Please help - possible shift to psychiatry

[DocP]

Thank you!

---

Members don't see this ad.

 

[Kazema]

This was actually an unusual year for psych as there were only 2 or 3 real spots available for the scramble; I imagine those spots are gone now. While it's possible a spot might open here or there between now and June, you're most likely looking at applying for psych next year if you are serious about switching gears.

 

[DocP]

This was actually an unusual year for psych as there were only 2 or 3 real spots available for the scramble; I imagine those spots are gone now. While it's possible a spot might open here or there between now and June, you're most likely looking at applying for psych next year if you are serious about switching gears.

Yes, that is what I have heard as well, it seems like it's been an unusual year for many specialties (I know it was for Neuro). I am looking for general advice on switching gears.

 

[peppy]

Sorry to hear you didn't match either. When I found out I didn't match (I was trying for psychiatry!), it was one of the worst disappointments I've ever experienced. However, I've happily found an internship position that I believe will lead to good opportunities for me, so it just goes to show that not matching is not the end of the world even when it feels like it!

I think your best bet at this point is to try to find an FM or IM spot. Who knows, you might come to realize you like one of those fields more than you thought (FM in particular involves a lot of minor psychiatric issues). If you were to decide to try to switch specialties later, I believe Neuro and Psych would both be able to give you credit for at least part of your rotations in IM or FM (since they both require some amount of IM in the first year anyway). Of course, conifrm that with a trusted advisor or a program you might be interested in instead of just relying on me...I'm the dummy who couldn't even get into psych of all things. (I can joke about it now that I have a spot I like!)
Good luck to you!

 

[DocP]

Congratulations peppy! You're a success story . I was shocked and devastated when I didn't match. But it is what it is.

If you don't mind me asking, how did you go about finding your internship position - and what do you mean (did you find a PGY1 in a categorical IM/FM or is it a prelim)? I am already pursuing the usual avenues (findaresident, etc.).

Good luck with everything!

 

[peppy]

I am a DO instead of an MD so the internship I got is a DO specific kind (traditional rotating internship). I believe it's the equivalent of the MD transitional year, though.

The way I found my spot was just to call every program I could possibly imagine being happy at and asking the program coordinator if there were still any openings left.
If I were you, I'd just go down the list of Family Medicine and IM programs in ERAS and try calling them all. In the event that they say they have no openings, I'd probably try asking if I could give them my name/number to contact if an opening comes up later.
Some programs may not be receptive (one program in NJ just said "No" to my inquiry about open spots and hung up on me without even a goodbye) but it can't hurt to try!

 

[DocP]

I am a DO instead of an MD so the internship I got is a DO specific kind (traditional rotating internship). I believe it's the equivalent of the MD transitional year, though.

The way I found my spot was just to call every program I could possibly imagine being happy at and asking the program coordinator if there were still any openings left.
If I were you, I'd just go down the list of Family Medicine and IM programs in ERAS and try calling them all. In the event that they say they have no openings, I'd probably try asking if I could give them my name/number to contact if an opening comes up later.
Some programs may not be receptive (one program in NJ just said "No" to my inquiry about open spots and hung up on me without even a goodbye) but it can't hurt to try!

Thanks peppy. The phone call route is an avenue I am preparing myself to follow. I am just still stuck on whether entering an IM/FM program is going to ultimately help me. I am confused about funding, etc., if I were to switch later to psych.

 

[kcrd]

DocP I'm sorry to hear you didn't match. I think the previous poster is correct, though. If you do IM for a year, this should count towards a PGY1 for Neuro and Psych. My progam, for example, takes a PGY2 nearly every year. For Psych you may need to do an additional 6 months, but I haven't heard of funding being a problem. I'm not sure if FM would count. Good luck!

 

[whopper]

Agree with the above.

You can try IM (or Family Medicine or Pediatrics) & switch into Psychiatry as a PGY II. The disadvantage is that several programs are not looking for PGY IIs, but it is an option and one that is actually built into the ACGME guidelines-they state that PGY Is from IM can switch into Psychiatry.

Why not read the actual document yourself?
http://www.acgme.org/acwebsite/rrc_400/400_prindex.asp
http://www.acgme.org/acWebsite/downloads/RRC_progReq/400_psychiatry_07012007_u04122008.pdf
Its on the first page!

But let me reiterate, "he disadvantage is that several programs are not looking for PGY IIs" I've rarely seen any program specifically look for someone to fill a PGY II spot, and they usually reserve open spots for incoming PGY Is. That will put you at something of a disadvantage if trying to enter as a PGY II.

