Weak applicant on paper, how to choose what programs to apply to...

[TisNowd]

So I'm a 4th year gearing up for residency applications and am kind of struggling with figuring out which residency programs I should apply to, or which ones I even have a chance at. What I've done so far is go through all of Freida and look at which programs take DOs, if they have minimum board requirements, if they're heavily regionally biased, and if they've taken candidates from my school. I also looked at what percent of non-DOs were USMD vs. IMGs, as I figured I'd have a better shot at a place with 10% DOs and 90% IMGs than a place with 10% DOs and 90% USMDs (I figure the latter would be more competitive?). I'm planning on applying to around 60-70 ACGME programs initially (along with AOA programs), and I'm trying to figure out if there's some way to decide which ones I should apply to other than the ones that take a ton of DO students (not many).

My stats:

DO student
Preclinical: Bottom 10% of class (GPA tanked second year when curriculum changed)
COMLEX Level 1: <450 (didn't take Step)
COMLEX Level 2: Awaiting score, probably <500, not taking Step 2
Clinical grades: All P in a H/P/F system, grades are 100% determined by national shelf percentile (typically landed around 40th percentile nationally except for psych which was 75th percentile and IM which was 10th percentile).
Clinical Class rank: ~20th percentile
Clinical comments: Mostly glowing, no negative comments (I'm confident I'd have mostly honors if clinical comments were included as part of clinical grades...). Very strong comments from my psych and FM rotations.
LORs: 2 Psych letters (one Subi), two from other psych-relevant fields. I know 2 of them are pretty outstanding (was told by the authors) and the other two are supposedly strong.
No research in medical school, in a few clubs and decent volunteering, but not really anything psych related because I didn't think I'd go psych until halfway through 3rd year (thought I'd do FM)
Red Flags: Had to remediate my neuro block. I can explain why this happened and I crushed the remediation exam, but I'm worried this alone will kill my chances at many places.
General positives: I did both my 3rd year electives in psych and am doing several more psych rotations 4th year. I have neuro rotations set up to try and address that weakness in my app and am legitimately very passionate about entering this field.

In a nutshell, I'm a really hard working and enthusiastic student who is a terrible test-taker (thus why I didn't take USMLEs) and had a slip-up in a pre-clinical class important to psych. I also have limited research/psych ECs because I realized I'm really passionate about it so late.

So my question is, what's my next step? I'm applying AOA and ACGME, but I'd like to forgo the AOA match if I get enough interviews on the ACGME side as there aren't many AOA psych programs left and many are in the few places I don't want to end up. I realize I can't be picky and am okay ending up almost anywhere geographically or in terms of type of institution, but I'd like to try and stay within commuting distance of a decent sized city if possible. Am I on the right track? How else do I narrow down which programs I actually have a shot at getting an interview at without just shot-gunning every program in Freida? Am I making any stupid assumptions?

All help is greatly appreciated!

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[benlinus]

So I'm a 4th year gearing up for residency applications and am kind of struggling with figuring out which residency programs I should apply to, or which ones I even have a chance at. What I've done so far is go through all of Freida and look at which programs take DOs, if they have minimum board requirements, if they're heavily regionally biased, and if they've taken candidates from my school. I also looked at what percent of non-DOs were USMD vs. IMGs, as I figured I'd have a better shot at a place with 10% DOs and 90% IMGs than a place with 10% DOs and 90% USMDs (I figure the latter would be more competitive?). I'm planning on applying to around 60-70 ACGME programs initially (along with AOA programs), and I'm trying to figure out if there's some way to decide which ones I should apply to other than the ones that take a ton of DO students (not many).

My stats:

DO student
Preclinical: Bottom 10% of class (GPA tanked second year when curriculum changed)
COMLEX Level 1: <450 (didn't take Step)
COMLEX Level 2: Awaiting score, probably <500, not taking Step 2
Clinical grades: All P in a H/P/F system, grades are 100% determined by national shelf percentile (typically landed around 40th percentile nationally except for psych which was 75th percentile and IM which was 10th percentile).
Clinical Class rank: ~20th percentile
Clinical comments: Mostly glowing, no negative comments (I'm confident I'd have mostly honors if clinical comments were included as part of clinical grades...). Very strong comments from my psych and FM rotations.
LORs: 2 Psych letters (one Subi), two from other psych-relevant fields. I know 2 of them are pretty outstanding (was told by the authors) and the other two are supposedly strong.
No research in medical school, in a few clubs and decent volunteering, but not really anything psych related because I didn't think I'd go psych until halfway through 3rd year (thought I'd do FM)
Red Flags: Had to remediate my neuro block. I can explain why this happened and I crushed the remediation exam, but I'm worried this alone will kill my chances at many places.
General positives: I did both my 3rd year electives in psych and am doing several more psych rotations 4th year. I have neuro rotations set up to try and address that weakness in my app and am legitimately very passionate about entering this field.

