Preliminary 2017 ERAS data

[clozareal]

Just thought this data was interesting and wanted to share.

For psych programs, there is about 150 more applicants this cycle (US grads mostly) compared to last year.

The average number of programs each US grad applied to was 39 programs this year, up from 33 last year. There is a increase of about 20% each year in number of programs applied to per applicant

Each program is now getting on average 323 applications, up from 270 last year. This is also about a 20% increase in number of applications received per program.

IMG numbers have remained stable.

I think this means that psych is getting more competitive.

https://www.aamc.org/services/eras/stats/359278/stats.html


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[Blitz2006]

Yep, as usual, psych continues to be motoring up the charts.

But remember, the main indicator on this particular spreadsheet of increased competitiveness is the number of applicants.

270 to 323 doesn't impress me, because this could also mean that psych applicants are just more anxious/neurotic and applying to more programs. Doesn't necessarily mean competitiveness is going up.

The obvious signs of competitiveness are:

1) Board Score cutoffs
2) Number of applicants

The fact that psych has gone up from 1541 to 1691 (150 increase, or 10%) is very impressive. Especially since this continues the 10% annual increase from the past 2 years.

It actually appears Psych is the only specialty for the past 3 consecutive years to see a 10% annual increase.

The only other specialty with an upward trend is Rads, which is 10% annual increase x 2 years. Nice to see radiology bouncing back.
901 -> 1,049 -> 1,251

 

[Blitz2006]

.

 

[sazerac]

Another possible interpretation is that USGs are now applying earlier in the cycle. Maybe those 150 extra people would have applied in November, if it were last year.

 

[Blitz2006]

Another possible interpretation is that USGs are now applying earlier in the cycle. Maybe those 150 extra people would have applied in November, if it were last year.

True, but then this would impact all specialties, not just psych.

 

[Amygdarya]

Yet another possibility is that more people are applying to psychiatry as a backup specialty.

 

[clozareal]

Yep, as usual, psych continues to be motoring up the charts.

But remember, the main indicator on this particular spreadsheet of increased competitiveness is the number of applicants.

270 to 323 doesn't impress me, because this could also mean that psych applicants are just more anxious/neurotic and applying to more programs. Doesn't necessarily mean competitiveness is going up.

The obvious signs of competitiveness are:

1) Board Score cutoffs
2) Number of applicants

The fact that psych has gone up from 1541 to 1691 (150 increase, or 10%) is very impressive. Especially since this continues the 10% annual increase from the past 2 years.

It actually appears Psych is the only specialty for the past 3 consecutive years to see a 10% annual increase.

The only other specialty with an upward trend is Rads, which is 10% annual increase x 2 years. Nice to see radiology bouncing back.
901 -> 1,049 -> 1,251

You're right in that the number of applicants is the big indicator of competitiveness here, whereas applications per applicant is a sign of applicant neuroticism/anxiety/uncertainty.

Actually, I forgot to count the DO students. There was a jump from 186 to 267 (81 increase, or ~45%) which is huge. Each program is now getting 159 DO applications up from 76 applications last year, which is more than double the # of applications. This is the biggest increase in DO applications ever since they started tracking it. This means it is MUCH more competitive for DO students this year, and as a result MD applicants too.

 

[Psychotic]

Yet another possibility is that more people are applying to psychiatry as a backup specialty.

That's a bingo...

 

[Mosonik]

Yet another possibility is that more people are applying to psychiatry as a backup specialty.

I agree. That much of an increase could not reasonably be that many more people who just decided psychiatry is for them, probably more multi-specialty applicants.
Also, with the Single Accreditation System AOA-ACGME residency mergers in the middle of the multi-year transition, this explains the DO rise. More programs are switching to the other match and the few that still remain AOA encourages more DO applicants to enter the ACGME match (at least as a safety net should they not match to a program or two they want in the AOA).

 

[Dharma]

I agree. That much of an increase could not reasonably be that many more people who just decided psychiatry is for them, probably more multi-specialty applicants.
Also, with the Single Accreditation System AOA-ACGME residency mergers in the middle of the multi-year transition, this explains the DO rise. More programs are switching to the other match and the few that still remain AOA encourages more DO applicants to enter the ACGME match (at least as a safety net should they not match to a program or two they want in the AOA).