But I'd still reccomend doing a year of residency in IM, FM or Peds instead of just taking a year off. You will hone your clinical skills, perhaps get your foot into the door of a Psychiatry program that is in the same university as the program you enter, and when you take USMLE Step III, you'll be well armed to take down & destroy it.

Target programs with good affiliations with a psychiatry residency program.

Some programs may not be receptive (one program in NJ just said "No" to my inquiry about open spots and hung up on me without even a goodbye) but it can't hurt to try!

Ouch. Try not to let what may be the constant barrages of "Nos!" get you down. Consider that during Match--programs are barraged with dozens possibly even hundreds of scared applicants trying to get into the program. Its utter heck for the program coordinator, and I've seen several coordinators role their eyes when having open spots and trying to filter candidates.

 

[DocP]

kcrd and whopper - great suggestions (and thank you for those links!) .

Right now it does seem as entering a PGY1 IM year is best. I didn't exactly think programs were looking for PGYIIs but was thinking of an instance in which someone left the program (d/t personal reasons, etc.) and the program was looking to fill the spot.

Thank you so much guys!

 

[whopper]

If you do happen to get into an IM, FM or Peds program and still want to enter psychiatry as a PGY II, my advice is to target which psychiatry programs you would like to enter (make a long list because as I said, its hard to get in as a PGY II), politely email or write a letter (don't call--reason why is becuase the PC (Program Coordinator) is most likely to simply forget your name after the call-reason why is because the likelihood of them needing a PGY II is remote, writing also leaves a better impression & will only cost you the price of the stamp, envelope & paper, and is more likely to be filed, and possible re-examined should the program eventually need a PGY-II in the future), and state that you are a PGY I in residency & would like to hear if they eventually open a PGY II spot.

What usually makes a program want to take a PGY II is if a current PGY I gets kicked out or leaves the program. It happens--its rare but it happens. It can also happen if there's not a good distribution between the various PGYs. E.g. if a program has for some reason very few PGY Is in a particular year, they may want more PGY IIs for the following year to make the distribution more even.

When PGY II spots are made available, at least in my program, people connected to the program are asked--"any friends or relatives who want to enter the field?" Reason why it was not publically announced was the PD & PC at the time didn't want the flood of 1000 phone calls of scared people, several of which still called even after it was filled "please?" For a PC that is extremely frustrating, especially when he/she has a regular work day and has to spend about 8 hrs of the day getting phone calls from people who really are saying they need a supportive 20 minute hand holding. That's not to criticize those people--I'd be scared as heck too, but when you're a PC with already 8 hrs of other work you can't get to, it really is the thing to ruin your day.

By doing the above, it may insert you into the inside of a program that will seek people for a PGY II spot before that program seeks outside to fill the spot.

However the drawback is very few programs rarely do ever look for a PGY II. That's why I say make a long list. Use a machine gun strategy & shoot that gun at full auto.

PCs remember have to help organize the day to day operations of a residency, and as such have a full 8 hr workday in addition to the frustration of applicants calling in. I've seen many an applicant get permanently nixed from the consideration list for being too intrusive, calling too much and seeming too whiney on the phone. Yes--while I understand why they are such, it is a situation of extreme anxiety, it is so too for the PC who must take in these phone calls. I've seen 4 out of 4 PCs pretty much erase someone out of consideration if they call too much in a manner that is very irritating for the PC.

A lesson I learned from a friend who is a lawyer--"the key to the boss is getting the secretary on your side". True in this case.

 

[DocP]

Thank you very much for all this advice whopper. Everything you say makes total sense and I will take all of it on-board. I especially like your quote. Luckily, I am a pretty polite/reserved person by nature, but never say never - this past week I can say I was feeling pretty d*mn whiny.

 

[Terpskins99]

Just fyi...

For acgme neurology (I do not know for psych, but I imagine it is the same), you MUST complete an acgme medicine or transitional year. Family medicine will not count. Nor will an osteopathic internship.

I confirmed this with an ABPN credentialling officer.

Keep in mind, neuro or psych PD's may permit you to start your neuro or psych residency with a FM year, but the ABPN will not allow you to sit for your boards once you've completed residency.

http://www.abpn.com/initial_neuro.htm
American Board of Psychiatry and Neurology, Inc.
2150 E. Lake Cook Road, Suite 900, Buffalo Grove, IL 60089
Phone: 847.229.6500

 

[masterofmonkeys]

IIRC Yale specifically looks for PGY2s. 4 spots...

