What does it take to match?

[Superior_Colliculus]

I'm a few years away from the match process, but I was wondering what you all think it takes to match into psych in today's environment? What should I be doing to give myself the best chances? What does the typical profile of a successfully matched applicant look like right now?

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[FlowRate]

An average matched psych applicant is still roughly an average or even slightly below average med student. And psychiatrists are still physicians. So just focus on trying to do the best you can in med school as a whole. I don't think anyone needs to have some sort of life-long proven passion/involvement in psych to match the way you might in uber competitive fields like derm. Stated another way, rocking med school is far more important than spending time on psych projects. Maybe this is less true if you're at a school that's P/F only, I'll leave it to people more in the loop on that to comment.

Even successfully matching at top psych programs is much more about being an excellent med student overall more than it is about anything psych specific. It's still very common for students matching at competitive programs to have realized they wanted to do psych only during their psych rotation and to have had interests and productivity in other fields because they were initially aiming for something else.

 

[Superior_Colliculus]

An average matched psych applicant is still roughly an average or even slightly below average med student. And psychiatrists are still physicians. So just focus on trying to do the best you can in med school as a whole. I don't think anyone needs to have some sort of life-long proven passion/involvement in psych to match the way you might in uber competitive fields like derm. Stated another way, rocking med school is far more important than spending time on psych projects. Maybe this is less true if you're at a school that's P/F only, I'll leave it to people more in the loop on that to comment.

Even successfully matching at top psych programs is much more about being an excellent med student overall more than it is about anything psych specific. It's still very common for students matching at competitive programs to have realized they wanted to do psych only during their psych rotation and to have had interests and productivity in other fields because they were initially aiming for something else.

It seems that psych is different from other specialties in that a higher board score doesn't seem to directly increase your chances as much as it does in other specialties. Also, isn't it competitive for DOs?

 

[FlowRate]

It seems that psych is different from other specialties in that a higher board score doesn't seem to directly increase your chances as much as it does in other specialties. Also, isn't it competitive for DOs?

Everything is more competitive for DO's.

That's because the threshold step scores required to be considered / competitive for psych are lower. AFAIK that's also true for other uncompetitive specialties. Top programs in all specialties care about board score (IM vs IM at MGH are totally different things the same way Psych vs Psych at MGH are.)

 

[Merovinge]

Everything is more competitive for DO's.

That's because the threshold step scores required to be considered / competitive for psych are lower. AFAIK that's also true for other uncompetitive specialties. Top programs in all specialties care about board score (IM vs IM at MGH are totally different things the same way Psych vs Psych at MGH are.)

It's hard when you are a med student and hear everyone categorically ranking specialties to understand what is happening. Yes every Derm program is more competitive than most other things, however in the range of middle or low competitive specialties the top programs are still very competitive. It's not like it's easy to roll up to MGH for IM. I just didn't understand this concept at a M2. Similarly many community psychiatry programs are still quite attainable for many applicants despite the rise of our field overall.

 

[Stagg737]

It's hard when you are a med student and hear everyone categorically ranking specialties to understand what is happening. Yes every Derm program is more competitive than most other things, however in the range of middle or low competitive specialties the top programs are still very competitive. It's not like it's easy to roll up to MGH for IM. I just didn't understand this concept at a M2. Similarly many community psychiatry programs are still quite attainable for many applicants despite the rise of our field overall.

Everything is more competitive for DO's.

That's because the threshold step scores required to be considered / competitive for psych are lower. AFAIK that's also true for other uncompetitive specialties. Top programs in all specialties care about board score (IM vs IM at MGH are totally different things the same way Psych vs Psych at MGH are.)

IM is a little different though, it's almost more like applying to med schools than any other fields in the match where you have to be the best of the elite candidates out of all med students just to get looked at. The top few programs in the nation are as competitive as specialties like neurosurg or ortho. Not really the same for psych or FM or EM or most other less competitive specialties where you have to be strong but not the best of the best of all med students to get in.

