Matching Psych w/ Dismissal on Transcript

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2000 Man

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So here's my story:
I was originally accepted to a DO school in 2005 (class of 2009). I managed to get to the end of second year before I failed enough classes to get dismissed for academic failure. The reason for my failures was the fact that I was drinking heavily. The school knew nothing of my drinking and I did not have any legal/professional violations for any reasons. So after getting the boot I sought help and got sober (I am now have almost 4 years of sobriety).

Fast foward a year later. I went back to my school and told them about my drinking and what I had done to get better. They agreed to let me back in as a first year student. I signed a contract that included weekly AA meetings, meeting with a program monitor and random urine tests.

So here I am now finishing up my second year and peparing for boards. I have not had any slips in my sobriety. I am starting to look at psych as a possible career choice. How will residency PDs look at my record? Do I have a shot?
 
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Too soon to say. You haven't taken your boards yet. Step 1 will have a bearing on your application. At this point planning on your applications and future is a bit premature. Contrary to others, I encourage it as it will only give you a better impression of programs, specialties and the application process. Just don't lose track of your current focus. Your objective right now is to finish 2nd year strong, give your best effort at the licensing exams, and take USMLE, too.

Stay sober. Get comfortable telling your story. You'll need to do it openly, and illustrate how it strengthened your professionalism to be more accountable for your actions. When it comes time for interview season you will tell your story at every single interview - prepare for it now. Also, apply to programs that have addiction programs. You can use it to your advantage by illustrating how you have an interest in that patient population - I could be wrong, others should comment, too.
 
2000 Man said:
So here's my story:
I was originally accepted to a DO school in 2005 (class of 2009). I managed to get to the end of second year before I failed enough classes to get dismissed for academic failure. The reason for my failures was the fact that I was drinking heavily. The school knew nothing of my drinking and I did not have any legal/professional violations for any reasons. So after getting the boot I sought help and got sober (I am now have almost 4 years of sobriety).

Fast foward a year later. I went back to my school and told them about my drinking and what I had done to get better. They agreed to let me back in as a first year student. I signed a contract that included weekly AA meetings, meeting with a program monitor and random urine tests.

So here I am now finishing up my second year and peparing for boards. I have not had any slips in my sobriety. I am starting to look at psych as a possible career choice. How will residency PDs look at my record? Do I have a shot?
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So I am now halfway through 3rd year. My peclinical GPA is an 85%. I scored 473/80 on Comlex I. So far I have been getting excellent evaluations on my rotations (don't do psych until March) and 3 great LORs from FM and IM.

Anyone have any thoughts/advice on my matching a psychiatry residency with my "checkered" past?
 
It's debated whether you should do an audition rotation for psych residencies. If you do well, some argue it doesn't help much, but if you do poorly it can have a significantly negative effect on matching to that program.

In your case, IF you are doing well in your clinical rotations, I think you should do auditions early in 4th year. People will get to know as a solid medical student, prior to your application being sent in by ERAS. Also you should get a LOR from the attending at that program. I would imagine it's a lot easier to accept someone with your history if they know you're reliable and hardworking.

Based on your COMLEX score you will probably score below average on USMLE. I would not attempt to take the USMLE to boost my application in your case. I'm pretty sure most psych residencies don't care if you only have COMLEX.
 
Good luck and please keep us up to date. I have a similar background and I'm in the middle of my third year, and I'll be matching in to psych next year. Glad I'm not alone 👍
 
Indeed, you would do very well in Addiction Psychiatry.
 
I hate saying this and mentioned this before in other threads.

In every application process where there's far more applicants for an available spot, the admissions team will weed out people using filters. E.g. a GPA or a USMLE score below a certain amount, throw the application out.

Such a filtering method could have your application thrown out denying you a fair chance of being considered. As bothersome as it is, for those in the program's side, when you have thousands of applications to sort through, you have little choice but to use these methods. If I were a PD, I would not be able to put a careful consideration of over 4000 applications. I have to weed them down somehow, and when I get to perhaps around 200 applications I can actually put the time to try to figure these applicants out. No filtering method will be completely fair.

I have, however, seen a few programs, where the PD knew of the unfair methods going on, and that some people do stumble and fall and manage to get themselves back up. A buddy of mine was kicked out of a program, got into another program, became a chief resident and specifically targetted applicants in similar circumstances that had otherwise great records, citing that these were probably great residents kicked out of malingnant programs that would have all cylinders fired up to do well as a resident to prove they weren't a screw-up, when they were likely never one to begin with. The former PD of where I graduated would not use something like the above against an applicant unless there was a repeated and clear pattern of problems. In fact I believed if the person had one large strike against them, but everything else was fine, he would've actually seen that as a mark for the candidate because he knew the person likely felt they had to prove themselves because in medical academia, such an event was the equivalent of a scarlet letter.

