What programs should I be looking at realistically?

[spinnerette]

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[billypilgrim37]

All other things being equal, you would probably match at Yale or Mt Sinai without a ton of difficulty.

You might have a bit of trouble at MGH, Columbia, and Cornell with that profile, but otherwise, the Northeast is probably yours for the taking. Apply to 8-10 of the best programs, and you'll probably match at one of your top 3, excluding those three above.

 

[LEdaddy]

Hi folks,
Thank you again for your time. I'm a 4th year med student working on my applications.
I just briefly spoke to my clerkship director about applying to psych program but we never got a chance to talk about my competitiveness. He thinks I would be competitive (thinking that I should shoot for Yale or Mount Sinai) because I received great evals from my psych attendings. The problem is, I am not a good test taker and my shelf scores and Step 1 score were mediocre, so I ended up with just HP for all rotations (clinical honors brought down by shelf scores) and a 225 (96) on Step 1.
Because I do want to go into academia eventually, I do hope to go to a good university program for residency.

Here's a little more about me
I'm studying at a top 20 med school. Clerkship grades were all HP except surgery P. One thing that my dean mentioned is that I do have great extracurricular activities (lots of program/education development for the med school, lots of community work and research, etc). I haven't asked for letters yet but there are quite a few attendings in IM, neuro, and psych who offered to write me great letters.

What are your take on this?
What sort of programs should I be looking at? I am thinking of applying to 30 programs in the Northeastern regions. Is that adequate?

My 2 cents:
So, I'm not seeing any glaring weakness in your profile. Maybe an honors in Psych would have been a good addition, but you said your evals and letters are strong. A 225 shouldn't be a problem for most psych programs. It's your research and other activities which can help you stand out. With a good personal statement and interviews, I think you'll be very happy on match day. Good luck.

 

[LEdaddy]

All other things being equal, you would probably match at Yale or Mt Sinai without a ton of difficulty.

You might have a bit of trouble at MGH, Columbia, and Cornell with that profile, but otherwise, the Northeast is probably yours for the taking. Apply to 8-10 of the best programs, and you'll probably match at one of your top 3, excluding those three above.

BP37, I'm curious what changes to the OP's profile would put her/him in a safe range for MGH/Cornel/Columbia.

 

[billypilgrim37]

BP37, I'm curious what changes to the OP's profile would put her/him in a safe range for MGH/Cornel/Columbia.

The clerkship grades.

 

[notdeadyet]

The clerkship grades.

Ditto this. I'd apply anyway, but the really competitive programs can afford to screen out based on anything.

OP- You have an application that most programs would drool for. You'll have a wealth of choices anywhere in the country you apply. Good luck with it...

 

[cleareyedguy]

You would do fine at any program, most likely, since you seem to play well with others. You might want to look at this issue of not testing well, since what it might mean is that your interpersonal skills have compensated for your relative, small deficit in your knowledge base (ie, you might want to study harder when you're a resident). Of course, a 225 is nothing to sneeze at, so perhaps no worries.

In picking a place, you should try to really narrow down where you want to go by figuring out what you want and what the programs have. The best way for you to get into a top program is to do an elective there (this advice does not hold if you'd made straight honors and are a jerk, since then you're best NOT giving the program an opportunity to get to know you). The next best is to discuss a very specific reason why you'd be a good fit. The third best is to demonstrate your specific enthusiasm--all programs like enthusiasm.

You can be an academic generalist, but beware that most psych applicants are generalists, and you'll serve yourself well by developing a strong focus to allow the evaluators to pigeon hole you in the way that you choose. And you don't want to be seen solely as a nice guy who's involved broadly, since it's VERY tough in a one-day interview process to be seen as all that much "nicer" than the other applicants. Good luck--as others have said, the process should go fine for you.

 

[neopsych12]

Do you guys think it is necessary to have a publication to get into programs like MGH, Columbia, or Cornell?

I have great usmle scores (252) and honors in 4/6 rotations including psych and medicine. I also have been very involved throughout college and less so in medical school. I would like to think that my letters will be strong but you just never know. The biggest thing lacking in my application is a research publication although I have research experience and a poster presentation. Also, I am not at a top 40 medical school.

 

[atsai3]

Do you guys think it is necessary to have a publication to get into programs like MGH, Columbia, or Cornell?

I have great usmle scores (252) and honors in 4/6 rotations including psych and medicine. I also have been very involved throughout college and less so in medical school. I would like to think that my letters will be strong but you just never know. The biggest thing lacking in my application is a research publication although I have research experience and a poster presentation. Also, I am not at a top 40 medical school.