For DOs, things are competitive but not completely unattainable anywhere in psych, which is not the same in other fields. There are some threads on here about DOs applying to psych but they're 10+ years old. Even then when the bias was far more prevalent programs like Yale and Columbia (the latter being notoriously anti-DO in other fields) still interviewed and accepted DOs. At the same time there were IM programs (I recall NYU specifically) directly posting on their websites that they didn't consider DO applicants at all.

ETA: some links to previous threads discussing this. Times have changed, especially after the merger and requirements regarding necessary testing, which has made psych and medicine in general friendlier to DO applicants. Also, reading those threads some of you all have been posting in this sub-forum for a long time

Psychiatry Residencies that say NO to DOs....

Hey guys...I was wondering if you could help provide a list of programs that are not considering DOs....whether they are transparent about the subject or not. I have a feeling Yale is one of them.

forums.studentdoctor.net

FAQs for DOs interested in psychiatry residency

Inspired by splik's FAQs for IMGs a few of us have put together something for DOs interested in psychiatry residencies. This thread is intended to address a few DO specific questions. Multiple members contributed their thoughts and, while each of us had different circumstances and interests...

forums.studentdoctor.net

 

[calvinhobbes]

Psych is very DO friendly, but when you apply I would still apply to as many programs as you can because it is always smarter to apply to more, interview at as many as you can, and rank every program so you are not left unmatched, because SOAPing is a horror show.

Everything is getting more competitive but just focus on studying hard, getting good LOR, volunteering/research and knowing how to beef up your ERAS application, etc. And of course, having a genuine interest in psych which would show in your interview and your application. Psych (like any speciality?) wants people who really want to do Psych.

 

[psych_0]

As someone who has sat through a bunch of residency interviews and seen a lot of candidates.....just act normal and you'll be ahead of the pack. Don't dress with loud clothes, wild colored hair. Try to act even remotely interested in the specific program where you are interviewing (i.e. read at least the bio about the person interviewing you). Come with enthusiasm, don't look bored, ask questions that cannot be easily Google'd, no weird offensive jokes, etc.

You would be SHOCKED how much just acting like a normal human being sets you apart from the other candidates. Also would not stress about the LORs, unless your LOR comes from like Stephen Stahl or someone recognizable from the program/area. With the rise of ChatGPT, I am just going to assume every LOR comes from that or a generic template unless there is a real life story that is unique to you buried in the LOR. Last year I skimmed through 3 LORs that were so generic they used blatantly incorrect pronouns the whole way through.

Honestly, probably the same with the personal statement. ChatGPT is so good and I have too little time to actually cut/paste personal statements into an AI-bot checker, that I'm just going to assume every personal statement has been generated by ChatGPT and barely skim them.

tl;dr act normal, you'll be fine.

 

[calvinhobbes]

As someone who has sat through a bunch of residency interviews and seen a lot of candidates.....just act normal and you'll be ahead of the pack. Don't dress with loud clothes, wild colored hair. Try to act even remotely interested in the specific program where you are interviewing (i.e. read at least the bio about the person interviewing you). Come with enthusiasm, don't look bored, ask questions that cannot be easily Google'd, no weird offensive jokes, etc.

You would be SHOCKED how much just acting like a normal human being sets you apart from the other candidates. Also would not stress about the LORs, unless your LOR comes from like Stephen Stahl or someone recognizable from the program/area. With the rise of ChatGPT, I am just going to assume every LOR comes from that or a generic template unless there is a real life story that is unique to you buried in the LOR. Last year I skimmed through 3 LORs that were so generic they used blatantly incorrect pronouns the whole way through.

Honestly, probably the same with the personal statement. ChatGPT is so good and I have too little time to actually cut/paste personal statements into an AI-bot checker, that I'm just going to assume every personal statement has been generated by ChatGPT and barely skim them.

tl;dr act normal, you'll be fine.

This is superb advice!

 

[Stagg737]

I'm a few years away from the match process, but I was wondering what you all think it takes to match into psych in today's environment? What should I be doing to give myself the best chances? What does the typical profile of a successfully matched applicant look like right now?

