Options if NO match!?!

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ee2k3

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I did not match. This came as a shock for my supporters and me. Step 1 >240. Step 2>250. No red flags other than I took 9 months off for reasons that were thoroughly explained in my PS and during interviews (had nothing to do w/ drug addiction, trouble w/ the law, or going psychotic).

What are my options at this point? I still want to apply for Psychiatry match next year.
What can I do over the next year to show residencies my value?

Any ideas, in or out of the box, are deeply appreciated.

This has been a difficult time in the lives of my family, friends, and medical staff that have supported me over the years. However, I'm here to put a strong step into what tomorrow brings. Thank you for your contribution.

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Look for a research 'post-doc' position and/or plug into the SOAP match hoping for some kind of internship in FM or IM which is non-categorical. You could potentially find a spot in a couple of months when people quit for whatever reason.
 
Look for a research 'post-doc' position and/or plug into the SOAP match hoping for some kind of internship in FM or IM which is non-categorical. You could potentially find a spot in a couple of months when people quit for whatever reason.
Applied to all of the position allowed for SOAP. No beuno there.

How would I go about finding a spot post match?

I'll do some research into post doc positions. Thank you.
 
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How many programs interviewed you? Did you constrain yourself geographically or fail to include some programs of perceived lower prestige? How did you feel you related to the interviewers? There's more to life than board scores...
 
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Applied to all of the position allowed for SOAP. No beuno there.

How would I go about finding a spot post match?

I'll do some research into post doc positions. Thank you.
There is a forum on heer for open positions, you may want to check that.
 
How many programs interviewed you? Did you constrain yourself geographically or fail to include some programs of perceived lower prestige? How did you feel you related to the interviewers? There's more to life than board scores...
I applied narrowly but non-restrictively geographically. Interviewed 6. Ranked 5. 2 schools in cali, 1 in Tx, 1 in NC, 1 in Utah. Relate-ability wise, my perception is favorable. To paint a basic picture, american graduate, tall, white, male, passionate about psych and honest about my strengths and weaknesses. All interviews seemingly went really well, other than one interviewer asking if I was psychoanalyzing him/her after we shared a moment of prolonged eye contact after I finished answering their question. I have research (reviewing high risk peripartum women for psychiatric disease and trauma hx). Top 25% class.
 
Top 25% and scores like yours, it has to be something. Either your interviews don’t come off as you feel they do, or the gap in school was worrisome or poorly explained and mysterious, or maybe there is something in your application of concern that you have not identified as concerning.

If you did SOAP and had no luck, maybe it is your application and not your interview presentation. I’m guessing SOAP doesn’t allow as much interview exposure. I would think you would be one of the more impressive SOAP participants given your scores rank, and research.

If you have a psych PD or associate PD you trust, have them review your application and ask them to tell you honestly the strengths and weaknesses as they see it. PDs tent to have a lot of inter-rater reliability in my experience. This may help you to deal with what the issue is as you move forward.

I know this is a very long hard road to be on just to have things derail. There isn’t much anyone can say to make you feel better about this, but this is just a bump in the road, not the end of the road. You will get passed this, but you may need to seek out objective criticism to help you know what to do. Best of luck,
 
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Top 25% and scores like yours, it has to be something. Either your interviews don’t come off as you feel they do, or the gap in school was worrisome or poorly explained and mysterious, or maybe there is something in your application of concern that you have not identified as concerning.

If you did SOAP and had no luck, maybe it is your application and not your interview presentation. I’m guessing SOAP doesn’t allow as much interview exposure. I would think you would be one of the more impressive SOAP participants given your scores rank, and research.

If you have a psych PD or associate PD you trust, have them review your application and ask them to tell you honestly the strengths and weaknesses as they see it. PDs tent to have a lot of inter-rater reliability in my experience. This may help you to deal with what the issue is as you move forward.

