What does it take to land a psychiatry residency?

[CTR]

I'm a 3rd year DO student interested in psychiatry. My COMLEX-1 score is above average, and class rank is in the upper 25%. I'm not taking the USMLE, but I plan on applying to several MD programs as there aren't that many DO programs. I will be taking a psychiatry elective rotation early in 4th year to make sure it's something I want to do for a living, and hopefully to get a strong letter of recommendation, but other than that my experience with psychiatry is mostly limited to my core 3rd year rotation.

Based on this information, what are my chances of being able to specialize in psychiatry? I don't need to attend a very prestigious program; I just want to go somewhere that will train me well, and I imagine that any program should be able to do that. I also understand that some programs require the USMLE, so naturally I won't be applying to those ones, but for those that accept the COMLEX, how strong would you say my application is? And, in addition to what I have provided here, what else goes into making a strong applicant?

Thank you!

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[nitemagi]

I'd start by just making a list of those programs that accept the comlex without the USMLE. Somehow I'd suspect there's not a huge number. But I may be wrong.

 

[peppy]

I am confident that you will be able to get into an ACGME psych program. Psych has had a small uptick in competitiveness compared to a few years ago, but it's not like we're talking about derm here. You will be fine as long as you apply to enough programs and go to enough interviews.

My advice would be to decide right now if one of the DO psych programs is likely to be one of your, say, top 3 choices. If so, sure, apply to the AOA match hoping that you'll match there and if not then you still have a chance in the ACGME match.
If you really don't think you would prefer a DO program, don't bother applying to the DO programs. As you may know, the AOA match is before the ACGME match, and if you match at an AOA program you're pulled out of the ACGME match. You don't want to end up wasting time interviewing at DO programs only to end up not going into the AOA match because your heart is set on an ACGME program and you want a chance to see if you match at the ACGME one. If your true goal is to go for an ACGME program, you'd be better off using the time you would have spent doing DO interviews at several more ACGME interviews to improve your overall chance of matching.

I took the USMLE and while some programs did seem to consider it a nice bonus, my feeling is that board scores are not given as much weight in Psych as they are in many other specialties. I think most psych programs are really just looking for someone who seems emotionally healthy, easy to work with, and has a sincere interest in psych. If you can demonstrate that, I think you have a solid chance at most programs.
I would suggest looking at the websites for programs you're interested in to see if they list the medical schools their current residents came from - pay attention to how many DOs they already have in their residency. That is often a good indicator of how truly DO friendly the place is - I think it's more reliable than just a program telling you they take DOs or the COMLEX (since some programs may say that just to avoid ill will when in reality they don't take DOs as seriously).
Good luck to you. I am sure you'll be fine.

 

[CTR]

Thank you for the replies...

You will be fine as long as you apply to enough programs and go to enough interviews.

How many would you say is enough?

 

[zac16125]

I'm a third year DO student as well, and judging from my research almost every pysch program accepts COMLEX scores (I haven't looked into programs such as the Ivy League schools, but even a top notch program like Pitt/UPMC does not require USMLE if you have COMLEX scores). I've also looked at the websites of a number of schools which are not the "top-tier" programs but which I consider to have very good reputations and almost all of them currently have, or in the past have had, DO's in their programs. Also, your COMLEX score is decent, should be approximately top 1/3 once all the number are in. Judging from what I've seen and read you should be able to get an allo residency without much of a problem. My question to you is, why not take USMLE Step 2? I only took COMLEX level 1 but I intend to take both for Step 2, if nothing else just to make it easier on programs by having comparitive numbers.

 

[zac16125]

More specifically, I looked at the list I have compiled of the programs I may be interested in. Of the 20, 15 currently have DO residents, 2 do not, and 3 do not list their residents so I am not sure if they do or not.

 

[myPsychAlt]

Being a DO is certainly not going to hurt you for psych. Hell, even Pitt/WPIC had a St. George's student invited for an interview when I was there.

 

[atsai3]

Probably depends on where you are applying. I doubt UCSF would take a D.O. (Forget for the moment that their chief of child psych is a D.O.)

-AT.

 

[zac16125]

I quick look at the 2010 match stats shows slightly greater than 1 in 10 pysch residents at allo programs are osteopathic pysicians. Approximately 2.5 out of 10 pysch residents are FMG's.

