Psych becoming an easier match

[yanks26dmb]

Ok. What specialty is easier to get compared to psych?

Based on % of unmatched USMDs last year...almost all of them.

Based on average Step score...almost none of them.

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[Shufflin]

For 2018, the Top 5 lowest match rates for US Allopathic Seniors were enjoyed by:

1. Interventional Radiology

2. Dermatology

3. Orthopedic Surgery

4 = 5 tie. Gen Surgery, and... believe it or not, Psychiatry

Psych is rather selective, and we don't over-emphasize Step scores. I see this as the beginning of a shift for Psych, and predict the Step scores will follow an upward trend over the next several years as more competitive applicants get in the game.

 

[TexasPhysician]

For 2018, the Top 5 lowest match rates for US Allopathic Seniors were enjoyed by:

1. Interventional Radiology

2. Dermatology

3. Orthopedic Surgery

4 = 5 tie. Gen Surgery, and... believe it or not, Psychiatry

Psych is rather selective, and we don't over-emphasize Step scores. I see this as the beginning of a shift for Psych, and predict the Step scores will follow an upward trend over the next several years as more competitive applicants get in the game.

I partially disagree. I don’t think competition will trend up compared to many other fields, just adding more US med students (they are coming). As US MD’s flood the system, advisors will need to stay current.

The current low match rate is a result of advisors telling applicants that they are more competitive than they are. Too many good applicants are applying to the same good programs.

 

[VA Hopeful Dr]

I partially disagree. I don’t think competition will trend up compared to many other fields, just adding more US med students (they are coming). As US MD’s flood the system, advisors will need to stay current.

The current low match rate is a result of advisors telling applicants that they are more competitive than they are. Too many good applicants are applying to the same good programs.

A quick review of the 2018 Match statistics seems to support this.

The hard numbers (research, Step scores, programs applied to and so forth) are almost identical between psych and FM. The only difference that looks significant is y'all have significantly more PhD applicants than we do.

 

[ziggyhope]

holy necro, I read a few posts before realizing it's from 2012. This is very misleading for applicants.

 

[OldPsychDoc]

holy necro, I read a few posts before realizing it's from 2012. This is very misleading for applicants.

Really shows how amazingly fast things have changed in 5 years.

 

[Shufflin]

I partially disagree. I don’t think competition will trend up compared to many other fields, just adding more US med students (they are coming). As US MD’s flood the system, advisors will need to stay current.

The current low match rate is a result of advisors telling applicants that they are more competitive than they are. Too many good applicants are applying to the same good programs.

This is, by definition, what we mean by a competitive landscape. It's six of one, half a dozen of the other. If you have more good applicants applying to the same programs, then the programs can be much more selective, and suddenly things are more competitive. We're saying the same thing from different angles. And I don't think this fully explains a much lower match rate. Advisors across the board are not inept as to not build in a range of safety schools for their own cherished med students.

Bottom line, Psych is more competitive. Med students are waking up to the possibility of fascinating medicine with a superb work-life balance. Time will tell as to the Step score trends and what not. We already dominate in PhDs.

 

[TexasPhysician]

This is, by definition, what we mean by a competitive landscape. It's six of one, half a dozen of the other. If you have more good applicants applying to the same programs, then the programs can be much more selective, and suddenly things are more competitive. We're saying the same thing from different angles. And I don't think this fully explains a much lower match rate. Advisors across the board are not inept as to not build in a range of safety schools for their own cherished med students.

Bottom line, Psych is more competitive. Med students are waking up to the possibility of fascinating medicine with a superb work-life balance. Time will tell as to the Step score trends and what not. We already dominate in PhDs.

Average Step scores have partially been a result of step score inflation (not competition). Passing and average scores have increased in recent years. More med schools are opening (3-4 just in Texas) and Texas schools have increased enrollment in the last 6 years. This isn’t Texas unique. More US MD’s are hitting the residency process which is gradually pushing out IMG’s. This is not psych specific but an overall increase in competition.