I know this is a very long hard road to be on just to have things derail. There isn’t much anyone can say to make you feel better about this, but this is just a bump in the road, not the end of the road. You will get passed this, but you may need to seek out objective criticism to help you know what to do. Best of luck,
Thank you for this insight and your realistic encouragement.
 
Assuming there are no big red flags in your application you are unaware of (such as a poor LOR or poor comments on rotation evals), the number of programs you interviewed at and ranked is the most concerning part that I see. Were you very limited in your number of applications? Or did you receive outright rejections from most programs you applied to? Ideally I think most applicants should be interviewing at and ranking at least double the number of programs you interviewed at/ranked.
 
Assuming there are no big red flags in your application you are unaware of (such as a poor LOR or poor comments on rotation evals), the number of programs you interviewed at and ranked is the most concerning part that I see. Were you very limited in your number of applications? Or did you receive outright rejections from most programs you applied to? Ideally I think most applicants should be interviewing at and ranking at least double the number of programs you interviewed at/ranked.

Yes, this. Interviewing at 6 programs is on the low end, especially for an applicant with a red flag, which your 9 months off could be. If you applied to many more places and didn't get interviews, that would further suggest some programs with your application on paper. Also being likable enough to match without a red flag is different from being likable enough to match with a red flag. I don't want to be critical when you're facing this rejection, but I've got to say applying in a pretty restricted manner with a red flag might suggest some limitations in judgment (or guidance) in your application. Apply very widely next year.

As for the upcoming year, spots really do pop up. I have a friend who didn't match years ago who got a spot after the scramble. Doing IM internship also wouldn't be the end of the world and might open up options for transferring into a program in the 2nd year. Is deferring graduation an option? At my medical school, you could defer and get an MPH, which somewhat hides the not matching and gives you another year where you don't have to pay your loans.
 
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you can try LIH 9 months psychiatry externship program.
 
Assuming there are no big red flags in your application you are unaware of (such as a poor LOR or poor comments on rotation evals), the number of programs you interviewed at and ranked is the most concerning part that I see. Were you very limited in your number of applications? Or did you receive outright rejections from most programs you applied to? Ideally I think most applicants should be interviewing at and ranking at least double the number of programs you interviewed at/ranked.
Perhaps hubris or poor guidance, I applied only to the top programs in the country (most of which I had no desire to go to, merely curious what the programs and people were like). My personal statement may be considered risque (in a non-sexual sense). I talk about my desire to understand more about being in the role of patient therefore signed up for psychotherapy. Also talked about a meditation retreat I went to (Vipassana, it's free and a wonderful experience). Also at the end of the PS I describe what I want from a residency. (IF you wish I can post or private message it).
 
Yes, this. Interviewing at 6 programs is on the low end, especially for an applicant with a red flag, which your 9 months off could be. If you applied to many more places and didn't get interviews, that would further suggest some programs with your application on paper. Also being likable enough to match without a red flag is different from being likable enough to match with a red flag. I don't want to be critical when you're facing this rejection, but I've got to say applying in a pretty restricted manner with a red flag might suggest some limitations in judgment (or guidance) in your application. Apply very widely next year.

As for the upcoming year, spots really do pop up. I have a friend who didn't match years ago who got a spot after the scramble. Doing IM internship also wouldn't be the end of the world and might open up options for transferring into a program in the 2nd year. Is deferring graduation an option? At my medical school, you could defer and get an MPH, which somewhat hides the not matching and gives you another year where you don't have to pay your loans.
Next year I will be throwing out a very large application net. The schools I truly wanted were quite limited. I felt confident in applying narrowly, lesson learned.

How does one become privy to such openings? Is cold calling residencies a good idea, is it even acceptable? I already graduated. I will be taking Step 3 soon.
 