Not sure what it will look like in 2-3 years, but the data for 2018 (when I matched) and 2022 in charting the outcomes for DOs in psychiatry are almost identical with the only notable differences in summary of stats being that the match rate for DOs in psych increased from 72.7% (216/297) in 2018 to 86.6% (298/344) in 2022 and the number of contiguous ranks in psychiatry increasing from 8.7 to 10.3. In 2018, there were 9 people who ranked 10 or more programs who didn't match, and in 2022 everyone who ranked at least 10 programs matched. Test scores were actually LESS important in 2022 by the numbers. So overall, DOs have actually been doing better in psychiatry for matching than they did 5 years ago when I matched.

My N=1 is that I matched in 2018 as a relatively poor DO candidate. I was in bottom quartile in for my first 2 years, failed neuro 2 in M2 year and had to repeat it, scored <450 on Level 1, scored <425 on Level 2, and did not take USMLE. Straight P's in M3 year where the entire grade was dependent on our percentile on the shelf exams. I did have glowing comments from my attendings which were included in my Dean's letter and was told at multiple interviews my LORs were very strong. More than one interviewer commented that my app interested them because everything from M3 seemed so discordant with my pre-clinical stats which I had a good explanation for (school had a massive curriculum shift between M1 and M2 which killed me). In total, I applied to 75 programs in the MD match and around 10 in the DO match (last year it existed I believe). I only got 1 ii in the first 2-3 weeks after apps were released and was starting to get down/anxious, but then got 5 in the span of one morning and withdrew from the DO match. Ended up with 9 ii's total, attended 8 and ranked all 8, and matched at my first choice mid-tier academic program where I'd done an audition rotation at an affiliated hospital (not the main academic center). I can't be sure what would have happened at the other programs, but a former classmate ahead of me at a program I interviewed at later said I wouldn't have had to worry about going unmatched if I hadn't ended up at my top choice, so probably would have matched anyway.

I was really anxious going into it because I knew that by the numbers I looked pretty bad and didn't decide on psych until winter/spring of M3 year, so didn't have an app heavily geared toward psych. Imo I was successful because I researched every program in FRIEDA and applied broadly and realistically, I had strong comments from attendings and in LORs, and was a strong interviewer. As Psych_0 alluded to, my "strong interviewing skills" really just meant I was able to hold a normal conversation and had solid explanations for some of the more concerning points in my application. I was actually only directly asked about my test scores at one program I interviewed at ("What is your plan to make sure you pass Level 3?"), which is where I matched.

Summary: Early on, just focus on doing well in class and on boards. If you know you're interested in psych, do an EC or two related to it and/or do some research and present to show interest. Work hard during clinical years and don't be unpleasant to be around to avoid negative comments. If you can get direct quotes put in your Dean's Letter that show you're a strong candidate, wonderful. Try and get strong LORs, but definitely avoid ones where you'll be portrayed negatively in any way. Make sure everything is submitted on time and apply broadly and realistically. Programs that have accepted DOs from your school or area should be considered as well as anywhere with a solid geographic connection. Once you get ii's, be prepared to answer any potential problem areas in your app and just be a normal human being. Most interviews are more like a conversation than an interrogation, treat them as such.

 

[TexasPhysician]

At face value, psychiatry in general is not a difficult match. Average med student is at an advantage.

Unlike other specialties, the interviews will pry more to discover whether you are “weird”, damaged, cry easily, or become agitated.

While we may be accepting of mental health issues in general, seeing them during the interview can be an automatic rejection.

There are program chairs that will ask tough questions. Crying will make you unrankable. I’ve personally seen other faculty love an applicant and a program chair swipe the name off the board completely over this. Some faculty will even argue a bit to see how you respond.

Like-ability and interviews can play a big role on where you land on a rank list. Those US AMG’s that ranked 10 programs and didn’t match are almost guaranteed to have an interview problem.

One applicant I recall did an away rotation and performed excellently. Despite academic red flags, this person moved up on the rank list because of how well the away rotation went. I wouldn’t say the away rotation demonstrated any superior knowledge. It did demonstrate interest and the ability to bond with faculty and residents well.

