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What's more competitive psych or IM

Discussion in 'Medical Students - MD' started by Merely, Jul 28, 2015.

  1. Merely

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    Very straightforward question, what's more competitive psychiatry or internal medicine to match into? thanks
     
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  3. tantacles

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    Internal medicine.
     
  4. Moose A Moose

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  5. olivarynucleus

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    Both are filled with IMGs, two of the least competitive specialties. I hope they stay uncompetitive, seems like the job market in every non primary care specialty is getting saturated ( except psych ob/gyn) and primary care residents are getting offers of 250-300k right out of residency.
     
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  6. notbobtrustme

    notbobtrustme Crux Terminatus
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    Top IM programs are the most competitive programs in any specialty.

    IM is unique in that the spread is so wide. If you want to match, you will somewhere.
     
  7. MeatTornado

    MeatTornado On Sabbatical
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    Nothing in this post is true.

    Nobody is getting offered $250k+ out of residency for a primary care job and as someone already mentioned IM is extremely competitive at elite programs (think derm, plastics, etc) and moderately competitive at most University programs in desirable locations while at some malignant community programs or those in undesirable locations they'll take anyone with a pulse.
     
  8. olivarynucleus

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    Yeah they are, check the IM/FM forums. Its not uncommon at all. Psych gets offered around the same thing.
     
  9. Moose A Moose

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    This is true.

    If you're alright with living in the underserved sticks of America compensation for PCPs is right about 250k+.
     
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  10. SoulinNeed

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    Both are about the same, I think.
     
  11. Jabbed

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    I was actually having this conversation with someone the other day. If psych is less competitive than IM, are there any AMGs that are "forced" into psych for performance reasons?
     
  12. bashwell

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    I don't think anyone is "forced" if by "forced" you mean doing a specialty they simply don't want to do? If IM really isn't for them, but they're otherwise performing and behaving well etc., and their PD is supportive, then they could try for something else they like or at least can learn to like, whether psych or something else.

    Of course if someone has no other options due to serious enough problems in residency, and they want to stay in medicine, and if only psych will take them, then I guess so. But I would think if they have serious enough problems in IM, then it's possible psych may not want them either. Sorry it's hard to give a general answer. It really depends on the specific case.
     
  13. Merely

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    Wow these posts are completely unexpected I thought psych was a little more competitive than internal..also the guy that said top internal medicine programs are hardest to get into...wtf is that even true..what about top ent or derm...
     
  14. W19

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    Can people in SDN stop with the psych bashing?

    Diagnostic Radiology has almost 100% matching rate for AMG in the last 'charting the outcomes'...
     
  15. TBV

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    Hes talking about top IM programs... as in feed you right into GI/Cardio etc
     
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  16. Frazier

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    I don't think there is any real bashing going on here. Hell, one of the historically most outspoken critics, our buddy @notbobtrustme , even refrained from wisecracks.

    Psych is a less competitive field than IM...as noted above, the spress is huge...that said, IM is the gatekeeper to a lot of competitive subspecialties (cards, gi, heme/onc). No big surprise/deal.
     
  17. Merely

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    So cardiology is more competitive than derm?
     
  18. TBV

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    Difficult to say because one is a fellowship and one is a residency and I'm not sure the comparison in stats has been done. Both are highly competitive and I have no intention on quantifying that.
     
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  19. seminoma

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    I would say top programs in any specialty are almost equivalent in difficulty of matching. The people matching at top ENT/derm programs probably aren't much better than the people matching at top IM programs.
     
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  20. Elevencents

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    Truth is not bashing. You need to pass boards to match psych. That's the truth.
     
  21. Merely

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    So psych is the least competitive specialty? Does anyone have a list that ranks them based on competitiveness?
     
  22. Frazier

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    Look up charting outcomes... general construct is to sequence to Step scores.

    It goes something like:

    FM < PMR ~ Psych < Peds ~ OBGYN .... other fields.

    It really means jack in the grand scheme of things.

    Do your best and do what you like best.
     
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  23. collegestud2013

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    Psych salaries are currently very similar to IM on average, but remember psych works less hours (54.9 vs 46.5, according to AAMC Careers in Medicine) so a psychiatrist could probably make an above average income by working IM-like hours and seeing an above average number of patients.

    IM is much more more competitive (much higher average Step 1 score) because it's the gateway to Cards, GI, Heme-Onc, etc.... It's very easy to get into any IM program, but coming from the lower tier IM programs will make it very difficult to get into the competitive subspecialties. Psych on the on the other hand is mostly terminal just FM (there are probably fellowships you can do within both FM and Psych but they at least don't usually lead to significant financial benefits).
     
  24. KinasePro

    KinasePro Das it mane
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    Huge over-exaggeration. Top IM is competitive, but nowhere near derm/ent/ortho/uro, etc...
     
  25. NickNaylor

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    Your signature is awesome.
     
  26. J ROD

    J ROD Watch my TAN walk!!
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    I concur with everything in this thread..........including the signature comment. Continue on......................
     
