Is it dramatic to think you won’t match because of one level one failure?

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cryhavoc

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I honestly have been stressed all year because of this. I did pretty well on the retest. All my pre-clinical and clinical grades are A’s and B’s. I worked very hard and long for my dream of being a doctor, particularly a psychiatrist, and it is all I ever envisioned myself doing.

Plus I’m in a level of debt that could never be repaid if I don’t succeed.

If I apply very broadly to psych residencies (roughly 80-100 apps), do I have a good chance? Should I apply to family medicine as a back-up and do I have a good chance of that? I’d be totally willing to become a family doctor and then become a psychiatrist if I had to. Or transfer if possible. I would be willing to be a resident that long to do what I love. Advice?

Thank you, I apologize if I’m being dramatic but I’m honestly very worried about this.
 
i am going into EM so my knowledge of psych is limited i had a classmate who wanted to go for psych but failed the PE and he had to do a TRI year and reapply to psych. the programs told him that the PE is why they did not rank him. This is something that might happen to you because you have a board failure however dont let this get you down apply broadly to psych 100+ apps if you can afford it and go for all of your interviews throw a few TRIs on your rank list or apply to them in the SOAP. Accept that if you want to do psych and nothing else than you might have to go this route. if you would be happy doing FM then by all means go for both.

It depends on what you want from psych if youre interested in something like addiction medicine you can do that through FM. bottom line if you want something go for it even if that means you have to do a transitional or TRI year pass all of your boards (you will pass COMLEX 3 during the TRI year) so programs dont have to worry about you failing boards while in residency
 
What was your retake score?

This is a valid concern and honestly based on the psych match this year, your best and maybe only shot at matching psych is probably going to be through connections and away rotations assuming you impress them enough to overlook a failure.

You should apply to every psych program that has ever taken a DO (>100 apps) as well as a significant number of FM programs (50-80+). A COMLEX failure without a USMLE is going to be a massive uphill battle going forward. You need great aways, letters, level 2 score and a USMLE step 2 if you can muster a decent score.

You need to figure out what went wrong on level 1, fix it, and crush everything from this point forward
 
You need backups. I don't know what else to say. I don't think psych is likely straight up. I feel like its the flavor of the month now and its applications have been inflated. Maybe nuerology? Seems like that is still open and there are some similarities.
 
BorntobeDO? said:
You need backups. I don't know what else to say. I don't think psych is likely straight up. I feel like its the flavor of the month now and its applications have been inflated. Maybe nuerology? Seems like that is still open and there are some similarities.
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I don’t really like anything but psych. So I guess I’m going with family medicine as a back-up or a traditional rotating internship and then later try to transfer.
 
cryhavoc said:
I don’t really like anything but psych. So I guess I’m going with family medicine as a back-up or a traditional rotating internship and then later try to transfer.
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Transferring will be even harder than matching psych will be. Essentially what I'm saying is that if you don't match psych straight up you might have to get comfortable with the idea of doing family med as a career, because a transfer to a psych residency likely isn't going to happen. Not in the current psych craze we are experiencing.
 
cryhavoc said:
I don’t really like anything but psych. So I guess I’m going with family medicine as a back-up or a traditional rotating internship and then later try to transfer.
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I've done family medicine clerkship. It's psychiatry in all but name
 
A backup is an absolute necessity. With a board failure, I would say even applying psych at all is a bit ridiculous. I say this after a ton of people of my school failed to match psych with average USMLE on the first attempt
 
AnatomyGrey12 said:
Transferring will be even harder than matching psych will be. Essentially what I'm saying is that if you don't match psych straight up you might have to get comfortable with the idea of doing family med as a career, because a transfer to a psych residency likely isn't going to happen. Not in the current psych craze we are experiencing.
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Then I’ll have to become a family medicine doctor and then become a psychiatrist. I don’t see why a fully fledged family medicine doctor would not be able to procure a residency. People do switch specialties after all.

I doubt a fully fledged family medicine doctor has never once changed his specialty?