 

[m1forever]

So the worst happened - and I was surprised to not match (or scramble) into my chosen specialty of Neurology.

In trying to consider all my options, I have come to realize that this may be an opportune time to switch to Psychiatry as it is a field I can see myself greatly enjoying (I have always straddled the fence between Neuro and Psych in the first place).

Does anyone have any advice on what I can do to increase my chances, either in the interim between now and July for any unfilled positions, or if I have to participate in next year's match?

What constitutes a good application for a Caribbean IMG? Are there any resources I can go to to find avg board scores, etc. (I have been so geared toward researching Neuro that I am almost lost at this point).

Also, is it possible to switch from another residency into Psychiatry (ex: Family Medicine ... Internal Medicine?).

Any input would be greatly appreciated. Thank you!

there are no unfilled psych spots available. There were none available in the scramble.

You can try to find a prelim IM or ty spot....last I checked these are either all gone or pretty much all gone, but one might open up if you have connections or your school can help you out. And then after that just apply to pgy-2 psych and neuro programs but also be prepared to apply broadly to psych and neuro programs in the match next year for py-1 positions...

good luck.

 

[DocP]

Terpskins99 - I knew FM wouldn't help me as far as Neuro was concerned, but I didn't realize this was the case for Psych as well (especially the part where they might take you but then you wouldn't be able to sit for the boards), so thank you!

Thank you masterofmonkeys (like the SN btw)

m1forever - Actually I was going to ask - would a PGY1 Prelim be acceptable for switching into Psych - (I realize all the spots are filled).

ETA - I think I saw your answer in peppy's thread just now ... it doesn't seem too possible. Repeating PGY1 (for Psych) would be more likely?

 

[Terpskins99]

Terpskins99 - I knew FM wouldn't help me as far as Neuro was concerned, but I didn't realize this was the case for Psych as well (especially the part where they might take you but then you wouldn't be able to sit for the boards), so thank you!

Actually, I think psych is only a categorical residency so my post only applies to neurology residency. Sorry for the mixup.

 

[peppy]

This whole thing is pretty confusing. I would have thought that even if you can't get credit for a full year, since the 1st year of psych requires IM and neuro rotations if you had done IM/neuro during your first year of an FM program that you would be able to get credit for at least a few months of rotations. Is anyone able to confirm that?

Regardless, my reasoning is that I would rather just have a job for the upcoming year even if I wind up having to start over next year when I get into Psych, so I was willing to accept my internship spot even without knowing if it would count for the psych residency I wind up at eventually.

 

[futuredo32]

This whole thing is pretty confusing. I would have thought that even if you can't get credit for a full year, since the 1st year of psych requires IM and neuro rotations if you had done IM/neuro during your first year of an FM program that you would be able to get credit for at least a few months of rotations. Is anyone able to confirm that?

Regardless, my reasoning is that I would rather just have a job for the upcoming year even if I wind up having to start over next year when I get into Psych, so I was willing to accept my internship spot even without knowing if it would count for the psych residency I wind up at eventually.

After speaking with someone at MSU, if you do an internship at a program that is dually acreditted, you could potentially get credit for all or part of your intern year in the next match at either a DO or MD residency. But, if you do an intern year at a hospital that is purely an osteopathic, you can only get credit for part or all of your intern year at an osteopathic program.
I think it's pretty program specific overall. I met an applicant at a preinterview dinner who didn't match last year, did an intern year at an osteopathic hospital and was interviewing at both allo and osteo programs. One program of four was willing to give him credit for his intern year and start him as a PGY-2, Arrowhead.

 

[nancysinatra]

Weren't there quite a few open peds spots? Some of those shouldn't be that hard to get and you could apply for PGYII spots next year I'd think. And if not, you can stay in peds and do the 6 year route to psych, which is discussed in another thread, whereby pediatricians can get boarded as adult/child psychiatrists through a 3 year fellowship.

 

[m1forever]

This whole thing is pretty confusing. I would have thought that even if you can't get credit for a full year, since the 1st year of psych requires IM and neuro rotations if you had done IM/neuro during your first year of an FM program that you would be able to get credit for at least a few months of rotations. Is anyone able to confirm that?

Regardless, my reasoning is that I would rather just have a job for the upcoming year even if I wind up having to start over next year when I get into Psych, so I was willing to accept my internship spot even without knowing if it would count for the psych residency I wind up at eventually.

