MS4 switching at last minute, need advice!

[getunconcsious]

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Hey everyone,
I'm an MS4 who was going to apply for Pathology this year. But, now that I'm finished with 6 weeks of path, I realize that I really don't like it and it's very boring and burdensome.

I would really like to apply for the triple board, but I don't know if I'd have a shot at this point since there are only like 22 or 23 spots. How competetive is the triple board? Are all the spots probably effectively spoken for already? I have pretty stellar numbers: 244/99 on step 1 and honors in psych, peds, surgery, and neurology. I'm just worried b/c I get the impression that child psych is not all that numbers driven and more about who you know...which for me is no one. Not any TB residents or attendings or anything. Because I had planned on applying to Pathology. Is it realistic for me to go ahead and apply to the TB based on my numbers alone? I can probably rustle up some LOR's from MS3 but they may not be all that stellar. I'm not sure how successful I will be in getting psych electives at some point before October (currently I'm scheduled for more path). Are there any programs known to be number-whoring types that will take someone like me? I also have no extracurriculars, basically I've got great numbers, but no personality. I'm 110% sure that child psychiatry is what I want to do and I'm really passionate about it. I did 3 weeks of it in MS3 and it was by far my favorite rotation, enjoyed every minute of it. I'm just worried that I won't be able to convince PD's of this since I came so close to applying for Path. I feel like I knew in my heart of hearts even then that I would not like Path, but I just really wanted the lifestyle and figured it was a headache-free specialty. It is but it's just not for me at all, I can't look at slides all day, and I'd rather have the headaches including overnight call, angry parents, and all the rest.
How can I show evidence of committment to a profession that I'm just now realizing I want to do? Is it simply too late?
I'm also planning to apply to integrated psych-child psych programs, so if anyone can comment on the competetiveness of those or what they would be looking for, that would be great!
Sorry this is totally rambling and likely incoherent but I'm a little panicked right now! 😱😱😱

Any advice would be greatly appreciated.

 

[Doc Samson]

Hey everyone,
I'm an MS4 who was going to apply for Pathology this year. But, now that I'm finished with 6 weeks of path, I realize that I really don't like it and it's very boring and burdensome.

I would really like to apply for the triple board, but I don't know if I'd have a shot at this point since there are only like 22 or 23 spots. How competetive is the triple board? Are all the spots probably effectively spoken for already? I have pretty stellar numbers: 244/99 on step 1 and honors in psych, peds, surgery, and neurology. I'm just worried b/c I get the impression that child psych is not all that numbers driven and more about who you know...which for me is no one. Not any TB residents or attendings or anything. Because I had planned on applying to Pathology. Is it realistic for me to go ahead and apply to the TB based on my numbers alone? I can probably rustle up some LOR's from MS3 but they may not be all that stellar. I'm not sure how successful I will be in getting psych electives at some point before October (currently I'm scheduled for more path). Are there any programs known to be number-whoring types that will take someone like me? I also have no extracurriculars, basically I've got great numbers, but no personality. I'm 110% sure that child psychiatry is what I want to do and I'm really passionate about it. I did 3 weeks of it in MS3 and it was by far my favorite rotation, enjoyed every minute of it. I'm just worried that I won't be able to convince PD's of this since I came so close to applying for Path. I feel like I knew in my heart of hearts even then that I would not like Path, but I just really wanted the lifestyle and figured it was a headache-free specialty. It is but it's just not for me at all, I can't look at slides all day, and I'd rather have the headaches including overnight call, angry parents, and all the rest.
How can I show evidence of committment to a profession that I'm just now realizing I want to do? Is it simply too late?
I'm also planning to apply to integrated psych-child psych programs, so if anyone can comment on the competetiveness of those or what they would be looking for, that would be great!
Sorry this is totally rambling and likely incoherent but I'm a little panicked right now! 😱😱😱

Any advice would be greatly appreciated.

Why do triple board? Why not match into psychiatry and fast track into C&A? Do you really want the peds training?