I didn’t work all these years to hate my job for the rest of my life. It will happen. It is just a matter of extra years of my life I suppose.

This thread has enlightened me about what an uphill battle it will be though. So at least I know what I’m dealing with.
 
cryhavoc said:
I don’t really like anything but psych. So I guess I’m going with family medicine as a back-up or a traditional rotating internship and then later try to transfer.
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I would try the specialties you didn't get to rotate in during third year. Maybe something will surprise you. Is there a fellowship off peds for child psych? I have heard of Behavior and Development fellowship (The Society for Developmental and Behavioral Pediatrics (SDBP)). I would start looking for alternative paths like that.
 
BorntobeDO? said:
I would try the specialties you didn't get to rotate in during third year. Maybe something will surprise you. Is there a fellowship off peds for child psych? I have heard of Behavior and Development fellowship (The Society for Developmental and Behavioral Pediatrics (SDBP)). I would start looking for alternative paths like that.
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My entire life has been devoted to wanting to help adults with mental illness. I can’t just change my life like that. Some of my classmates just randomly happen to like psych because of a rotation. I think my passion can possibly overcome my resume and if it doesn’t I’ll have to take the long road.

More than a dozen people told me I had no shot at getting into medical school and I killed my interview. I’m not unused to fighting bad odds.

I’ll just have to do that again I suppose. I am thankful for these posts though. They’ve shown me that I have a very small chance and will have to overcome a lot to get where I want.
 
cryhavoc said:
My entire life has been devoted to wanting to help adults with mental illness. I can’t just change my life like that. Some of my classmates just randomly happen to like psych because of a rotation. I think my passion can possibly overcome my resume and if it doesn’t I’ll have to take the long road.

More than a dozen people told me I had no shot at getting into medical school and I killed my interview. I’m not unused to fighting bad odds.

I’ll just have to do that again I suppose.
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You are getting legitimate advice which is what you asked for. If you want people to tell you to apply to 30 psych programs and good luck that's fine, but you will be SOAPing.

In this last match there were approximately 1700 psych spots and 2700 applicants to psych. You can do the math. Failing a minimum competency exam puts you in a terrible position and unfortunately you no longer get to be picky.

Its not impossible but like I mentioned above, your only chance at matching psych is going to be from strong connections and impressing people on away rotations. That needs to be your focus at this stage. When application season comes around you need to have 100-200 applications to family med and psych because with a board failure you are at a major disadvantage and run the real possibility of not even matching family med. I'm sorry for the harsh reality but as you mentioned, the only way to pay back your debt is with an attending physician salary and you need to know how to play the game or you are going to be in a bad spot
 
I realize that. I would be fine with family medicine to survive my debt. But I would want to go back later in life and become a psychiatrist. Doctors do change their speciality, don’t they?
 
cryhavoc said:
My entire life has been devoted to wanting to help adults with mental illness. I can’t just change my life like that. Some of my classmates just randomly happen to like psych because of a rotation. I think my passion can possibly overcome my resume and if it doesn’t I’ll have to take the long road.

More than a dozen people told me I had no shot at getting into medical school and I killed my interview. I’m not unused to fighting bad odds.

I’ll just have to do that again I suppose. I am thankful for these posts though. They’ve shown me that I have a very small chance and will have to overcome a lot to get where I want.
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I generally discourage this kind of thinking in myself. Financially, it is almost always better to prepare for the worst and hope for the best, and this line of thought has served me well in the past. Part of preparing is acknowledging where you stand in this world. I would also point out that the difference between adults with mental illness and kids, is that kids have a better chance of recovering. I can understand you saying you can't stand kids, but I would point out psych is mostly dealing with adults acting like kids, so that really shouldn't be a thing.

If you want to die on that hill of 'I must do adult psych only!', go ahead. But I am a realistic solutions focused person, and you have been given many in this thread. Going Family and then switching to psych later in the career is not a realistic solution. The only way I could see that working is if you did a FM residency in a place that had a psych residency and literally did every elective in psych while somehow convincing the PD to take you despite no residency funds. That is not likely at all.

