Switching Residencies from Pathology To Psychiatry

[Path2Psychiatry]

Hey all,

I am currently in my PGY-1 year of Pathology Residency. I enjoy Pathology, but feel my greatest strengths lie in clinical medicine. I have spoken to my program director and chair of the Pathology Department at my institution, and they have been very supportive and have agreed to make calls on my behalf to program directors.

My best friends in medical school eventually went into psychiatry. I am reasonably conversant in 4 languages, and have a background in History and English from undergrad that allows me to understand an ethnoculturally diverse patient population. In my program there is a large amount of neuropathology and we have brain cutting weekly. I feel that my knowledge of neuroanatomy and neurological disease has greatly increased compared to medical school.

I am not currently in the match. Pathology intern year involves no patient contact. Thus, I would have to go through an intern year thus I would have to repeat an intern year. I have a few questions and am more than open to suggestions:

1.) Would it be possible to apply to programs outside the match for a spot for next year. Has anyone heard of this happening?

2.) If I did an intern year in family medicine or internal medicine (a transitional year), would this be counted toward residency in psych?

3.) I did not take an elective in psychiatry my fourth year of medical school and although I have recommendation letters from neurosurgeons, internists, and radiologists I do not have any from psychiatrists. How would you address this issue if you were in my situation?

Regards,

Path2Psychiatry

---

Members don't see this ad.

 

[nitemagi]

Hmm. You could attempt to apply outside the match, though your chances might be reduced. I would start by shadowing and spending time with a psychiatrist at your hospital or a local training program, aiming to get a letter from them. Psych doesn't require an internal medicine intern year, but if you were to do one you could then enter as a PGY-2 (outside the match). So you have options. Coming from path and being outside of clinical medicine, I'd recommend you aim to match next year as a PGY-1, or you could try to get an application together quick and get in to scramble with any open spots. It's hard enough to be good at clinical psychiatry in 4 years (if you're really aiming to be any good at psychotherapy and have mastery in any area), and I've seen many enter a year later and really struggle to catch up (just harder, not impossible).

 

[Wednesday]

I'm not sure about PGY-1 spots now. You could have applied for spots outside the match for next year but it's probably too late now since the match is coming up soon. Scramble is a good idea but might be a long shot. I think that doing a year of internal medicine or a transitional year would be great. You only miss 6 months of psychiatry anyway, and this can be made up during the PGY-4 year. I started as a PGY-2 after a year of ob/gyn and I graduated feeling very well trained with the advantage of having a depth of knowledge in ob/gyn that I would not have otherwise had. Medicine knowledge is very important in psychiatry. A transitional year would be even better (although harder to get I assume) because you may be able to do a psychiatry rotation and get a letter that way. A family medicine year would be tricky because those are usually three year programs and you would be leaving a program without a resident when you went to psych.

There are many programs throughout the country that have PGY-2 spots open every year. Not when people drop out or transfer out (although this happens too) but just to add more trainees at that point. The nice thing about those programs (I went to one) is that they are used to PGY-2s coming in and they know how to deal with you. In my program anyway, we didn't start any psychotherapy until the R2 year anyway, so the therapy training was just like any other R2.

As far as letters, you can probably contact your course director from you psychiatry core rotation or your attending from that rotation. That's what I did and the attending was happy to write me a letter--he remembered me. They will also be interested in letters from your current program, specifically your program director. Sounds like that's all in order, which is great. It seems like a lot to worry about now, but this is completely doable. Happens all the time! Good luck in your transition! And good choice!

 

[Leo Aquarius]

Good choice. Welcome!

 

[Path2Psychiatry]

Hey thanks!

Id appreciate it if anyone has anymore advice on how to secure a position outside the match. My PD is very supportive and would have no problem making calls on my behanyalf. It seems like everyone is going through Eras now. Is there anything to get around this? I feel it should be easier as i learned a lot this year and i know i will be a better doc in the future because of it.

Thanks you

Path2psychiatry

 

[nitemagi]

I'd try to get a list of programs that have traditionally not filled, and try contacting their PD's ahead of time, expressing your interest and your situation - be apologetic and respectful, honest and eager, and mention that you may be applying to their program for next year's match, but should they for any reason have an opening earlier that you would love to be considered. And get letters together asap, because if there is an opening, that time window to get your materials together might be quite narrow.

 

[BeverPath]

Hmm we'll see if posting on this old thread works. I too am a first year path resident who is not really satisfied overall with what pathology has turned out to be. I am thinking of switching into a psych residency. I am not sure if it is too late for this year to do so. Also, I did not have the best experience during my psych rotation in medical school (but loved the patients) so I most likely will not be able to get a psych LOR. Any suggestions?

 

[shan564]

Hmm we'll see if posting on this old thread works. I too am a first year path resident who is not really satisfied overall with what pathology has turned out to be. I am thinking of switching into a psych residency. I am not sure if it is too late for this year to do so. Also, I did not have the best experience during my psych rotation in medical school (but loved the patients) so I most likely will not be able to get a psych LOR. Any suggestions?

Not sure what exactly you're asking for suggestions for... I'm sure you know that the Match hasn't even opened yet, so it's definitely not too late. As for what to do at this point, you should talk to your program director and explain your issue... since you just started your intern year, they might be able to help you work something out.

 

[BeverPath]

Sorry, I was specifically trying to ask about the LOR. So if I most likely cannot get a Psychiatry LOR from my medical school, will this be a problem? If so, any suggestions on what to do? This would be the only area of my application that could be a hang up. Thanks.

 

[BeverPath]

Any advice?