Jan 10, 2010
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So, I know it's a little late in the year, but I finally decided to leave IM for psych. I just need more pt. contact then I'm getting here and psych is the only place for that. I'm currently a PGY-1, but have yet to make any moves. I'm at a mid-level, university affiliated hospital in a big city. My question is this, I'm an FMG w/ Step 1 -224 and Step 2 -210, no faliures, the psych program in the hosptial im at now is okay, but not too many fellowships offered. I've been told I should start there and see if they can get me a spot for PGY-2. I just want to know if anyone thinks this is the best idea, or would I be competative enough to land a better residency program if I left my program and just reapplyed next year (to either PGY-1 spots or PGY-2). It is somewhat comforting to think I can just slip into a spot in the hospital I'm at now, but I don't want to sell myself short and if I approach the program director here and he has something for me, I won't be able to say no at that point. Any advice would help.
 
Jul 20, 2009
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So, I know it's a little late in the year, but I finally decided to leave IM for psych. I just need more pt. contact then I'm getting here and psych is the only place for that. I'm currently a PGY-1, but have yet to make any moves. I'm at a mid-level, university affiliated hospital in a big city. My question is this, I'm an FMG w/ Step 1 -224 and Step 2 -210, no faliures, the psych program in the hosptial im at now is okay, but not too many fellowships offered. I've been told I should start there and see if they can get me a spot for PGY-2. I just want to know if anyone thinks this is the best idea, or would I be competative enough to land a better residency program if I left my program and just reapplyed next year (to either PGY-1 spots or PGY-2). It is somewhat comforting to think I can just slip into a spot in the hospital I'm at now, but I don't want to sell myself short and if I approach the program director here and he has something for me, I won't be able to say no at that point. Any advice would help.
if you could slip into a pgy-2 spot now at your current hospital, and it's an "okay" program, I'd do it. As for fellowships, you can always go somewhere else for those. Most aren't going to be uber competitive.

Because if you apply for pgy-1 slots next year in the match at programs you "want" more, that would be TWO years of internal medicine you will have eventually done, to essentially get to do another intern year as a pgy-1 in psych. As opposed to just transitioning into this pgy-2 slot if possible. To me that's not even a question......thats a huge difference.

Heck if I was going to apply for pgy-1 psych positions eventually, I'd probably actually just finish the last year of my categorical IM position and get board certified in IM and then apply to psych......

but if you really want to do psych, the way that would seem to make the most sense is just take that open pgy-2 position at your hospital in 3 months....
 

st2205

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Heck if I was going to apply for pgy-1 psych positions eventually, I'd probably actually just finish the last year of my categorical IM position and get board certified in IM and then apply to psych......
:thumbup:

If it were my decision, I'd view it as one of two options:

1) Slide over to your hospital's psych program
2) Finish IM before entering psych

I wouldn't leave any middle-ground, but that's just me. What you'd be doing if you waited another year would be finishing 2/3 of an IM residency and, in many regards (but not all) throwing away an entire year (or more) of training, when instead you could invest an extra year to just finish it. If you're being that callous about a year of education, you may as well invest an extra one rather than throw one away.

So if you can answer the question "is the possibility of being at a 'better' institution worth a year of my life?" in the affirmative, then I think you can really do whatever you feel comfortable with.
 

psychattending

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You should be going for a PGY2 slot. I would think few programs would take you as a PGY1 for both educational and financial reasons.

Your chances at getting a PGY2 slot for next year are on the low side for now because of it being late in the year. However, you should check out your local psych program as well as others to see if there is an opening.

In general, I would say dropping out of a training for a year would look bad on your record and could potentially put you in a situation where you never are able to finishing training in any specialty.

You need to talk to your current program director if you have not already done so. He/she can be instrumental in helping you successfully navigate a change in specialty so that your's and other's education is interrupted as minimally as possible. He/she also will be required to write a letter to the new program about how you preformed during your training. He/she will also be commenting on your professionalism. If either of these are an issue, it will diminish your chances of changing programs.
 
Sep 2, 2009
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It's hard to know if you'd be competitive for a "better" program since we don't know which program you are currently at. I'll tell you what I think... Your usmle scores are good but not great. Also, your FMG status will be a disadvantage. There is no guarantee that by waiting around you'll land a better program...it may be a downgrade or you may not land one at all. If you have a good chance to switch to the psych dept at your hospital, I think it would be wise of you to take it.

Psych fellowships are relatively easy to land overall...it's not like cardio or GI...I wouldn't worry about this right now.
 

BobA

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I would also strongly consider finishing your IM residency. Perhaps you could talk the PD into letting you use your electives for Psych and get done earlier. You'd have TONS of career flexibility that way, and you've already gotten much of the difficult parts of IM out of the way.

Transferring to psych as a PGY2 can be tricky. You have to know where the openings are, and often they are more competitive than PGY1 spots b/c the #applicants / #spots ratio is much larger than applying for PGY1. So if you could get a PGY2 spot at your current program I'd take it. Don't worry about fellowships. The only competitive psych fellowships are pain and sleep, with forensics fellowships at good programs a close third. If you're interested in pain and sleep you'd be better off getting there through medicine anyway.

Good luck!
 
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