 

[OldPsychDoc]

Hey everyone,
I'm an MS4 who was going to apply for Pathology this year. But, now that I'm finished with 6 weeks of path, I realize that I really don't like it and it's very boring and burdensome.

I would really like to apply for the triple board, but I don't know if I'd have a shot at this point since there are only like 22 or 23 spots. How competetive is the triple board? Are all the spots probably effectively spoken for already? I have pretty stellar numbers: 244/99 on step 1 and honors in psych, peds, surgery, and neurology. I'm just worried b/c I get the impression that child psych is not all that numbers driven and more about who you know...which for me is no one. Not any TB residents or attendings or anything. Because I had planned on applying to Pathology. Is it realistic for me to go ahead and apply to the TB based on my numbers alone? I can probably rustle up some LOR's from MS3 but they may not be all that stellar. I'm not sure how successful I will be in getting psych electives at some point before October (currently I'm scheduled for more path). Are there any programs known to be number-whoring types that will take someone like me? I also have no extracurriculars, basically I've got great numbers, but no personality. I'm 110% sure that child psychiatry is what I want to do and I'm really passionate about it. I did 3 weeks of it in MS3 and it was by far my favorite rotation, enjoyed every minute of it. I'm just worried that I won't be able to convince PD's of this since I came so close to applying for Path. I feel like I knew in my heart of hearts even then that I would not like Path, but I just really wanted the lifestyle and figured it was a headache-free specialty. It is but it's just not for me at all, I can't look at slides all day, and I'd rather have the headaches including overnight call, angry parents, and all the rest.
How can I show evidence of committment to a profession that I'm just now realizing I want to do? Is it simply too late?
I'm also planning to apply to integrated psych-child psych programs, so if anyone can comment on the competetiveness of those or what they would be looking for, that would be great!
Sorry this is totally rambling and likely incoherent but I'm a little panicked right now! 😱😱😱

Any advice would be greatly appreciated.

Agree with Doc Samson--just come into psych, you'll make plenty of connections which will get you into child. It sounds from your post that you're letting the insecurities associated with your overachieving nature get the best of you. Take some deep breaths, get your psych LORs in order, and get ready to enjoy the interview trail. Unless you have psychopathology (beyond MS4 neuroses) or a criminal record, I guarantee that you will match--personality or no.

 

[getunconcsious]

Why do triple board? Why not match into psychiatry and fast track into C&A? Do you really want the peds training?

Sorry--Should have explained better. Yes I would like to do the peds training b/c I am most interested in taking care of kids with co-morbid psych and medical conditions. But I am not indecisive in which I would pursue if I can't get the TB spot. I know that I want to be a child psychiatrist, not a pediatrician. I just think that triple board training would be ideal for me in accomplishing my ultimate professional goals.

I should have just stuck with it when I became interested in it last year, but like I said the path lifestyle and I thought I would like it on paper, it's just really boring in practice. Picking psych isn't really some random last-minute revealation, I always knew that if not path then I'd do child psych. Since path didn't work out, I now have no doubt that this is what I want to do.

Thanks for the advice, I've got to try and get a new advisor, change my schedule, all that stuff This is why they should let us do electives in third year!

 

[LadyJubilee8_18]

Agree with Doc Samson--just come into psych, you'll make plenty of connections which will get you into child. It sounds from your post that you're letting the insecurities associated with your overachieving nature get the best of you. Take some deep breaths, get your psych LORs in order, and get ready to enjoy the interview trail. Unless you have psychopathology (beyond MS4 neuroses) or a criminal record, I guarantee that you will match--personality or no.

Don't let him fool you, he's got a great personality! I'd know better than almost anyone

 

[Faebinder]

BAH! Three boards.... that's like a life time worth of punishment for simply existing. You're gonna have to take 3 tests every 10 years instead of 1 or even 2.

