To Successful/Fellow Bottom Quartile Applicants,

[goldenretrieverhaver]

I'm a bottom quartile MS4 through and through interested in psychiatry. {Passed all my classes, passed step 1, passed all my rotations (near honors on 1-2 core rotations), and got a low 23- score on step 2. Decent (ish?) research with some leadership. Thankfully, I think at least a couple really nice LORs both clinical and research related, and at a well respected T20 school that matched well this past match cycle}. As the looming threat of application season becomes more real everyday, I'm starting to feel suffocated with the idea of not matching, especially reading through how every other anxious applicant seems to have at least honored a decent chunk of their core rotations. I was just never able to excel from a test-taking standpoint no matter how much people like me on my rotations. Everything just feels bad lol.

Medical school has really torn apart my confidence in being able to do well in much. The only thing I have to look forward to are a few exciting sub-i's/electives before ERAS is due.

If anyone would be willing to share, how did you find ways to stand out when applying to residency? or how did you manage any stress/anxiety that came with the uncertainty of matching? or even, how did you keep your chin up when going through this process knowing there are a bunch of weak spots/lukewarm areas on your application?

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[Angus Avagadro]

Well, first you need to target residencies where your stats are within their metrics. Then target a few " Reach" programs where you might stand out or have some pull. LORs from grads of the program, the PD at your school, etc..
Many people who don't match don't apply broadly enough or don't apply to programs where their stats are competitive. If you have less competitive stats, then apply even more broadly and target a program. Do an elective or audition there making sure to shine. Good luck and best wishes.

 

[esob]

I recently honed in on the # of clerkships honored stats for the 2023 Texas STAR and was surprised that the average # for Psych was 2. The Step 2 avg was 244. At a rough glance, at least a quarter of applicants had 0 clerkships honored. Psych, in general, is significantly less focused on stats and really puts an emphasis on fit.

I know people with stats hovering in the surgical specialty range that didn't match and others who could arguably be at risk for failing step 3 based on previous scores that matched at good programs.

I feel like I had a great interview season and matched favorably, so I'll share some of the things that I think went right and a couple of things that I would change if I could do it again.

1. Apply broadly but emphasize the geographic areas designated in the supplemental application. For example, if you have ties to Texas, I would strategical shotgun apps to every state that touches a state I had ties to. I used this approach, and probably 1/3 of my invites came from states I had no direct tie to but did border a state I had a tie to. Apply to more programs than you think you need. The people I know of that didn't match to psych almost universally applied to too few programs.

2. Attend every PS workshop you can regarding psych and comb through your PS to ensure you have surgically engineered your PS to fit the data. For example, data from a PD survey was presented regarding things that were turn-off topics for PS's. The usual suspects were there (politics, religion, etc.), as well as some surprising items such as personal experience with a family member's mental health struggles. Positive topics included interest in therapy and inspiring mentors.

3. Make sure your PS is flawless. Use a professional editing service for your final essay. These services go beyond AI algorithms such as Grammarly and apply typical post-grad level polishing. People reviewing apps need a reason to pass on applications, and I've heard a PD say that a single grammatical error sends a strong message about attention to detail.

4. Do a deep dive into the programs that invite you before the interview day. Often you will know who your interviewers are ahead of time, and it pays dividends to google them for some background reference. Probably the most helpful thing for me this cycle was finding youtube videos where an interviewer was on a local news segment regarding one topic or another. Not only does it provide you an opportunity to get over the first time meeting someone jitters, but it also allows you to tie elements about your interest in the program into topics that they are passionate about.

Things that I would do differently:

- I would get my letters earlier. It was stressful waiting on letter writers to finish at the last minute. I would also ensure to periodically remind those who agreed to write a letter. I had one strong letter writer that agreed six months in advance but later said they couldn't do it because I reminded them too close to the due date.

- I would have personalized my essays to select programs. My #1 choice had one interviewer that said, "You'd be a perfect fit, except that you talked about this certain patient population and we have almost no exposure to that population." Aside from that interviewer, I felt like the rest were great. It's speculation ofc, but I feel like if I had taken the time to target my essay to that program, I would have increased my chances of being ranked higher.

- I would have applied to more reach schools. My step scores were average, so I only applied to a few top-tier programs. Ironically, about 1/3 of those programs invited me to interview. I think this reinforces the idea that psych is at least as much about fit as it is about stats.