. if you want to go to Columbia, then put them on the ERAs(do they still do eras?) and if they don't give you an interview....so what? what did you lose? 50 bucks or whatever it is? Apply to plenty of other places, rank them accordingly based on preferences after the interview, and you'll be fine.

 

[GlobalMental]

Just not George Washington University in DC

 

[skunky386]

That's a bit of a difficult question to answer. There are so many variables that factor into the list of places to apply to. The list of programs you should apply to depends entirely upon your career goals, personal interests, and style of psychiatry you prefer/intend to practice. For instance, a program director I am personally familiar with trained at Stanford and has remarked that it tends to train fantastic clinical researchers with a large focus on the evidence base, but as far as actual clinical training with patient care and interaction, he felt it was a bit disappointing. I'd caution against completely buying into the notion that more research dollars equates to better training.

Furthermore, as psychiatry is practiced in a variety of flavors, it's important to find a program that suits your particular style. Are you more of a psychopharm/biologically-focused practitioner? Or are you more into psychotherapy? What patient populations do you want to work with in the future? The type of attendings and fellow residents you'll be around, as well as local resources, specialty clinics, researchers, etc., will undoubtedly have an impact upon your future clinical practice.

I'd suggest thinking long and hard about your personal goals and what would satisfy your future self.

You can take a look at FRIEDA Online which lists all the accredited programs across the country. There's some program-specific data on there about average Step scores, %IMG and DO, residency spots open, etc. if that is of importance to you.

I'd highly suggest speaking to psychiatrists you respect, be it your program director, training director, attendings, community psychiatrists, etc. I'd also suggest reading through the interview review threads in this forum as well, which should give you some flavor of a variety of programs. I hope you'll soon see that programs really aren't all that different from each other due to the necessity to comply with ACGME requirements, though they are sufficiently different from each other to make it worthwhile to apply to many so that you can find a good fit.

 

[OldPsychDoc]

Vistaril is being quite sarcastic, as you wouldn't know since you're new. Talk to your school's faculty. Keep up the good boards performance, do well on rotations, and get some good psych letters. You'll have a chance even at the "top" programs, and be very strong for very good programs in the region that are perhaps mildly less famous--UMass, Dartmouth, etc. But go ahead and give Columbia and Mclean a shot!

 

[member2721]

Just based on your numbers you would be offered interview at MGH mclean if you have strong letters, thoughtful essay, and some extracurriculars reflective of your personality and interests.

 

[SEPsych]

For instance, a program director I am personally familiar with trained at Stanford and has remarked that it tends to train fantastic clinical researchers with a large focus on the evidence base, but as far as actual clinical training with patient care and interaction, he felt it was a bit disappointing. I'd caution against completely buying into the notion that more research dollars equates to better training.

So whats the deal with Stanford? I always see it come up in this sort of context on SDN, but then when I talk to psychiatrists in person people seem to only have good things to say. For example I was talking to a chairman (from the east coast) about programs I was considering and I mentioned stanford as being a step down in my mind compared to places like MGH, Columbia, Yale. But he didnt seem to think so at all and said I should consider all those places as being about the same as far as launching an academic career and just go wherever I felt the best fit.

 

[member2721]

Its a very strong academic program, with a mix of very well-respected researchers, psychodynamic faculty, and leaders in its field; but it is small and in a rich suburb so its clinical exposure is not as diverse as MGH Columbia and Yale.

 

[Leo Aquarius]

So I'm an M3 at a smaller school in the northeast. I've always been interested in Psych and just finished my psych rotation...and loved it! So now that I know for sure I want to do this I"m starting to look at places that offer residency (I"m an M3) but I"m lost. I've seen the lists and read which programs people regard highly on this board. However I don't know how competitive those programs are (programs like MGH/McLean, Columbia).

I did decent on step 1 I got a 240. My preclinical grades are all passes, and my clinical grades have so far all been pass with honor in psychiatry, medicine and surgery. I don't have any psychiatry specific research or publications, but 2 poster presentations non psych related. I'm not sure if I should even look at those top programs. I know psychiatry as a whole isn't very competitive but I assume those programs which everyone regards highly are.

Any advice on the competitiveness of those programs? I had a hard time finding any data. Thanks!

Welcome! It's so great that you enjoy psychiatry so much. Congrats on discovering what you love. Many don't reach that stage. (I thought someone here should give you a warm welcome.)