I'm not sure the merger plays too much of a role here. The word on the street has always been to go for ACGME programs when it comes to psych, unless one has a few uglies smearing his ERAS app. AOA programs have traditionally been avoided by psychiatry applicants with half-way decent or better applications. I think if anything DO students see psychiatry as an in to quality academic programs that are otherwise off the table for most other specialties. As stigma has dwindled a bit and lifestyle factors more into the equation, the numbers have increased.

 

[Blitz2006]

Yet another possibility is that more people are applying to psychiatry as a backup specialty.

This is very possible.

But I'm just skeptical, because I feel like psych is so different from "mainstream medicine" (ie, ER/IM/FM). I don't know that many IM people that backup with psych (before you pounce on me, I'm not saying it never happens, but just in general). Its usually the IM/FM combo, or ER/IM combo. I actually think this is why IM is "artificially" more competitive than it really is, because I know that almost everyone backs up with IM (relatively), like Derm, ER...I've even heard of some GSurg that backs up with IM. Backing up with Psych is kinda like backing up with pathology (another field that is very 'unique'). The only 'mainstream' field that has some similarity is Neuro, and statistically I'm not even sure Neuro is even that much more competitive than psych anymore?

And I can't imagine people applying for Derm/Ophtho/ENT are backing up with psych....again, I'm sure it happens, but I presume it is relatively rare..

But maybe I'm wrong.

 

[Amygdarya]

And I can't imagine people applying for Derm/Ophtho/ENT are backing up with psych....again, I'm sure it happens, but I presume it is relatively rare.

I know several people who appiled/applying this year/planning to apply next year to both Psych and Derm for lifestyle reasons. Pretty much all of them end up/will end up matching into Derm, but whatever helps them sleep at night during the application season. N of several people; my sample may be scewed but here it is.
Also, seeing how apathetic and cynical many medical students become by the 4th year I'm more inclined to believe that students who don't really care much about any specialty would choose psychiatry over, say, internal medicine because it's "easier", than believe that many more people suddenly discovered a burning interest in mental health. But it's just me... guess I must be getting a little apathetic and cynical at this point myself... except I do have an interest in a certain specialty

 

[Candidate2017]

You're right in that the number of applicants is the big indicator of competitiveness here, whereas applications per applicant is a sign of applicant neuroticism/anxiety/uncertainty.

Actually, I forgot to count the DO students. There was a jump from 186 to 267 (81 increase, or ~45%) which is huge. Each program is now getting 159 DO applications up from 76 applications last year, which is more than double the # of applications. This is the biggest increase in DO applications ever since they started tracking it. This means it is MUCH more competitive for DO students this year, and as a result MD applicants too.

DO's are contributing to the bump in apps. Pre-merger, I would've ranked my top 3 DO programs and applied to 10 or fewer ACGME places as backup. With the merger looming, I've applied to a bazillion ACGME spots like other DO's. Few DO psychiatry programs have applied for ACGME accreditation, giving the impression almost all will shut down by the 2020 deadline and leave their residents without a residency. DO psychiatry programs were once a safety net but are now a huge liability. DO's are applying to large numbers of ACGME programs to make up for the loss of that safety net.

I disagree it is much more competitive for DO's beyond the top academic powerhouses, NYC, and Cal. Most psychiatry programs are community or regional academic programs with a disproportionate number of DO's working side by side with MD's in faculty and leadership positions. These programs are more similar in culture to osteopathic programs than different. The psychiatry attendings at osteopathic hospitals are largely MD's who trained at these community and regional academic programs.

 

[Candidate2017]

I'm not sure the merger plays too much of a role here. The word on the street has always been to go for ACGME programs when it comes to psych, unless one has a few uglies smearing his ERAS app. AOA programs have traditionally been avoided by psychiatry applicants with half-way decent or better applications. I think if anything DO students see psychiatry as an in to quality academic programs that are otherwise off the table for most other specialties. As stigma has dwindled a bit and lifestyle factors more into the equation, the numbers have increased.