You don't need a publication. 252, several honors, etc -- you have as good a shot at MGH/Columbia as anyone.

 

[spinnerette]

Thanks guys for the opinions.
Really nice to hear from a 3rd party. The attendings at my hospital have been trying to convince me to stay and they tend to steer away from topics about which programs I should shoot for.

As far as the poor test taking skills, I really have no idea why. I usually stand out during rounds when attendings do the pimping. Sometimes I even answer questions that the interns can't answer. I just have no idea why my scores haven't been good. I might go see some counselling about stress management. I don't know...

 

[billypilgrim37]

Just because your test-taking skills bump you down a notch below your peers at a very good medical school, you've still managed to get this far with a step 1 score that won't wow, but won't be a hindrance either. Like most parents, your scores are "good enough." You'll comfortably pass step2 and step3. You'll probably not have any problems with psych boards. Don't worry about it!

 

[SAS1284]

Hi all, thanks for the great info. I also had a question regarding competitiveness. I have spoken to my med school deans and psych educator and I haven't received a clear answer on what programs are within my range. From what they said, there is no harm applying to top programs, but it is hard to predict what scores/grades will make you competitive at programs. I have a 225 step 1, honors in psych, psych sub-i, surg, and a couple other. I have done some research (no pubs) and some extracurriculars for psych. Any clues as to whether I should be shooting for the MGH/Columbia type schools or should I aim for less competitive types? Thanks for any help!!

 

[notdeadyet]

Thanks guys for the opinions.
Really nice to hear from a 3rd party. The attendings at my hospital have been trying to convince me to stay and they tend to steer away from topics about which programs I should shoot for.

Then take any of their advice with a big grain of salt. That's pretty a pretty $hitty thing to do as educators.

I just have no idea why my scores haven't been good. I might go see some counselling about stress management. I don't know...

I'm with billypilgrim: I wouldn't sweat it. Your Step 2 scores will probably be in the neighborhood of your Step 1 and you only need to pass the Step 3. Stress management and counseling would be good advice if you were symptomatic and not able to pass exams. Keep in mind that you're doing better than about half the medical students out there. That's something I'd be proud of.

Don't sweat the scores so much. My Step 1 was waaaay below yours and my Step 2 not much better and I got interviews at almost every program I applied to and matched at a program that is considered one of the most competitive. The scores never came up in interviews. You'll be absolutely fine.

 

[billypilgrim37]

Keep in mind that you're doing better than about half the medical students out there.

Even better than that. At least my year the mean was 217 and the SD was 17. A 225 gives a cohen's d of almost 0.5. That's better than Strattera for ADHD!

Given that my med school's average was in the mid 230's, and the average of my circle of friends was about a 242, I can understand why somebody with a good score like a 225 might feel rotten. The lowest score in my group of friends was a 226, and he wound up going to Duke for peds.

Scores in the 220s don't help you in psych. But they don't hurt you either. I knew people who matched psych at Cornell and UCSF with scores under 210. They otherwise walked on water and delivered AIDS babies on Jupiter and actually brokered peace in the Middle East in a Fringe universe, but their 207s didn't disqualify them from the programs they wanted.

 

[notdeadyet]

Even better than that. At least my year the mean was 217 and the SD was 17. A 225 gives a cohen's d of almost 0.5.

I meant medical students as a whole, where 225 is about average. The OP's well above the norm for psych applicants.

 

[billypilgrim37]

I meant medical students as a whole, where 225 is about average. The OP's well above the norm for psych applicants.

Wow, it's crept up that much? In 2005, 217 was the mean with that SD of 17 for all med students. At my med school, the mean was 232/234 (depending on if you're talking about the class I started with or graduated with).

The average for psych was mid 200s. I think last year the mean psych went up to 209.

I'm shocked that a 225 is now an average Step 1 score for all med students. Grade inflation!

 

[notdeadyet]

In 2005, 217 was the mean with that SD of 17 for all med students.

Looks like the truth is somewhere in the middle. The most recent released average of all Step 1 takers is 221. 225 was the score on my brain because that was the mean of matched allopathic seniors, according to Charting Outcomes (the NRMP data bible).

The average for psych was mid 200s. I think last year the mean psych went up to 209.

Psych was 216 for matched allopathic seniors in 2009, up from 210 in 2007. I'll be curious to see how it trends...

I'm shocked that a 225 is now an average Step 1 score for all med students. Grade inflation!

Yeah, sorry, that's just matched allopaths.

 

[fancyN]

BUMP!