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How does one become privy to such openings? Is cold calling residencies a good idea, is it even acceptable? I already graduated. I will be taking Step 3 soon.

yes absolutely, send your CV and letter of interest/personal statement to programs you are interested in and have your referees/school forward their letters of recommendation and your MSPE to the programs you are interested in and tell them to let you know if a PGY-1 spot becomes available. they will then invite you for an interview if something becomes available. this is really the best way to go about this as often residency spots are not advertised on apa clearinghouse or findaresident and the good openings can go quickly or the top programs won't fill them at all.

doing step 3 won't help your application any. i am sure you will do fine given your scores but it does help having some intern experience as you cant really prepare for it. also your program might pay for it as a resident. i would make sure your LoRs are strong and spend the year doing something of value to you. i think they meant LIJ externship, this wont help you any and is probably for IMGs

p.s. no one is going to believe that you only had psychotherapy to "understand being in the role of the patient" and if you really believe that well... the more dynamically oriented would think you were insightless. i would not put this in your next personal statement. especially as you took 9 months off everyone will assume (whether the case or not) this was due to mental illness and unfortunately psychiatrists are the most stigmatizing and unforgiving.
 
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especially as you took 9 months off everyone will assume (whether the case or not) this was due to mental illness and unfortunately psychiatrists are the most stigmatizing and unforgiving.

srs? :eek:
 

Yes, seriously. Or they'll wonder if you went to rehab. And yes, while we do probably have a higher proportion of people with mental illnesses in our field than other fields of medicine, we're pretty judgmental about it. At my program, talking about a personal history of mental illness in your personal statement was considered concerning. Residency programs want people who are going to be able to show up to work everyday -- any sign that that's been a struggle in the past (and a 9 month leave is a sign) will be a potential red flag. Acceptable gaps -- doing a research year, a parent dying, cancer treatment ... -- other gaps (including unexplained ones) are going to make programs worry. Not to say a red flag means you won't match because lots of people in medicine have red flags, but you can't have a red flag and then under apply and write a questionable personal statement.
 
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Perhaps hubris or poor guidance, I applied only to the top programs in the country (most of which I had no desire to go to, merely curious what the programs and people were like). My personal statement may be considered risque (in a non-sexual sense). I talk about my desire to understand more about being in the role of patient therefore signed up for psychotherapy. Also talked about a meditation retreat I went to (Vipassana, it's free and a wonderful experience). Also at the end of the PS I describe what I want from a residency. (IF you wish I can post or private message it).

Umm, so maybe you should talk to your therapist about why you self-sabotaged yourself in your application. I know this is a mean thing for me to say, but I'm really shaking my head about why you would intentionally apply to long shot places you didn't want to go to and then write a personal statement that you know would be perceived as odd/different. Part of being a patient is exploring why we do things like this.

Or you're trolling us, which I'm starting to suspect.
 
yes absolutely, send your CV and letter of interest/personal statement to programs you are interested in and have your referees/school forward their letters of recommendation and your MSPE to the programs you are interested in and tell them to let you know if a PGY-1 spot becomes available. they will then invite you for an interview if something becomes available. this is really the best way to go about this as often residency spots are not advertised on apa clearinghouse or findaresident and the good openings can go quickly or the top programs won't fill them at all.

doing step 3 won't help your application any. i am sure you will do fine given your scores but it does help having some intern experience as you cant really prepare for it. also your program might pay for it as a resident. i would make sure your LoRs are strong and spend the year doing something of value to you. i think they meant LIJ externship, this wont help you any and is probably for IMGs

p.s. no one is going to believe that you only had psychotherapy to "understand being in the role of the patient" and if you really believe that well... the more dynamically oriented would think you were insightless. i would not put this in your next personal statement. especially as you took 9 months off everyone will assume (whether the case or not) this was due to mental illness and unfortunately psychiatrists are the most stigmatizing and unforgiving.
Wonderful! thank you for this. Curious though, letter of interest? Is this different from PS? Sending both?

I didnt have PT solely for that. My PS goes on to explain that as well. The better we come to understand our self the better we can help others walk this path. This was my ultimate purpose for discussing PT, again made clear in PS. However, what you are saying makes sense. It can be a delicate process discussing this topic, and I likely lacked in finesse at times during interviews. Do you feel that a major theme of a PS being self discovery being at the root of a great therapist is appropriate?

