what are programs looking for in an applicant

[knowhow]

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Hi all,

I plan on applying to psychiatry residency programs this fall and need some insight on how best to boost my application. I am an US IMG and older grad ('07) and was formerly in a FM program after graduating med school. Unfortunately, I was not enjoying FM at all and resigned from the program after a few months. At the time I thought I didn't want to continue with medicine so I've been working in healthcare financial management (I have a finance BA degree). I've had a successful career in this field but now I'm really missing clinical medicine. After giving it much thought, I think that psychiatry is the best fit for my interests. I think I was miserable in FM b/c of the lack of time you get to spend with your patients and not being able to develop a relationship with them. I definitely have stellar communication skills and it's my biggest asset.

So, I know I'm at a disadvantage b/c I graduated so long ago. My step scores aren't stellar. I passed Step 1 on the 1st attempt, CS on the 1st attempt, CK on the 3rd attempt, and Step 3 on the 1st attempt. I did bad on CK b/c I scheduled too many tough rotations during that time, was studying for CS, on top of travelling across the country for 10 IVs- and I was in a rush to pass my tests in time for the ROL. So given my red flags, what would be the best strategy to boost my app? I've been engaging in research for the past year (albeit cardiovascular and not psych related). I was thinking about either taking up a psych research project, volunteering at a mental health clinic, or maybe even trying to set up a psych observ/externship. Which one of these do you think would be the most beneficial? What else should I do/work on? What are the biggest things program directors look for?

I have a lot of friends who matched into psych who had much worse stats than me, but I think being recent grads gave them an advantage. I hope there is some hope for me.

Any suggestions and feedback would be much appreciated!

 

[vistaril]

Hi all,

I plan on applying to psychiatry residency programs this fall and need some insight on how best to boost my application. I am an US IMG and older grad ('07) and was formerly in a FM program after graduating med school. Unfortunately, I was not enjoying FM at all and resigned from the program after a few months. At the time I thought I didn't want to continue with medicine so I've been working in healthcare financial management (I have a finance BA degree). I've had a successful career in this field but now I'm really missing clinical medicine. After giving it much thought, I think that psychiatry is the best fit for my interests. I think I was miserable in FM b/c of the lack of time you get to spend with your patients and not being able to develop a relationship with them. I definitely have stellar communication skills and it's my biggest asset.

So, I know I'm at a disadvantage b/c I graduated so long ago. My step scores aren't stellar. I passed Step 1 on the 1st attempt, CS on the 1st attempt, CK on the 3rd attempt, and Step 3 on the 1st attempt. I did bad on CK b/c I scheduled too many tough rotations during that time, was studying for CS, on top of travelling across the country for 10 IVs- and I was in a rush to pass my tests in time for the ROL. So given my red flags, what would be the best strategy to boost my app? I've been engaging in research for the past year (albeit cardiovascular and not psych related). I was thinking about either taking up a psych research project, volunteering at a mental health clinic, or maybe even trying to set up a psych observ/externship. Which one of these do you think would be the most beneficial? What else should I do/work on? What are the biggest things program directors look for?

I have a lot of friends who matched into psych who had much worse stats than me, but I think being recent grads gave them an advantage. I hope there is some hope for me.

Any suggestions and feedback would be much appreciated!

I'd pick a couple programs that:

1) accept lots of imgs every year
2) are very noncompetitive and struggle to get decent people

and then do month long observerships at each. You want to take those months to try to show that you are interested, fit in, and get to know people who can make decisions for you. The point of the observerships wouldnt be to get more experience but rather to increase your chances at those two programs.

The biggest problem in your application is the fact that you have already washed out of one application. The other parts of your application are question marks/red flags to varying degrees(img, graduated a long time ago, low scores and 2 ck failures), but that FM residency that you washed out of is going to be your biggest problem.

Good luck....you have an uphill battle, but psych is definately your best(and maybe only) shot.

 

[OldPsychDoc]

1) I think that if you've passed Step 3, the Step 2 issue is moot--we usually look at fails on Step 2 as being a bad prognostic sign for 3, which is what really matters to be licensable and stay in the program.

2) You've GOT to have something that screams "Psych is my calling now". Given that, we definitely would not extend an interview if you didn't have at least one stellar, glowing, we-want-this-person-in-OUR-program-but-we-can't-stop-them-from-applying-to-you letter from a psychiatrist NOW--i.e. not from 2006. Therefore, if you truly want Psych, you'll need that externship/observership or something similar in order to get that letter. You also need to convince us that you're not just a fickle person who really doesn't know what they want to do in life. What do you mean "psych is the best fit"? How do you know that if you haven't actually done any psych? What can you put in your PS and CV to make me believe that about you? (Also wouldn't hurt to have a letter from the FM program saying how painfully disappointed they were with your decision to leave, that they still miss you...etc.) I know this stuff is a really tall order--but that's the way a lot of programs, even many of the IMG-friendly "less competitive" 🙄 programs are going to look at you.

3) Be aware that you've already burned a year of the GME funding assigned to you. Hopefully you can get clinical credit for at least some of your FM months applied to your PGY1 psych year. Otherwise your program will have to fund you on its own for up to 2 years of your training--which can be a problem for some hospitals, and is likely to get worse, given Medicare funding shifts.

Good luck.

 

[vistaril]

1) I think that if you've passed Step 3, the Step 2 issue is moot--we usually look at fails on Step 2 as being a bad prognostic sign for 3, which is what really matters to be licensable and stay in the program.
.

I think at many programs it's a factor. Simply because it documents 2 bad outcomes in the person's medical education.

I mean many/most programs don't use step 1 and 2 results as simply a prognostic measure for step 3. Heck we know that someone who has a 215 on step 1 and 2 is 99%+ likely to pass step 3 just as someone who has a 245 on step 1 and 2, but the difference in that level of performance is still going to be very relevant to most programs.....not because it has anything to do with concerns about step3 but because it speaks to what a person has done in the past.

I do agree that this person really needs to show up on a few observerships and really come across as a person motivated in psych, hard working, passion for psych, etc....

 

[knowhow]

I sincerely thank everyone for their advice. I will definitely step it up and work on getting an observership/externship and a strong LOR. I know it will be an uphill battle but I'm giving it my best shot....wish I could have done things differently but the past is out of my hands at this point.