Hey guys, I'm a newbie MS3 and just finished my child psych rotation and ABSOLUTELY LOVED IT...psych is now essentially at the top of my list to apply to and I'm wondering how competitive I would be for most programs, and if getting involved in some research (I've met some wonderful attendings who have offered to mentor me with their projects over the next year if I want) would improve my app. I'm at a top 20 med school, have a 238/99, not so great/very average preclinical grades (but hoping for good clinical grades...I'm getting honors from my psych attendings so as long as I don't bomb the shelf I should have an A for psych).

I guess I'm particularly interested in cali/northeast programs, I'm coming from TX. I'm kind of concerned about my not so good preclinical grades. Would doing some research over this next year (the rest of my MS3 year and possibly into MS4 year) help boost my application significantly? Also, which of the top programs offer good exposure/opportunities w/child psych during residency? I know it can vary from 1 month to many months during your R2/R3 years. Thank you in advance!!! 🙂

 

[psychphan]

On kind of the opposite end of the spectrum, how far does a really good board score take you? I'm a DO student who didn't take USMLE step 1 but decided to take USMLE step 2 more out of curiosity than actually thinking I would need it on my application. Well it turns out I did quiet well, >260/99 and the idea of applying to some big name programs has now crossed my mind. I would probably consider myself an average applicant otherwise. Middle of the road grades in the pre-clinical years, good step 1 scores but again COMLEX only, involved in a large amount of clubs with a decent amount of volunteering, did some non-psych clinical research in undergrad but have no publications, clinical grades have been good but my school doesn't do the P, HP, honors thing its just letter grades, which I have A's in my psych rotations; letters of rec say great things (at least thats what the writers have told me) but aren't from any PDs or attendings from elite universities. Do you think the 260+ step 2 score would land me some interviews at some big name places?

 

[PistolPete]

Do you think the 260+ step 2 score would land me some interviews at some big name places?

Yes, I do. I think you're on track for some big name interviews. Good luck!

 

[Doctor Bagel]

Wow, it's crept up that much? In 2005, 217 was the mean with that SD of 17 for all med students. At my med school, the mean was 232/234 (depending on if you're talking about the class I started with or graduated with).

The average for psych was mid 200s. I think last year the mean psych went up to 209.

I'm shocked that a 225 is now an average Step 1 score for all med students. Grade inflation!

I don't think I'd call it grade inflation because it's not like it's easier to score higher on step 1 than it was in the past. Instead, medical students are just overall more academically talented, which is reflected by increasing competition to get into medical school. Also, since people place more emphasis on step 1 now, most likely we all study a little more.

Anyway, I've still got to say I think it's a little sad that psych applicants have lower Step 1 scores than average.

 

[tortuga87]

The increase in step 1 scores is more because of better prep books than the test getting easier, ppl getting smarter, or every specialty suddenly wanting higher scores

 

[billypilgrim37]

Well, it's a standardized score, so whatever trends have something to do with statistical distributions, so relative performance, not true performance, would be driving that (i.e., I don't think we would know either way whether that meant students were in actuality doing any better or worse). I don't think there's much evidence that medical students are any more academically talented, especially not in just the past 5 years.

 

[notdeadyet]

I don't think there's much evidence that medical students are any more academically talented, especially not in just the past 5 years.

I don't know about the criteria for "talented" but the data indicates that average Step 1 and GPA in matriculants has gone up in the past five years. For what that's worth.

 

[JabsterL]

The increase in step 1 scores is more because of better prep books than the test getting easier, ppl getting smarter, or every specialty suddenly wanting higher scores

and let's not forget about UW and SDN/online freebies increasing access to the type of better review materials, study plans, practice questions, and overall better advice to better prepare us for all exams (esp. shelves and steps)

 

[zen76]

You're as good as any candidate. It is true that the general trend in psychiatry is higher step scores, but that hasn't translated into better candidates, just a weakening of reliance on step scores as a screening tool. That being said, applications have grown in recent years, and most likely step scores will continue to be used by some groups. If you're feeling neurotic, do an away elective at top 3 choices for you, so they can match a name with a face, and have a more personal connection.

best of luck,
zen76

 

[Igor4sugry]

What would be the reasons for going into those big name programs (e.g. Yale). What do they offer that smaller programs do not? Are they important primarily for those interested in academia?

I'm interested in going into private practice, so I'm not sure whether an academic driven program will be the best fit for me. Do smaller programs give more preparation for the private practice world?

 

[curiositykat]

What would be the reasons for going into those big name programs (e.g. Yale). What do they offer that smaller programs do not? Are they important primarily for those interested in academia?

I'm interested in going into private practice, so I'm not sure whether an academic driven program will be the best fit for me. Do smaller programs give more preparation for the private practice world?