  27. jw3600

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    This is not facebook man. Take your social justice bull**** elsewhere. Discussing the objectively uncompetitive nature of matching psychiatry is not "psych bashing."
     
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  28. W19

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    You like replying to my posts for some reason, and always resorting in attacking me... No social justice here since I am a 'hardliner' on these 'things'. I somewhat adhere to the 'sink or swim' philosophy when it comes to social issues... Radiology has ~100% matching rate and I don't see many in here that are quick to point the 'uncompetitiveness' of psych say the same about diagnostic rad... In fact, they always try to defend radiology by attempting to point out the competitiveness of top programs.
     
  29. Instatewaiter

    Instatewaiter But... there's a troponin
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    Top IM programs are very competitive and just as competitive as uro, derm and the like. You tend to need to be AOA, all or almost all honors and 240s-250s step 1. That said, I suspect the top derm programs probably have better stats than the top IM programs.
     
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  30. W19

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    My friend, a carib grad, did only 2 year internship in PR. He is basically a GP or what people used to call GP back then. In short, he did not complete a formal residency. He got a job in rural Montana... 180k/year... 20k relocation cost and 25k/year loan repayment with other bennies such as 401k, heath insurance etc... It seems like physicians can make some money in rural America.
     
  31. jw3600

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    I don't mean to attack you. Sorry if you feel that way. Maybe this is a language thing but it seems to happen more than rarely with you where you miss a nuanced point of a thread or conversation. This thread is about the competitiveness of IM vs. Psyche. That is LITERALLY what the title is. Almost every poster gave the same opinion that psyche is fairly uncompetitive at every level while IM is insane at the top and has a nice spectrum all the way down (with the exception of olive nucleus guy but this is not the first time he has expressed his inaccurate opinions, so whatever). No one even made a point about psyche practice or the integrity of them as real doctors. To be totally honest, I don't even understand the post of yours I just quoted. Hardliners? Sink or swim? Dude. WTF are you talking about. Radiology? Who is discussing that. When you continue to make derailing comments about thread topics people will reply and "attack" you. This is easily fixable on your end.
     
  32. W19

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    @jw3600 I am not derailing any thread here; I was point out a trend that I have seen so often in SDN, which is people are quick to say psych is not competitive while trying to defend others specialties that are also not competitive by using the same top program nonsense argument... There is a spectrum in MOST specialties. Stop the nonsense of top IM/Rad etc... are ultra competitive when people are talking about these specialties as a whole...

    As far as my hardliner/sink or swim reference, that was a lame attempt of telling you I am not into promoting social justice BS...
     
  33. jw3600

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    I just can't do it anymore man.

    Psych is objectively uncompetitive. Maybe you want to do it and you feel insecure. I don't know. I like psychiatry. I think it is important and interesting. My personal issue with it is I don't feel like you get to incorporate as much of the "rest of the body" medicine. It is too narrow for my personal preference. There are plenty of psych residents here who do not feel the need to "point out a trend in SDN...which people are quick to say psych is not competitive..." Partly because it's true? and most likely because they don't define their self worth by what specialty has the most competitive matching data.

    @NickNaylor @Nasrudin
     
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  34. MeatTornado

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    well as a whole IM and radiology are still more competitive than psych
    Step 1 averages for matched US seniors:
    psych 220
    IM 231
    Radiology 241

    ...the step 1 average for UNmatched radiology candidates is even higher than psych (221) so i have no clue what you're trying to argue but this one's not even close.

    To your point about the 100% match rate in radiology: that has more to do with supply and demand... there are too many spots and not enough people interested mostly because of the way the job market is starting to look. There's also significant self-selection in radiology.
     
  35. notbobtrustme

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    Match rate is a poor surrogate for competitiveness. Stats are much better.
     
  36. Merely

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    Did not expect psych to be so uncompetitive
     
  37. W19

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  38. olivarynucleus

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    Psych is uncompetitive but jobs are abundant, there is a shortage, and you can write your own ticket. Radiology is going the way of pathology, you need 1 or 2 fellowships after an already 5 year residency and you still may not find a job, that's why rads is uncompetitive right now.
     
  39. Frazier

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    It is largely due to the fact that there are a ton of spots available (say vs. rad onc) and there aren't a ton of medical students interested in the patient population, pathology, treatments, or all of the above. That is all fine. If the ~1,300 psych spots were widdled down to only 180 available spots (a la radonc), the former would be just as competitive if not more than the latter (assuming psych programs would shift their M.O. and have an interest in more heavily weighing step scores). There are a ton more spots because there is a much higher need for a voluminous supply of psychiatrists than radiation oncologists. Not saying the utility of one is higher than the other, but rather more are simply needed of the former.

    If psych was to take their top 180 candidates from the pool, the average would be well into the 240's. So what? That isn't how things are done and likely won't be any time soon.

    If you took away the fact that IM is the ONLY gateway to 6+ popular subspecialties and therefore people that match IM would have to stay IM, it might have an average score of 210 instead of 230. Maybe not. Again, so what?

