Welcome to the Future... please help me get in

[deleted1041327]

My goal in medicine was to be a psychiatrist. It was the reason I went to medical school (instead of going into clinical psychology). I ended up SOAPing into internal medicine (IM). I tried in good-faith giving IM a chance and reasoned I will complete my 3-year IM residency and then re-apply for psychiatry. However half-way through my intern year I realized it would be pointless to complete IM. A few program directors I e-mailed agreed that though I may be a stronger applicant after completing 3 years of IM I would likely not be using most of what I learned as an internist if I wanted to do psychiatry. In either case by the time I decided to try and re-apply to psychiatry as a PGY-1 it was already late into the ERAS application season. I attempted to SOAP however I stood little chance with such short notice and limited options.

I do intend on apply again to psychiatry during the 2020-2021 ERAS cycle.
- Should I stay put in my IM residency as a PGY-2 or should I try to do some research in psychiatry?
- What can I do to be a stronger applicant beside taking Step 3?
- Should I just do integrative medicine (presumably after completing IM)?
- Should I quit medicine and social distance myself on a beach in ______?
- Do I really need psychiatry or does psychiatry need me more?

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[J ROD]

Your last statement tells me you should stay in internal medicine. So you hate it that bad to go back and risk what you have?

 

[TexasPhysician]

While not impossible, you’ve found yourself in a tough spot. Obviously your best chance was pre-IM for a PGY-1. After SOAP, you could have been applying for PGY-2 spots in psych while you were an intern. Now you have even further reduced funding as you do pgy-2 IM. I would keep going with IM for now as it’s the only sure thing that you have. You could try for a pgy-2 spot during the next round of applications. Your odds of matching psych after completing IM residency is even lower as funding is further reduced.

My residency and other residency programs that I’ve been involved with automatically screens out applicants that completed another residency.

Keep trying, but I would also start looking into IM options that would be most enjoyable to you.

 

[MacDonaldTriad]

I agree, at this point I would keep going. I also think that not all GME funding is CMS based. VAs, and to some extent public hospitals with local funding don't get much or get very little CMS funding so it could be possible to get into psych later.

 

[Sushirolls]

A Bird in the Hand is Worth Two in the Bush

 

[deleted1041327]

My last statement was a bit(e) tongue-in-cheek. A misplaced attempt to illustrate my frustration with a reaction formation. But I see what you mean.
I don't really think psychiatry needs me at all (aside from notion that patients' need doctors for mental healthcare). Yet, conversely I don't need psychiatry, as I need sustenance and shelter, or even happiness.

I didn't realize programs based selections based on CMS funding. Some of my co-residents explained it to me. I also understood once you are fully licensed (i.e. complete a residency) you are a financial asset because you can generate revenue independently. So maybe it isn't all that hopeless if I finish an IM residency, after all wasn't IM then psychiatry residency the traditional route of being double-boarded? (Not saying that was my initial goal.