Did not match psych. Incredibly uncertain about next steps

[Peter_Griffin]

DO. 21x/56x 25x/57x. Failed a first year class, LOA. Rotations generally P/HP with comments like pleasant, knowledgeable and personable. Scathing review in surgery and OB which was never mentioned to me on any of my interviews. Some relevant volunteering in the field prior to medical school.

Applied to 100+ residencies. 13 interviews. Did not match, SOAPed into a categorical medical specialty. I was stunned as I thought I had this in the bag and was not at all prepared to SOAP.

I can't identify a main reason why I didn't match. I didn't do interview coaching and might have come off much worse than I thought. I might not have adequately stressed that the reason for my leave was temporary. Finally, I probably was also just a very boring and forgettable candidate as I saw multiple interviewers struggle to try to find something on my application interesting. My app was good, but definitely not amazing and I got overconfident with my scores.

The SOAP process was a blur and I regret several decisions I made in the stress of the moment. I don't want to do the full categorical residency I SOAPed into, much less practice that. My current plan is to give my current PGY1 my all, reapply on ERAS for psych PGY1 spots, post on Residency Swap, reach out to new programs on ACGME, look for PGY2 spots, network, meet with school faculty for advice and ask about potential blind spots, etc.

(I am sorry to take the categorical position from somebody who wants it but my back is against the wall financially.)

How likely is this to succeed? If it's not, what are my other options in life if I truly don't want to do regular medicine? While I'm lucky to have anything, the current track I've gotten myself into is not the right one in the long term. Thank you all for your input!

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[NotAProgDirector]

I think you've formulated a good plan. Add to it: many psych programs will accept you into a PGY-2 spot with an IM PGY-1 year. Hence you should also be shopping for PGY-2 positions. There are less of them, but also less people interested / qualified for them. They won't be in ERAS or the match. Stay in contact with the psych PD at your medical school, or at your new program.

 

[Peter_Griffin]

I think you've formulated a good plan. Add to it: many psych programs will accept you into a PGY-2 spot with an IM PGY-1 year. Hence you should also be shopping for PGY-2 positions. There are less of them, but also less people interested / qualified for them. They won't be in ERAS or the match. Stay in contact with the psych PD at your medical school, or at your new program.

I matched a very small program with no psych department. However, I do have connections with the psych program about 45 minutes away. Hopefully I'll be able to hop on with research or some extracurricular there.

 

[rokshana]

You got a decent number of interviews, so on paper, you are probably fine.
It’s most likely how you interview.
You many want to consider speaking with the psych PD at your med school and have an appt to discuss your application, and try to figure out what went wrong and where you need to improve.

 

[Entadus]

I hope you didn't soap into EM (because the field is in bad shape and completing a categorical residency should absolutely be high on your list of priorities). Even if you did it's not the end of the world.

5 years ago I soaped into IM (also "failed" to match psych) and now I'm a practicing palliative attending (spent 4 years in training). Grateful all the time that things worked out. Honestly glad I didn't match psych since IM saved me a year of residency and made a transition to palliative much easier. stay focused and optimistic, things get much better.

 

[Mad Jack]

Going to concur that it was probably interviews that held you back. Having been on the interviewing side, generally your file is what gets you there and your interview is that bumps you up or down the list at the places I've been a part of.

 

[Dral]

Concur on the interview thing. I had 15 interviews and didn't match. I suspected it was something about how I interviewed.

 

[NotAProgDirector]

IN this case, I'm not sure it's the interview. Yes, your performance on paper gets you the interview. But a common assumption is that once you're in the door with an interview, everyone is equal and everything hangs on the interview. That may be the case at some very competitive programs where everyone who interviews is a superstar. But at more middle of the road / normal programs, it's very likely that programs use your medical school performance to determine some part of where you will rank, and your interview performance to modify that.

In that light, what I see from what you've posted is someone who did OK on the standardized exams (much better on S2), but has what looks like are not great clinical grades with P/HP. This is complicated because it depends on the grade distribution at your school -- big difference if it's 80P / 10HP / 10H vs 20P / 60HP / 20H. So it's possible that programs which interviewed you did so with the preconceived idea that you'd be in the bottom quarter of their list. Then, your interview wasn't good enough to move you out of that zone.

Food for thought.

 

[j4pac]

Someone doesn’t match by getting a ton of interviews. You match by finding at least one program that ranks you to match. If you’re near the backend of every programs rank list, you may not match.

 

[rokshana]

IN this case, I'm not sure it's the interview. Yes, your performance on paper gets you the interview. But a common assumption is that once you're in the door with an interview, everyone is equal and everything hangs on the interview. That may be the case at some very competitive programs where everyone who interviews is a superstar. But at more middle of the road / normal programs, it's very likely that programs use your medical school performance to determine some part of where you will rank, and your interview performance to modify that.

In that light, what I see from what you've posted is someone who did OK on the standardized exams (much better on S2), but has what looks like are not great clinical grades with P/HP. This is complicated because it depends on the grade distribution at your school -- big difference if it's 80P / 10HP / 10H vs 20P / 60HP / 20H. So it's possible that programs which interviewed you did so with the preconceived idea that you'd be in the bottom quarter of their list. Then, your interview wasn't good enough to move you out of that zone.

Food for thought.

Though he had 13 IVs…statistically that should have given him a 90% of matching somewhere…
Would it be possible he was at the bottom end of all 13 places?

 

[NotAProgDirector]

Though he had 13 IVs…statistically that should have given him a 90% of matching somewhere…
Would it be possible he was at the bottom end of all 13 places?

That's exactly what happened. The only explanation for ranking 13 places and not matching is that they were ranked below the last matched person on every list. What isn't clear is why that's the case.

 

[Entadus]

90% chance of matching = 100% chance that 10% will not match

 

[dozitgetchahi]

Tbh, I am surprised that nobody in this thread has pointed out OPs red flags yet.

This is a DO candidate with average to above average step scores, a first year class fail (red flag #1) and a mixture of P/HP with two scathingly negative rotation reviews (red flag #2) who got 13 interviews yet didn’t match. These aren’t exactly glowing credentials, and speaking from my own experiences as a DO, being a DO isn’t helping the cause here either.

The match is getting more competitive across the board, and even if OP had a totally acceptable interview performance, I am not surprised that he/she didn’t match because of the red flags. I would not expect anyone with that sort of record to be placed in the upper reaches of a rank list at competitive institutions. Psych is more competitive than it used to be, and there are no shortage of well qualified FMGs most programs can find to take that spot. I’d rank a well qualified FMG over someone with this sort of record any day of the week.

OP needs to step their game up and make PGY-1 go well to ensure things start going their way in the future.

 

[LeaveNoTrace]

Did OP apply to competitive institutions? With a hundred programs, there's got to have been some programs in rural Georgia or something in the mix...

 

[seroquantom]

It was definitely your interviews OP. I'm sorry to say this, but sometimes we do not come off the way we perceive ourselves to. You should try to see if you can work on your interview skills and then try again. Things are very competitive now.