I couldn't find the # of DO applicants compared to the # that matched specifically for pysch. I did however, find that approx 71% of DO's as a whole, who applied to allo programs matched. Compared to 47% of US-born FMG, 39% of foreign born FMG, and 93% of US schooled MDs. I would think pysch specifically would be higher than the overall average, since it isn't as competitive as many of the specialities included in these numbers.

 

[CTR]

My question to you is, why not take USMLE Step 2?

Thank you for your input. To answer your question above, I simply don't want to take another exam if I don't need to.

 

[235750]

Hi CTR,

Over-eager OMS2, psychiatrist wanna-be here. I've spent far too much time in the last 1.5 yrs talking to people about this question. I've had the pleasure of speaking with PDs at psychiatry conferences about DO applicants, and it's good news: the vast majority take the COMLEX.

As people have pointed out, the numbers for you (as an applicant) are fantastic. Crack open your old step 1 First Aid or have a gander at the acgme website. You'll find that the median score last year in psychiatry was a 208 with a range starting at passing, and the top 10% of successful applicants scored around 225. Now, if you were to successfully match into a derm residency with a 225, that would put you below the bottom 5th percentile. Add in that over a quarter of your competition are FMGs/IMGs and it's clear that things are in your favour.

Currently, psychiatry is the least competitive specialty. That's not to say that one should be cocky and that you'll get exactly what you want. But, if you apply broadly and are flexible with where you live, then there should not be a problem.

It's not all good news though. The consensus that I got from speaking with PDs was that hell will freeze over before a DO is accepted to many (but not all) of the ivy leagues. It's not that there has never been or will be an outstanding DO pscyh applicant, but rather it is a part of their principles. Like many osteopathic schools, my college has DO-only residencies in IM, plastics, general surgery, etc, so we can't throw stones. There's a lot of silliness on both sides, so just accept that you're not going MGH.

Also, from talking to SDN members as well as real-life PDs, psychiatry doesn't care much about research experience. I've busted my bum getting 5 (soon to be 6) publications + more abstracts accepted in some mediocre/very good journals (IFs 1.5-8), and the response I got was a shoulder shrug and a 'meh, good for you'. So, don't stress about that part of your application. Really wish I knew that before I started all that work!

Congrats on your excellent step 1 score and good luck to you. Keep us updated!

 

[TexasPhysician]

Also, from talking to SDN members as well as real-life PDs, psychiatry doesn't care much about research experience. I've busted my bum getting 5 (soon to be 6) publications + more abstracts accepted in some mediocre/very good journals (IFs 1.5-8), and the response I got was a shoulder shrug and a 'meh, good for you'. So, don't stress about that part of your application. Really wish I knew that before I started all that work!

Congrats on your excellent step 1 score and good luck to you. Keep us updated!

I think research is very program specific. My program doesn't care much, but others care quite a bit. Mostly the top 10 or so "name" programs care the most, but that may be a problem for DO's (I really have not idea on DO's competitiveness in psych). Stanford collects residents that are research heavy. MGH has a cupboard full of MD/phd's. Cornell stockpiles research students like nuclear weopons. Ok maybe that is a bit of an exageration, but research isn't useless. Trust me.

 

[atsai3]

Also, from talking to SDN members as well as real-life PDs, psychiatry doesn't care much about research experience. I've busted my bum getting 5 (soon to be 6) publications + more abstracts accepted in some mediocre/very good journals (IFs 1.5-8), and the response I got was a shoulder shrug and a 'meh, good for you'. So, don't stress about that part of your application. Really wish I knew that before I started all that work!

At which programs did you get this kind of a response? Most of the highly competitive programs care a great deal about your publications. They cannot make up for critical deficiencies in the rest of your application, but they can certainly help more than a 'meh, good for you'.

-AT.

 

[235750]

My program doesn't care much, but others care quite a bit. Mostly the top 10 or so "name" programs care the most

At which programs did you get this kind of a response? Most of the highly competitive programs care a great deal about your publications.

I guess what I was trying to say was that those top programs that weight publications more are not realistic for us DOs. At the end of the day then, research doesn't matter very much, and it would be wise instead to put that time into school/standardized exams/rotations, etc.

They cannot make up for critical deficiencies in the rest of your application, but they can certainly help more than a 'meh, good for you'.

I heard that a lot too, that publications can't make up for deficiencies, but the thing is: if you do research right, it will cause deficiencies in other parts of your life. You can bet that my 6 pubs have cost me a lot in terms of my class ranking. Getting published requires significant sacrifice, and as you say, the sacrifice is not worth it (again, saying this as a DO who is not eligible for the top name program)