Stick with SOAP specialty or try for originally desired specialty?

[NRP]

Usmd with low stats 220s/220/pass and a shelf retake with 12 psych interviews. Ranked all programs, had 4 "safeties" 2 of which were relatively new programs. Rest were mid or low tier other than my top. Did not send post communication other than #1.

Didn't match psych but managed to soap into FM. The thought of doing rotations like surgery and ob gyn again is honestly the biggest mental hurdle in my mind. I really am feeling burnt out and am pretty disenfranchised with medicine after not matching and am terrified of intern yet in FM. Also, I'm well aware I'm luckier than a lot of other people.

I've been scouring the internet for pgy2 switching information but I have the feeling most of these applicants had a lot better scores. Would I stand a chance at trying to switch into a pgy2 spot with my low stats and soap history?

Should I just survive FM and...good God... Do a psych residency afterwards and try to get a pgy2? That would be 6 years of residency at the minimum.

On top of my scores I'm going to have to assume I interviewed poorly? I asked relevant questions and smiled. Maybe I didn't sell myself bc I'm typically reserved and quiet but I was talking plenty with the residents. Residents I've worked with say Im fun to hang out with both as a colleague and in general. I usually considered myself self aware but maybe not anymore.

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[NotAProgDirector]

Does the institution where you SOAP'ed into FM have a psych residency? If so, trying to get a spot there might be the easiest solution. Hopefully you could get 6 months of PGY-1 credit.

 

[NRP]

Does the institution where you SOAP'ed into FM have a psych residency? If so, trying to get a spot there might be the easiest solution. Hopefully you could get 6 months of PGY-1 credit.

Unfortunately no. It's a community based hospital in that aspect. I'd even be willing to repeat a pgy-1 year if I had to. I'm afraid with the rising competition in psych my application would be even less favorable next year and the possibility of even switching. I've read many times on this forum that it's possible but not likely but was wondering if more people had experience with this or numbers.

 

[Nemologist]

Does the institution where you SOAP'ed into FM have a psych residency? If so, trying to get a spot there might be the easiest solution. Hopefully you could get 6 months of PGY-1 credit.

Probably a dumb question but just wondering if you could be a little more specific in what really makes it a little easier. It makes sense that it is because it is in the same institution. But is it also easier because you’ll get a chance to talk to the PD in person and ask if you have a chance in joining the program next year? What would be the best approach if one is thinking of switching specialty at the same institution?

 

[NotAProgDirector]

It's easier because they know you, they know from your current program if you're having problems (hence the chance of getting someone with problems that were hidden is less), it's easy to interview, they know you are serious, etc. But all this assumes that you're actually competitive for the spot in the first place.

 

[GastriqueGraffin]

I had a resident in my IM residency who completed psych residency first and then IM in order to be a PCP and pscyhiatrist for patients with mental health. Maybe consider that after FM.

 

[DokterMom]

Give your FM residency your very best shot with the mindset that you might really enjoy practicing family medicine. It's a great specialty with lots of flexibility, lots of patient contact, enormous potential to make meaningful differences in your patients' lives, and no real need to practice the surgical and OB/GYN parts you disliked in 3rd year. You might be very pleasantly surprised if you're open to it.

 

[Mad Jack]

Usmd with low stats 220s/220/pass and a shelf retake with 12 psych interviews. Ranked all programs, had 4 "safeties" 2 of which were relatively new programs. Rest were mid or low tier other than my top. Did not send post communication other than #1.

Didn't match psych but managed to soap into FM. The thought of doing rotations like surgery and ob gyn again is honestly the biggest mental hurdle in my mind. I really am feeling burnt out and am pretty disenfranchised with medicine after not matching and am terrified of intern yet in FM. Also, I'm well aware I'm luckier than a lot of other people.

I've been scouring the internet for pgy2 switching information but I have the feeling most of these applicants had a lot better scores. Would I stand a chance at trying to switch into a pgy2 spot with my low stats and soap history?

Should I just survive FM and...good God... Do a psych residency afterwards and try to get a pgy2? That would be 6 years of residency at the minimum.

On top of my scores I'm going to have to assume I interviewed poorly? I asked relevant questions and smiled. Maybe I didn't sell myself bc I'm typically reserved and quiet but I was talking plenty with the residents. Residents I've worked with say Im fun to hang out with both as a colleague and in general. I usually considered myself self aware but maybe not anymore.

Plenty of psych interviewees got burned this year because psych is no longer a backup specialty and higher quality applicants are ranking it as their first choice. This has resulted in a lot of applicants dropping far down their rank lists or not matching at all. It isn't that you are a poor interviewer in all likelihood, but rather that you're average and programs just filled before hitting the middle of their ROLs. I wish you the best of luck moving forward.

 

[Raryn]

Does the institution where you SOAP'ed into FM have a psych residency? If so, trying to get a spot there might be the easiest solution. Hopefully you could get 6 months of PGY-1 credit.

Psych is unique in that their board has a ton of elective time built in. People from almost any other field can (at the discretion of the PD of course) transfer in with a full year of credit and start as PGY2s. I've personally seen it happen to a number of people, including situitations like a former ER or a radiology resident starting as a PGY2 psych resident.

It also has among the highest attrition rates of any field, so there's a significant # of PGY2 psychiatry spots that open up every year.

Regardless for OP though, the most important thing is to sincerely try in your new residency. You are contractually obligated to start it. See how you like it. If you still want to do psych, inquire after that.

 

[Brain Whisperer]

It also has among the highest attrition rates of any field, so there's a significant # of PGY2 psychiatry spots that open up every year.

Not to go off tangent from OPs thread, but would you know the reasons why that is?

 

[Raryn]

Not to go off tangent from OPs thread, but would you know the reasons why that is?

I don't know.

The data I saw supporting this is getting fairly old at this point, but came from this 2013 paper (that focused on ob/gyn).

Figure of interest, detailing yearly attrition rates between 2000 and 2009:

I haven't seen too much speculation as to why. In fact, I've never seen a single paper from the academic psychiatry world examining the topic of attrition, and I've searched a couple times out of curiosity (including a cursory search today). I think that part of the elevated attrition in the study might be people fast-tracking into child psych, but that isn't mentioned anywhere in the original paper and I have no clue if that even factored in to their analysis. That said, even if every single child/adolescent fellow fast-tracked, it alone can't explain a 32-38% attrition rate over 4 years (depending on whether you apply the annual attrition rate geometrically or arithmetically). Even if that was the major part of the explanation, psych would still have >3% annual attrition rate, up there with the procedural fields.