What do "top" psychiatry residencies look for / will average clerkship grades matter?

[woof_iamadog]

I am an MS3 just finishing up my clerkship year. I am at a school where we do 1 1/2 years of preclinical, so I am actually only at the beginning of my third year even though I'm done with clerkship year (I still have 2 full years of medical school left).

Nearing the end of my clerkship year, I realize that I was by far the happiest on psychiatry and I am pretty much set on the field. I can easily see myself having a very fulfilling and meaningful career as a psychiatrist. My ideal career would be a mix of outpatient psychotherapy/med management (50/50 mix) and some emergency psychiatry shifts (I loved CPEP). I want to go to a well-regarded program with good psychotherapy training. I have read that places like MGH/McLean, Columbia, Cornell, Yale, etc have good psychotherapy training. I realize this is just a somewhat random list of "top" psych programs with good psychotherapy training from what I read on the internet. I need to talk to a psych advisor to really figure out which programs are best for my interests. Regardless...

MY QUESTION: What do these "top" psychiatry residencies look for in an applicant? Will average clinical grades matter? I go to a top 10 school, tried hard during clerkship year and got a lot of great comments, but I only Honored psychiatry (high pass in everything else). Will this count against me at any of the programs I mentioned?

My plan is to take as many psychiatry electives as possible, and do psych research (which I am starting in a month) to try and help improve my chances. I have just been reading that psych is getting more and more competitive, and I'm stressing about how the aforementioned programs would look at my clerkship grades.

Thank you.

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[FlowRate]

You honored psych at a top 10 school and HP'd the rest so your grades will be fine UNLESS you went to UChicago or somewhere that similarly gives out so many honors that getting one high pass puts you in the bottom half of your class. That's not to say you're a "shoo-in," just that it's reasonable to apply.

 

[Monocles]

^agreed.

OP you'll be fine. I'm sure that you'll be a competitive applicant.

Also don't forget to add Cambridge to that list! They are probably the most psychotherapy oriented out of the harvards.

 

[dl2dp2]

You can probably get into a top 20 program, but it's not a guarantee that you'll get into a top 5-10 program.

Typically research and other leadership-oriented activity is the most important for the top academic departments, as they are looking for rainmakers, either from building a research program or otherwise. Doesn't mean they always get them, but that's what they are looking for.

 

[woof_iamadog]

Thanks for the replies everyone. What step 1 score should I aim for if I want to go to a top 10 (we take step 1 after clerkship year at my school)? Also, is there anything else I can do to improve my chances? Starting psych research soon, but would a research year where I get a few more pubs make me more of a sure shot?

 

[clausewitz2]

Thanks for the replies everyone. What step 1 score should I aim for if I want to go to a top 10 (we take step 1 after clerkship year at my school)? Also, is there anything else I can do to improve my chances? Starting psych research soon, but would a research year where I get a few more pubs make me more of a sure shot?

I think if you have a reliable way to pre-determine your step 1 score you should probably quit now and organize a series of paid seminars where you impart your secrets as it will be far more lucrative than this field will ever be.

 

[FlowRate]

Thanks for the replies everyone. What step 1 score should I aim for if I want to go to a top 10 (we take step 1 after clerkship year at my school)?

As good as possible. Who knows? Maybe you'll discover a love of dermatology.

 

[woof_iamadog]

Haha. Fair enough. Someone told me that many people with solid psych-oriented apps and high board scores (i.e. 250+ step I) had trouble matching at top 10 psych programs so I was trying to see if any score would rule me out. Sounds like these numbers are hard to find, so I'll just do my best and see what happens. Thanks!

 

[clausewitz2]

Haha. Fair enough. Someone told me that many people with solid psych-oriented apps and high board scores (i.e. 250+ step I) had trouble matching at top 10 psych programs so I was trying to see if any score would rule me out. Sounds like these numbers are hard to find, so I'll just do my best and see what happens. Thanks!

Those people sometimes get into trouble matching because a) characterological issues b) the charisma of a banana slug or c) they apply ONLY to a small handful of top programs.

Don't do that.

 

[whopper]

An issue with any application process with many more applicants vs spots is it tends to follow 2 phases. The first phase is there's too many to go through without being able to give each applicant the due diligence anyone deserves. E.g. if you got 1000 applicants per 1 spot and there's 10 spots there's no way in heck someone could go through all of them.

