Its worth adding, many foreign medical schools aren't equivalent in terms of depth of education that US medical schools provide. I worked with FMG completing an externship hoping to match this cycle, he told me how difficult it was for him to pass the USMLEs because much of the stuff preclinical stuff wasn't taught, particularly biochemistry, microbiology, and pathology. Some foreign countries just don't go into the same depth we do in the US.
While this may be true in some cases, its important not to rely or put too much stock into something like this. For one thing, its not like medical school preclinical material is particularly difficult for someone with mild/moderately above average intelligence. So in other words, even if they don't have the same knowledge base, a few months of board prep and studying USMLE material might be enough for them to catch up.
There are also tons of IMGs that have very strong training (arguably better with regards to knowledge base than many US schools), but that's not really what we're talking about. I also want to make it clear that if IMGs match, it usually means they did well. So if any of you in the future are working alongside them, I'd be careful to recognize that (not saying this is what you meant, but I don't want someone on here reading your post and assuming that IMGs all had a sub-par education, because that's just not true).
More competitive, yes. "Very" competitive - not really. Even if there is a larger applicant pool, board scores aren't the sole deciding factor at a lot of psychiatry programs.
Our PD likes to see candidates who passed on the first attempt and who have a genuine, demonstrated interest in psychiatry. The residents here don't really care about a candidate's board scores; our input is largely based on a candidate's work (if they auditioned), social skills (we tend to veto annoying/negative/lazy/apathetic people), and personal compatibility with the residents.
Fit and interest matters a lot for most residency programs. I know we harp on the importance of board scores constantly (and they are important), but unless we're talking the very competitive surgical subspecialties, a low score doesn't necessarily block you out of most fields.
I did exactly what these people are saying. I scored horribly on level 1, though not as low as OP. I took step 1 at the end of 3rd year with my back against the wall and pulled 230's. It was one of the hardest things I've ever had to do, but honestly it saved my career as far as I'm concerned. My score (and OP's score) wouldn't even meet the cutoff for an away rotation for most programs. I had no idea how limited you truly are with a low comlex score.
Congratulations on the Step 1, especially taking it after 3rd year. That's not an easy thing to do. That said, don't overemphasize how limited you are with lower board scores. There are plenty of places that have cutoffs for auditioning, but actually interview a lot of people below their auditioning cutoffs. There were a couple places I interviewed at that just did not take any DOs for auditions (pretty much a university policy) that had no problem interviewing and ranking DOs.
In other words, you'd be surprised by the application cycle. Its unpredictable. Don't limit your applications just because you think a place won't interview you. If you want to interview there just apply and let the invites fall where they may.
