What are my chances of matching?

[LeaveNoTrace]

US MD student
Taking research year
All Passes; 4th quartile.
No psych pubs yet; passed Step 1; didn't take Step 2.
Potential for needing to take a LoA for academic reasons due to miscommunication with dean.
My question: how likely am I to match psych with, say, a 250 step 2? Will the academic LoA hurt me badly?

P.S: Will I be able to match community family medicine with this application?

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[surfguy84]

The loa certainly won't help but I think you're otherwise good on paper.

 

[psych_0]

I don't do the filtering of applications, only the actual interviews. I can tell you from direct experience with the process I do not care about your Step 1 or Step 2 or your leave of absence. I assume that if you've been selected to interview at our program and made it through the filtration system thus far, the job is yours to lose on interview day.

Main tips. Write interesting hobbies that you truly enjoy talking about (most common boring ones I see: travel, cooking, video games). These aren't boring on their own, but describe what these mean to you more: i.e. where do you want to go, what do you cook, what games do you play?. Don't mention the word "lifestyle" when describing why you like psych. We ALL know psych is a lifestyle specialty, but throwing it in our face as a med student applying for residency is off putting and makes you look like a greedy douche, even if you're not. Don't dress like an idiot. Save the neon pink glass or clown tie for less formal occasions. Act like a normal human being. Do this and you will be ahead of other applicants.

Chose an early interview day if you can. You'll be compared to less applicants and likely score higher on any scoring system that the program is using to rate applicants. Our program doesn't let us go back and alter previous scores, so if you looked great compared to the 3 other people interviewing on the first interview day of match season for that year, but wouldn't have looked that great when compared to all applicants I've interviewed as a whole, you'll come out ahead. Personally, I hate this, but it is what it is. Also, the people interviewing you will be in a better mood , more enthusiastic and less burnt out from application season if you're interviewing early on. I have my fourth set of interviews in 2 weeks and I'm not dreading it, but also exactly looking forward to it.

 

[LeaveNoTrace]

The loa certainly won't help but I think you're otherwise good on paper.

Good on paper for psych...or good on paper for FM? I've heard that psych was getting fairly competitive; at my home program (mid-tier US MD school) my program director put it this way: I'd be DoA if I failed Step 2.

 

[surfguy84]

Good on paper for psych...or good on paper for FM? I've heard that psych was getting fairly competitive; at my home program (mid-tier US MD school) my program director put it this way: I'd be DoA if I failed Step 2.

Good for psych. A below average step 2 and I'd still say youre solid since coming from mid tier MD.

 

[b52bomber]

Are you taking a research year, as in, an actual research year where you will have published research/poster/results?

Or is this a 'research' year in the sense of a disguised LOA"?

What was this miscommunication with the dean and how will you explain it when asked?

You should have a USMLE Step 2 score before you apply (it is not required, but I think it would be very helpful).

Did you honors or HP any psychiatry rotations?

 

[LeaveNoTrace]

Are you taking a research year, as in, an actual research year where you will have published research/poster/results?

The goal is to have published research.
Didn't honors or HP any psychiatry rotations.
Am still talking about next steps with the dean.

 

[forchinet121]

The goal is to have published research.
Didn't honors or HP any psychiatry rotations.
Am still talking about next steps with the dean.

That’s a red flag..why would someone applying into a field not honor it? Or at the least HP?

 

[b52bomber]

The goal is to have published research.
Didn't honors or HP any psychiatry rotations.
Am still talking about next steps with the dean.

Is this a research year as well as a LOA? Or is the LOA after your research year?

What was your Step 1 score?

I would say that a LOA is at best has a mildly negative connotation. Not having a HP or H in the specialty may raise some questions, especially depending on whether or LORs came from that rotation or what your MSPE comments from that rotation say.

Psychiatry has become a competitive field with more competitive applicants. A 250 on Step 2 would be a good card to have, but that's a hypothetical.

 

[Stagg737]

OP, you need to have a Step 2 score. There are plenty of programs that will not consider an applicant for interview without one, especially if you have a concerning Step 1 score.