    That addresses the first issue, the second issue (uninterested in patients/path/treatments) is one that is fair and honest...if a med student has exposure to a wide range of the practice settings where a large variety of patients are treated with different modalities -- and still have zero interest -- that is great. They successfully weeded out a field they do not wish to practice, but hopefully grew at least a bit more appreciation for the services that psychiatry can offer whatever their future patient population might be.

    Then there is the psychiatry stigma thing, but outside of SDN, youtube, and scientology circles there isn't as sharp of an issue as led to believe. The average joe walking down the street has no idea what a rheumatologist, gastroenterologist, nephrologist, or otorhinolaryngologist is...or what they do for a living. Again, so what? As astutely mentioned earlier -- try to develop to the point of doing what is best for you.
     
    #38 Frazier, Jul 30, 2015
    Last edited: Jul 30, 2015
  40. Merely

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    Thank you
     
  41. jw3600

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    I think OP learned a valuable lesson today. There is no such thing as a straight forward question on SDN.
     
  42. Member 1337

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    Speaking of not being straight-forward, I'm surprised we're not seeing more "who the hell cares" responses.

    If you want to match into psych or IM, you'll have no trouble matching into either, and if you do have trouble it's because you will have difficulty matching *period,* no matter what you try to match in.

    OP is presumably a smart med student capable of googling publicly posted Step 1 / Residency statistics. So why does OP want to hear people get all hot and bothered about the relative competitiveness of two uncompetitive specialties? This obsessive focus on competitiveness, even in cases where it makes no difference at all, feeds a need to perseverate over the minutia of stratifying one med student over another, helping them cope with no longer being the top 1% undergrad student and having to deal with being a just a normal, average med student.

    Yes, I'm a psychiatrist.
     
  43. Mad Jack

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    Hospitalist work can be quite lucrative.

    http://www.comphealth.com/3planding?jobnumber=745831&source=indeed-pd-phys-perm&rx_medium=cpc&rx_job=27307539&rx_source=Indeed&rx_campaign=Indeed124&rx_group=77

    http://www.practicelink.com/jobs/460692/physician/hospitalist/Tennessee/Claiborne%20County%20Hospital?utm_source=Indeed&utm_medium=organic&utm_campaign=Indeed

    http://www.comphealth.com/3planding?jobnumber=745984&source=indeed-pd-phys-perm&rx_medium=cpc&rx_job=32385396&rx_source=Indeed&rx_campaign=Indeed186&rx_group=77

    http://www.indeed.com/m/viewjob?jk=f43395c6617b1ee2

    I could keep posting for pages. Outpatient primary care can also net you 250k+

    http://www.healthecareers.com/job/physician-internal-medicine/1674492?type=partner&source=indeedorganic

    http://www.healthecareers.com/job/metro-primary-care-4-day-work-week/1674501?type=partner&source=indeedorganic

    http://webconnect.sendouts.com/CN_Frame.aspx?ID=BSM&SiteID=Webconnect&Group=Webconnect&Key=CN&CNTrackID=14&CnId=&PostId=2d0d7740-4fc6-4320-9892-0ee668c56edd&ApplyNewCan=1

    You may not end up in the big city for pay like that, but for the financially savvy, the lower cost of living and higher pay in BFE is a great combo, especially for a mere 3 years of training.
     
  44. Moose A Moose

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    I think psych's competitiveness will go up drastically in the next decade, as well as its compensation. The ACA and other federally backed medicine incentives- whether you love'm or hate'm- are starting to incorporate psych screenings and psychotropics quite a bit. Maybe as interest, job availability and pay gets scaled back with specialties such as rads, psych will fill that void. Just a thought of mine.
     
  45. Ibn Alnafis MD

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    Psych is the best hidden secret in medicine
     
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  46. Mad Jack

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    I hope psych stays uncompetitive- it's a great blend of lifestyle and pay, with a relatively relaxed residency to bit at many institutions.
     
  47. Moose A Moose

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    Once upon a time it was EM, lol.
     
  48. Mad Jack

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    EM was never really a lifestyle specialty, as many that jumped on the EM train are quickly finding out. Psych truly is- minimal call, no nights, no weekends, no holidays, with pay over 200k and style of the best opportunities to avoid the government's destruction of the health insurance industry and EMR requirements in all of medicine. Eventually people might catch on and competitiveness might increase, but I certainly hope not before I match.
     
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  49. Mad Jack

    Mad Jack Critically Caring
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    You're more likely to just end up in a low end IM sweatshop than be forced into psych. Plus most people who like IM would likely be more apt to go the FM route before the psych route, as IM and FM provide many of the same opportunities for those without a fellowship.
     
  50. Salt Salt

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    I agree that no one was psych-bashing, but take a chill pill. This was unwarranted.
     
  51. J ROD

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    Psy is like voodoo, man! It will mess with your mind. Don't do it. Stay far away!!!!
     

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