It's during this first phase where several applications are tossed out without being given a fair evaluation, and I cannot blame program directors and others involved in this process for doing so. One simply cannot read more than a dozen applications and keep everything going on in your head. It's at this stage where superficial characteristics such as simply just the board-score might make someone not make the cut. Will "average" grades matter? Possibly but other characteristics such as your school and your USMLE scores will also be considered. I can't definitely answer the question because this will matter on how each program handles their application process. I will say that most PDs are smart enough to know that institutions grade differently with some of them being much more hard on their students so they tend to look at other factors such as the USMLE as a type of equalizer.

I've mentioned this before. Despite my rants against board exams they are the best metric in studies that is reliable and accurate to predicting how well a candidate will be for a job. Its one of those things I hate that holds in the evidenced-based data. I hate it because it takes the human element out of the process and there are several great candidates who don't score well on exams whose real value becomes known when you work with them in person for several weeks. Unfortunately that type of exposure can only be given to a such a small number of people relative to the number of applicants.

 

[NewmansOwn]

I graduated recently from a so-called top 10 program. Anecdotal by nature, but I was privy to the profiles, including board scores, of the matched students each year and was repeatedly surprised by how low some of the scores were. My unscientific feeling is that as psychiatry becomes more competitive, matching into it is becoming more like getting into Harvard. Rather than impressive metrics on objective measures being paramount, we're starting to see that more unique things are likely to be your ticket in. I suspect the student who established a counseling or psychiatric consultation arm of the local clinic serving an urban indigent population with a 218, or who won a medical literature/humanities writing contest would be more likely to match at my program these days than an honors student with a 255 and little else on the CV. An impressive research background, regardless of board scores, also made you pretty much a shoo-in at my program.

 

[kopftonmd]

An impressive research background, regardless of board scores, also made you pretty much a shoo-in at my program.

Out of curiosity, if an applicant has an impressive research background outside of the sciences (like medical humanities), does their research have as much weight as someone with a similar number of scientific publications? I'd always thought no but figured I'd ask anyways.

 

[NewmansOwn]

Out of curiosity, if an applicant has an impressive research background outside of the sciences (like medical humanities), does their research have as much weight as someone with a similar number of scientific publications? I'd always thought no but figured I'd ask anyways.

That's a good question. I would guess these days that would get you quite a bit of positive traction in the match, mostly due to the uniqueness of it. The Ivy League programs in particular would eat that **** right up.

That said, if your goal is a psychiatry research career you'd probably be at a disadvantage for competitive dedicated research time/electives as compared to your colleagues who are coming in with field specific-research.

 

[downwithDTB]

If there are 10 top 20 programs there are 10 PDs and 10 chairs and each has their own unique priorities, experiences and biases. They each have many even more diverse people under them reading and judging applications. I value class quartile as a measure of overall normed performance including clerkships. Some will value their personal personality judgement of you. Some your writing. Some aoa more than humanism, some humanism more than aoa. Some like number of publications others care only about impact factor of first author publications.

I agree that top candidates are probably those viewed as having clearly demonstrated ability to succeed at something valued by academic medicine beyond grades/steps... beyond that, it's PDs whim.

As far as the good on paper candidate who doesn't match well. I'd bet that 99/100 they are either terrible interviewers, make it clear that they value going home early over learning OR most likely have a significant red flag in their application that they aren't aware of... A bad letter of rec, a bad internet footprint, ect. I've definitely seen applications from otherwise strong people with a kiss of death LOR.

 

[whopper]

I suspect the student who established a counseling or psychiatric consultation arm of the local clinic serving an urban indigent population with a 218, or who won a medical literature/humanities writing contest would be more likely to match at my program these days than an honors student with a 255 and little else on the CV. An impressive research background, regardless of board scores, also made you pretty much a shoo-in at my program.

Very much agree.

Thing with medical doctors are the overwhelming majority are clinicians. Researchers on the other hand stand out. Someone being interested in research and having a long list of research experience shows to me they are much more likely of being a great critical thinker vs someone who can just score well on an exam. As many of us know some people score great on exams but those incredibly board scores don't translate into good critical thinking or clinical skills.

 

[OldPsychDoc]

Out of curiosity, if an applicant has an impressive research background outside of the sciences (like medical humanities), does their research have as much weight as someone with a similar number of scientific publications? I'd always thought no but figured I'd ask anyways.

I interviewed an MD/PhD last year whose PhD was in anthropology. He'll be an amazing niche academic someday.
Also knew an MD/PhD medical historian in residency. Look at careers of folks like Vanderbilt's Jonathan Metzl (Dying of Whiteness, Protest Psychosis, etc.) for examples of how these folks can thrive. That said, there aren't ever going to be too many of them!