In a nutshell, I'm a really hard working and enthusiastic student who is a terrible test-taker (thus why I didn't take USMLEs) and had a slip-up in a pre-clinical class important to psych. I also have limited research/psych ECs because I realized I'm really passionate about it so late.

So my question is, what's my next step? I'm applying AOA and ACGME, but I'd like to forgo the AOA match if I get enough interviews on the ACGME side as there aren't many AOA psych programs left and many are in the few places I don't want to end up. I realize I can't be picky and am okay ending up almost anywhere geographically or in terms of type of institution, but I'd like to try and stay within commuting distance of a decent sized city if possible. Am I on the right track? How else do I narrow down which programs I actually have a shot at getting an interview at without just shot-gunning every program in Freida? Am I making any stupid assumptions?

All help is greatly appreciated!

First off, congrats on getting into medical school and finishing, you should already be proud of yourself. Yes, your scores aren't "stellar" but you're not the only one. It's great that you have positive LORs. That will be helpful in beefing up your application and making it more competitive. The MD/DO bias is getting less and less every year, though it does still exist, but less so than 5-10 years ago. Apply to both osteopathic and allopathic programs broadly. You'll definitely have more luck with getting interviews at programs that are DO/IMG heavy but it's not always the case. Every program has their own criteria and what they are looking for in applicants and there could be something in your file they like, so don't be surprised if you hear back from a program you thought was a "stretch". If you apply broadly enough (it will be expensive), you will get at least a handful of interviews. Keep in mind that psychiatry is getting more competitive based on data from the past couple of years, so don't get discouraged. Be yourself at the interviews and don't make excuses. Be honest and show them how you are improving everyday and have a passion for the specialty. Be relaxed and have normal conversations. I always think it's nice to send a thank you card to the programs that you've interviewed with, handwritten, mailed to the program coordinator. It's not a necessity but lets them know you cared enough to do it, and it may help you "stick" in their mind during all of the applicant interviews and applicant review panels down the road. Ranking is fun and stressful at the same time. I always say rank by where you felt the happiest and would like to be, not based on who you think will rank you first (to be honest, you'll never know who will rank you first and likely would be surprised if you knew). Best of luck!

 

[TisNowd]

Thank you for the response! I guess I should have clarified that my biggest concern is "How do I make sure I get interviews?" I've been told by a few people that they thought I would do really well as long as I get enough interviews, so that doesn't really worry me yet. I'm just really scared that I won't get any. I know my board scores/lack of USMLE combined with my neuro failure and being a DO puts me at a huge disadvantage, and I'm afraid I'll just get screened out and tossed into the rejection pile before my app really even gets looked at :/

I am planning on applying to all of the AOA programs other than 2 or 3, but there are less than 20 left total, and all of the programs I'd really love to end up at are ACGME programs. My goal is to get 10 interviews from ACGME programs and I really am looking for advice on what I should be looking for in programs to get the interviews. What can I do to figure out which programs I actually have a shot at vs. which programs I shouldn't bother applying to?

Thank you again for the response and the encouragement!

 

[benlinus]

Thank you for the response! I guess I should have clarified that my biggest concern is "How do I make sure I get interviews?" I've been told by a few people that they thought I would do really well as long as I get enough interviews, so that doesn't really worry me yet. I'm just really scared that I won't get any. I know my board scores/lack of USMLE combined with my neuro failure and being a DO puts me at a huge disadvantage, and I'm afraid I'll just get screened out and tossed into the rejection pile before my app really even gets looked at :/

I am planning on applying to all of the AOA programs other than 2 or 3, but there are less than 20 left total, and all of the programs I'd really love to end up at are ACGME programs. My goal is to get 10 interviews from ACGME programs and I really am looking for advice on what I should be looking for in programs to get the interviews. What can I do to figure out which programs I actually have a shot at vs. which programs I shouldn't bother applying to?

Thank you again for the response and the encouragement!