 

[Bartelby]

Unlike other specialties, the interviews will pry more to discover whether you are “weird”, damaged, cry easily, or become agitated.
...
There are program chairs that will ask tough questions. Crying will make you unrankable. I’ve personally seen other faculty love an applicant and a program chair swipe the name off the board completely over this. Some faculty will even argue a bit to see how you respond.

Interesting! I had never heard of this. Maybe that explains one PD who was outright offensive with some things he asked (at a very good program) and who basically treated me like dirt, leaving me wondering why they invited me to interview in the first place. I kept my cool and remained polite but dropped that program to dead last on my list thinking that is not the kind of person I want overseeing my training, and that the program having chose such a person as PD was a red flag.

Every other interview I did that year the people were very nice and at most quirky, never rude or mean. I suspect programs that do what you mention above might weed out some unstable applicants but scare off those who have options!

 

[clausewitz2]

At face value, psychiatry in general is not a difficult match. Average med student is at an advantage.

Unlike other specialties, the interviews will pry more to discover whether you are “weird”, damaged, cry easily, or become agitated.

While we may be accepting of mental health issues in general, seeing them during the interview can be an automatic rejection.

There are program chairs that will ask tough questions. Crying will make you unrankable. I’ve personally seen other faculty love an applicant and a program chair swipe the name off the board completely over this. Some faculty will even argue a bit to see how you respond.

Like-ability and interviews can play a big role on where you land on a rank list. Those US AMG’s that ranked 10 programs and didn’t match are almost guaranteed to have an interview problem.

One applicant I recall did an away rotation and performed excellently. Despite academic red flags, this person moved up on the rank list because of how well the away rotation went. I wouldn’t say the away rotation demonstrated any superior knowledge. It did demonstrate interest and the ability to bond with faculty and residents well.

It is fine and unobjectionable for residency applicants to be in therapy. It will not prevent you from matching.

I should not, however, know extensive details of what your therapy has entailed after speaking to you for five minutes at lunch. This is fatal and happened multiple times in the few years I was involved in residency interviews.

 

[zenmedic]

Im a DO that matched this past cycle around NYC. In short all of medicine is getting more competitive, but psych is not close to competitiveness when compared to fields like anesthesia, radiology, surgery, etc. Any average DO med student should be able to match if they apply broadly, don't have red flags on their application, and are normal on interviews. Feel free to reach out with any questions.

 

[FlowRate]

It is fine and unobjectionable for residency applicants to be in therapy. It will not prevent you from matching.

I should not, however, know extensive details of what your therapy has entailed after speaking to you for five minutes at lunch. This is fatal and happened multiple times in the few years I was involved in residency interviews.

Reminds me of the great-on-paper applicant who basically insisted on telling every interviewer her trauma history despite questions not being directed toward that at all.

 

[Mad Jack]

Reminds me of the great-on-paper applicant who basically insisted on telling every interviewer her trauma history despite questions not being directed toward that at all.

I knew a program that basically picked candidates based on their board scores that ran into problems with no less than 3 residents like that

 

[LeaveNoTrace]

At face value, psychiatry in general is not a difficult match. Average med student is at an advantage.

Unlike other specialties, the interviews will pry more to discover whether you are “weird”, damaged, cry easily, or become agitated.

While we may be accepting of mental health issues in general, seeing them during the interview can be an automatic rejection.

There are program chairs that will ask tough questions. Crying will make you unrankable. I’ve personally seen other faculty love an applicant and a program chair swipe the name off the board completely over this. Some faculty will even argue a bit to see how you respond.

Like-ability and interviews can play a big role on where you land on a rank list. Those US AMG’s that ranked 10 programs and didn’t match are almost guaranteed to have an interview problem.

One applicant I recall did an away rotation and performed excellently. Despite academic red flags, this person moved up on the rank list because of how well the away rotation went. I wouldn’t say the away rotation demonstrated any superior knowledge. It did demonstrate interest and the ability to bond with faculty and residents well.