Anon6134 is correct in saying that the only reasonable way you have a shot doing adult psych is auditions. You need to get somebody important in your corner. I would focus on former DO programs, hopefully with grads from your school.

Also I have to say it, as someone who has a family, and is nontrad: You don't have time for that FP then Psych residency nonsense. Your kids, your spouse, they all deserve to get some reward from what your putting them through right now. Especially if you already failed a board exam, this has not been easy for them. Make sure you make it work, don't let day dreaming turn into a real life nightmare.
 
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I don’t have kids or a wife. I can wait for that. There is no rush. If I cared about money I would have done something else.
 
cryhavoc said:
I don’t have kids or a wife. I can wait for that. There is no rush. If I cared about money I would have done something else.
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For some reason I had it in my mind that you were nontrad with family, apologies. Either way, the rest of the post still applies. That second sentiment is foolish, money is always important. As Kanye said so well:
261439
 
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any way you could pass USMLE Step 1? Do better on Step 2CK?

do you have "important names" who can write letters for you? are you doing aways at programs known to prefer their rotators and take chances on those who did not pass boards? do you have research that demonstrated your commitment to psychiatry? are you involved with psychiatric professional societies? what about neurology?

A step failure is very difficult to overcome, as passing it demonstrates "minimal competence..." ie you should do more than pass. When I entered med school in 2015 psych was likely one of the least competitive specialties. Now in this past match it has become one of the more desired specialties, which means PDs want the scores, the letters from prestigious academic faculty, research, awards, etc.

as a sidenote, as a family physician, you will likely be managing uncomplicated psychiatric issues in some patients however you have to ask yourself what you will do if a patient suffers an adverse outcome (suicide, homicide, permanent disability, medication adverse effect). You will be judged against the standard of practicing psychiatrists... that's why a physician refers out patients who become "too complicated" as they cannot provide the same standard of care as a physician practicing in a particular specialty. The jury or the judge will ask themselves "would another FM doc practicing in this area/state manage this complex PTSD patient or refer them to a psychiatrist" and if the answer is refer and you did not, you are very much liable and are committing malpractice and harming your patients if you insist on managing patients who should be referred to a specialist.
 
To answer the title of this thread: no, this isn’t being over dramatic at all.

After reading this thread, OP, you’re not being realistic about this. Sure, people do switch specialties, but don’t make it like this is super commonplace or necessarily easy to do. My (now) MS4 advice is to follow the advice of others on here... apply to psych with a FM backup and hope for the best. Try to not hate FM.
 
I hope it works out OP. But don’t ask for opinions if you plan to ignore ones you don’t like hearing.

You failed level 1. Sucks and I hate it for you. But you should be concerned about matching at all into anything.
 
In all seriousness, I will have a back-up but that doesn’t mean I am not going to try. But sometimes how you say something is more important than what you are saying. Keep that in mind when you start seeing patients. It can make people defensive.
 
I hope you match psych @cryhavoc (tried to PM you but I can't). An exam failure doesn't define who you will be going forward. Continue to work hard on your rotations and show your passion and interest in psych to PDs. I hope you succeed!
 
AnatomyGrey12 said:
Nice. Keeping it classy after getting very good and realistic advice I see.
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It's a standard SDN response. Someone asks for advice, people respond honestly, the asker gets frustrated with advice they don't like and tries to use Burnett's Law to reprimand people for poor empathy/clinical skills just from an anonymous forum discussion
 
Lawper said:
It's a standard SDN response. Someone asks for advice, people respond honestly, the asker gets frustrated with advice they don't like and tries to use Burnett's Law to reprimand people for poor empathy/clinical skills just from an anonymous forum discussion
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I apologize then. I want to thank everyone for their advice and apologize if I was defensive about it. You’re right, I’m sorry. I will be more realistic with my residency application. I will have to apply broadly and to a lot of programs and if it doesn’t work out, be grateful to be able to practice at all. The empathy thing from me did come from a place of me being defensive and that wasn’t cool.