There isn't too much that you can do to make sure you get interviews or even know who will choose you for an interview. What you can do is finish strong with your remaining rotations and grades, hopefully step 2 score will be better than step 1, have strong LORs, sometimes you can talk to your Dean and administration about your Dean's letter to make sure it looks how you want it to look (such as making it Psych specific, some schools will do this for you or ask), and if you find programs that you really like you can set up a 4th year rotation there and that will increase your chances (at my program a lot of the 4th year students who did rotations at the program were accepted into the residency class)

 

[GUH]

So I'm a 4th year gearing up for residency applications and am kind of struggling with figuring out which residency programs I should apply to, or which ones I even have a chance at. What I've done so far is go through all of Freida and look at which programs take DOs, if they have minimum board requirements, if they're heavily regionally biased, and if they've taken candidates from my school. I also looked at what percent of non-DOs were USMD vs. IMGs, as I figured I'd have a better shot at a place with 10% DOs and 90% IMGs than a place with 10% DOs and 90% USMDs (I figure the latter would be more competitive?). I'm planning on applying to around 60-70 ACGME programs initially (along with AOA programs), and I'm trying to figure out if there's some way to decide which ones I should apply to other than the ones that take a ton of DO students (not many).

My stats:

DO student
Preclinical: Bottom 10% of class (GPA tanked second year when curriculum changed)
COMLEX Level 1: <450 (didn't take Step)
COMLEX Level 2: Awaiting score, probably <500, not taking Step 2
Clinical grades: All P in a H/P/F system, grades are 100% determined by national shelf percentile (typically landed around 40th percentile nationally except for psych which was 75th percentile and IM which was 10th percentile).
Clinical Class rank: ~20th percentile
Clinical comments: Mostly glowing, no negative comments (I'm confident I'd have mostly honors if clinical comments were included as part of clinical grades...). Very strong comments from my psych and FM rotations.
LORs: 2 Psych letters (one Subi), two from other psych-relevant fields. I know 2 of them are pretty outstanding (was told by the authors) and the other two are supposedly strong.
No research in medical school, in a few clubs and decent volunteering, but not really anything psych related because I didn't think I'd go psych until halfway through 3rd year (thought I'd do FM)
Red Flags: Had to remediate my neuro block. I can explain why this happened and I crushed the remediation exam, but I'm worried this alone will kill my chances at many places.
General positives: I did both my 3rd year electives in psych and am doing several more psych rotations 4th year. I have neuro rotations set up to try and address that weakness in my app and am legitimately very passionate about entering this field.

In a nutshell, I'm a really hard working and enthusiastic student who is a terrible test-taker (thus why I didn't take USMLEs) and had a slip-up in a pre-clinical class important to psych. I also have limited research/psych ECs because I realized I'm really passionate about it so late.

So my question is, what's my next step? I'm applying AOA and ACGME, but I'd like to forgo the AOA match if I get enough interviews on the ACGME side as there aren't many AOA psych programs left and many are in the few places I don't want to end up. I realize I can't be picky and am okay ending up almost anywhere geographically or in terms of type of institution, but I'd like to try and stay within commuting distance of a decent sized city if possible. Am I on the right track? How else do I narrow down which programs I actually have a shot at getting an interview at without just shot-gunning every program in Freida? Am I making any stupid assumptions?

All help is greatly appreciated!

Things you have going for you:
Passed boards on first attempt (this is important)
Did 3rd year electives in psych
You have auditions set up for fourth year
It sounds like you're geographically flexible

Depending on where you audition, demonstrating that you're reliable, not afraid to work hard, and capable of holding a good conversation can take you really far when it comes time for the match.

 

[grapefruit17]

To match into a md program you need to do as many auditions as possible at low to mid level md programs and apply to as many programs that won't screen you out.

I think this will be an uphill battle for you on the md side but you should match on the aoa side just fine. Unfortunately psych is tougher than it used to be to match into. I am wishing you the best though and rooting for you.
Apply broadly, maximize audition rotations. Focus on places that aren't super competive

 

[Psychotic]

Apply to a crap ton of programs. Probably no fewer than 50.

 

[TisNowd]

To match into a md program you need to do as many auditions as possible at low to mid level md programs and apply to as many programs that won't screen you out.

I think this will be an uphill battle for you on the md side but you should match on the aoa side just fine. Unfortunately psych is tougher than it used to be to match into. I am wishing you the best though and rooting for you.
Apply broadly, maximize audition rotations. Focus on places that aren't super competive

My goal is to aim for as many "realistic" programs as I can, I guess I just don't know what programs are in what tier. I know the places like MGH and Yale are top tier, but there are so many that I'm just clueless about. For example I saw a thread on here saying that Minnesota was a stronger program than Mayo and that Mayo isn't really top tier. So how do I figure out which programs actually fall into that low to mid-level range? %IMG/DO? Reputation? The Doximity list? Cold call PDs/coordinators and ask if I'd even get looked at? I'm applying to so many programs that I just want to make sure most of them are places that won't just auto-reject me.