That’s a red flag..why would someone applying into a field not honor it? Or at the least HP?

This isn't true at all for psych. I know many people, including myself, who had no problems getting interviews or matching without honoring psych (or any rotations for that matter). Failed rotations (especially psych), would be much more problematic.

 

[b52bomber]

OP, you need to have a Step 2 score. There are plenty of programs that will not consider an applicant for interview without one, especially if you have a concerning Step 1 score.


This isn't true at all for psych. I know many people, including myself, who had no problems getting interviews or matching without honoring psych (or any rotations for that matter). Failed rotations (especially psych), would be much more problematic.

I agree with the above on the Step 2 score. I know for sure I was not given certain interviews (especially at my 'home' program) because my Step 2 score came out in December and all the interview slots had been filled.

 

[LeaveNoTrace]

Is this a research year as well as a LOA? Or is the LOA after your research year?

What was your Step 1 score?

I would say that a LOA is at best has a mildly negative connotation. Not having a HP or H in the specialty may raise some questions, especially depending on whether or LORs came from that rotation or what your MSPE comments from that rotation say.

Psychiatry has become a competitive field with more competitive applicants. A 250 on Step 2 would be a good card to have, but that's a hypothetical.

Step 1 was pass/fail; I passed. Practice tests are putting me around 240 for step 2; want to get up into the 250-260 range.

 

[television]

Why are you taking an LoA? One does not take one due to "miscommunication" with a Dean. Heck, most people barely speak with their dean throughout medical school.

I ask because this would certainly be brought up at some point during interviews.

A "research year" is something nobody does when applying for psych residencies (opposed to derm, ortho, etc).

 

[b52bomber]

I would sans the LOA you'd have a decent shot, a high Step score will help. a strong LOR from your rotation in absence of a H or HP will help.

I know when I interview candidates I definitely focus on the LOA, especially if I feel it's not represented correctly. I would definitely ask for a detailed explanation of what the miscommunication was, why was it needed etc. Also agree that research years are generally very rare, either someone has a major passion for research and it shows (MD/PhD, prior/current pubs, a school that supports it), or they've had to take a research year that's essentially a LOA in disguise.

 

[Freud20]

Psych is becoming more competitive. High scores and strong LOR will make it easier to match

 

[LeaveNoTrace]

I would sans the LOA you'd have a decent shot, a high Step score will help. a strong LOR from your rotation in absence of a H or HP will help.

I know when I interview candidates I definitely focus on the LOA, especially if I feel it's not represented correctly. I would definitely ask for a detailed explanation of what the miscommunication was, why was it needed etc. Also agree that research years are generally very rare, either someone has a major passion for research and it shows (MD/PhD, prior/current pubs, a school that supports it), or they've had to take a research year that's essentially a LOA in disguise.

Fair enough; thanks. Do you think I could match anywhere, or am I essentially DOA for any specialty because of this?

 

[b52bomber]

Fair enough; thanks. Do you think I could match anywhere, or am I essentially DOA for any specialty because of this?

You should certainly be able to match, I wouldn't say you are DOA for any specialty especially as a US MD student.

 

[LeaveNoTrace]

You should certainly be able to match, I wouldn't say you are DOA for any specialty especially as a US MD student.

Update: the LOA will be categorized as research. I am concerned that my STEP score isn’t up to snuff…I think I’ll get somewhere in the 220s or low 230s. Would that, plus a few papers, get me a chance at a community psych program in the Midwest?

 

[moto_za]

As a US MD you will be fine. Apply broadly to be safe.

 

[MacDonaldTriad]

Deans are measured by how may medical students don't match, so having an LOA categorized as research isn't surprising. The question is, will the MSPE (AKA Dean's letter) say anything about the reason for this? There is a section for "any disciplinary action". Be ready to discuss your motivation for a research year. If you are not convincing, or if there is something in your MSPE suggesting discipline, you need to be upfront about it. If you are vague, programs will assume the worst and our imaginations will likely be worse than the reality.