We will have to agree to disagree on advisors. Most that I’ve met have no idea which programs are competitive, how many to apply to, or where the safeties are. Every year is a changing landscape, and they don’t keep up. Some just tell everyone to interview at 15+ because they can’t gauge competition and want their match numbers up. Others just say to apply to 5 or so since that is what they did. My psych advisor couldn’t even give me info on the program he attended - he hasn’t contacted them since graduation and he is the lead psych advisor.

So sure psych competition is increasing, but so is everyone else. When you add up the numbers, US MD’s will need to apply to historically lower competition safety schools.

Psych has always been a lower income lifestyle type field. While psych may be mildly more competitive as a whole, we are not the next derm. There is no reason for applicants to panic.

 

[MacDonaldTriad]

Texasphysician is spot on. Advisors don't have a clue. At least they don't know as much as we do and I don't have a clue lately. IMGs are getting the squeeze and the most expansion room for all of the new increases in domestic grads are in psych, family medicine, Peds... This means that in order to land training, a larger portion of domestic grads will need to consider these specialties. Although I welcome more interest in psych and larger numbers, I'm not excited about matching a bunch of accidental psychiatrists who didn't get the specialty they really wanted. I just don't think psych is a good field for people without the calling so to speak.

 

[Techmed07]

Nothing has changed everybody....still the easiest speciality to match into!

 

[Shufflin]

Nothing has changed everybody....still the easiest speciality to match into!

5 to 10 years ago, perhaps. Today, not so much.

Here's a question for you, why do you hold psychiatry in such low regard Techmed07? Any esteem folks give the specialty, you're quick to shoot down, often without any attempt at reason. Curious why the cynicism.

 

[MacDonaldTriad]

Psychiatry is one of the easier matches still, and we do suffer more than our fair share of knuckle heads practicing psychiatry out there. That being said, there are also some very impressive people and we do have a very interesting and evolving field with a lot to offer. I looked at PRITE the other day and none of the answers would be in a 30 year old text book. If you read a 50 year old neurology book, you would be half way to passing their boards I bet.

 

[Nahom]

Raise the median income to $250k. I'd bet money that even if we all became douche-bags we'd be more competitive

I was under the imppression psych was already around of even a bit above 250? Medscape last year: male P doc in PP=$285. Overall average salary: 256k. From my home institution, doing inpatient (8-4 pm) STARTS at 250, even fresh out of residency.

 

[FFH]

Not sure the break down of US senior and IMG and DO, but one of the PD I talked to today said that there had been 20% increase in the number of applicants this year as compared to last year.

 

[Stagg737]

Average Step scores have partially been a result of step score inflation (not competition). Passing and average scores have increased in recent years. More med schools are opening (3-4 just in Texas) and Texas schools have increased enrollment in the last 6 years. This isn’t Texas unique. More US MD’s are hitting the residency process which is gradually pushing out IMG’s. This is not psych specific but an overall increase in competition.

Actually, Step 1 inflation has been minimal. Average Step 1 has consistently been between 227 and 230 for the past 5-6 years and scores of matched individuals has only increased 4-5 points. Meanwhile the average score for matched psychiatrists has increased from ~115 to ~125, which is significantly greater than the average rate of overall matched applicants. So while it's still one of the lower means to match, it's increasing at a faster rate than almost every other field.

 

[TexasPhysician]

Actually, Step 1 inflation has been minimal. Average Step 1 has consistently been between 227 and 230 for the past 5-6 years and scores of matched individuals has only increased 4-5 points. Meanwhile the average score for matched psychiatrists has increased from ~115 to ~125, which is significantly greater than the average rate of overall matched applicants. So while it's still one of the lower means to match, it's increasing at a faster rate than almost every other field.

Since 2008, the average matched US MD Step 1 score has increased in:
Derm: 19 points
Rad Onc: 19 points
Plastic surgery: 18 points
PMR: 17 points
Anesthesia: 16 points
Psychiatry: 16 points
Pediatrics: 12 points
Family Medicine: 10 points

We are continuing to become even more competitive than peds/fm, no farther competitively from anesthesia, and losing ground in pmr, derm, plastics, rad onc. There are some outliers like EM that became very competitive in 2008 with ER being a hit pop culture show. They haven’t changed much at all since.

