Prior Pediatric Intern Now Applying Psychiatry

[navydoc2019]

---

Members don't see this ad.

Needing advice on how to become a completive applicant:

I am a prior pediatric intern (completed in 2017) and currently in year 3 of 4 in my Navy payback as a General Medical Officer (GP with independent practice for primary call and routine sick call). I plan on separating from the military and applying for a civilian psychiatry residency/CAP.

Prior to joining the military I had wanted to pursue CAP, but did not because it wasn’t a offered in the Navy. While I have managed routine psychiatric cases in my clinic for the past 2 years, I haven’t had a formal psych rotation in 4 years and have few to no good psychiatry networking contacts.

I am applying in a year and in need of guidance on what I can do in my spare time to become a competitive applicant, how to get a good psych LOR without a psych rotation, and what to do when changing fields. I am trying to become as competitive as possible as my wife is finishing her derm residency and pending her job opportunities, I may be geographically limited.

Currently my plan is to get as many psychiatric primary care cases at my clinic, search for research, and reach out to local clinics for shadowing/work opportunities.


Any advice is greatly appreciated, thank you.

 

[MacDonaldTriad]

You have been practicing medicine since you graduated and you have been in the Navy so it isn't like you have been sitting around getting rusty. I think you will probably be OK. Maybe apply for the combined adult CAP programs. I think you will be repeating your PGY-I year anyway. Some peds can count, but not enough to come in as a PGY-II and then fast track into CAP after 2 years.

 

[downwithDTB]

You sound pretty decent to me. Psych residency exists to train you in psych; being strong in medicine before hand only helps and some places really like vets.

Depending on the flexibility of the program you join, I'm not 100% sure that you couldn't finish in 4 more years (PGY2/3 psych, 4/5 CAP). You've got your 4 months of primary care done. You need 80% of an outpatient year (can double count 20% in your child fellowship). You only need one month of neuro (can double count 1 CAP month). That means that you might just barely be able to squeeze in the 6 months inpatient and the geri/substance/ED stuff and still make it. Of course, you might be stronger committing to be cheap labor for 3 years...

 

[TexasPhysician]

Funding would be an issue if all civilian, but I’m unsure how starting military peds could charge things.

If same as civilian world:
Some places can find other income to compensate and some places refuse/can’t. I’d say maybe 50% of programs will automatically reject you or significantly drop your ranking. If so, you’ll need to apply broadly and spouse should change jobs/wait.

If military doesn’t effect funding, you are a good applicant, but not so good that you shouldn’t interview at 7-12 mid-tier places in my opinion.

Overall chances of a match are pretty good, but spouse will need to be flexible.

 

[abc2019]

How is funding a issue? OP only completed Peds intern year so he should still have 2 more full years of GME funding.

 

[TexasPhysician]

How is funding a issue? OP only completed Peds intern year so he should still have 2 more full years of GME funding.

Exactly. 2 full years isn’t the 3+ still needed. Outside of competitive combined programs, that won’t fly. Programs won’t bet on the applicant “possibly” fast-tracking into child.

 

[navydoc2019]

Appreciate the input.

I will be 4 years out of Intern year and assume I'd be restarting as PGY1 anyways and really have no reservation against that. My goal will be CAP.

 

[FlowRate]

Exactly. 2 full years isn’t the 3+ still needed. Outside of competitive combined programs, that won’t fly. Programs won’t bet on the applicant “possibly” fast-tracking into child.

Wouldn't fast tracking into child help by taking someone off of the payroll who isn't earning funding?

 

[TexasPhysician]

Wouldn't fast tracking into child help by taking someone off of the payroll who isn't earning funding?

Likely, but no program would accept that risk of the OP not fast tracking if they have this policy. These programs will automatically filter OP out.

 

[abc2019]

Exactly. 2 full years isn’t the 3+ still needed. Outside of competitive combined programs, that won’t fly. Programs won’t bet on the applicant “possibly” fast-tracking into child.

Why would the competitive combined programs be willing to take a resident without the full funding? How are combined programs funded?

 

[downwithDTB]

Small points: 1) residents make hospitals money on average 2) hospitals are willing to pay a lot for acgme resident spots (see recent hahnemann bankruptcy auction) probably because they are valuable financially 3) not all programs are driven entirely by the bottom line or by acgme funds.

Things like state lines, large research driven slush funds and chairs who don't intend to maximize resident revenue at some programs give them flexibility to take on potentially unfunded (via acgme) slots. Granted this is probably mostly at fancy places but perhaps not always. A know several people who have started PGY2 psych after IM or Peds PGY1. Also, a program with a child fellowship that would really benefit from having this person work there might be willing to take the "risk" of an unfunded year by including a fast-tracked fellowship in the match agreement.

 

[TexasPhysician]

Why would the competitive combined programs be willing to take a resident without the full funding? How are combined programs funded?

I’m not sure they would be different, but if OP is 100% child psych and can convince a combined program of this, maybe they would take a stab despite filters. Unlikely though. There are many programs ok with partial/alternative funding. Probably only 50% would automatically filter.

Think of it this way. Just an example, so don’t focus on numbers. You have 700 applicants for your job. 600 will net your department $100k. 100 would net you $75k. You have 8 positions open. Who do you filter to reach 90 interviews? Some programs will use other filters for other reasons, but finances can be an issue even at top programs.