As MSPEs and step 1 scores become more vague, programs will become more concrete about step 2 and school quality. Everyone in undergraduate medical education would like to make the whole experience pass fail, but when you graduate, you will be ranked by graduate medical education programs as things are set up currently. Not my rules, just a messenger of reality. Of course, compelling stories will count and overcoming adversity and diversity counts, but that is not going to excuse multiple overt failures at some point. My fear is that there will be a moment when that point will become less forgiving for URMs who have anything negative on their records. If MSPEs / scores / LORs become even less transparent the movement towards pass fail could backfire on the goal of the movement. In the end, everyone is being judged and ranked. As the information used to do the ranking narrows, those elements left will be more exaggerated.

 

[Merovinge]

As MSPEs and step 1 scores become more vague, programs will become more concrete about step 2 and school quality. Everyone in undergraduate medical education would like to make the whole experience pass fail, but when you graduate, you will be ranked by graduate medical education programs as things are set up currently. Not my rules, just a messenger of reality. Of course, compelling stories will count and overcoming adversity and diversity counts, but that is not going to excuse multiple overt failures at some point. My fear is that there will be a moment when that point will become less forgiving for URMs who have anything negative on their records. If MSPEs / scores / LORs become even less transparent the movement towards pass fail could backfire on the goal of the movement. In the end, everyone is being judged and ranked. As the information used to do the ranking narrows, those elements left will be more exaggerated.

This seems like a very expected "unintended" consequence of the PF change to step 1 and less transparency on MSPEs. Is there an actual solution to inevitable need for a ranking system that PDs ultimately have to have that accomplishes any of the goals with these more recent changes?

 

[LeaveNoTrace]

Deans are measured by how may medical students don't match, so having an LOA categorized as research isn't surprising. The question is, will the MSPE (AKA Dean's letter) say anything about the reason for this? There is a section for "any disciplinary action". Be ready to discuss your motivation for a research year. If you are not convincing, or if there is something in your MSPE suggesting discipline, you need to be upfront about it. If you are vague, programs will assume the worst and our imaginations will likely be worse than the reality.

As MSPEs and step 1 scores become more vague, programs will become more concrete about step 2 and school quality. Everyone in undergraduate medical education would like to make the whole experience pass fail, but when you graduate, you will be ranked by graduate medical education programs as things are set up currently. Not my rules, just a messenger of reality. Of course, compelling stories will count and overcoming adversity and diversity counts, but that is not going to excuse multiple overt failures at some point. My fear is that there will be a moment when that point will become less forgiving for URMs who have anything negative on their records. If MSPEs / scores / LORs become even less transparent the movement towards pass fail could backfire on the goal of the movement. In the end, everyone is being judged and ranked. As the information used to do the ranking narrows, those elements left will be more exaggerated.

No, this was not even close to any kind of disciplinary action. I came into some money and was able to pursue research that I had wanted to do.

 

[MacDonaldTriad]

No, this was not even close to any kind of disciplinary action. I came into some money and was able to pursue research that I had wanted to do.

Good for you, and more support for my point if anyone who has to explain anything. If you have baggage that is out there and not explained, that is death. If is a health issue or something like that like having an opportunity, be clear.

 

[LeaveNoTrace]

So do you think that psych is still realistic with a 230 on step 2, bottom quartile class rank, no Honors, and no "red flags" like failing a rotation? It goes without saying that I will apply broadly - but I would be very happy with a rural community psych program in the Midwest. Might be able to get the Dean's Letter to explain exactly what happened...until now, I didn't know that sometimes students were "strongly suggested" to do things like take research years.

 

[Psychresy]

Are you really asking if getting into psych is still possible with the average score of applicants who get into psych? Lol c'mon man

 

[J ROD]

Since Step 1 is pass/fail now, I would think you have to have Step 2 done to be considered? I cannot comment on being competitive now given change in process. I do know I would have paid attention to any "different" situations. Simply, at my program we wanted folks that were not douche bags, "normal", would show up, work, and care, with basic competence. Step scores do not show me you can interview and do psych well. Personality etc in interview does.

 

[LeaveNoTrace]

Are you really asking if getting into psych is still possible with the average score of applicants who get into psych? Lol c'mon man

With a Step 2 score that is one full standard deviation below the average Step 2 score; Step 1 I took pass/fail.