SDN is biased toward academics but DO's aren't obsessed about academics. I can count the number of DO students I've talked to who've mentioned academics on one hand but none are interested in psychiatry. Typically, DO psychiatry applicants who go ACGME are average applicants. They go ACGME because the solid DO programs get filled by stronger DO applicants, they don't want to get snatched up by a mediocre DO program, and there are more ACGME programs than DO programs.

 

[clozareal]

DO's are contributing to the bump in apps. Pre-merger, I would've ranked my top 3 DO programs and applied to 10 or fewer ACGME places as backup. With the merger looming, I've applied to a bazillion ACGME spots like other DO's. Few DO psychiatry programs have applied for ACGME accreditation, giving the impression almost all will shut down by the 2020 deadline and leave their residents without a residency. DO psychiatry programs were once a safety net but are now a huge liability. DO's are applying to large numbers of ACGME programs to make up for the loss of that safety net.

I disagree it is much more competitive for DO's beyond the top academic powerhouses, NYC, and Cal. Most psychiatry programs are community or regional academic programs with a disproportionate number of DO's working side by side with MD's in faculty and leadership positions. These programs are more similar in culture to osteopathic programs than different. The psychiatry attendings at osteopathic hospitals are largely MD's who trained at these community and regional academic programs.

I'm wondering how that will change now that we have a higher # of MD applicants going into psych this year for the same # of spots as well as an increased number of DO applicants competing for those same spots. Most psychiatry programs had DO's working side-by-side with MD's at community/regional academic programs, but that might be less so now with the increased number of applicants. However, the bump might just end up being negligible though, and perhaps the FMGs might get knocked out of those spots.

 

[splik]

The sky is not falling. overall, I am not terribly convinced there there has been any significant increase in competitiveness of psychiatry. You must also take into consideration people are apply to multiple specialties increasingly, and psych is often a backup - for example 62 people have applied to both psych and derm, a whopping 582 people applied to neurology and psychiatry, 10 to ortho and psych, 260 to ob/gyn and psych, 408 to anesthesia and psych, 320 to gen surg and psych, and 152 to EM and psych....

 

[clozareal]

The sky is not falling. overall, I am not terribly convinced there there has been any significant increase in competitiveness of psychiatry. You must also take into consideration people are apply to multiple specialties increasingly, and psych is often a backup - for example 62 people have applied to both psych and derm, a whopping 582 people applied to neurology and psychiatry, 10 to ortho and psych, 260 to ob/gyn and psych, 408 to anesthesia and psych, 320 to gen surg and psych, and 152 to EM and psych....

Wow I didn't know that it was that many. I don't think I've seen the data before you posted it. Thanks splik!

 

[medicool]

https://www.aamc.org/download/362774/data/residency.pdf
https://www.aamc.org/download/448286/data/2014.pdf

If you compare the above 2016 cross speciality applicant data with the 2014 data you actually see a decrease in the number of applicants applying to different specialities along with psychiatry. I would assume that it means an increase in unique applicants but my interpretation could be wrong if I am missing something.

 

[Drrrrrr. Celty]

SDN is biased toward academics but DO's aren't obsessed about academics. I can count the number of DO students I've talked to who've mentioned academics on one hand but none are interested in psychiatry. Typically, DO psychiatry applicants who go ACGME are average applicants. They go ACGME because the solid DO programs get filled by stronger DO applicants, they don't want to get snatched up by a mediocre DO program, and there are more ACGME programs than DO programs.

Idk why stronger DO applicants would want to go to smaller programs with less training, poorer pay, and less selectivity in location. Especially when a strong DO applicant can easily match a decent program on the ACGME side with more pay, more training and, and a better name.

 

[Drrrrrr. Celty]

The sky is not falling. overall, I am not terribly convinced there there has been any significant increase in competitiveness of psychiatry. You must also take into consideration people are apply to multiple specialties increasingly, and psych is often a backup - for example 62 people have applied to both psych and derm, a whopping 582 people applied to neurology and psychiatry, 10 to ortho and psych, 260 to ob/gyn and psych, 408 to anesthesia and psych, 320 to gen surg and psych, and 152 to EM and psych....