 

[notdeadyet]

So whats the deal with Stanford?

It's a great program that will make you a great psychiatrist. It isn't an MGH level program but it doesn't need to be for 99% of applicants.

I think the issue comes from this weird thing where folks equate a programs undergraduate reputation with having some cache with its residency. Look on SDN at all the frequent mention of "Ivy League" psych programs as a classic example. Folks don't get that UCSF is a rotten place to get a BA and Swarthmore's psych residency sucks....


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[SEPsych]

So when people talk about their clinical concerns w/ Stanfords training are they just referring to the fact the patients are more affluent and less of the chronic homeless w/ psychosis type patients?

 

[notdeadyet]

Stanford historically was very biologically biased and didn't have great psychotherapy training. They've come a long way, but still do not have the extensive network of psychodynamic training/supervision people associate with the top programs. This will come with time. It also does not have the diversity and heavy exposure to the underserved via the county environment that you get at those programs.

That said, I think it I sometimes unfairly characterized as a marginal program on SDN. It is not. It's a very good program. I just would not consider it at the same level as MGH, UCSF, etc. but not every program needs to be...

 

[DocSox85]

LOL. Don't go to Albany Medical Center!

 

[enoughsaid12]

Let's cut the ****. Picking a residency is based on
1. Location
2. Location
3. Location
This includes affordability, physical location, closeness to family (if that is important to you).
Like anything else, you can make a residency anything you want. They are all accredited so only minor details differentiate them. Prestige and competitiveness should be last on your mind. You want a place where you can be happy and thrive. Your a grownup now, this is your time to decide where you want live and start your career.

 

[DocSox85]

i would like to know programs that have unions for residents. which ones?

 

[splik]

most of the NYC programs, cambridge health alliance, boston medical center, michigan, UCSF, Harbor-UCLA, USC, UW off the top of my head. there are more. go to the CIR site to find more. most of these are part of the Committee and Interns and Residents, except michigan and UW which have their own collective bargaining units.

 

[Leo Aquarius]

Any complaints? Any hours violations? Want more funding for something? Does your unit need fresh paint? Now you can tell the CIR and they magically put pressure on programs to get things fixed.

 

[skunky386]

Either due to the PD's philosophy or Michigan's resident union, they have nearly 4 weeks of vacation a year! Most programs I'm looking at have 2 and at most 3 weeks!

 

[hamstergang]

Either due to the PD's philosophy or Michigan's resident union, they have nearly 4 weeks of vacation a year! Most programs I'm looking at have 2 and at most 3 weeks!

Every program I interviewed at (from the Bronx to DC) had 4 weeks vacation. But who knows why.

 

[notdeadyet]

Every program I interviewed at (from the Bronx to DC) had 4 weeks vacation.

Ditto this. 4 weeks is pretty common...


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[Armadillos]

Yeah

they have nearly 4 weeks of vacation a year! Most programs I'm looking at have 2

Are you interviewing at sweatshops?

Seems like most programs are at worst 3 week vacation + 1 week conference time.

 

[splik]

Either due to the PD's philosophy or Michigan's resident union, they have nearly 4 weeks of vacation a year! Most programs I'm looking at have 2 and at most 3 weeks!

vacation doesn't have anything to do with the PD, it's set by the GME office. as people have said 4 weeks is standard in psychiatry (this is the maximum allowed in surgical specialties) though there are programs that have less. I would avoid anywhere that has 2 weeks, schedules all your vacation for you, or won't let you take it as you like. i remember this was one reason i didn't rank emory. Michigan's union is why all housestaff get their birthday off or receive extra pay if they are on call on their birthday.

 

[splik]

also its good to find out if programs are flexible with educational/conference leave. I had 4 weeks of educational leave last year (in addition to 3 weeks of vacation) and this year also have 4 weeks+ education leave in addition to vacation.

 

[splik]

I am really pleased to see applicants thinking about these things, when I was an applicant people looked at me like I was crazy for saying these things are important. You will realize once you're a resident that benefits matter and also say something about either how the institution values housestaff or how influential the residents are. you also want to think about whether residents are represented on various committees (other than GME which is mostly toothless) that have the ability to give and take away from you (such as transport)

 

[skunky386]

Sorry for the misunderstanding, for most of the places I'm looking at if you add sick days + vacation days then indeed it's about 4 weeks on average. Michigan's website states that they give you 4 weeks of vacation + 4-5 days off during the christmas/new year holidays. imnot sure if they give you a separate number of sick days.