 

[Stagg737]

With a Step 2 score that is one full standard deviation below the average Step 2 score; Step 1 I took pass/fail.

I'm a DO who was bottom quartile on Level 1, and two full standard deviations below the average on Level 2. I did not take Step exams. I had no problems getting interviews including multiple academic programs or matching within the past 6 years. So yes, you will be fine with your stats. Not getting ii's or matching would likely indicate some other issue with your application or just not applying to enough or the right programs.

 

[LeaveNoTrace]

I finally got my Step 2 score. It was...somewhere in the high 220s or low 230s, for what it's worth.

Psych's gotten more competitive in the last six years. In 2019, when I started medical school, the assistant dean told me that I could match psychiatry with failing boards scores as long as you retook and passed. I met with the program director of my home program a few months ago. She told me that applicants with failing boards scores were pretty much dead on arrival for psychiatry and that there was very little chance they could enter the field.

 

[Merovinge]

I finally got my Step 2 score. It was...somewhere in the high 220s or low 230s, for what it's worth.

Psych's gotten more competitive in the last six years. In 2019, when I started medical school, the assistant dean told me that I could match psychiatry with failing boards scores as long as you retook and passed. I met with the program director of my home program a few months ago. She told me that applicants with failing boards scores were pretty much dead on arrival for psychiatry and that there was very little chance they could enter the field.

While that is true, you did not fail anything so you are not dead on arrival. If you specifically did not match it would almost certainly be because of too narrow of applications (e.g. only top tier places) or some other deficit on your application/personality during interview day. Particularly if you can have a good discussion about your fairly unique LoA and how that lead you to where you are now.

 

[FamousLinen]

So do you think that psych is still realistic with a 230 on step 2, bottom quartile class rank, no Honors, and no "red flags" like failing a rotation? It goes without saying that I will apply broadly - but I would be very happy with a rural community psych program in the Midwest. Might be able to get the Dean's Letter to explain exactly what happened...until now, I didn't know that sometimes students were "strongly suggested" to do things like take research years.

You will match. If a rural community program in the Midwest is your goal, I would focus more on some psych EC and/or becoming a well-rounded person over trying to get more research. You will match though unless you're horrible at interviews, will it be a top 10 program? Probably not. But a lot of places will show you love.

 

[LeaveNoTrace]

You will match. If a rural community program in the Midwest is your goal, I would focus more on some psych EC and/or becoming a well-rounded person over trying to get more research. You will match though unless you're horrible at interviews, will it be a top 10 program? Probably not. But a lot of places will show you love.

Thank you for the advice. Ideally, I would be at a decent university program on the West Coast. Pipe dreams, perhaps; that being said, I would love to practice psychiatry and would be very OK with a community program in South Dakota. I dislike the climate in the South and don't plan on applying there; hopefully, that will not be a problem.

 

[Dantes]

I finally got my Step 2 score. It was...somewhere in the high 220s or low 230s, for what it's worth.

Psych's gotten more competitive in the last six years. In 2019, when I started medical school, the assistant dean told me that I could match psychiatry with failing boards scores as long as you retook and passed. I met with the program director of my home program a few months ago. She told me that applicants with failing boards scores were pretty much dead on arrival for psychiatry and that there was very little chance they could enter the field.

This seems extreme. Psych is more competitive than it used to be, but if you look at the numbers it's still not very competitive compared to other specialties. If you can take some fourth year electives in psych, or even better a psych sub-I and honor that, I think that will look good in addition to any research or other specialty-specific ECs you have, especially as a US MD.

 

[LeaveNoTrace]

This seems extreme. Psych is more competitive than it used to be, but if you look at the numbers it's still not very competitive compared to other specialties. If you can take some fourth year electives in psych, or even better a psych sub-I and honor that, I think that will look good in addition to any research or other specialty-specific ECs you have, especially as a US MD.

I don't know about that. I'm glad for the message of hope. That said, I'm just repeating what I was told as a medical student at a mid-tier US MD school.