Sorry if I was a butt.
 
cryhavoc said:
I apologize then. I want to thank everyone for their advice and apologize if I was defensive about it. You’re right, I’m sorry. I will be more realistic with my residency application. I will have to apply broadly and to a lot of programs and if it doesn’t work out, be grateful to be able to practice at all. The empathy thing from me did come from a place of me being defensive and that wasn’t cool.

Sorry if I was a butt.
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You're fine. It's part of the Match fun.

For the record, I really do hope you succeed and get where you want to be. You'll come to see people realize reality in the year to come and it really is unfortunate after all the work put in to school and getting to this point. If you start off with realistic expectations and do what you need to do to succeed you'll be much better for it. Many of my classmates are in not so great situations because they refused to face the music and they are unfortunately paying for it.

Good luck to you, sincerely
 
Definitely need a backup, likely family med. Apply broadly and rank psych programs over family med/IM/whatever your back up is. This was likely OP's plan already.

I may be way off and putting the cart before the horse, but it may be good for OP to do a little research about specific psychiatric exams, diagnoses, treatments administered and see what can be billed for and for how much it can be billed for and compare the numbers between a doc that has a board certification in Psychiatry vs. one that does not. You can carve out a nice niche even as a family medicine physician if your practice is psych-oriented.

A quick google search of "psychiatry fellowships for family medicine" shows there are options to pursue some type of psych-oriented fellowship after completion of residency. There are also behavioral health fellowships that can help tailor your practice toward psych when you're done. Pursuing this path may help you bill for more exams/diagnoses/treatments, bill for a greater amount, and serve to legitimize your psych-oriented practice to the patients you help.

*Edit: Adding "Good Luck!"
 
I’m IM, but at my clinic a good third of our patients have depression or anxiety or ADHD (or dementia) and we’re managing it, so if you think you won’t help adults with mental health problems in FM, you’re mistaken. You can also do an addiction fellowship after FM, and lord knows we could use more experts in that.

Apply for psych- no reason not to- but apply to FM as a backup as well. Maybe it’ll work out, and if it doesn’t, you’re better off as a FM doc or a FM doc applying for psych than an unmatched med student or TRI (who’s used a year of funding) applying for psych.m

Edited to add info
 
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ortnakas said:
I’m IM, but at my clinic a good third of our patients have depression or anxiety or ADHD and we’re managing it, so if you think you won’t help adults with mental health problems in FM, you’re mistaken. You can also do an addiction fellowship after FM, and lord knows we could use more experts in that.

Apply for psych- no reason not to- but apply to FM as a backup as well. Maybe it’ll work out, and if it doesn’t, you’re better off as a FM doc or a FM doc applying for psych than an unmatched med student or TRI (who’s used a year of funding) applying for psych.
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There's an addiction fellowship in FM? That's neat.
 
One of our FM preceptors has a FM residency with an addition med fellowship - he doesn’t work in regular FM, only addiction. It’s an interesting niche.
 
ortnakas said:
AAFP Addiction Medicine
No idea how competitive it is, or how useful it is, or if psych fellowships through the academy of psych accept FM grads- but I know it exists.
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FM practitioners who see tons of addiction patients are also able to sit for the Addiction Med boards without doing the formal fellowship if their practice meets certain requirements and they feel confident enough to pass. I've spoken to a couple docs on here who have done so. They seem pretty happy.
 
I think sleep medicine and geriatrics are also still on the table. As you guys said, so is addiction.

I find all of those things also fascinating and psych oriented in some ways. I’m sure it will all work out. Addiction hit my family and community hard so I could find that work satisfying. I could also find geriatrics satisfying because I love the elderly and find dementia interesting.

So it is a good back-up.
 
ortnakas said:
AAFP Addiction Medicine
No idea how competitive it is, or how useful it is, or if psych fellowships through the academy of psych accept FM grads- but I know it exists.
Click to expand...

I looked at a couple of programs and Stanford will accept applications from anyone who graduated from an ACGME residency, so it is definitely open.
 