Apply to a crap ton of programs. Probably no fewer than 50.

That's the plan right now. I've got about 65 listed for ACGME and only a couple of them I know are reaches. If I don't get enough interviews within a month I'm going to send out more. I'm also applying to 16 or 17 on the AOA side (there's only about 20 left).

This is my other conundrum:

There are 2 or 3 cities that I really want to end up in and I've been told by some of my attending physicians who did residency there that I've definitely got a shot at some of the programs and have LORs from alumni from those programs. So the problem I'm worried about is what if I only get 3 or 4 or less to ACGME programs? Do I forgo the AOA match and gamble on getting into one of the programs that are my top choices or do I stick to the AOA match and end up somewhere that's way down my list? My goal is to get 8-10 ACGME interviews so I can skip the AOA match if I get interviews at my top programs. It's not that I have a problem with the AOA programs, but my top 7 or 8 choices right now are all ACGME, and most of the AOA programs are in locations I really don't want to end up at. I know I've got to take things one step at a time, but I really want to make sure I get enough interviews from ACGME programs that I can skip the AOA match if I choose to do that and not be freaking out about not matching at all.


Sorry for another long post. I'm just really anxious about the whole process since I haven't wanted something this bad in a long time and I know that on paper I'm a weak candidate. Thanks again to everyone who has responded, I really appreciate all the help, encouragement, and honesty.

 

[grapefruit17]

personally I wouldn't go by name. I would just look at websites/frieda for cutoffs and whatever place didn't have your cutoff, apply there.

 

[grapefruit17]

you're thinking too far ahead tho. apply to both matches, schedule your AOA interviews late in the season and see how many MD ones you get before you stress yourself out

 

[Lunzio]

Just an FYI but Psych AOA is even smaller this year - only 11 programs across the country (you can also already apply to them!).

 

[heartsink]

The MD/DO bias is getting less and less every year, though it does still exist, but less so than 5-10 years ago.

Not to hijack the thread but is this really accurate? I had generally gotten the impression it was trending in the opposite direction (especially in psychiatry which is a hidden gem becoming less and less hidden).

 

[MacDonaldTriad]

I am unaware of any data to show this. The number of psych positions going to DOs is up and the number going to domestic MDs is going up, and the number going to IMGs is dropping. This doesn't necessarily mean less bias against DOs. Programs that want to become no DO zones can do so more easily, but programs that want to replace IMGs with DOs can also do that more easily. I guess you can look at the percentage of unmatched DOs going into psychiatry, but only a minority of DOs go into psych and this would be confounded by DOs who apply to multiple specialties. It seems to me you would have to look at DO school data bases. If you could see where people applied and where they got in over time, this might show something. I do know you will find a wide variety of opinion on this. As some programs open their minds to DOs, some will be closing.

 

[TisNowd]

personally I wouldn't go by name. I would just look at websites/frieda for cutoffs and whatever place didn't have your cutoff, apply there.

That's part of the problem though, I don't know how hard those cutoffs are. I won't be applying to the places that have cutoffs of 550 or way above my score. Looking at Freida though there are quite a few places that say their cutoff is 500 but that the average Level 1 of their DO residents is below 500. So Idk how to find out which programs use that as a hard cutoff and which ones it's more of a "recommendation" for other than calling the programs directly.

Just an FYI but Psych AOA is even smaller this year - only 11 programs across the country (you can also already apply to them!).

This is part of why I'm worried about the situation, there aren't many AOA programs left, which is why I really want to get as many ACGME interviews as possible. I know I'm getting ahead of myself, but it's just been sitting in the back of my mind.

 

[grapefruit17]

That's part of the problem though, I don't know how hard those cutoffs are. I won't be applying to the places that have cutoffs of 550 or way above my score. Looking at Freida though there are quite a few places that say their cutoff is 500 but that the average Level 1 of their DO residents is below 500. So Idk how to find out which programs use that as a hard cutoff and which ones it's more of a "recommendation" for other than calling the programs directly.



This is part of why I'm worried about the situation, there aren't many AOA programs left, which is why I really want to get as many ACGME interviews as possible. I know I'm getting ahead of myself, but it's just been sitting in the back of my mind.

Rule of thumb is if you aren't sure then apply