Switching to Psychiatry?

[WhereNow]

I am in real need of some advice! I am currently a first year resident in pathology. I went to medical school with every intention of becoming a psychiatrist. Along the way, I developed what I thought was an equal interest in pathology. Choosing which specialty to pursue was extremely difficult for me. Now I am realizing that I may have made a mistake by not pursuing my initial interests. I don't know what my next move should be to make the switch to psychiatry. I have so many questions:

1) Do I have to enter the MATCH process all over again, or is it possible to make a deal outside of the match? (Basic statistics: American medical grad; 3.63 GPA; 239 Step 1; 261 Step 2)

2) Is it too late to enter this year's MATCH; how am I supposed to get letters of recommendation for psychiatry when my psych rotation was nearly 2 years ago?

2) When should I let my program know of my decision? I'm assuming they are going to be pretty angry.

Any advice is greatly appreciated. I'm trying not to have a panic attack.

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[sunlioness]

I switched after an intern year in IM. I don't know what PGY-1 of a pathology residency consists of, but if it's mostly internal medicine type stuff you might be able to switch into a PGY-2 spot. Again, I don't know enough about pathology to say if this is feasible. You would have to find PGY-2 spots on your own by calling programs you're interested in and explaining your situation.

Talk with your current program director NOW. Tell him/her what you just told us. Part of their job is to provide mentorship and guidance so if they're worth their salt, they'll be supportive and even help you work through the decision making process of staying vs switching. My IM program director was wonderful in this regard. Also, if your current pathology program is affiliated with an institution that has a psychiatry residency, reach out to that PD as well. S/He might not have a spot open, but they will also have good advice and support. The absolute worst thing you can do, imo, is to keep your current program in the dark about your intent to leave. It's unprofessional and is actually a red flag for any psych program that will consider you. The one thing I was told over and over again when I interviewed for PGY-2 psychiatry positions was how impressed they were that I had kept my current program in the loop every step of the way.

 

[WhereNow]

Thanks so much for the reply. Pathology residents don't do a typical "intern" year; they go straight into pathology training. Thus, I would be applying for a PGY-1 spot. I have heard of many situations where residents switch specialties and the specialty they switch into goes ahead and guarantees them a spot. Without this guarantee, it will make changing specialties very risky. For instance, if I am not accepted into a psychiatry program of my choosing, then I will have to stay at my current program with everyone knowing that I wanted to leave. It would make for a horrible work environment. I agree, however, that the best thing to do is to inform my current program director as soon as possible.

 

[billypilgrim37]

Well, they'll know you wanted to leave to be a psychiatrist. I mean, come on, being the weird guy in a room full of pathologists? Is this really such a concern?

 

[psychattending]

I am in real need of some advice! I am currently a first year resident in pathology. I went to medical school with every intention of becoming a psychiatrist. Along the way, I developed what I thought was an equal interest in pathology. Choosing which specialty to pursue was extremely difficult for me. Now I am realizing that I may have made a mistake by not pursuing my initial interests. I don't know what my next move should be to make the switch to psychiatry. I have so many questions:

1) Do I have to enter the MATCH process all over again, or is it possible to make a deal outside of the match? (Basic statistics: American medical grad; 3.63 GPA; 239 Step 1; 261 Step 2)

2) Is it too late to enter this year's MATCH; how am I supposed to get letters of recommendation for psychiatry when my psych rotation was nearly 2 years ago?

2) When should I let my program know of my decision? I'm assuming they are going to be pretty angry.

Any advice is greatly appreciated. I'm trying not to have a panic attack.

1) Officially since you are not a graduating 4th year student you are not required to go through the Match. However, you will need to be a PGY1 in psych next year; so most program would probably want to see our application via ERAS.

2) It's not too late to apply this year but you should me quickly to get your stuff submitted. Try writting your old attendings to see if they will write letters for you. You should also have a letter from your current program director.

3) Program Directors are use to residents wanting to change fields. It needs to be done in a responsible and professional manner. You should let your program director know ASAP what your desire is. He/she can also help you navigate the switch.

 

[WhereNow]

Often I read posts on these forums about a certain person's situation and always wonder how it turned out for them, so I thought I'd give an update on my situation as well as take the opportunity to thank Sunlioness and Psychattending for the great advice. Shortly after my original posting, I met with my program director to let her know of my decision to switch into psychiatry. The following couple of weeks were pretty tough with having to tell each of my fellow residents the news. There was even a separate resident meeting and faculty education meeting to discuss the impact of my decision on my current program. But I can say, it has all turned out for the best. Everyone from residents to attendings has been nothing but professional and supportive. My ERAS application is finished, and I have received 10 interviews so far for psych residency. So for anyone thinking about switching specialties, I would agree with sunlioness and psychattending that it is best to first let your current program director know before making any moves. Best of luck to everyone this Match season.

 

[sunlioness]

Thanks so much for the update! I'm really glad to hear that things worked out. Good luck on your interviews!

 

[Manicsleep]

I switched during a transitional program.
Starting all over isn't that bad. I actually started as a PGY1 so I could have more electives. I was offered a pre-match at several programs but went through the match because the program I went to (my top choice) only went through the match. I also entered a little late but if you are a strong candidate its still time. I applied in about early November from what I remember and had to call old attendings and places I rotated to make calls to get me interviews because many places had stopped interviewing by the time they got my application etc.

Like it has been posted in another thread, phone calls/emails and letters from colleagues can go a long way. It helps to be a strong candidate with respect to numbers as well. It is really important that your current training director write a strong LOR.

 

[psychattending]

Wherenow,

Thanks for the update. I'm glad that it worked out for you. Most of us PDs are very understanding of this situation and don't get upset by it. If anything makes us upset, it is finding out late since it not only makes it harder for us to help the resident who is switching but it also makes it tough for us to recruit somebody else to fill the vacancy.

I'm glad to hear that you have heard back from 10 programs already.

 

[st2205]

I switched during a transitional program.
Starting all over isn't that bad. I actually started as a PGY1 so I could have more electives. I was offered a pre-match at several programs but went through the match because the program I went to (my top choice) only went through the match. I also entered a little late but if you are a strong candidate its still time. I applied in about early November from what I remember and had to call old attendings and places I rotated to make calls to get me interviews because many places had stopped interviewing by the time they got my application etc.

Like it has been posted in another thread, phone calls/emails and letters from colleagues can go a long way. It helps to be a strong candidate with respect to numbers as well. It is really important that your current training director write a strong LOR.

Interesting story. So what'd you switch from?

 

[Manicsleep]

A completely unrelated field. That is all I will say. I like some anonymity.

 

[Scrooge1]

I switched after an intern year in IM. I don't know what PGY-1 of a pathology residency consists of, but if it's mostly internal medicine type stuff you might be able to switch into a PGY-2 spot. Again, I don't know enough about pathology to say if this is feasible. You would have to find PGY-2 spots on your own by calling programs you're interested in and explaining your situation.

Talk with your current program director NOW. Tell him/her what you just told us. Part of their job is to provide mentorship and guidance so if they're worth their salt, they'll be supportive and even help you work through the decision making process of staying vs switching. My IM program director was wonderful in this regard. Also, if your current pathology program is affiliated with an institution that has a psychiatry residency, reach out to that PD as well. S/He might not have a spot open, but they will also have good advice and support. The absolute worst thing you can do, imo, is to keep your current program in the dark about your intent to leave. It's unprofessional and is actually a red flag for any psych program that will consider you. The one thing I was told over and over again when I interviewed for PGY-2 psychiatry positions was how impressed they were that I had kept my current program in the loop every step of the way.

What made you want to switch from IM to Psych?