Advice to you-apply to more programs just in case. If you are passionate about doing well and love what you do, you will do well, but don't take any chances.
 
whopper said:
If I were a PD, I would not be able to put a careful consideration of over 4000 applications. I have to weed them down somehow, and when I get to perhaps around 200 applications I can actually put the time to try to figure these applicants out. No filtering method will be completely fair.
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Yes programs do filter but you are exaggerating here. There aren't even 2000 applicants for psychiatry, let alone 4000, the most competitive places get 800+ applicants, competitive places get 600+ places, less desirable places will get even less. When you put into context most of these are IMGs (who are often first to be filtered out) and there less than 700 US MD students and less than 200 DO students applying to psych as first choice specialty things are much less bleak.

As long as you're not too picky where end up I suspect you will be fine with getting interviews though I suspect there is a bias and you may end up further down rank lists.
 
splik said:
Yes programs do filter but you are exaggerating here. There aren't even 2000 applicants for psychiatry, let alone 4000, the most competitive places get 800+ applicants, competitive places get 600+ places, less desirable places will get even less. When you put into context most of these are IMGs (who are often first to be filtered out) and there less than 700 US MD students and less than 200 DO students applying to psych as first choice specialty things are much less bleak.

As long as you're not too picky where end up I suspect you will be fine with getting interviews though I suspect there is a bias and you may end up further down rank lists.
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I'm a 4th year DO student applying this year.

I also sucked at COMLEX 1 (which is a god awful test, truthfully). I was expecting ~530-ish based on my test scores at school, and pretest stuff...I didn't quite make it. Wound up in the mid-to-upper 400's. I think it was partly due to pretty severe test anxiety, which I only had for that one test, go figure, which left me with practically zero sleep the night before. I should've rescheduled, but oh well...

I did MUCH MUCH better on COMLEX 2. >550. Make sure you rock COMLEX 2. I watched the Kaplan Step 2 videos over and over and over until I was kicking USMLE World's rear. Step 2 Secrets Book should also be memorized, and the Green OMM book.

The rest of my app is similar to yours, average student, etc. I was never kicked out or anything though. No substance use issues for me either.

I was very worried about my crappy Step 1, my DO-ism, and my average grades, and was expecting a luke-warm response to my application. Applied to ~30 places, got >20 invites. Had to cancel or decline many interviews.

The bottom line is that I don't think your Step 1 score is the death knell that SDN makes it out to be. Do very well on Step 2 and that can make up for it. I've had more than a few PDs tell me that they care more about Step 2 anyways.

I am more worried about the "interruption" in your education. Work on your story and try to spin it into a true interest in addiction psychiatry, and get very, very comfortable talking about it and writing about it. Work on your writing if you're not a superb writer (how'd you do on MCAT writing?). Start working on your personal statement and your "why my education was interrupted" statement now.

Think about trying to get a letter from someone who may have a similar past history but is now a successful psychiatrist. This would mean working with this person, either late in 3rd year or very early in 4th. Maybe there's someone here like that who could PM you...cough cough. Or maybe someone here just knows someone who knows someone...

Put Step 1 behind you. Destroy Step 2. Do some audition rotations. Get great letters.
 
Thanks for your honesty, as I think this thread will help a few people in similar situations for many years.