I think they need to reform the way they do this whole application thing before the average applicant is sending out 40 applications of which 30 they wouldn't go work at unless they were forced to.

 

[Blitz2006]

I still don't understand why this is a bad thing.

An increase in Derm applicants who are backing up with Psych are still stellar applicants (250s, multiple pubs, etc). I'm fairly certain that most Derm applicants to Psych would be much stronger on paper than 90% of IMGs.

So even these ppl that backup with psych will still increase the overall competitiveness. Now obviously, if there is a huge spike in Peds/IM/FM/PMR applicants that are also applying to psych, than this will probably not increase competitiveness of psych.

 

[Candidate2017]

Idk why stronger DO applicants would want to go to smaller programs with less training, poorer pay, and less selectivity in location. Especially when a strong DO applicant can easily match a decent program on the ACGME side with more pay, more training and, and a better name.

Some DO programs are as good as any ACGME program. They are accredited by the ACGME (or on the accreditation pathway). These programs reserve half their spots for DOs and the other half are up for grabs by MD's and DO's. The DO spots are usually snatched up by strong DO applicants in the February DO match. Failing that, a DO is free to then enter the regular March allopathic match. Two matches and two bites at the apple. The merger occurred because MD's wanted access to these reserved DO spots and threatened to ban DO's from ACGME fellowships unless DO's agreed to abolish the osteopathic match, open osteopathic spots to MD's, and limit themselves to a single match.

 

[Candidate2017]

I think they need to reform the way they do this whole application thing before the average applicant is sending out 40 applications of which 30 they wouldn't go work at unless they were forced to.

The DO world solves this problem with the unwritten rule that an applicant is unlikely to be ranked highly unless they've done a monthlong audition rotation at the program in their 4th year.

 

[Candidate2017]

I still don't understand why this is a bad thing.

An increase in Derm applicants who are backing up with Psych are still stellar applicants (250s, multiple pubs, etc). I'm fairly certain that most Derm applicants to Psych would be much stronger on paper than 90% of IMGs.

So even these ppl that backup with psych will still increase the overall competitiveness. Now obviously, if there is a huge spike in Peds/IM/FM/PMR applicants that are also applying to psych, than this will probably not increase competitiveness of psych.

Derm applicants are smart people and aren't just backing up with psychiatry. They're also backing up with other more desirable, higher paying specialties. The odds of a derm applicant ending up in psychiatry is low. Ranking derm applicants over an US IMG is a surefire way for PD's to make their non-MGH program go unfilled. If a derm applicant ended up in psychiatry, they can and will easily leave after intern year for a residency in another specialty. Test scores and publications aren't everything in psychiatry. Someone who enjoys publishing papers about skin lesions, running through 100 patients a day, churning out steroid scripts immediately after greeting a patient, and has the scores to do any specialty, would hate psychiatry.

 

[splik]

Derm applicants are smart people and aren't just backing up with psychiatry. They're also backing up with other more desirable, higher paying specialties. The odds of a derm applicant ending up in psychiatry is low. Ranking derm applicants over an US IMG is a surefire way for PD's to make their non-MGH program go unfilled. If a derm applicant ended up in psychiatry, they can and will easily leave after intern year for a residency in another specialty. Test scores and publications aren't everything in psychiatry. Someone who enjoys publishing papers about skin lesions, running through 100 patients a day, churning out steroid scripts immediately after greeting a patient, and has the scores to do any specialty, would hate psychiatry.

someone doesn't understand how the match works. ranking stronger applicants over bottom of the barrel ones will
not in any way affect a programs chances of filling

 

[Candidate2017]

someone doesn't understand how the match works. ranking stronger applicants over bottom of the barrel ones will
not in any way affect a programs chances of filling

Go ahead and invite, interview, and rank all derm-level applicants who are using psychiatry as a backup over numerically weaker applicants and see if it's not a waste of time. The rule of 1/3 applies to both programs and applicants.