"May you help me walk my own path, so that I may help others discover their own." This was the closing line of my PS.
 
Umm, so maybe you should talk to your therapist about why you self-sabotaged yourself in your application. I know this is a mean thing for me to say, but I'm really shaking my head about why you would intentionally apply to long shot places you didn't want to go to and then write a personal statement that you know would be perceived as odd/different. Part of being a patient is exploring why we do things like this.

Or you're trolling us, which I'm starting to suspect.
Certainly so. I ultimately effected the outcomes of my matching (not matching). In light of your last sentence, I applied to places I didnt want because I was still interested in meeting the doctors first hand. Also I love interviewing. It was exciting to image the challenging interviews I may face at certain programs. In regards to the PS, as I reread rough drafts and watch the trend, they started off even more odd. It brings to light a certain idealization I was carrying towards a potential residency program. I so badly wanted a program to challenge the way I perceived reality, from the patient, to the relationship, as well as myself. The sculpting of the PS founded its self on rooting out programs that couldn't provide me this, by being upfront about what I wanted.

Self-sabotage, uncertain. Consciously I am unable to find any intention to do so. However, it's an interesting thought. If any insights come forth from it, I will use it purposefully in the future. Thank you.
 
Wonderful! thank you for this. Curious though, letter of interest? Is this different from PS? Sending both?

its like a PS but it's in epistolary form and should basically be a cover letter explaining your interest in the program and what you have to offer. it is a letter for a job not a college admission essay, so waxing lyrical of your own therapy or vipassana meditation is not a good idea. some people will appreciate heartfelt personal statements wrought with self-disclosure but many will not (I can image all the bitchy comments i would have made about yours had i read it, but i'm just a horrible person) and doing something different is not the way to go in your case.

the other thing is that while it is fine to mention being interested in psychotherapy most of your training is going to be spent doing things far removed from that (especially the first 2 years of residency) and programs are looking for people who know what psychiatrists do (mostly NOT psychotherapy), and be able to/interested in doing it. there are few places less therapeutic than a locked involuntary psychiatric unit. also know your audience. top programs are looking to train the leaders in the field, and while many residents may end up doing things that you're interested in, that doesn't mean programs are trying to select for it.
 
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its like a PS but it's in epistolary form and should basically be a cover letter explaining your interest in the program and what you have to offer. it is a letter for a job not a college admission essay, so waxing lyrical of your own therapy or vipassana meditation is not a good idea. some people will appreciate heartfelt personal statements wrought with self-disclosure but many will not (I can image all the bitchy comments i would have made about yours had i read it, but i'm just a horrible person) and doing something different is not the way to go in your case.

the other thing is that while it is fine to mention being interested in psychotherapy most of your training is going to be spent doing things far removed from that (especially the first 2 years of residency) and programs are looking for people who know what psychiatrists do (mostly NOT psychotherapy), and be able to/interested in doing it. there are few places less therapeutic than a locked involuntary psychiatric unit. also know your audience. top programs are looking to train the leaders in the field, and while many residents may end up doing things that you're interested in, that doesn't mean programs are trying to select for it.
HAHA, well, I will being seeking many peoples feedback on my next PS which I will be starting soon. Hopefully I will have someone who is "bitchy" and a horrible person review it. I truly appreciate your feedback.
 
Yes, seriously. Or they'll wonder if you went to rehab. And yes, while we do probably have a higher proportion of people with mental illnesses in our field than other fields of medicine, we're pretty judgmental about it. At my program, talking about a personal history of mental illness in your personal statement was considered concerning. Residency programs want people who are going to be able to show up to work everyday -- any sign that that's been a struggle in the past (and a 9 month leave is a sign) will be a potential red flag. Acceptable gaps -- doing a research year, a parent dying, cancer treatment ... -- other gaps (including unexplained ones) are going to make programs worry. Not to say a red flag means you won't match because lots of people in medicine have red flags, but you can't have a red flag and then under apply and write a questionable personal statement.