I can speak to how it is with two people at my program who did a year or either IM or TY and then matched as pgy-1's:

they got credit for their 4 months of non-neuro/non-psych the first year(keep in mind it doesnt have to be IM...it can be family, peds, er, etc). And so basically instead of doing 4 months of family and im they got to do 4 extra months of psych....but it's not like their residency was 3 years 8 months or whatever. But even the guy who did 2 months of neuro, both had to do the 2 months of neuro first year because those slots at the VA had to be filled be a pgy-1 for neuro consult and they wouldnt have had enough people.

I don't think any program who takes on someone who has done a year of Im or a TY will say "well ok, you owe us only 3.5 years of all psych and then you're done". Depending on the program some programs may let you do the 4-6 months(depending on whether your ty had 2 months of neuro) extra on psych and psych electives than medicine/family medicine stuff.

But it's going to vary from program to program depending on what their needs, requirements, and affiliations are.

 

[m1forever]

Terpskins99 - I knew FM wouldn't help me as far as Neuro was concerned, but I didn't realize this was the case for Psych as well (especially the part where they might take you but then you wouldn't be able to sit for the boards), so thank you!

Thank you masterofmonkeys (like the SN btw)

m1forever - Actually I was going to ask - would a PGY1 Prelim be acceptable for switching into Psych - (I realize all the spots are filled).QUOTE]

sure, it's possible. I think you have maybe a better chance if you did a prelim medicine than a prelim transitional. Your chances for getting a pgy-2 spot rather than a pgy-1 spot just depend on how strong an applicant you are.

Apply to both pgy-1 and pgy-2 programs, but be prepared to take a pgy-1 if you dont get a pgy-2 spot.

 

[HCE]

Agree with the above.

You can try IM (or Family Medicine or Pediatrics) & switch into Psychiatry as a PGY II. The disadvantage is that several programs are not looking for PGY IIs, but it is an option and one that is actually built into the ACGME guidelines-they state that PGY Is from IM can switch into Psychiatry.

Why not read the actual document yourself?
http://www.acgme.org/acwebsite/rrc_400/400_prindex.asp
http://www.acgme.org/acWebsite/downloads/RRC_progReq/400_psychiatry_07012007_u04122008.pdf
Its on the first page!

But let me reiterate, "he disadvantage is that several programs are not looking for PGY IIs" I've rarely seen any program specifically look for someone to fill a PGY II spot, and they usually reserve open spots for incoming PGY Is. That will put you at something of a disadvantage if trying to enter as a PGY II.

But I'd still reccomend doing a year of residency in IM, FM or Peds instead of just taking a year off. You will hone your clinical skills, perhaps get your foot into the door of a Psychiatry program that is in the same university as the program you enter, and when you take USMLE Step III, you'll be well armed to take down & destroy it.

Target programs with good affiliations with a psychiatry residency program.


Ouch. Try not to let what may be the constant barrages of "Nos!" get you down. Consider that during Match--programs are barraged with dozens possibly even hundreds of scared applicants trying to get into the program. Its utter heck for the program coordinator, and I've seen several coordinators role their eyes when having open spots and trying to filter candidates.

PGY II posiitons are rare, but do show up during the year.....look at this website from time to time.... http://archive.psych.org/career_corner/careers_psych/clearinghouse/CHsearch.cfm

 

[HCE]

Sorry to hear you didn't match either. When I found out I didn't match (I was trying for psychiatry!), it was one of the worst disappointments I've ever experienced. However, I've happily found an internship position that I believe will lead to good opportunities for me, so it just goes to show that not matching is not the end of the world even when it feels like it!

I think your best bet at this point is to try to find an FM or IM spot. Who knows, you might come to realize you like one of those fields more than you thought (FM in particular involves a lot of minor psychiatric issues). If you were to decide to try to switch specialties later, I believe Neuro and Psych would both be able to give you credit for at least part of your rotations in IM or FM (since they both require some amount of IM in the first year anyway). Of course, conifrm that with a trusted advisor or a program you might be interested in instead of just relying on me...I'm the dummy who couldn't even get into psych of all things. (I can joke about it now that I have a spot I like!)
Good luck to you!

Congratulations Peppy

 

[BobA]

PGY II posiitons are rare, but do show up during the year.....look at this website from time to time.... http://archive.psych.org/career_corner/careers_psych/clearinghouse/CHsearch.cfm

Great link above!

Also, I think Hopkins and Dartmouth (in addition to Yale as MoM mentioned) regularly look to fill Pgy-2 spots. Others programs may do this as well - idk. However, I think these are all competitive spots that they look to fill with quality applicants from other fields (IM dropouts from their own programs, transfers from other good psych programs, etc)