Research Track Psychiatry

[Phoenix899]

Hey all,

I am an MD.PhD at a US school interesting in pursuing a research track psychiatry residency. I have a question, if that would be OK.

I know Psychiatry, in general, is less competitive compared with other specialties. However, I can't seem to get a real sense of what type of board scores and credentials the top, research oriented programs required (MGH, UPitt, Yale, NYU etc.). If I were simply interested in practicing it wouldn't matter to me, but since I want to pursue academia I think training at one of these places might be important. Can anyone help me get a sense of what range of board scores, clinical grades, and pubs would be required for such programs?

Thank you in advance!!!

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[OldPsychDoc]

It's a completely different game for mudphuds. As long as your thesis work shows that you really can and do want to pursue research (hopefully with a decent pub or 2, and assuming some abstracts, posters, etc), if you're halfway decent clinically, and your PhD makes sense for psychiatry (neuroscience, psychology, something clinical or even ethical/philosophical--but probably not microbiology...)--you're writing your own ticket. It's more a matter of finding a place where you fit, where there's some mentorship in your area(s) of interest, etc.

 

[Phoenix899]

Thank you for your reply! Are you saying that board scores are less important than the interest and competence to perform research? I know a lot of specialties where you basically need a 240+ to be considered and higher at top places. I haven't taken step 1 and right now my interest is primarily in research. I don't want to kill myself for a insane step 1 if its not really necessary, because I'd like to put my effort into other things that interest me more than studying for an exam (like working on clinical skills and doing science). With all that said, I don't want to close any doors with a subpar step 1 score and so I am just wondering what would be par for these programs. Can anyone point specifically to ranges (230-240 for example) that would give me a sense of where I need to be? I am primarily asking so that when I study for step 1 and am taking the practice tests I will know if I am hitting the scores that will be expected from these programs.

 

[OldPsychDoc]

Thank you for your reply! Are you saying that board scores are less important than the interest and competence to perform research? I know a lot of specialties where you basically need a 240+ to be considered and higher at top places. I haven't taken step 1 and right now my interest is primarily in research. I don't want to kill myself for a insane step 1 if its not really necessary, because I'd like to put my effort into other things that interest me more than studying for an exam (like working on clinical skills and doing science). With all that said, I don't want to close any doors with a subpar step 1 score and so I am just wondering what would be par for these programs. Can anyone point specifically to ranges (230-240 for example) that would give me a sense of where I need to be? I am primarily asking so that when I study for step 1 and am taking the practice tests I will know if I am hitting the scores that will be expected from these programs.

Psych is NOT one of those specialties--even at the top research programs. I'm sure you'll be more than fine >220 if your research phase goes well. What you do in your research years will far overshadow anything you do leading up to Step 1.

 

[billypilgrim37]

I'm sure you'll be more than fine >220 if your research phase goes well.

And by fine, he means you'd be made of magic and rainbows and puppies. I've interviewed several MDPHDs (even from good schools) who have paradoxically low Step 1 scores (like 195-205 range). If they've done well in research and clinicals, nobody cares about your Step 1 if you've got good academic potential.

 

[twright]

Hey all,

I am an MD.PhD at a US school interesting in pursuing a research track psychiatry residency. I have a question, if that would be OK.

I know Psychiatry, in general, is less competitive compared with other specialties. However, I can't seem to get a real sense of what type of board scores and credentials the top, research oriented programs required (MGH, UPitt, Yale, NYU etc.). If I were simply interested in practicing it wouldn't matter to me, but since I want to pursue academia I think training at one of these places might be important. Can anyone help me get a sense of what range of board scores, clinical grades, and pubs would be required for such programs?

Thank you in advance!!!

This sort of thing is really hard to predict, and unfortunately there's not really a 'range' that I can point you to. In my experience, I have seen committees overlook a mediocre Step 1 score, for example if you have a lot of research awesomeness. However, I have not seen committees overlook mediocre grades or Dean's Letter comments.

 

[SmallBird]

I agree its very difficult to get a range, but since your question is really about what you should aim for in terms of Step 1 prep I would say aiming for > 220 makes sense. You would probably be fine even at a top research program with less than that, but "aiming" for a below average score is probably never the right answer.

I matched at a top research program with 217 Step 1, but made up for it with a couple of publications.

 

[strangeglove]

It's okay if you don't have the most amazing board scores, though it is important to get honors in your psych and medicine rotations, at least if you want to go to either MGH/McLean or Columbia. They want to know that you are going to be a good clinician who can hack it as an intern. No amount of research awesomeness will compensate for bad clinical grades/letters. It's another story if you want to go to Stanford, Yale or UPitt, where they have amazing research but somewhat less amazing clinical training. Not too much going on at NYU research-wise. Great clinical training there, though.