this seems pretty hypocritical to me. Amazing that I have friends who got INTO top med schools because they had diabetes and cancer, or at least made that part of their app, but "we're pretty judgmental about" mental illness in the psychiatry field. I know more than one person who took time off because of depression in med school; it doesn't seem rare. I don't think OP approached his applications in the best way but I'm kind of shocked about the tone of this response. Glad to know we are making such huge strides in our stigmatization of mental illnesses:rolleyes:
 
this seems pretty hypocritical to me. Amazing that I have friends who got INTO top med schools because they had diabetes and cancer, or at least made that part of their app, but "we're pretty judgmental about" mental illness in the psychiatry field. I know more than one person who took time off because of depression in med school; it doesn't seem rare. I don't think OP approached his applications in the best way but I'm kind of shocked about the tone of this response. Glad to know we are making such huge strides in our stigmatization of mental illnesses:rolleyes:

If I had a mental illness that needed more than just drugs to treat, the last thing I would want is a psychiatrist who had issues as well. It's pretty difficult to gain a sense of normal behaviour/thinking when your provider is prone to mental illness. Their judgement could be clouded in subtle ways. It would be like the blind leading the blind. However, if it were a family medicine situation, it wouldn't matter to me that my physician had mental issues as long as they treated me properly. I'm not even close to being a psychiatrist, but I've seen radically different treatment plans for the same patient which I haven't seen in the family medicine clinic I work in. Is it possible for a psychiatrist with a mental illness to treat the broad range of patients they might see properly over their career? I don't think so, which is why the increased stigmatization makes sense, at least to me.
 
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If I had a mental illness that needed more than just drugs to treat, the last thing I would want is a psychiatrist who had issues as well. It's pretty difficult to gain a sense of normal behaviour/thinking when your provider is prone to mental illness.

and you could make the argument that someone who struggled with a mental illness and received treatment for it has a greater understanding and level of empathy. would you refuse to see an oncologist who had cancer herself? In other fields it is considered a positive to have firsthand understanding. Seems like more stigmatizing BS to me. People go through things, get treated, and move on with their lives as a "healthy" person. Just because you had debilitating depression at some point in your life doesn't mean you can't move past it. I'm not a psychiatrist myself but if this is seriously how psychiatrists think about things I don't have an increased level of respect for the field.
 
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and you could make the argument that someone who struggled with a mental illness and received treatment for it has a greater understanding and level of empathy. would you refuse to see an oncologist who had cancer herself? In other fields it is considered a positive to have firsthand understanding. Seems like more stigmatizing BS to me. People go through things, get treated, and move on with their lives as a "healthy" person. Just because you had debilitating depression at some point in your life doesn't mean you can't move past it. I'm not a psychiatrist myself but if this is seriously how psychiatrists think about things I don't have an increased level of respect for the field.

The truth is that we also know that people who have been debilitated by mental illness in the past are more likely to be debilitated by it in the future. Again, residency programs want people who can show up to work every day -- if anything makes you seem less like that person compared with other applicants than it will count against you.
 
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Oh, the stigma issue... I think it's hotly debated mostly because of the way folks use the word "stigma."

If we are using the word in the classical sense, in which a stigma is a sign of disgrace, I don't think there is a lot of stigma for mental health held by most of the psychiatrists looking over applications.I think most of us look at it with compassion.

If we are using it in the sense of it being simply a mark or a sign, then I think most folks do see it as such. I think most see it as a caution flag. Like applicants applying a year or two out of medical school, applicants having taken time out in the middle of medical school, or applicants applying from osteopathic or international schools we've never heard of. Can these people be outstanding applicants? Yes. Can we accept them into our program happily? Yes. Is scrutiny a good call? Yes.
 
I'm hoping ee2k3's situation points out one very important lesson that most folks on this board hammer again and again but that many of the folks who don't match seem to not hear: apply broadly and apply early.