More US MD’s are graduating each year and US MD’s score the highest on step 1 over other groups.

Compared to lifestyle fields, we are becoming relatively less competitive while simultaneously becoming more competitive than primary care fields.

 

[Old&InTheWay]

Not sure the break down of US senior and IMG and DO, but one of the PD I talked to today said that there had been 20% increase in the number of applicants this year as compared to last year.

I believe that given how many programs some people seems to be applying to. More applications does not necessarily mean more applicants.

 

[Mass Effect]

I'm curious about who on this thread is actually involved in training/recruitment because it seems whenever this topic comes up, there are certain people who jump up and down, set their hair on fire, to convince everyone psych is not competitive and vice versa. Historically, none of them are involved are involved in training and recruitment, where you hear a different story.

 

[Drrrrrr. Celty]

I'm curious about who on this thread is actually involved in training/recruitment because it seems whenever this topic comes up, there are certain people who jump up and down, set their hair on fire, to convince everyone psych is not competitive and vice versa. Historically, none of them are involved are involved in training and recruitment, where you hear a different story.

Most people who I know who are involved in psychiatry training off this website think that it's significantly increased in competition.

 

[TexasPhysician]

Most people who I know who are involved in psychiatry training off this website think that it's significantly increased in competition.

Everyone is agreeing that it is getting more competitive for applicants as a whole, especially at the better programs. That’s very clear.

Psychiatry is not gaining on the top lifestyle fields that are becoming even more competitive than before. The rate of additional US MD’s to the pool without corresponding residency slots is tightening the belt.

 

[Stagg737]

Since 2008, the average matched US MD Step 1 score has increased in:
Derm: 19 points
Rad Onc: 19 points
Plastic surgery: 18 points
PMR: 17 points
Anesthesia: 16 points
Psychiatry: 16 points
Pediatrics: 12 points
Family Medicine: 10 points

We are continuing to become even more competitive than peds/fm, no farther competitively from anesthesia, and losing ground in pmr, derm, plastics, rad onc. There are some outliers like EM that became very competitive in 2008 with ER being a hit pop culture show. They haven’t changed much at all since.

More US MD’s are graduating each year and US MD’s score the highest on step 1 over other groups.

Compared to lifestyle fields, we are becoming relatively less competitive while simultaneously becoming more competitive than primary care fields.

Interesting data set to be sure. I'd be more curious about comparisons between now and 2012-14 though as my understanding is that this is the period where the competitiveness of psych has really taken off. No doubt the most competitive fields have remained highly competitive. It's just interesting how to see some fields (like psych and EM) shift from anyone can get in to no longer being a sure thing.

 

[Techmed07]

5 to 10 years ago, perhaps. Today, not so much.

Here's a question for you, why do you hold psychiatry in such low regard Techmed07? Any esteem folks give the specialty, you're quick to shoot down, often without any attempt at reason. Curious why the cynicism.

I haven’t put Psychiatry down— I pointed out facts. See below

1) It’s one of the easiest speciality to match into.
2) The work isn’t easy
3) The pay is good but doesn’t compare to procedural specialities
4) Stigma is still there


HOWEVER—
Psychiatry is still the best kept secret. Residency is more than doable, there is a lot of flexibility and the need is very high. However, this and other amazing qualities about the speciality do not make the things above untrue.

Will psychiatry become the new derm? Probably not due to the nature of the work. However, if TMS, Ketamine and ECT gets traction it’s a possibility.

 

[Mad Jack]

I'm curious about who on this thread is actually involved in training/recruitment because it seems whenever this topic comes up, there are certain people who jump up and down, set their hair on fire, to convince everyone psych is not competitive and vice versa. Historically, none of them are involved are involved in training and recruitment, where you hear a different story.