 

[sazerac]

someone doesn't understand how the match works. ranking stronger applicants over bottom of the barrel ones will
not in any way affect a programs chances of filling

I don't think C17 understands the mentality of the person who applies to derm -> psych either. That combo screams lifestyle uber alles. I don't imagine that sort of applicant switching into competitive IM followed by competitive fellowship.

 

[Dharma]

SDN is biased toward academics but DO's aren't obsessed about academics. I can count the number of DO students I've talked to who've mentioned academics on one hand but none are interested in psychiatry. Typically, DO psychiatry applicants who go ACGME are average applicants. They go ACGME because the solid DO programs get filled by stronger DO applicants, they don't want to get snatched up by a mediocre DO program, and there are more ACGME programs than DO programs.

Not in psychiatry. Stronger (and confident) DO students go all out for the ACGME programs because there really aren't many solid DO psychiatry programs. Only ones I knew who even bothered interviewing at DO programs were second guessing themselves in regards to matching ACGME, not the other way around. Regardless, doesn't matter all too much. Most of us matched at very good ACGME academic programs and never looked back- something i suggest others without red flags to do as well.

 

[clausewitz2]

Go ahead and invite, interview, and rank all derm-level applicants who are using psychiatry as a backup over numerically weaker applicants and see if it's not a waste of time. The rule of 1/3 applies to both programs and applicants.

You are conflating interview invitations with ranking. They are not the same thing.

 

[Dharma]

Some DO programs are as good as any ACGME program. They are accredited by the ACGME (or on the accreditation pathway). These programs reserve half their spots for DOs and the other half are up for grabs by MD's and DO's. The DO spots are usually snatched up by strong DO applicants in the February DO match. Failing that, a DO is free to then enter the regular March allopathic match. Two matches and two bites at the apple. The merger occurred because MD's wanted access to these reserved DO spots and threatened to ban DO's from ACGME fellowships unless DO's agreed

Completely disagree about the quality of DO programs; wishful thinking at best and likely misleading to current/future applicants who may read this. There are a couple of DO programs that may be as good as some ACGME programs (certainly not the majority of ACGME programs) but there is a very wide range of quality on the ACGME side given the numbers, so no surprise there. Those traditionally dually-accredited accredited programs are not those I'm referring to here. (Here's looking at you Michigan State). Let's face it- in essence they've been ACGME all along since they've had to keep up with the gold standard of medical training.

 

[Candidate2017]

Completely disagree about the quality of DO programs; wishful thinking at best and likely misleading to current/future applicants who may read this. There are a couple of DO programs that may be as good as some ACGME programs (certainly not the majority of ACGME programs) but there is a very wide range of quality on the ACGME side given the numbers, so no surprise there. Those traditionally dually-accredited accredited programs are not those I'm referring to here. (Here's looking at you Michigan State). Let's face it- in essence they've been ACGME all along since they've had to keep up with the gold standard of medical training.

It's perfectly accurate to say that some osteopathic programs are ACGME (or on the ACGME pathway) in response to a poster who incredulously asks why anyone would apply to an osteopathic psychiatry program and implies all osteopathic programs are of piss poor quality. It's misleading for you to remove osteopathic ACGME programs from the discussion of the quality of osteopathic programs. Osteopathic doesn't necessarily equal suck. There are a wide range of osteopathic psychiatry programs from AOA only osteopathic, ACGME only osteopathic, and dually AOA/ACGME osteopathic.

 

[Drrrrrr. Celty]

It's perfectly accurate to say that some osteopathic programs are ACGME (or on the ACGME pathway) in response to a poster who incredulously asks why anyone would apply to an osteopathic psychiatry program and implies all osteopathic programs are of piss poor quality. It's misleading for you to remove osteopathic ACGME programs from the discussion of the quality of osteopathic programs. Osteopathic doesn't necessarily equal suck. There are a wide range of osteopathic psychiatry programs from AOA only osteopathic, ACGME only osteopathic, and dually AOA/ACGME osteopathic.

The issue is that you implied that stronger applicants went to AOA residencies and not ACGME residencies.