In the case of the OP, applying to only 6 top schools is a bad, bad strategy. High scores are not a shoo-in. In fact, they seem to matter less at the top programs. I have a hunch the logic is that top programs can take folks they really like with lower step scores, unknown medical schools, or foreign education, because they don't have to worry about taking a hit to their reputation.
 
If I had a mental illness that needed more than just drugs to treat, the last thing I would want is a psychiatrist who had issues as well. It's pretty difficult to gain a sense of normal behaviour/thinking when your provider is prone to mental illness. Their judgement could be clouded in subtle ways. It would be like the blind leading the blind. However, if it were a family medicine situation, it wouldn't matter to me that my physician had mental issues as long as they treated me properly. I'm not even close to being a psychiatrist, but I've seen radically different treatment plans for the same patient which I haven't seen in the family medicine clinic I work in. Is it possible for a psychiatrist with a mental illness to treat the broad range of patients they might see properly over their career? I don't think so, which is why the increased stigmatization makes sense, at least to me.
What you are saying sheds much light onto our collective ignorance towards the potential of therapy. "The mentally ill. These are the people that seek therapy." We all have traumas, limiting beliefs systems, and self centered tendencies that cause great amount of suffering in our daily lives. The majority of us must shut down a part of who we are in order to continue functioning "normally." We continue this process until our system becomes pathologized to the point of losing a level of functionality. There is no doubt that a "psychiatrist who had issues" will effect some sort of bias, as have all of us who has ever given someone advice. We are all blind to varying degrees. The better we discover our own egoic personalities, the more integrated we can become, and perhaps the closer to observing reality we can achieve.

But in regards to my failure to match, I will use what you have written as a tool in crafting my PS and CV. Thank you for your insight.
 
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I'm hoping ee2k3's situation points out one very important lesson that most folks on this board hammer again and again but that many of the folks who don't match seem to not hear: apply broadly and apply early.

In the case of the OP, applying to only 6 top schools is a bad, bad strategy. High scores are not a shoo-in. In fact, they seem to matter less at the top programs. I have a hunch the logic is that top programs can take folks they really like with lower step scores, unknown medical schools, or foreign education, because they don't have to worry about taking a hit to their reputation.
Apply broadly, yes sir!! Another important point I'm learning and I hope others will learn as well is, blatant honesty is not wise. This experience has given me insight into my power of shaping people's perceptions on me. It's a little overwhelming, but a skill to develop. Thank you for rehammering your point.
 
What you are saying sheds much light onto our collective ignorance towards the potential of therapy. "The mentally ill. These are the people that seek therapy." We all have traumas, limiting beliefs systems, and self centered tendencies that cause great amount of suffering in our daily lives. The majority of us must shut down a part of who we are in order to continue functioning "normally." We continue this process until our system becomes pathologized to the point of losing a level of functionality. There is no doubt that a "psychiatrist who had issues" will effect some sort of bias, as have all of us who has ever given someone advice. We are all blind to varying degrees. The better we discover our own egoic personalities, the more integrated we can become, and perhaps the closer to observing reality we can achieve.

But in regards to my failure to match, I will use what you have written as a tool in crafting my PS and CV. Thank you for your insight.

Apply to an absurd number of programs next year. Rank everywhere that interviews you even if your ROL is 20 programs long. Play the game and have people review your application. Preferably people in the field. You really should have matched, and probably will next year if you apply to 50 ish programs.
I'm a premed (lol) but my husband didn't match and had to change careers. He's going into dentistry. ANYWHERE would have been better than no match. Just keep that in mind. I especially hate to see AMGs going unmatched.
 
If you dont mind me asking, do you have any geographic constraints? Not that I can help all that much, but know a bunch of people in different NYC programs and can keep an eye out if something opens up.

I know it's not what you are aiming for, but I would send out an application to large programs recruiting IMGs. It's not unheard of for foreign graduates to not be able to get a visa, and they are more likely to withdraw from their position if they decide to stay to stay at their home country.
 
Wonderful! thank you for this. Curious though, letter of interest? Is this different from PS? Sending both?