As someone who is now involved in the process, I can assure you psych is ridiculously competitive. At a small program, we need to rank less than 4 applicants per spot to fill, while we had over 200 applicants per spot. We could easily fill the entire program with US MDs or DOs, but our PD values applicant quality over pedigree. This year is even more competitive than last.

 

[Roxas]

As someone who is now involved in the process, I can assure you psych is ridiculously competitive. At a small program, we need to rank less than 4 applicants per spot to fill, while we had over 200 applicants per spot. We could easily fill the entire program with US MDs or DOs, but our PD values applicant quality over pedigree. This year is even more competitive than last.

So what I'm hearing is I shouldn't be holding my breath for an interview there?

 

[Mad Jack]

So what I'm hearing is I shouldn't be holding my breath for an interview there?

I have little say in the process, unfortunately. I just know how it's looking since we talk about it and who we're interviewing

 

[JohnnyWonderbread]

How I feel when older psych docs tell me how many apps they sent out for a match back in 2000 - 2010:

 

[Roxas]

How I feel when older psych docs tell me how many apps they sent out for a match back in 2000 - 2010:

lol

Somehow this came up with my current psych attending who kept emphasizing to me that back in her time (early 90's) you didn't have to apply for psych, and that she was actively recruited to the specialty by her program after internship

 

[mymembernames]

...

 

[VA Hopeful Dr]

As someone who is now involved in the process, I can assure you psych is ridiculously competitive. At a small program, we need to rank less than 4 applicants per spot to fill, while we had over 200 applicants per spot. We could easily fill the entire program with US MDs or DOs, but our PD values applicant quality over pedigree. This year is even more competitive than last.

The data doesn't really support that, at least as far as the things we can measure are concerned.

 

[Mad Jack]

The data doesn't really support that, at least as far as the things we can measure are concerned.

Competitive from a percentage of applicants that won't match perspective, not a board scores perspective. US MD applicants were 11.3% less likely to match psych than FM, 12% less likely to match than in anesthesia, 4.9% less likely to match than radiology, etc etc. Unlike these other specialties, unmatched applicants are found in decent numbers all the way up the score curve. For comparison in the 230+ score category, there were 11 unmatched US seniors in FM, 2 unmatched in anesthesia, 27 unmatched in general surgery, 5 unmatched in IM, and 27 unmatched in radiology, there were 27 unmatched US seniors with a 230+ in psych. When controlled for field size, psych becomes less competitive than GS and reads for high stat applicants, it is far more competitive than FM, IM, and anesthesia, though I'd also have to control for how many people within each category applied to each field, so these are just messy off the cuff numbers. Measuring the outcomes of exceptional candidates is a decent measure for field competitiveness overall, and comparing the outcomes for high performing candidates in psych in past years shows that they had much better outcomes than today

 

[Stagg737]

lol

Somehow this came up with my current psych attending who kept emphasizing to me that back in her time (early 90's) you didn't have to apply for psych, and that she was actively recruited to the specialty by her program after internship

This used to be all fields. My pre-med mentor was an orthopod who did residency in the late 80's/early 90's and he did basically the same thing. Said you pretty much just applied to where you wanted to go and didn't even need a back-up unless you were applying somewhere like MGH. He said he literally called the PD at the program he wanted to go to and he said to submit an app and he went there. Crazy how much things have changed...

 

[VA Hopeful Dr]

Competitive from a percentage of applicants that won't match perspective, not a board scores perspective. US MD applicants were 11.3% less likely to match psych than FM, 12% less likely to match than in anesthesia, 4.9% less likely to match than radiology, etc etc. Unlike these other specialties, unmatched applicants are found in decent numbers all the way up the score curve. For comparison in the 230+ score category, there were 11 unmatched US seniors in FM, 2 unmatched in anesthesia, 27 unmatched in general surgery, 5 unmatched in IM, and 27 unmatched in radiology, there were 27 unmatched US seniors with a 230+ in psych. When controlled for field size, psych becomes less competitive than GS and reads for high stat applicants, it is far more competitive than FM, IM, and anesthesia, though I'd also have to control for how many people within each category applied to each field, so these are just messy off the cuff numbers. Measuring the outcomes of exceptional candidates is a decent measure for field competitiveness overall, and comparing the outcomes for high performing candidates in psych in past years shows that they had much better outcomes than today

That's not even close to true. If you score a 250 on step 1 and don't match in most fields, it means there is something wrong with you. I mean, there were 2 scores above 260 who didn't match in surgery. I don't think that means that surgery is super competitive.