 

[SmallBird]

It's okay if you don't have the most amazing board scores, though it is important to get honors in your psych and medicine rotations, at least if you want to go to either MGH/McLean or Columbia. They want to know that you are going to be a good clinician who can hack it as an intern. No amount of research awesomeness will compensate for bad clinical grades/letters. It's another story if you want to go to Stanford, Yale or UPitt, where they have amazing research but somewhat less amazing clinical training. Not too much going on at NYU research-wise. Great clinical training there, though.

I agree with you that MGH and Columbia might be more competitive, and that acceptance would require good performances on clinical rotations. But I don't think there is any good reason to suggest that clinical training wouldn't be as excellent at either Yale (Which has rotations at a VA, community hospital, free standing psych hospital and Univeristy Health service) or UPitt (Which after all has one of the largest psych hospitals in the US!).

 

[strangeglove]

I agree with you that MGH and Columbia might be more competitive, and that acceptance would require good performances on clinical rotations. But I don't think there is any good reason to suggest that clinical training wouldn't be as excellent at either Yale (Which has rotations at a VA, community hospital, free standing psych hospital and Univeristy Health service) or UPitt (Which after all has one of the largest psych hospitals in the US!).

It is the common wisdom that the clinical training is better at MGH/McLean and Columbia than at all other research powerhouses. They tend to shun the MD-PhD's who are not
also clinically strong. It follows from holding applicants to a higher clinical standard that they will be held to a higher clinical standard as residents. I'm sure that Pitt, Yale and Stanford have quite large hospitals and good clinical services, but this is not the same as saying that they have good clinical training.

 

[sanluis]

It is the common wisdom that the clinical training is better at MGH/McLean and Columbia than at all other research powerhouses. They tend to shun the MD-PhD's who are not
also clinically strong. It follows from holding applicants to a higher clinical standard that they will be held to a higher clinical standard as residents. I'm sure that Pitt, Yale and Stanford have quite large hospitals and good clinical services, but this is not the same as saying that they have good clinical training.

It would be very interesting to know where this wisdom originates from. Please feel free to elaborate

 

[strangeglove]

It would be very interesting to know where this wisdom originates from. Please feel free to elaborate

From this board, for one. Also from those who review applications for such programs, as well as those who hire their graduates.

 

[billypilgrim37]

It is the common wisdom that the clinical training is better at MGH/McLean and Columbia than at all other research powerhouses.

Just as it is common "wisdom" that folks from MGH/McLean and Columbia believe that they are vastly superior to other programs. Stanford and Pitt are usual targets for Northeastern elitism, but kudos for going so far as to trash Yale as well.

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[strangeglove]

Just as it is common "wisdom" that folks from MGH/McLean and Columbia believe that they are vastly superior to other programs. Stanford and Pitt are usual targets for Northeastern elitism, but kudos for going so far as to trash Yale as well.

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Not "vastly superior"; just better. My point here is not to put down these programs. Rather, it is to correct the notion that any MD-PhD with decent publications can get in anywhere. There's nothing bad about Yale, Pitt, Stanford. It's just that they tend not to scrutinize the clinical performance of their research track applicants to the same level as MGH and Columbia. If stating this makes me elitist, then I am guilty.

 

[SmallBird]

Not "vastly superior"; just better. My point here is not to put down these programs. Rather, it is to correct the notion that any MD-PhD with decent publications can get in anywhere. There's nothing bad about Yale, Pitt, Stanford. It's just that they tend not to scrutinize the clinical performance of their research track applicants to the same level as MGH and Columbia. If stating this makes me elitist, then I am guilty.

Ok, but I just don't think you have any basis for what you are saying. I can't say that any of the recent reviews on this site reflect that opinion. And how could you possibly know the extent to which different programs scrutinise based on clinical performance?

I think "common wisdom" is more in the line of - many psychiatry programs offer excellent clinical training, but there is some differentiation in terms of the research opportunities available. I think its fair to say that some places (like MGH and Columbia) have a lot of research funding, infrastructure and strong reputations that will facilitate growth in an academic career beyond the average program. To say that the clinical faculty you interact with as a resident will have the capacity to make you a more thoughtful and effective psychiatrist than the faculty at other programs is elitist, in my view.

 

[strangeglove]

Ok, but I just don't think you have any basis for what you are saying. I can't say that any of the recent reviews on this site reflect that opinion. And how could you possibly know the extent to which different programs scrutinise based on clinical performance?

I know a number of very accomplished MD-PhD's with multiple high profile publications who did not get interviews at MGH and Columbia, but did get interviews at Yale, Pitt and Stanford. What these applicants had in common was that they did not obtain honors in Medicine, Psychiatry or both. I infer from this fact that MGH and Columbia place a higher value on applicants' clinical abilities than Yale, Stanford and Pitt.