It's difficult to say how your match process will end up, but at the end of it, you will be that much more grateful to be where you end up.
As a former chief resident, I personally looked through 500+ applications (after a few hundred were weeded out through the Step I scores), and came across a hand full of applications with checkered pasts. Most of the checkered pasts include substance abuse, legal problems, unethical acts during school (cheating), or other Axis I disorders leading to alternate paths during the medical training.
Although it would seem that Psychiatrists would be the most forgiving about an applicant with a past substance abuse history, but my experience from conversing with the Chair, Program Director, and program director for addictions is that this is often not the case. I remember we had a couple of interviewees who had a substance abuse history, and the Addictions program director was very critical of their past alcohol history, also the chair would refuse to rank someone with a history of Meth dependence. A majority of doctors tend to look down on the type of patients they treat. Surgeons will have little patience for a resident/colleague who is physically weak or not able to stay awake. This is a generalization, but psychiatrists will look closely at your substance use and whether it is a current problem or not. I agree with the other poster in that your past will automatically put your application in another pile during the interview selection process, particularly for competitive programs. With that being said, you will see very unique Psychiatry residents, older ones, blind ones, and definitely those with a history of substance abuse. A majority of the residents/attendings I've met that have had a substance abuse history have stayed in the university that they did their medical school or residency training. You coming from an Osteopathic school, I would apply to as many schools as possible and just in case, training programs that are DO friendly.
There was a famous New England Journal of Medicine article many years ago about a physician who had a terminal illness, and he noticed that his colleagues would slowly start to avoid him. Doctors subconsciously avoid those they treat. Behind Cluster B patients, I've noticed that the patient with active addiction often conjures up the most negative countertransferance. During your interviews, I suspect that a majority of your interview time will be about your substance use history. This is very unfortunate, because then they won't have that time getting to know you and your strengths.
I agree with the other posters in that you will make an excellent Psychiatrist for patients with substance use disorders. 12-steps has its own language, and you will be able to converse very well with people who are "Friends of Bill" due to your experience. A general residency often doesn't have a strong addictions rotation, so your past can be an advantage. I've heard from several adult and child attendings and the one field that is often difficult to treat is the addicted patient. The most important advice I can give you is to stay sober and be open with your past.
I wish you luck and please keep us updated.
 
Fastball32 said:
...A majority of doctors tend to look down on the type of patients they treat. Surgeons will have little patience for a resident/colleague who is physically weak or not able to stay awake...

...There was a famous New England Journal of Medicine article many years ago about a physician who had a terminal illness, and he noticed that his colleagues would slowly start to avoid him. Doctors subconsciously avoid those they treat.
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This is interesting. So do you think a non-psychiatry PD would be more receptive to an applicant with a substance abuse history?
 
No, I don't expect a non-psychiatry PD to be more receptive for applicants with a substance abuse history.
I do know that Psychiatrists tend to know more about addiction than other specialties, and thus may be more prone to "evaluate" the applicant for current substance abuse problems. Everyone makes mistakes and substance abuse is one of the most common DSM diagnosis in young adults, however the nature of someone with true addiction is one of denial and relapse (not implying any poster here has substance dependence). A psychiatrist interviewing someone for a job may thus evaluate the situation a lot more thoroughly and the applicant's thought process, whereas a surgeon may just ask for the facts.

I think there are definitely psychiatrists who will look at your past and know how much it can help you in the field, but as a Program Director, they will have to decide to take a "chance" on someone with lower scores or a 'checkered' past.

For someone going through this, I imagine that my responses are somewhat disheartening. I would say to take a page from the Serenity Prayer and not worry about things you have no power over, at the same time, work hard to make yourself a strong candidate (strong scores, paper trail of sobriety, good letters of rec, and prepare to answer a lot of questions on the matter during your interview).
 
There aren't even 2000 applicants for psychiatry
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You are correct. Most psychiatry programs get a few hundred applications for about a dozen spots. The thought process going on in my mind at the time was to illustrate the need to weed out applicants using filters because the trend in this forum in the past was to criticize programs for doing this despite that giving every single application the time they deserve is impossible on a PD's schedule.

But not correcting my exaggeration would've also been a mistake. Several applicants go into the MATCH process thinking it is much more competitive than it really is, thus causing this already frustrating and scary process to be even scarier. From my experience, almost everybody gets in. They might not get into their first choice, but most get in, and a large amount seem to go to a place they highly ranked.
 
Fastball32 said:
No, I don't expect a non-psychiatry PD to be more receptive for applicants with a substance abuse history.
I do know that Psychiatrists tend to know more about addiction than other specialties, and thus may be more prone to "evaluate" the applicant for current substance abuse problems. Everyone makes mistakes and substance abuse is one of the most common DSM diagnosis in young adults, however the nature of someone with true addiction is one of denial and relapse (not implying any poster here has substance dependence). A psychiatrist interviewing someone for a job may thus evaluate the situation a lot more thoroughly and the applicant's thought process, whereas a surgeon may just ask for the facts.

I think there are definitely psychiatrists who will look at your past and know how much it can help you in the field, but as a Program Director, they will have to decide to take a "chance" on someone with lower scores or a 'checkered' past.

For someone going through this, I imagine that my responses are somewhat disheartening. I would say to take a page from the Serenity Prayer and not worry about things you have no power over, at the same time, work hard to make yourself a strong candidate (strong scores, paper trail of sobriety, good letters of rec, and prepare to answer a lot of questions on the matter during your interview).
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Thank you for all your advice
 
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How do you think my history will affect getting a license for residency? Do you think it will delay it? Deny it? Require me to continue the monitoring program? All the above?
 
