Where to Point My Efforts in 4th Year

[Watson & Sick]

Hi there. I'm currently in the throes of planning out fourth year and setting my sites on specific residency programs that I'd like to focus my attention on. I guess I don't necessarily know where I stand and was looking for some help on what caliber programs I should be aiming for.

DO student
Step 1: 233 Level 1: 602
No Step/Level 2 yet, but am confident I'll hit at least 240 based on shelf exams.
Class leadership and national student org leadership. This led to helping establishing another national level student organization.
Pretty consistent volunteer experience, with some being mental health focused.
Research at a top 5 engineering school on an interesting neuro project, but only got some small local presentations out of it.
Clinical grades have been about half pass, half high pass/honors. Honored my psych rotation.

Ideally I'd like a program that places emphasis on excellent clinical experience as I'd like to pursue either clinical education or start a PP eventually. Research would be great, but not necessarily at the top of the priority list. I'm particularly interested in programs that might discuss the philosophy of psychiatry (background in philosophy and the metaphysical aspect of psychiatric disease, classification, and ethics of treatment are part of what led towards this field).

I guess what I'm asking is... where do I fit? I feel like DO status and only slightly above average scores with no big publications takes me out of the running for "top" programs. So should I be looking toward mid-tier programs, or would I still have a shot at more impressive programs? Would a targeted sub-i help improve those odds?

 

[rjs2131]

I can't speak to specific programs but in general, you seem like a pretty solid applicant. In the end it's a numbers game, but if you are really interested in a "top tier" program it doesn't hurt to apply. Other threads will reflect that psychiatry programs are more interested in why you want to become a psychiatrist vs how well you can do on a board exam, but from what I keep hearing things are only getting more competitive.

On the plus side, there are a lot of very good programs out there - figure out your top 3-4 locations and go from there. I'd say that the vast majority of programs are good to very good, with a minority being "bad" or "excellent". Once you start interviewing you'll find that a few programs give you that "gut feeling" that you'd be happy there, while most others are hit or miss. There are a lot of variables that go into what residency program will be a good fit for you, but from my experience location, faculty, and co-residents are some of the most important. Good luck!

 

[Stagg737]

Others will disagree, but a targeted sub-i can certainly be helpful if you work with the right people and do really well. I had my attending, chief resident, and 2 or 3 other residents all e-mail the PD saying they liked me. Ranked it #1 and matched there with scores that were not good and a minor red flag. The "elite" programs are probably out, but I'd think if your application is solid you'd probably still have a decent chance at some top tier programs.

 

[Watson & Sick]

Thanks everyone. This is definitely helpful. Given the limited number of aways we're supposed to have this season, "targeted" might take on a bit more of a literal definition this year. Picking which target is a tricky thing at this point.

 

[clausewitz2]

Thanks everyone. This is definitely helpful. Given the limited number of aways we're supposed to have this season, "targeted" might take on a bit more of a literal definition this year. Picking which target is a tricky thing at this point.

Addressing your more personal preferences, UNC used to have a really active philosophy of psychiatry seminar series that psych residents seemed involved with but I think that no longer exists.

UPMC/WPH has some formal philosophy of psychiatry didactics, namely...uhh, me, but that is only a few sessions in fourth year at the moment. Otherwise fulfills your criteria nicely, and I don't need to tell you that the History and Philosophy of Science department in general at University of Pittsburgh is a big effing deal. They seem very open to psych residents turning up to audit their graduate courses and have some recent faculty hires who are specifically interested in philosophy of psychiatry.

 

[rjs2131]

Thanks everyone. This is definitely helpful. Given the limited number of aways we're supposed to have this season, "targeted" might take on a bit more of a literal definition this year. Picking which target is a tricky thing at this point.

Personally I’d try and get an away at a reach school you may not have a great chance of matching at otherwise. I doubt you’ll get more than 1-2 anyway so make the ones you can line up count. Of course, this is assuming you’re likable and do a good job clinically... you know your strengths better than we do but I’ve seen med students do away rotations and decrease their chances at a program because they weren’t at all a good fit.