I mean. I have a Step 2 of ~230, pass on all clinical rotations, pass on peds Sub-I, research year with possibly 1 paper, and honors on psych Sub-I. I'm still concerned about matching psych - and honestly, concerned about matching anywhere, period, in any specialty. No, I haven't failed anything...but things are getting more and more competitive these days. Do you think that I could match 1) a community psych program 2) a community FM program?

 

[TexasPhysician]

I mean. I have a Step 2 of ~230, pass on all clinical rotations, pass on peds Sub-I, research year with possibly 1 paper, and honors on psych Sub-I. I'm still concerned about matching psych - and honestly, concerned about matching anywhere, period, in any specialty. No, I haven't failed anything...but things are getting more and more competitive these days. Do you think that I could match 1) a community psych program 2) a community FM program?

There is no reason you couldn’t match the majority of psych programs from what you’ve stated.

 

[LeaveNoTrace]

There is no reason you couldn’t match the majority of psych programs from what you’ve stated.

Thank you. I would honestly be happy pretty much anywhere; I'd prefer not to be in a bottom-of-barrel "sweatshop" program, or in the Southeast. I don't really like the climate there. I'd be very happy with a community program in rural Wisconsin or something like that. Do you think that I have a shot at academic programs at places like the University of Connecticut or Ohio State or the University of Nebraska, or is that aiming a bit too high for - let's be honest - an applicant that is probably one cut above the bottom of the barrel? Yes, I'm a US MD...but have a low Step score and mediocre-at-best clinical performance.

 

[phonyreal98]

Thank you. I would honestly be happy pretty much anywhere; I'd prefer not to be in a bottom-of-barrel "sweatshop" program, or in the Southeast. I don't really like the climate there. I'd be very happy with a community program in rural Wisconsin or something like that. Do you think that I have a shot at academic programs at places like the University of Connecticut or Ohio State or the University of Nebraska, or is that aiming a bit too high for - let's be honest - an applicant that is probably one cut above the bottom of the barrel? Yes, I'm a US MD...but have a low Step score and mediocre-at-best clinical performance.

You're a couple cuts above bottom of the barrel, based on what you told us, you're probably within a standard deviation of average as far as all medical students go. I have some familiarity with one of the programs you stated and you'd be competitive there.

 

[LeaveNoTrace]

You're a couple cuts above bottom of the barrel, based on what you told us, you're probably within a standard deviation of average as far as all medical students go. I have some familiarity with one of the programs you stated and you'd be competitive there.

Interesting - my school's advisor told me to apply to every single FM program and that psych was a Hail Mary for me, and that I'd be lucky to get interviews. Thanks for the vote of confidence. I'm from a mid-tier US MD program for what it's worth.

 

[Stagg737]

Interesting - my school's advisor told me to apply to every single FM program and that psych was a Hail Mary for me, and that I'd be lucky to get interviews. Thanks for the vote of confidence. I'm from a mid-tier US MD program for what it's worth.

Either your school advisor knows something about your app you're not telling us (reasons for research year maybe?) or they don't know what they're talking about. I interviewed at U Conn several years ago and you can see my stats above. I would have been very happy matching there and really enjoyed the interview day and attending their grand rounds. They fell to 4th or 5th on my rank list purely because of geography.

 

[Celexa]

Interesting - my school's advisor told me to apply to every single FM program and that psych was a Hail Mary for me, and that I'd be lucky to get interviews. Thanks for the vote of confidence. I'm from a mid-tier US MD program for what it's worth.

Some places are going completely overboard in the scare mongering. Psych is not a hail Mary for you and your desires are achievable. Applying to family med as a backup is reasonable, but you certainly should not apply to every program but rather it would make sense to make a list of family med programs in places you would be happy to live and/or have connections to to serve as your backup plan.

This does assume you don't have some clear red flag like a professionalism concern.

 

[TexasPhysician]

Interesting - my school's advisor told me to apply to every single FM program and that psych was a Hail Mary for me, and that I'd be lucky to get interviews. Thanks for the vote of confidence. I'm from a mid-tier US MD program for what it's worth.