I think some people will deny you a fair chance due to the reason I mentioned above--the filters, but overall I do think you do have a fair shot but apply to a lot of problems (edit: I meant to say "programs", must be some type of Freudian slip!) to give yourself the best chance possible.

Missing out on the MATCH will lead to a year of likely wasted time. Further, I'm of the opinion that if one doesn't match, and they try again they look like damaged goods. While it's certainly possible to apply to too many programs, in your case I wouldn't take any chances. I'd certainly want too many programs asking for an interview vs. not enough. IMHO certainly worth it to spend a few hundred more dollars in applying to more programs through the MATCH to maximize your odds when you're in this situation.

In all honesty, I may be advising you to be overly cautious. The problem here is I don't know anyone who's done a controlled method of measuring how much you should be worried about it. I can, however, tell you I've seen the admissions process in a few programs, and I've seen friends not get in their first time in the MATCH and then literally never get in anywhere at all after applying again and again. With the friends that didn't match the first time, they seemed to be even unluckier than people on similar ground with the exception that they were applying for the first time. A buddy who didn't match tried some of the same programs again, and literally during the interview, was told "Oh it's you again" as if they didn't remember him but now that they did, they didn't want to be seeing him again.

I don't want you to freak out because like I said, most people do match, even the ones with a blemish such as failing the USMLE more than once or something to that effect. I'm just saying don't take chances. While it may be nothing to something small to worry about, balance it out with the facts that you may get filtered out and that you want to get in on the first time. All-in-all, based on that, I would apply to several several programs, but not try to worry about it too much more than you already have because further worry will get you nowhere.
 
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2000 Man said:
How do you think my history will affect getting a license for residency? Do you think it will delay it? Deny it? Require me to continue the monitoring program? All the above?
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The government expanded the admission rates to US Medical Schools around 2005, since 2009 ALL residencies have become more competitive. In 2009 and 2010, there were about 10 unmatched spots for all US Psychiatry residency programs across the nation for both years. I'm not sure what last year was, but I'm assuming it was similar.
The factors of increased Med Students, along with Psychiatry becoming a more accepted specialty, all make Psychiatry a bit more competitive.

I think Dr. Whopper is giving you excellent advice. You should definitely apply to as many programs in locations where you wouldn't mind spending the next 4 years.

As far as getting your license, it is hard to say. Some Program Directors will want you to be involved with a Diversion Program, even if the State Board doesn't require you to do so. Some states don't even have a Diversion Program (oddly enough I don't think California has one anymore). I think applying to states with a good diversion program (you will have to do your own research) is a good idea. I believe you are more likely to get your license if you are in a state diversion program, since they will not likely deny you a license based on substance use and instead refer you to a diversion program.
In your situation, if you only had one mishap with substances and if it was several years back, then you may not even need to be in a diversion program.
There is no way anyone can tell you for sure what the licensing process will be for you, since each state looks at the case individually. Keep building a paper trail of sobriety.
 
So we are now into Sept and I have sent my ERAS application to all the D.O. psychiatry programs (and a number of Family Medicine as backups). Have not heard a thing from the psych programs yet. Got one invite and had an interview with one of the FM programs, that went very well. Getting ready to transmit to the ACGME programs next weekend.

So I am starting to get nervous. Should I have been hearing something from the D.O. psych programs by now or is it still kind of early?
 
2000 Man said:
So we are now into Sept and I have sent my ERAS application to all the D.O. psychiatry programs (and a number of Family Medicine as backups). Have not heard a thing from the psych programs yet. Got one invite and had an interview with one of the FM programs, that went very well. Getting ready to transmit to the ACGME programs next weekend.

So I am starting to get nervous. Should I have been hearing something from the D.O. psych programs by now or is it still kind of early?
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I'd assume it's still early. I'd have to venture to guess that a lot of those programs have very little competition and I'd even guess that there will be many positions in the scramble. The published data from the AOA on board scores/failures and other such demonstrated that, at least among the small group of AOA psychiatry applicants, they were on average on the low end of the spectrum according to the measures they used.
 
The psychiatry program I am in interviewed an applicant last year who had been dismissed from one medical school due to substance abuse issues. The applicant went through rehab and went to school in the Carribean and he ended up matching into psychiatry at a good program.
 
futuredo32 said:
The psychiatry program I am in interviewed an applicant last year who had been dismissed from one medical school due to substance abuse issues. The applicant went through rehab and went to school in the Carribean and he ended up matching into psychiatry at a good program.
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Thanks for the encouragement.
 