I think looking at the lower end is actually a better measure myself.

 

[Mad Jack]

That's not even close to true. If you score a 250 on step 1 and don't match in most fields, it means there is something wrong with you. I mean, there were 2 scores above 260 who didn't match in surgery. I don't think that means that surgery is super competitive.

I think looking at the lower end is actually a better measure myself.

These aren't exceptional scores, I picked anything average or better. Though you seem to be implying that people with high scores and personality problems seem to cluster much higher in psych than other specialties, and that there has been an increase in people with these traits applying to psych this year versus 8 years ago, when such scores not matching was almost unheard of.

 

[VA Hopeful Dr]

These aren't exceptional scores, I picked anything average or better. Though you seem to be implying that people with high scores and personality problems seem to cluster much higher in psych than other specialties, and that there has been an increase in people with these traits applying to psych this year versus 8 years ago, when such scores not matching was almost unheard of.

My 14 years in medicine and on SDN has taught me that there is an increase in people with personality problems throughout medicine in general.

I would actually expect psych to care more about the personalities of their applicants than most.

 

[Mad Jack]

My 14 years in medicine and on SDN has taught me that there is an increase in people with personality problems throughout medicine in general.

I would actually expect psych to care more about the personalities of their applicants than most.

Which was kind of my point- psych is more competitive because regardless of score, you might not match, hence why the average scores of matches applicants are lower than they might otherwise be. In FM, IM, or anesthesia, scores can get you by in a lot of programs. So regardless of your boards, you are going to have to interview well and hope to god other people didn't interview better, because we usually aren't ranking based on scores alone beyond a certain threshold.

 

[VA Hopeful Dr]

Which was kind of my point- psych is more competitive because regardless of score, you might not match, hence why the average scores of matches applicants are lower than they might otherwise be. In FM, IM, or anesthesia, scores can get you by in a lot of programs. So regardless of your boards, you are going to have to interview well and hope to god other people didn't interview better, because we usually aren't ranking based on scores alone beyond a certain threshold.

I wouldn't say that makes you more or less competitive, just using different criteria. Its like the schools that don't require SAT/ACT for admission anymore.

 

[Mad Jack]

I wouldn't say that makes you more or less competitive, just using different criteria. Its like the schools that don't require SAT/ACT for admission anymore.

At that point, one could argue that the only factor is match rates, which puts psych well above most beaten only by derm, IR, or the, and tying with GS. It puts the field in a weird spot where it is both far more and far less competitive than it looks, depending on which measures you are using. Anyone can match, regardless of scores, but the things that will make you match are intangible and hard to quantify, and the number of people you are competing with is so high that even as a US MD there is a 16% chance you won't match.

 

[Mad Jack]

Oh, and by "ridiculously competitive," I mean it is ridiculous for this field, not ridiculous overall. Psych is much more competitive than it has been and is solidly in the middle of the pack due to applicant numbers and intangibles, but it certainly isn't the new derm (yet)

 

[VA Hopeful Dr]

At that point, one could argue that the only factor is match rates, which puts psych well above most beaten only by derm, IR, or the, and tying with GS. It puts the field in a weird spot where it is both far more and far less competitive than it looks, depending on which measures you are using. Anyone can match, regardless of scores, but the things that will make you match are intangible and hard to quantify, and the number of people you are competing with is so high that even as a US MD there is a 16% chance you won't match.

I think that's the key.

It would be like if next year IM made you run a 5K and used your time as a factor in their rank order. Its not what anyone is used to so it throws people off.

 

[yanks26dmb]

I think that's the key.