 

[splik]

no it's not misleading osteopathic only = sucks = only the worst of the worst apply. whether that is true or not is irrelevant as that is what everyone thinks and so it is. that's the way of the world

 

[abcdior]

Just thought this data was interesting and wanted to share.

For psych programs, there is about 150 more applicants this cycle (US grads mostly) compared to last year.

The average number of programs each US grad applied to was 39 programs this year, up from 33 last year. There is a increase of about 20% each year in number of programs applied to per applicant

Each program is now getting on average 323 applications, up from 270 last year. This is also about a 20% increase in number of applications received per program.

IMG numbers have remained stable.

I think this means that psych is getting more competitive.

https://www.aamc.org/services/eras/stats/359278/stats.html


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not sure about that avg 323 app's received / program

a couple # i came across (hearsay); eg. Drexel ~1600, Cleveland Clinic ~2000, even U of Nebraska had almost 1000

 

[splik]

not sure about that avg 323 app's received / program

a couple # i came across (hearsay); eg. Drexel ~1600, Cleveland Clinic ~2000, even U of Nebraska had almost 1000

he is talking about us allopathic student apps not total

 

[clozareal]

not sure about that avg 323 app's received / program

a couple # i came across (hearsay); eg. Drexel ~1600, Cleveland Clinic ~2000, even U of Nebraska had almost 1000

Splik is right. The 320 number is for allopathic US med applicants. There are 720 avg apps per program for IMGs and ~150 for DO applicants, which comes out to >1000 total apps per program on average. Also, this is as of 10/15 so more apps could have been sent in by then.


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[Dharma]

The issue is that you implied that stronger applicants went to AOA residencies and not ACGME residencies.

This.

 

[Candidate2017]

The issue is that you implied that stronger applicants went to AOA residencies and not ACGME residencies.

No. In English I said: Strong DO applicants take away spots at good DO programs from average DO applicants.

I'll repeat again in English:

Strong DO applicants go to (1) ACGME allopathic programs OR (2) strong osteopathic programs (preaccredited ACGME, dual AOA/ACGME, or ACGME only). Strong DO applicants that choose strong osteopathic places in the February match will shut out average DO applicants, who still have a shot at AOA programs and ACGME allopathic programs. These average DO applicants usually choose ACGME allopathic. They join the strong DO applicants, that do not enter the February match, in the March ACGME match.

 

[Candidate2017]

no it's not misleading osteopathic only = sucks = only the worst of the worst apply. whether that is true or not is irrelevant as that is what everyone thinks and so it is. that's the way of the world

Why do you feel the need to view osteopathic programs in absolute terms? AOA only osteopathic programs don't necessarily suck. Many do, some don't.

Let's continue to explore your need to reduce the osteopathic world into absolute terms. Is it a universal truth that "everyone" thinks AOA only osteopathic programs suck and "that's the way" it is?
-If all AOA only osteo programs suck, how can the ACGME justify approving some of them for initial accreditation?
-If all AOA only osteo ptograms suck, how can AGME allopathic fellowships justify taking people from AOA only osteopathic programs?

 

[splik]

Why do you feel the need to view osteopathic programs in absolute terms? AOA only osteopathic programs don't necessarily suck. Many do, some don't.

Let's continue to explore your need to reduce the osteopathic world into absolute terms. Is it a universal truth that "everyone" thinks AOA only osteopathic programs suck and "that's the way" it is?
-If all AOA only osteo programs suck, how can the ACGME justify approving some of them for initial accreditation?
-If all AOA only osteo ptograms suck, how can AGME allopathic fellowships justify taking people from AOA only osteopathic programs?

I cannot speak about every program because I don't know them all, just telling you what people think. I am talking only about psychiatry here. I think a lot of these programs are going to struggle with getting ACGME accreditation, and quite frankly the bar is extremely low for ACGME accreditation, it certainly isn't a marker of any distinction but not being able to get it is a massive red flag.

Psychiatry fellowships widely go unfilled and would happy to take anyone, no matter how bad they are. Even the best regarded fellowships have people who quite frankly should never even be allowed to practice medicine in them, so you can imagine the standards for the worst (or least desirable) fellowships might be even lower

Oh and I'm not saying all ACGME program are good, on the contrary...