There is a red flag you aren’t mentioning or your advisor is being extremely conservative. Psych is not a hard match

 

[shoenberg3]

Psychiatry IS getting more competitive, but it's still pretty easily obtainable for US-MDs with reasonable scores and no significant red flags. Which you clearly are, unless you are not telling us something.

 

[LeaveNoTrace]

I don't have any red flags as far as I know. Except possibly earning only a Pass on my pediatric Sub-I. There have been some comments that might be concerning - on one rotation I was told that my bedside manner needed work, which I was receptive to. However, there's nothing like professionalism concerns or shelf failures or anything like that on my record. I took the research year because I came into some money and was thus able to pursue unfunded research for a year.

 

[psych_0]

I don't have any red flags as far as I know. Except possibly earning only a Pass on my pediatric Sub-I. There have been some comments that might be concerning - on one rotation I was told that my bedside manner needed work, which I was receptive to. However, there's nothing like professionalism concerns or shelf failures or anything like that on my record. I took the research year because I came into some money and was thus able to pursue unfunded research for a year.

As someone who interviews residency candidates, I can assure you we're not reading through your entire Dean's letter or MSPE. I skip straight to the psych rotation and see what people had to say about you there. If you're getting bashed in the comments of your psych rotation, yea that's a red flag and I'm definitely asking you about it during the interview.

 

[LeaveNoTrace]

If you're getting bashed in the comments of your psych rotation, yea that's a red flag and I'm definitely asking you about it during the interview.

Fair enough; hopefully I get interviews. I'm concerned about being unmatched even if I apply very broadly to both psych and FM.

I did manage to do better in my psych Sub-I, earning honors and favorable comments. Hopefully this makes a difference.

 

[LeaveNoTrace]

There is a red flag you aren’t mentioning or your advisor is being extremely conservative. Psych is not a hard match

Yeah...my advisor told me that my chances of matching psych were ~25% and for FM around 90 percent...US citizen IMGs with Step 2 scores like mine have even odds. For IMGs matching psych...do they frequently have something that stands out that doesn't usually show up on paper? Things like connections, excellent publication history, or LoRs from influential attendings.

 

[Stagg737]

Yeah...my advisor told me that my chances of matching psych were ~25% and for FM around 90 percent...US citizen IMGs with Step 2 scores like mine have even odds. For IMGs matching psych...do they frequently have something that stands out that doesn't usually show up on paper? Things like connections, excellent publication history, or LoRs from influential attendings.

Again, unless there is something we're missing or you're hiding, your advisor is just wrong.

 

[Merovinge]

Again, unless there is something we're missing or you're hiding, your advisor is just wrong.

There's got to be more to that story and haven't worked through the denial about in on the anonymous internet forum stage of things. I find it very hard to believe an advisor at a US MD school would just be wildly misinformed.

 

[whopper]

Again, unless there is something we're missing or you're hiding, your advisor is just wrong.

Agree with the above and I used to be a professor in a medical university. Psych usually is easy to get in so long as you pass your exams, graduate, and are from an allopathic school in America. So unless there's some other red-flag like you have some blemish on your record I don't know why they'd say the above to you.

 

[LeaveNoTrace]

Agree with the above and I used to be a professor in a medical university. Psych usually is easy to get in so long as you pass your exams, graduate, and are from an allopathic school in America. So unless there's some other red-flag like you have some blemish on your record I don't know why they'd say the above to you.

My advisor might be conservative in general. I have a friend that took three LoAs, failed a clerkship, and has a 220 step 2. He had good reasons for the LoAs - family trouble with his younger brothers. They all cut ties with their parents...let's leave it at that. My advisor said that matching FM would be an uphill battle for him.

I have some comments like these on my primary care and psychiatry third year rotations, although I did well on my psych Sub-I and earned good comments and Honors:

"LeaveNoTrace knows which skills need improving, such as patient rapport and oral presentation. He actively sought feedback from the first day and made his team aware of his goals; it was apparent that he wanted to work on his skills. I would recommend that he continue to work on oral presentation, problem prioritization, and elimination of irrelevant information. I advised him to tell a story that made sense and focused on the dilemma he was addressing. He was a good team player and showed initiative and motivation. He unfortunately needed to leave the rotation early because of a broken leg. I would advise him to continue working on his oral presentations and build a rapport with patients by actively listening and paying attention to nonverbal cues. LNT is functioning at the Interpreter level."