I think it's also worth mentioning that when selecting a residency program thinking about finances is important. For the programs I'm looking at, first-year salaries range from the low-mid 40k to the mid 50k. State income taxes in the US range from nearly 10 percent in California and Oregon, to zero percent in texas, nevada, wyoming, florida, etc. With student debt compounding at a 7% interest rate, if you have a substantial amount of debt, then you can end up saving a large chunk of cash by going to a high-salary, low cost of living, low income tax place.

 

[hamstergang]

Sorry for the misunderstanding, for most of the places I'm looking at if you add sick days + vacation days then indeed it's about 4 weeks on average. Michigan's website states that they give you 4 weeks of vacation + 4-5 days off during the christmas/new year holidays. imnot sure if they give you a separate number of sick days.

There's no misunderstanding. Each year, I get 20 vacation days (4 weeks), plus 3 float/personal days, plus 12 sick days (that carry over if unused), in addition to the 6 or so holidays that the whole university has off.

 

[NickNaylor]

Let's cut the ****. Picking a residency is based on
1. Location
2. Location
3. Location
This includes affordability, physical location, closeness to family (if that is important to you).
Like anything else, you can make a residency anything you want. They are all accredited so only minor details differentiate them. Prestige and competitiveness should be last on your mind. You want a place where you can be happy and thrive. Your a grownup now, this is your time to decide where you want live and start your career.

Agree with this as well as the other things people mentioned in terms of benefits, ability to use time off, etc. etc.. Mind you, these were not things that I used when actually making my list to apply to. Frankly I had little motivation to go through sites and sift through all that information before even applying. Those things have certainly been important as I'm making my rank list, though.

I applied to places that 1) were in locations I and my fiance wouldn't mind being in and 2) had generally positive reputations as assessed by my mentors and their familiarity with various programs' graduates.

 

[splik]

Sorry for the misunderstanding, for most of the places I'm looking at if you add sick days + vacation days then indeed it's about 4 weeks on average. Michigan's website states that they give you 4 weeks of vacation + 4-5 days off during the christmas/new year holidays. imnot sure if they give you a separate number of sick days.

yes they absolutely have additional paid sick leave, up to 6 months in a 3 year period. if you are looking at programs that have 4 weeks total paid time off (sick leave/vacation included) I would avoid them like the plague.

 

[notdeadyet]

yes they absolutely have additional paid sick leave, up to 6 months in a 3 year period. if you are looking at programs that have 4 weeks total paid time off (sick leave/vacation included) I would avoid them like the plague.

I disagree with a lot of the metrics folks toss around for making snap judgments about programs (how many residents or faculty left, for example), but I think the issue of vacation time is valid.

You want a program that has reasonable vacation time. For many-to-most programs this will be 4 weeks of vacation. Sick days is an additional pot of time, most programs seem to have 5-15/year. If a program has PTO (a combined pool of vacation and sick time), I would consider anything less than 5-6 weeks to be a negative. Programs should also allow for educational leave (for conference attendance and the like). Sometimes this is not given to interns or it is something that builds in number over time, but by the time you're a PGY-2/3, programs should be offering 3-5 days.

The reason this is a good metric to use is that it is a very explicit statement of how a program views your health and development. Psychotherapy supervision, inpatient unit size, etc. is all a series of compromises. But a program that gives you adequate time to recharge is one that will likely be looking out for your welfare and a program that doesn't won't.

 

[TexasPhysician]

I think this thread has gotten too focused on vacation. In residency, I rolled-over vacation days every year and received a check for it when I left. This was my decision.

Much more important to me was location, lifestyle, moonlighting, and quality training. I ignored research opportunities (no interest), vacation days, and prestige (no academic interests).

Number of vacation days is much less important when you enjoy daily aspects of your program, have good hours, live in a great city (your opinion), and can moonlight often.

If you don't know where to apply, the first thing to do is determine what is most important to you. Some people would be miserable at MGH and only care about living in Cali. If you plan to practice in New Orleans, I'd recommend Tulane/LSU for networking and finding a good quality job right out of residency in that city.

Treat residency like applying for jobs. What do you want from it?