 

[Breaking Free]

The sky is not falling. overall, I am not terribly convinced there there has been any significant increase in competitiveness of psychiatry. You must also take into consideration people are apply to multiple specialties increasingly, and psych is often a backup - for example 62 people have applied to both psych and derm, a whopping 582 people applied to neurology and psychiatry, 10 to ortho and psych, 260 to ob/gyn and psych, 408 to anesthesia and psych, 320 to gen surg and psych, and 152 to EM and psych....

So, how should I, as a long-time committed, U.S. MD psych applicant, perceive this and then think about my own chances? My CV from head to toe is psychiatry focused and related, and while my boards aren't bad, they aren't great. I've done well in most of the professional categories of applying. I'm about average in metrics for psych, but I'm doing well in 3rd year and just honored psychiatry big time and will get great letters.

Are there ways I will need to offset this unhealthy trend, like apply to 30-40 programs like everyone else? Or, can I trust that I will be seen as the hard-working, committed psych hopeful I have always been? Is there anyway that someone who has done for the most part well and shows a lot of passion for psych over the course of many years gets drowned out? If so, I'd like advice on how to avoid that. I'm confident that if given an interview and enough of them, I'm golden, but I'm definitely concerned about how these weird application trends could make my life harder.


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[prok]

So, how should I, as a long-time committed, U.S. MD psych applicant, perceive this and then think about my own chances? My CV from head to toe is psychiatry focused and related, and while my boards aren't bad, they aren't great. I've done well in most of the professional categories of applying. I'm about average in metrics for psych, but I'm doing well in 3rd year and just honored psychiatry big time and will get great letters.

Are there ways I will need to offset this unhealthy trend, like apply to 30-40 programs like everyone else? Or, can I trust that I will be seen as the hard-working, committed psych hopeful I have always been? Is there anyway that someone who has done for the most part well and shows a lot of passion for psych over the course of many years gets drowned out? If so, I'd like advice on how to avoid that. I'm confident that if given an interview and enough of them, I'm golden, but I'm definitely concerned about how these weird application trends could make my life harder.


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It's not that bad out there. If you're an MD candidate without any true red flags (step failures, disciplinary issues, unexplained time off), you shouldn't have any trouble matching. The most recent charting outcomes did show an increase in applicants with very high scores or strong research backgrounds, but it's still much less than most other specialities. Honestly, from looking through threads here and talking to residents/faculty, it seems that psychiatry was just very not competitive even just a few years ago. Nowadays, you may not waltz into a top program, but you're still virtually guaranteed to go to a solid program. Just make sure you apply to a decent range of programs in terms of competitiveness.

I personally panicked and ended up applying to 30 programs this cycle and got a lot more interviews than anticipated. My classmates and friends at other MD schools have similar stories. The sky isn't falling.

 

[Blitz2006]

So, how should I, as a long-time committed, U.S. MD psych applicant, perceive this and then think about my own chances? My CV from head to toe is psychiatry focused and related, and while my boards aren't bad, they aren't great. I've done well in most of the professional categories of applying. I'm about average in metrics for psych, but I'm doing well in 3rd year and just honored psychiatry big time and will get great letters.

Are there ways I will need to offset this unhealthy trend, like apply to 30-40 programs like everyone else? Or, can I trust that I will be seen as the hard-working, committed psych hopeful I have always been? Is there anyway that someone who has done for the most part well and shows a lot of passion for psych over the course of many years gets drowned out? If so, I'd like advice on how to avoid that. I'm confident that if given an interview and enough of them, I'm golden, but I'm definitely concerned about how these weird application trends could make my life harder.


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Yeah if you are US MD you're good to go. The sky is falling for IMGs with red flags. Even strong IMGs shouldn't worry.

 

[Blitz2006]

It's not that bad out there. If you're an MD candidate without any true red flags (step failures, disciplinary issues, unexplained time off), you shouldn't have any trouble matching. The most recent charting outcomes did show an increase in applicants with very high scores or strong research backgrounds, but it's still much less than most other specialities. Honestly, from looking through threads here and talking to residents/faculty, it seems that psychiatry was just very not competitive even just a few years ago. Nowadays, you may not waltz into a top program, but you're still virtually guaranteed to go to a solid program. Just make sure you apply to a decent range of programs in terms of competitiveness.