Is this a red flag?

 

[psych2028]

Hijacking the thread a bit, sorry. How much of an uphill battle am I facing with a failed step attempt? Passed on 2nd try. US MD/MPH. High pass in all rotations so far, halfway through third year. Couple psych research projects, good connections to home dept, have shown interest in psych for years including working in psych related areas before med school (addiction, homelessness & trauma, etc).

 

[Celexa]

There's got to be more to that story and haven't worked through the denial about in on the anonymous internet forum stage of things. I find it very hard to believe an advisor at a US MD school would just be wildly misinformed.

Independent of the OPs particulars I do not find this hard to believe. It is genuinely hard to stay up to date on the situation in the match. Even though psych is still an average-difficult match *in general*, several schools were caught flat footed in the shift from "literally as long as you're breathing you can match" to "you need to actually put some effort in and pay attention" and had some bad results. Some places are now scaremongering.

 

[Celexa]

Hijacking the thread a bit, sorry. How much of an uphill battle am I facing with a failed step attempt? Passed on 2nd try. US MD/MPH. High pass in all rotations so far, halfway through third year. Couple psych research projects, good connections to home dept, have shown interest in psych for years including working in psych related areas before med school (addiction, homelessness & trauma, etc).

Matching is certainly viable but you need to have a solid step 2 score in before data transmits in ERAS. It's good advice for anyone but an absolute necessity if you failed step 1.

 

[FlowRate]

IM is a little different though, it's almost more like applying to med schools than any other fields in the match where you have to be the best of the elite candidates out of all med students just to get looked at. The top few programs in the nation are as competitive as specialties like neurosurg or ortho. Not really the same for psych or FM or EM or most other less competitive specialties where you have to be strong but not the best of the best of all med students to get in.

Somehow I missed this post earlier. Overall I agree, matching at top IM programs is probably still way more competitive than matching at top psych programs, although the top 10-20% of candidates at top psych programs look pretty close to the average interviewee at top IM programs.

My advisor might be conservative in general. I have a friend that took three LoAs, failed a clerkship, and has a 220 step 2. He had good reasons for the LoAs - family trouble with his younger brothers. They all cut ties with their parents...let's leave it at that. My advisor said that matching FM would be an uphill battle for him.

I have some comments like these on my primary care and psychiatry third year rotations, although I did well on my psych Sub-I and earned good comments and Honors:

"LeaveNoTrace knows which skills need improving, such as patient rapport and oral presentation. He actively sought feedback from the first day and made his team aware of his goals; it was apparent that he wanted to work on his skills. I would recommend that he continue to work on oral presentation, problem prioritization, and elimination of irrelevant information. I advised him to tell a story that made sense and focused on the dilemma he was addressing. He was a good team player and showed initiative and motivation. He unfortunately needed to leave the rotation early because of a broken leg. I would advise him to continue working on his oral presentations and build a rapport with patients by actively listening and paying attention to nonverbal cues. LNT is functioning at the Interpreter level."

Is this a red flag?

Is that comment going to show up on your application? At my med school, we had formative (critical, but hidden from applications) and summative (less critical, on MSPE) comments. That comment reads like a formative eval which wouldn't show up on MSPE at my med school. It is concerning although it sounds like your sub-I evals were more generous and show improvement.

Hijacking the thread a bit, sorry. How much of an uphill battle am I facing with a failed step attempt? Passed on 2nd try. US MD/MPH. High pass in all rotations so far, halfway through third year. Couple psych research projects, good connections to home dept, have shown interest in psych for years including working in psych related areas before med school (addiction, homelessness & trauma, etc).

I'm assuming the failure is on Step 1? If you can rock Step 2 it'll be less concerning. It might get you auto-screened out of more competitive psych programs but I doubt it'd screen you out of average programs.