You definitely have a chance of getting into psych. Apply to a ridiculously high number of programs. Do extra interviews, like 10-15, and sleep well at night. The game is just however many interviews/programs you rank = an increased chance of matching. Apply to a back up specialty like family and BOOM! Get this man a job.
 
cryhavoc said:
I realize that. I would be fine with family medicine to survive my debt. But I would want to go back later in life and become a psychiatrist. Doctors do change their speciality, don’t they?
Click to expand...

Take the advice here with a grain of salt. Ppl match every year into psych with board failures and others with average to high usmle scores don’t. If your passion is there make sure you have experiences/things you’ve done to back that up.

Psych is one of the most forgiving w/ board scores, with at least 33% (if not 66%, can’t remember off the top of my head) program directors saying they will rank someone with board failures (this number is higher than fm residency actually).

You sound like you really want it, you can get it. Find a way and get off Sdn for this... ppl here don’t know what matching into psych specifically is like. (It doesn’t follow the traditional norms of boards >>>> anything else).

And I don’t want to hear backlash from others, I won’t respond. This is my opinion.
 
MADD!!! said:
Take the advice here with a grain of salt. Ppl match every year into psych with board failures and others with average to high usmle scores don’t. If your passion is there make sure you have experiences/things you’ve done to back that up.

Psych is one of the most forgiving w/ board scores, with at least 33% (if not 66%, can’t remember off the top of my head) program directors saying they will rank someone with board failures (this number is higher than fm residency actually).

You sound like you really want it, you can get it. Find a way and get off Sdn for this... ppl here don’t know what matching into psych specifically is like. (It doesn’t follow the traditional norms of boards >>>> anything else).

And I don’t want to hear backlash from others, I won’t respond. This is my opinion.
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Your an anti-vaxxer too aren't you? Cause I mean, why play the overwhelming odds and vaccinate when I could just get harmless measles right!

-Just my opinion. I won't respond 😛 I still love you tho MADD, but I have to quarantine this bad advice like a Jenny McCarthy kid with a rash.
 
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I also have a level 1 failure and I’m applying psych. My realistic plan is that I have set up auditions at a couple AOA programs that held on into AOA till this year. I have a vsas application into 1 MD programs, that has accepted people from my school with red flags in the past 2 years, and I’ve set up another through vsas with a history of taking students from my school. My goal is to snag a residency at one of the places I’m doing auditions. I’m applying psych broadly, with a few specific family medicine programs as back up with a strong connection to my school.
If you wanna talk it out you can message me.
 
FM and then 1 yr addiction medicine fellowship...

I am a PGY1 in IM and plan to apply to addiction medicine...
 
Alternate route to becoming a full fledged Psychiatrist:
Peds residency —> post pediatric portal program
Seeing as peds is very non-competitive, this is a path that is worth looking into.
 
PsychApp777 said:
Alternate route to becoming a full fledged Psychiatrist:
Peds residency —> post pediatric portal program
Seeing as peds is very non-competitive, this is a path that is worth looking into.
Click to expand...
What's that?
 
Splenda88 said:
What's that?
Click to expand...
It's a program at CHOP to bridge pediatricians over to general psych and CAP. But it's CHOP and it seems like it's the only such program (?) so idk how competitive it is.

Post Pediatric Portal Program

The Post Pediatric Portal Program is a three-year combined training program in general psychiatry and child and adolescent psychiatry, which is approved and overseen by the American Board of Psychiatry and Neurology.
www.chop.edu www.chop.edu
 
Hippogryff said:
It's a program at CHOP to bridge pediatricians over to general psych and CAP. But it's CHOP and it seems like it's the only such program (?) so idk how competitive it is.

Post Pediatric Portal Program

The Post Pediatric Portal Program is a three-year combined training program in general psychiatry and child and adolescent psychiatry, which is approved and overseen by the American Board of Psychiatry and Neurology.
www.chop.edu www.chop.edu
Click to expand...

Actually there appear to be 4 such programs thus far.

www.aacap.org

Post Pediatric Portal Programs

www.aacap.org www.aacap.org
 
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