Just go to psych.. match and apply to child psych fast track. It's not about whom you know so much as how well you did in PRITE/USMLE. OPD said it, you'll make the connections in residency. Even if you dont fast track, you can finish the four years and apply to start after the four years.

 

[OldPsychDoc]

Sorry--Should have explained better. Yes I would like to do the peds training b/c I am most interested in taking care of kids with co-morbid psych and medical conditions. But I am not indecisive in which I would pursue if I can't get the TB spot. I know that I want to be a child psychiatrist, not a pediatrician. I just think that triple board training would be ideal for me in accomplishing my ultimate professional goals.

I should have just stuck with it when I became interested in it last year, but like I said the path lifestyle and I thought I would like it on paper, it's just really boring in practice. Picking psych isn't really some random last-minute revealation, I always knew that if not path then I'd do child psych. Since path didn't work out, I now have no doubt that this is what I want to do.

Thanks for the advice, I've got to try and get a new advisor, change my schedule, all that stuff This is why they should let us do electives in third year!

Well, more power to ya. You should be competitive for those slots--they're less popular than one might expect. Personally, I still have a PTSD startle reflex associated with the pager ringtone I used on my Peds clerkship!

 

[Doc Samson]

If you want to be a psychiatrist and take care of kids with med/psych comorbidity, then match to psychiatry, fast track into C&A (or match into a guaranteed 5 year program), then specialize in child CL (with or without the additional fellowship year). It's a growing market (am actually trying to recruit a child CL doc now), and if you aren't practicing pediatrics the extra training/exams/fees aren't worth it. Some of the guaranteed 5-year programs (MGH/McLean for example) will let you do your PGY-1 non-psych months in peds/peds neuro instead of adult medicine/neuro.

 

[homeobox_genes]

Just go ahead and apply, you'll be competitive. At the interview, be friendly, open and persuasive about your interest in child psychiatry. The interview is the most important variable you're ignoring.

 

[DebDynamite]

I really thought at one point that I wanted to do med/psych.

Now, I'm in the middle of my 2 months of IM inpatient, and every day I'm so, so, so thankful that I didn't do it. Adult med psych patients don't seem to want to talk about their psych issues . But they really dig somatization, avoidance of psych issues in favor of basic medical issues, etc...(or, conversely, that's all they want to discuss).

Just my 2 cents.

Are you sure you wanna triple board?

I think it's less competitive than you might realize.

 

[getunconcsious]

I really thought at one point that I wanted to do med/psych.

Now, I'm in the middle of my 2 months of IM inpatient, and every day I'm so, so, so thankful that I didn't do it. Adult med psych patients don't seem to want to talk about their psych issues . But they really dig somatization, avoidance of psych issues in favor of basic medical issues, etc...(or, conversely, that's all they want to discuss).

Just my 2 cents.

Are you sure you wanna triple board?

I think it's less competitive than you might realize.

I'm about 99% sure that I would like to do the triple board. Intresting what you're saying about med-psych. I guess I just found kids much more fun to take care of both in child psych vs. adult and in peds vs. medicine. I think that I could enjoy pediatrics, but not medicine. That said everyone is different, so maybe I would become burned out. I'm doing a NICU elective in the next few months to make sure that I would actually like the more burdensome peds months. Hopefully I'll be ok, maybe it's not as competetive as it looks (35 applicants for 20 spots last year!) but it's got me a bit freaked out. I do think I can get a good psych spot though even if I don't get a TB one, and ultimately child psych is what I want to do. Would be nice to have the peds training too though, IMO.

Thanks for the replies/encouragement everyone! I'm one of those types that likes to have everything planned out way way in advance, so switching specialties was hard for me, since I had the perfectly planned Pathology schedule. Kinda sad to give it up, but I mean it was a bit problematic when I realized I didn't actually enjoy pathology at all!

 

[DebDynamite]

I don't know what it is about Psych and Path. I almost did Path. I even liked my rotation in it 4th year. I just like Psych more. Not my first time to hear this from someone else.

Good luck- you'll get a spot, I'm sure!