How many ACGME programs did you end up applying to? With all the ACGME programs out there I think some of them will give you a chance. Good luck. 🙂
 
I will be shocked if you don't end up matching somewhere.

I've known of people who got dismissed from medical school due to failures and ended up going the Caribbean route and matched in Psychiatry, people who got kicked out of Psychiatry residencies due to poor performance and matched at another Psychiatry residency program etc...

Just apply to a ton of programs and you will match somewhere. Best of luck.
 
Chianti said:
I will be shocked if you don't end up matching somewhere.

I've known of people who got dismissed from medical school due to failures and ended up going the Caribbean route and matched in Psychiatry, people who got kicked out of Psychiatry residencies due to poor performance and matched at another Psychiatry residency program etc...

Just apply to a ton of programs and you will match somewhere. Best of luck.
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Still nothing from psych. A ton of FM, but no psych. ?????
 
Is the fat lady about to sing?
Still nothing.
(3 sorry but you suck emails though)
 
Got another "thanks for applying, but no thanks" email today. I guess psych is not to be....
 
How many programs did you apply to? And you applied to all the DO ones, even all the new ones?
 
Applied to all DO programs except CA and NY. About 40 programs total.
 
Can you add more ACGME programs? I actually think your chances might be better in the MD match than the DO match because a lot of DO programs are small and they also can be picky about things like only considering people who have rotated at the program.

If it does turn out that you go into family med, all is not lost. There are definitely a huge amount of psychiatric issues that come up in primary care. However, I definitely wish you well in getting some positive response from your preferred programs.
 
peppy said:
Can you add more ACGME programs? I actually think your chances might be better in the MD match than the DO match because a lot of DO programs are small and they also can be picky about things like only considering people who have rotated at the program.

If it does turn out that you go into family med, all is not lost. There are definitely a huge amount of psychiatric issues that come up in primary care. However, I definitely wish you well in getting some positive response from your preferred programs.
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Completely agree. I'd add as many as possible before your Dean's Letter comes out tomorrow. A lot of the DO programs might also be waiting for your MSPE to get an explanation of your history and to make sure there have been no other problems since you came back.
 
BS81 said:
Completely agree. I'd add as many as possible before your Dean's Letter comes out tomorrow. A lot of the DO programs might also be waiting for your MSPE to get an explanation of your history and to make sure there have been no other problems since you came back.
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MSPEs for all students were released October 1. The 15th is for DO residencies and not students.
 
Finally, got 2 interview invites! One DO one MD. There is still hope!
 
Congratulations, that's great to hear.
 
So I have got 4 interview invites from psych programs; 3 from places I really have no interest in and 1 that I would not mind but was nowhere near the top of my list. Meanwhile I have gotten numerous interviews from the other specialty that I applied to.

Maybe it was my app, but it sure seems to me that the psych programs were a lot less sympathetic to my situation. I find this somewhat ironic and understandable at the same time.
 
2000 Man said:
So I have got 4 interview invites from psych programs; 3 from places I really have no interest in and 1 that I would not mind but was nowhere near the top of my list. Meanwhile I have gotten numerous interviews from the other specialty that I applied to.

Maybe it was my app, but it sure seems to me that the psych programs were a lot less sympathetic to my situation. I find this somewhat ironic and understandable at the same time.
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Scuttlebutt says that psych has increased in competitiveness this year. I assume your other specialty is FM. If that's the case, psych has always been ever-so-slightly more competitive than FM, IM, and Peds.
 
Fastball32 said:
Any updates?
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It was interesting. I got many offers to interview at the primary care programs I applied to but only 4 psych interviews (3 were D.O. programs that I had no interest in attending). Ultimately I matched at my 1st choice allopathic FM program and I am thrilled. I guess psych was not in the cards for me.
 
Having an interest in mental health will be a great thing in primary care. Good luck to you. 🙂
 
2000 Man said:
It was interesting. I got many offers to interview at the primary care programs I applied to but only 4 psych interviews (3 were D.O. programs that I had no interest in attending). Ultimately I matched at my 1st choice allopathic FM program and I am thrilled. I guess psych was not in the cards for me.
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The two addiction specialists who are attendings at my program are both fps and they both have a history of addiction and they are spectacular attendings. Based on their own histories with addiction they can relate to the patient much better than others could, I would imagine.
 
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