I didnt have PT solely for that. My PS goes on to explain that as well. The better we come to understand our self the better we can help others walk this path. This was my ultimate purpose for discussing PT, again made clear in PS. However, what you are saying makes sense. It can be a delicate process discussing this topic, and I likely lacked in finesse at times during interviews. Do you feel that a major theme of a PS being self discovery being at the root of a great therapist is appropriate?

"May you help me walk my own path, so that I may help others discover their own." This was the closing line of my PS.
Dont talk about what it takes to be a good therapist. You havent been a psychiatrist and dont know what it will take. I would read that as "over-confident" and prone to making uninformed decisions, which can be really dangerous in medicine. Talk about why you love psychiatry. The personal statement should be mostly bland and straightforward - with a cherry on top for presentation-sake.
 
Psychiatry residencies, even "top" programs, are primarily looking for candidates who are reliable, trustworthy, easy to work with, and willing to learn. If you can't show that you are, it doesn't matter what your board scores were, what your class rank was, how many publications you have, how clearly intelligent you are, or what innovative ideas you have about the future of psychiatry.

A 9 month leave of absence, whatever the reason, is a red flag, because it makes programs worried you will take a leave of absence during residency. A history of mental illness or addiction can be a red flag, because it can make programs worried you will need to take time off during residency due to relapse or inpatient treatment. If you talk about your own mental illness, addiction, or even your own psychotherapy in your personal statement or interviews, you need to do so in a way that conveys a sense that it will not interfere with your ability to function well as a resident or treat patients. I have seen a few personal statements that do this successfully, but this is uncommon. It is usually in the way the candidate is able to write about the experience, rather than assertions about how well they are doing, and I don't think it is something you can learn to do in a formulaic way. Using your psychotherapy experience to explain how a great therapist "should be," and describing in your PS what you want/expect from a residency do not do those things - they convey a sense of overconfidence or even of entitlement.
 
Psychiatry residencies, even "top" programs, are primarily looking for candidates who are reliable, trustworthy, easy to work with, and willing to learn. If you can't show that you are, it doesn't matter what your board scores were, what your class rank was, how many publications you have, how clearly intelligent you are, or what innovative ideas you have about the future of psychiatry.

A 9 month leave of absence, whatever the reason, is a red flag, because it makes programs worried you will take a leave of absence during residency. A history of mental illness or addiction can be a red flag, because it can make programs worried you will need to take time off during residency due to relapse or inpatient treatment. If you talk about your own mental illness, addiction, or even your own psychotherapy in your personal statement or interviews, you need to do so in a way that conveys a sense that it will not interfere with your ability to function well as a resident or treat patients. I have seen a few personal statements that do this successfully, but this is uncommon. It is usually in the way the candidate is able to write about the experience, rather than assertions about how well they are doing, and I don't think it is something you can learn to do in a formulaic way. Using your psychotherapy experience to explain how a great therapist "should be," and describing in your PS what you want/expect from a residency do not do those things - they convey a sense of overconfidence or even of entitlement.

What if it's a "medical illness" with a possibility of relapse? Then I assume suddenly it's taboo to consider this as a factor and who knows it might actually be a positive. Based on what's written in this thread so far probably ego was a major problem in how you presented yourself, so you have to make sure to tone it down. They may have liked it in surgery, but psychiatrists are especially attune to smell it and they don't like the smell.
 
What if it's a "medical illness" with a possibility of relapse? Then I assume suddenly it's taboo to consider this as a factor and who knows it might actually be a positive. Based on what's written in this thread so far probably ego was a major problem in how you presented yourself, so you have to make sure to tone it down. They may have liked it in surgery, but psychiatrists are especially attune to smell it and they don't like the smell.

This does point out the hypocrisy in how we judge people with a history of mental illness. I agree that we would probably feel differently if it were clearly a non-psychiatric issue, even one that has a possibility of recurring. Of course psych applicants don't generally write personal statements about their non-psychiatric issues.
 
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