I personally panicked and ended up applying to 30 programs this cycle and got a lot more interviews than anticipated. My classmates and friends at other MD schools have similar stories. The sky isn't falling.

Agreed.

I do think DOs/IMGs are gonna feel the squeeze next few years, and US MDs are going to need to improve their stats quite a bit next few years if they want to match into a "strong" university psych program. But US MDs over next 3-4 years should NOT worry about matching at all, unless you have serious red flags.

 

[MacDonaldTriad]

I think the very tip top programs always fill with the most qualified domestic MD graduates and any growth in numbers will not change their world much. Historically, US training programs favor US grads and yes, because perception has a way of creating its own reality, MDs are at some advantage over DOs who are at some advantage over IMGs. There have been many discussions as to how much "the wrong school" vs. "a red flag", should matter. My personal view is that "red flags" come in many levels; did you fail a USMLE, or did you repeat year one? Graduate Medical Education in the US will always favor US grads as a primary mission. If medical schools keep expanding and opening up, less well qualified applicants will find themselves with fewer options. Specialties with the highest proportion of IMG matches will be where most of the expansion is absorbed. This does include psychiatry. I'm not crazy about creating more "accidental psychiatrists", but I suppose this has been going on for a very long time already. Allopathic domestic grads will just join the reality of everyone else more as they become less rare. GME really should expand, but I don't think psychiatry is the right place to expand much more than the market will handle. Sure, we could still fill if we doubled the number of slots, but we will never become competitive if we expand out of proportion to medical school growth. If we want to attract more students, we need to create better medical school clinical experiences. We also need undergraduate medical education leaders who don't propagate the tradition of teasing our students during a surgery rotation.

 

[Blitz2006]

I think the very tip top programs always fill with the most qualified domestic MD graduates and any growth in numbers will not change their world much. Historically, US training programs favor US grads and yes, because perception has a way of creating its own reality, MDs are at some advantage over DOs who are at some advantage over IMGs. There have been many discussions as to how much "the wrong school" vs. "a red flag", should matter. My personal view is that "red flags" come in many levels; did you fail a USMLE, or did you repeat year one? Graduate Medical Education in the US will always favor US grads as a primary mission. If medical schools keep expanding and opening up, less well qualified applicants will find themselves with fewer options. Specialties with the highest proportion of IMG matches will be where most of the expansion is absorbed. This does include psychiatry. I'm not crazy about creating more "accidental psychiatrists", but I suppose this has been going on for a very long time already. Allopathic domestic grads will just join the reality of everyone else more as they become less rare. GME really should expand, but I don't think psychiatry is the right place to expand much more than the market will handle. Sure, we could still fill if we doubled the number of slots, but we will never become competitive if we expand out of proportion to medical school growth. If we want to attract more students, we need to create better medical school clinical experiences. We also need undergraduate medical education leaders who don't propagate the tradition of teasing our students during a surgery rotation.

Exactly, and this is what happened to Rads. They increased their spots exponentially over the past 15 years, creating an over saturated job market, and thus making radiology "less competitive" in recent years. On the other hand, Derm continued to keep their spots "exclusive" and thus remains the pinnacle of medicine.

 

[deleted547631]

Exactly, and this is what happened to Rads. They increased their spots exponentially over the past 15 years, creating an over saturated job market, and thus making radiology "less competitive" in recent years. On the other hand, Derm continued to keep their spots "exclusive" and thus remains the pinnacle of medicine.

Has Psych been increasing spots significantly? If so by how much?

 

[Blitz2006]

Has Psych been increasing spots significantly? If so by how much?

Refer to Table 8: http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

It has been increasing in recent years. The up side is that there is such a shortage of psychiatrists, it won't affect job market. The "downside" (I use that term loosely) is that it won't really help "competiveness" either. But we need psychiatrists, so increasing spots is not a bad thing for our field, even if it means that we will have to "water down" the applicant pool because of it.