 

[twright]

I know a number of very accomplished MD-PhD's with multiple high profile publications who did not get interviews at MGH and Columbia, but did get interviews at Yale, Pitt and Stanford. What these applicants had in common was that they did not obtain honors in Medicine, Psychiatry or both. I infer from this fact that MGH and Columbia place a higher value on applicants' clinical abilities than Yale, Stanford and Pitt.

Important to recognize here is that the Match results are a match between program preferences and applicant preferences. So an equally plausible inference is that Yale/Stanford/Pitt care about applicants' clinical abilities just as much as MGH/Columbia but they are simply not as competitive in the market for talent. That mechanism could produce a situation in which the rockstars of the rockstars (i.e., 270 Step 1, 2 first authors in Molecular Psych, 7 Honors) end up matching at the MGHes and Columbias just because they can, and the lesser ones (i.e., 240 Step 1, 1 first author in Biol Psych, 3-4 Honors) end up at the Yales and Stanfords.

 

[strangeglove]

Important to recognize here is that the Match results are a match between program preferences and applicant preferences. So an equally plausible inference is that Yale/Stanford/Pitt care about applicants' clinical abilities just as much as MGH/Columbia but they are simply not as competitive in the market for talent. That mechanism could produce a situation in which the rockstars of the rockstars (i.e., 270 Step 1, 2 first authors in Molecular Psych, 7 Honors) end up matching at the MGHes and Columbias just because they can, and the lesser ones (i.e., 240 Step 1, 1 first author in Biol Psych, 3-4 Honors) end up at the Yales and Stanfords.

I'm not talking about the match. I'm talking about applicants who wanted to be interviewed at MGH and Columbia but were not invited, most likely because they had merely average grades in core clinical clerkships. They were invited to Yale/Stanford/Pitt.

 

[tortuga87]

Here are some calculations based on averages:

According to the MD/PhD match data (http://forums.studentdoctor.net/showthread.php?t=805676) approximately 20 MD/PhDs apply to residency in psychiatry each year. From 2011 charting outcomes, the mean of the psychiatry USMLE Step 1 for matched US seniors is 214. Assuming standard deviation of 21.

About 4 people usually go to Columbia and MGH. That's top 20% (top 4/20). The 80th percentile for psychiatry step 1 is about 231.6. Taking the 90th percentile as average (80+100 / 2), that's about 241.

Yale, Pitt and Stanford take another 6. Top 50% (top 10/20). The 50th percentile for psychiatry step 1 is about 214. Taking the 65th percentile as average (50+80 / 2), that's about 222.

This is assuming worst case scenario where all applicants go to the best school they can which will probably not be the case. Subtract some points to account for that (although idk how much)

 

[nancysinatra]

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[nancysinatra]

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[dl2dp2]

From the perspective of an ex-MD/PhD student and now research track resident, I would say to skimp on your Step 1 studying is probably not a great idea, even for psychiatry. There is considerable score inflation and this trend will likely continue during your PhD years, and you'll be facing a decent number of applicants with great scores applying for the same positions as you.

If you can spare 1 month of studying, I'd say it's worth aiming for >230-240.

Keep in mind that as time goes on when you go for more competitive career tracks such as administration and research at a high powered place, every bit of your resume will be helpful. This becomes a game of trying to do as much as possible while balancing having a life outside of work and staying happy and sane. The sooner you realize this the better. There is no free lunch.

 

[cleareyedguy]

I posted the following a couple months ago. for this thread, I'd add in the importance of mentorship fit as well as the quality of your research.

​

The following is a couple years old and was lifted from a post by Doctor and Geek, who'd counted the number of MD-PhD residents at different programs. It's a gauge of sorts for where presumably serious researchers go for training. By the way, as others have pointed out, programs vary significantly in regards to accessibility of grant-getting faculty and the flexibility afforded for research time (hence Hopkins--a research mecca--at 0 and Cornell--supposedly a haven for analysts--at 10). As for whether this is useful info for the average, bright general applicant who has a somewhat vague sense of what they might want to study (which is most people), I dunno.


Harvard programs 11
Cornell 10
Columbia 9
UCLA 9
UCSF 8
Yale 8
Penn 5
Pitt 5
U of Washington 5
UCSD 5
NYU 4
Stanford 4
Wisconsin 4
Duke 3
Emory 3
Michigan 3
Mt. Sinai 3
UTSW 3
Chicago 2
UCDavis 2
WashU 2

 

[DrShineBright]

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[tennreb]

MUSC has a research track. You should apply there.

 

[Phoenix899]

Thank you to everyone who responded! I really appreciate you sharing your insight. This was such an extensive set of replies that I don't have any further questions. Thank you!