 

[TexasPhysician]

Hijacking the thread a bit, sorry. How much of an uphill battle am I facing with a failed step attempt? Passed on 2nd try. US MD/MPH. High pass in all rotations so far, halfway through third year. Couple psych research projects, good connections to home dept, have shown interest in psych for years including working in psych related areas before med school (addiction, homelessness & trauma, etc).

I’d plan to be screened out of the top half of all programs. Pass step 2 first try and you still stand a good chance to match somewhere in psych as a US MD.

 

[LeaveNoTrace]

Is that comment going to show up on your application? At my med school, we had formative (critical, but hidden from applications) and summative (less critical, on MSPE) comments. That comment reads like a formative eval which wouldn't show up on MSPE at my med school. It is concerning although it sounds like your sub-I evals were more generous and show improvement.

I don't think so...although supposing it did, how big a red flag would this be? In this thread I'm seeing doctors tell people with Step failures that they stood a chance at community programs; both the program director and my academic advisor have said that applicants with those are DoA and their chances of matching psych are very slim. The people here seem considerably more sanguine about applicants' chances...not only for psych but also for FM.

 

[Stagg737]

I don't think so...although supposing it did, how big a red flag would this be? In this thread I'm seeing doctors tell people with Step failures that they stood a chance at community programs; both the program director and my academic advisor have said that applicants with those are DoA and their chances of matching psych are very slim. The people here seem considerably more sanguine about applicants' chances...not only for psych but also for FM.

I went to a mid-tier academic program and while it was a huge red flag, applicants were not DoA if the rest of their app was solid. Those comments in your MSPE are what I'd consider a minor red flag. Meaning probably going to raise some eyebrows and won't help, but are unlikely to be something that will prevent you from getting interviews by itself.

Somehow I missed this post earlier. Overall I agree, matching at top IM programs is probably still way more competitive than matching at top psych programs, although the top 10-20% of candidates at top psych programs look pretty close to the average interviewee at top IM programs.

Right, but the top 10% of IM candidates at the top programs could be competitive in any field they wanted. That's true of a very tiny number of psych applicants.

 

[FlowRate]

I went to a mid-tier academic program and while it was a huge red flag, applicants were not DoA if the rest of their app was solid. Those comments in your MSPE are what I'd consider a minor red flag. Meaning probably going to raise some eyebrows and won't help, but are unlikely to be something that will prevent you from getting interviews by itself.


Right, but the top 10% of IM candidates at the top programs could be competitive in any field they wanted. That's true of a very tiny number of psych applicants.

About 20-30% of our interviewed candidates had 260+ step scores (several notable 280's), straight-honors on everything, glowing LOR, etc. Hard to know the exact breakdown. You're right that there's a top end of IM applicants that are a bunch of future cards/GI/hemeonc and they tend to be pretty darn impressive.

I don't think so...although supposing it did, how big a red flag would this be? In this thread I'm seeing doctors tell people with Step failures that they stood a chance at community programs; both the program director and my academic advisor have said that applicants with those are DoA and their chances of matching psych are very slim. The people here seem considerably more sanguine about applicants' chances...not only for psych but also for FM.

TBH I don't have as much insight into pre-interview process which is where I think it'd be most impactful (deciding whether to interview you or not.) It would be something that interviewers and ranking committee would see as well but the interview is way more important at that stage.

 

[psych2028]

I don't think so...although supposing it did, how big a red flag would this be? In this thread I'm seeing doctors tell people with Step failures that they stood a chance at community programs; both the program director and my academic advisor have said that applicants with those are DoA and their chances of matching psych are very slim. The people here seem considerably more sanguine about applicants' chances...not only for psych but also for FM.

My school said the step 1 pass rate dropped below 90% this first p/f year and we have heard many other schools are in the same boat. I guess I would hope that hundreds of US MD applicants with a step 1 fail wouldn’t be dead on arrival for psych/fm but maybe that will be the case now. I really have no idea and I guess the only thing I can do now is hope for the best moving forward.