welshman14 said:
I am a 2nd year, in the 4th quartile of my class, interested in Psychiatry. Can anyone shed some light on what strategy I should have on getting a decent residency in psych (or family med) inspite of poor grades? What thought process have any of you older students had when applying, knowing your grades are working against you?
Although my grades aren't "working against me," I think that there are a few key things that you should concentrate on when looking ahead to residency programs.
First... since you're a 2nd-year, I assume that you haven't yet taken the USMLE Step 1. If you haven't started thinking about a study schedule yet, make an appt. to see someone in your office of student affairs to discuss USMLE strategies. Having sub-par grades doesn't necessarily mean that you haven't learned the material, but if your med school is like the majority and used multiple-choice exams to test your knowledge, then you have to (and maybe you already have) determine if you're just a bad objective test taker. Regardless, the USMLE is completely multiple choice with multi-layered and multi-tiered questions and sometimes up to 20+ answer choices. Grab a copy of First Aid for the USMLE (everyone swears by this book), and in my opinion, a book called "Step Up to the Bedside." It's a USMLE Step 1 review book that reviews high-yield pre-clinical material using a case study format. It may be a little early to start right into these books for some hard studying, but the occasional flipping through at a leisurely pace may not be such a bad idea. First and most important, start talking to someone about test-taking strategies. Every school has programs in place to help students on their way to taking the boards. You'll need to do well on your boards to offset your transcript.
Second... network. Get in touch with physicians in the fields that you're interested in pursuing. REMINDER: you're only a 2nd-year, and you haven't yet experienced clinical medicine (rotations and clerkships). Don't make the mistake of trying to convince yourself too early what field you want to pursue. Life weighs in and there is more to your decision than just your current point-of-view. But nevertheless, speak to docs in psychiatry and family medicine. Perhaps set up some volunteer or shadowing time, and at a minimum, speak with them about pursuing careers in the field. See what they think about it and speak with them earnestly and honestly regarding your feelings and preferences. Doesn't hurt to have someone on your side of things should you decide to go into a particularly field.
Third... another way to offset your transcript is to rock your clinical rotations/clerkships. Work your butt off to learn as much as you can during your rotations and do as much as you can to supplement your studying. Work closely with your residents and teams. Work to impress. CAUTION: do all of this without working to showboat, suck up, etc etc. Impress them with your drive and your desire to learn, not with your desire to show that you're better than others. It may seem hard to differentiate the two right now, but it'll become plainly clear which students are following which strategies once you get on the wards. Each rotation has a final examination, and most are national board "shelf" exams which are made up of 100 questions from the national board of medical examiners for that particular specialty. Again, multiple choice and very objective. Again, if you're a bad test taker, you'll have to offset your test scores with other assessment methods... this is where your hard work and dedication comes in. Attending and resident (especially chief and senior residents) evaluations are often heavily weighted and can be a great help come time to determine clerkship grades.
Lastly... remember to have fun. You came to medical school because somewhere deep down inside you want to help people, and actually enjoy the material that you're trying to digest and apply. The first two years can feel like torture, and once you get on the wards, you'll experience what real medicine is all about. I had a ton of fun my third year, and although I probably could have worked harder (can't you always when you look backwards in time... as the saying goes, hindsight is always 20/20), I enjoyed my rotations and clerkships. So much that I changed my mind on residency choices. Came in wanting to do one thing and came out pursuing something else. If you remember that you enjoy it all and you have fun, it doens't seem as much like slave labor, and if it doesn't seem as much like slave labor, you can relax more, and if you relax more, you'll find that digesting the material comes much more naturally.
I hope that this helps... at least a little bit. I apologize for the length, and I hope you made it through it all. I'm always giving advice via the list servs at my school to people in years behind me, because, well, there just didn't seem to be anyone giving advice to us on issues such as boards, and rotations, and how to study/prepare. I think that med school is all about constructive learning and partnerships, and when we all shed that ultra-competitive shroud that everyone initially seems to think you need to have to be successful, everyone ends up being a lot better off. Good night and good luck
🙂
- Fred
PS - Feel free to share the above with anyone, and feel free to PM me at any time. I'll do my best to get back to you in a timely fashion.