I'm under the impression that most graduates of the biggest name programs go into private practice within 5 years of graduation. I'm also under the impression that some of the biggest names emphasize psychotherapies quite a lot, even if they would really prefer that more of the graduates emulate them by working within an academically-oriented hospital.

 

[Doctor Bagel]

I don't know about the criteria for "talented" but the data indicates that average Step 1 and GPA in matriculants has gone up in the past five years. For what that's worth.

And entrance MCAT and college GPAs have gone up as well. Either way, Step 1 is not easier now than it was in the past. People are just doing better on it; there's no score inflation.

 

[Salpingo]

I'm under the impression that most graduates of the biggest name programs go into private practice within 5 years of graduation. I'm also under the impression that some of the biggest names emphasize psychotherapies quite a lot, even if they would really prefer that more of the graduates emulate them by working within an academically-oriented hospital.

So then who's producing the academic psychiatrists?

 

[notdeadyet]

I'm under the impression that most graduates of the biggest name programs go into private practice within 5 years of graduation. I'm also under the impression that some of the biggest names emphasize psychotherapies quite a lot, even if they would really prefer that more of the graduates emulate them by working within an academically-oriented hospital.

Most folks I've talked to in the big name programs seem to be more skewed towards academics than private practice.

As for the emphasis at psychotherapy at the top programs, that's definitely what I've seen. I think the pharmacotherapy is top notch too, but I think when programs start triaging, good psychotherapy is probably one of the first to get the knife.

 

[DeepThought]

Hey, long time lurker here. I'm hoping someone can give me some advice about what programs I should apply to.

DO student. Only took COMLEX. Average basic science grades, mostly solid B's, couple of A's.

Did mediocre on Step 1 = 463/79. Average is ~500, failing is 400/70. 463 is around 30th percentile. I was expecting to do much better, but I think I had some pretty severe test anxiety.

Clinical Rotation grades have been almost all A's. Two A's in psych. Also A's in IM, OB, Surgery, Peds. So far, I have 2 good psych letters, one of which is from an attending who said I'm better than the resident I was working with, and I'm hoping they say similarly glowing comments in my letter. Also have a good FM letter, where I had some good psych experiences and an overall good rotation.

Took COMLEX Step 2 a few weeks ago. I think I did much better than on Step 1. Expecting >550/85-90. Average is ~500, just like step 1.

I'm really having trouble narrowing down my chances. I feel like I'm a pretty good applicant aside from my Step 1 score, but programs keep telling me that they "look at other factors" when I email them. I am hoping for a well-balanced community or academic program that doesn't have to be a powerhouse.

I'd welcome any thoughts. I think it's kinda tough to say, so I'll probably be applying very broadly and see what happens...

 

[atsai3]

So then who's producing the academic psychiatrists?

Many clinical faculty work out arrangements with their departments whereby they work in the academic medical center faculty practice, but they also have a part time private practice (where they can leverage their connection to the academic center to make the really big bucks).

 

[cleareyedguy]

So then who's producing the academic psychiatrists?

Once people get into good academic psychiatry jobs, they tend to stick around for decades. This contrasts with some of the more clinically-oriented jobs, which tend to have a revolving door of recent grads. So if 5 of 10 grads from a big name program went into research/writing careers and stuck with those jobs for a decade (and the other 5 were primarily clinical+/- private practice), I think their programs would be thinking that's a strong academic class.

 

[Fastball32]

As someone who has been through interviews/match, and as a former chief resident who has personally looked through 500+ applications, I would say that if you are a US Grad with an average Step 1 score (~220), without any negatives, then you will likely get an interview at most programs.

Negatives I mean: A failure on a STEP, a failure on a clinical rotation, a failure in a med school class, any disciplinary actions.

If you have one of the negatives, then it is not an automatic denial for an interview, but if you have two or more, then it will be much tougher.

Remember, you are competing against several hundred candidates for less than 100 interview spots. The program director, assistant, attendings, and residents are looking for anything...anything... that separates you from someone else, and often times negatives are easier to spot.

 

[atsai3]

Negatives I mean: A failure on a STEP, a failure on a clinical rotation, a failure in a med school class, any disciplinary actions.

If you have one of the negatives, then it is not an automatic denial for an interview, but if you have two or more, then it will be much tougher.

At a highly competitive program, any of these red flags will get you screened out by the PD even before your application heads to committee. Negative comments in your letters of recommendation will get you screened out in committee (i.e., because the PD simply doesn't have time to read all of the letters carefully).

There are just too many other applicants to look at for competitive programs to be willing to take a chance on someone with these red flags.