It would be like if next year IM made you run a 5K and used your time as a factor in their rank order. Its not what anyone is used to so it throws people off.

But isn't it much different than that? A 5k gives a quantifiable number to be used to rank. Psych don't seem to care much for numbers...

 

[Mad Jack]

But isn't it much different than that? A 5k gives a quantifiable number to be used to rank. Psych don't seem to care much for numbers...

Numbers matter, but the interview is truly make or break. Most of my psych interviews were between two and four hours of solid questions

 

[psychattending]

I would say that most PDs don't focus on Step scores or GPAs (nor IMG status) in doing a rank list. Some of those things might impact whether you get an interview or not but once you get an interview we are focusing much more on whether you will make a good psychiatrist or not. If a person can't interact on a human level, then that person no matter what their Step score is going to be a poor psychiatrist (similar to whether a surgeon as the manual dexterity to be a surgeon). Thus, we will take a lower Step score if the non-score aspects of a candidate are strong. Also what last year's numbers show is that the field will take a good IMG over a poor AMG.

 

[psychdoc222]

I would say that most PDs don't focus on Step scores or GPAs (nor IMG status) in doing a rank list. Some of those things might impact whether you get an interview or not but once you get an interview we are focusing much more on whether you will make a good psychiatrist or not. If a person can't interact on a human level, then that person no matter what their Step score is going to be a poor psychiatrist (similar to whether a surgeon as the manual dexterity to be a surgeon). Thus, we will take a lower Step score if the non-score aspects of a candidate are strong. Also what last year's numbers show is that the field will take a good IMG over a poor AMG.

Thanks very much for this post.I've been scouring every psychiatry thread in the forum for a glint of hope. This is something to push me forward through this season.

 

[FFH]

PD of the program where I'm at said that step score was used initially to sort out the 1200+ apps they received each year, but at the end of the day, pretty much everyone gets reviewed and it's the non-step part that matters.

 

[psychdoc222]

PD of the program where I'm at said that step score was used initially to sort out the 1200+ apps they received each year, but at the end of the day, pretty much everyone gets reviewed and it's the non-step part that matters.

Thank you very much! Just needed some positivity to keep up the hope.

 

[deleted407021]

Thank you very much! Just needed some positivity to keep up the hope.

Same! All this about how competitive psych is getting is really scaring me

 

[FFH]

Same! All this about how competitive psych is getting is really scaring me

My hypothesis for the high unmatched rate from last year was a combination of somewhat increased competitiveness and that many applicants under apply and under rank, likely due to impressions that psych is easy. I feel like the conversations I had with few PDs from various part of the country confirmed this.

 

[yanks26dmb]

My hypothesis for the high unmatched rate from last year was a combination of somewhat increased competitiveness and that many applicants under apply and under rank, likely due to impressions that psych is easy. I feel like the conversations I had with few PDs from various part of the country confirmed this.

Can you expand on that? What did the pds mention?

How do they know how many programs people are ranking for instance?

 

[Stagg737]

Also what last year's numbers show is that the field will take a good IMG over a poor AMG.

Do they though? The charting the outcomes for IMGs showed that any IMG with less than a 240 Step 1 had less than a 50% chance of matching. Those with scores above 240 only had a 74% chance of matching. Meanwhile, USMDs with a scores below 210 had a 75% chance of matching, and those with scores below 200 still had a 69% chance of matching. If you look at DOS, the lowest COMLEX scorers (400-450) had a 73.5% chance of matching. So I'd argue that even poor AMGs stand a better chance than foreign grads.

Additionally, total match rates for IMGs was 29.7% while the FMG match rate was 38%. DO match rate was 77.5% and USMD rate was 85%.


I'm not debating that Step scores are of lesser importance for psych. I'm curious how you're defining "good IMG" and "poor AMG" though given the data from the most recent CTO.

 

[OldPsychDoc]

Can you expand on that? What did the pds mention?
How do they know how many programs people are ranking for instance?

It's all guesswork until after the Match. We don't know any more than you do.