How to Gauge Competitiveness for Psych Residency Apps

[I'm Psyched]

Hi all,

Question as we enter residency application season: With psychiatry placing relatively more weight on an applicant's intangibles and relatively less on one's test scores than other medical specialties, any advice on how one can gauge their competitiveness?

Talking to advisors/attendings at my home program, and residents at mine and others in my area, (with my CV and test scores in-hand) has yielded advice that's either been:
-Contradictory
-A little broader than I would have wished, e.g., apply where you want to live (which I don't have a hard limit on)

Checking FREIDA/Doximity/program websites/SDN reviews has been interesting, but again not sure how much stock I can place in those when many do not list their average Step scores (for example), and opinion posts come from n=1 taken with a grain of salt. One thing that has been a helpful starting point for me is my school's match history over the past several years, as there are a few names that pop up multiple times, with the drawbacks of a small sample size and not knowing any details about the applicants.

I'm not looking for program suggestions, but rather any strategic ways in which to cut my list down. Right now, it's pretty long, due to my openness to geography and broad enough specialty interests that they can likely be found at most places. I know that for me, the most important thing in eventually generating my rank list will be my sense of fit with my potential colleagues and a program's "vibe", and after seeking in-person advice, I'm convinced that I'll only really be able to tell this after visiting and talking to people on the interview trail. So I've accepted that I may end up applying to a larger number of places than necessary. But figured it can't hurt to mine the collective wisdom of this forum first.

Thanks so much in advance!

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[finalpsychyear]

Hi all,

Question as we enter residency application season: With psychiatry placing relatively more weight on an applicant's intangibles and relatively less on one's test scores than other medical specialties, any advice on how one can gauge their competitiveness?

Talking to advisors/attendings at my home program, and residents at mine and others in my area, (with my CV and test scores in-hand) has yielded advice that's either been:
-Contradictory
-A little broader than I would have wished, e.g., apply where you want to live (which I don't have a hard limit on)

Checking FREIDA/Doximity/program websites/SDN reviews has been interesting, but again not sure how much stock I can place in those when many do not list their average Step scores (for example), and opinion posts come from n=1 taken with a grain of salt. One thing that has been a helpful starting point for me is my school's match history over the past several years, as there are a few names that pop up multiple times, with the drawbacks of a small sample size and not knowing any details about the applicants.

I'm not looking for program suggestions, but rather any strategic ways in which to cut my list down. Right now, it's pretty long, due to my openness to geography and broad enough specialty interests that they can likely be found at most places. I know that for me, the most important thing in eventually generating my rank list will be my sense of fit with my potential colleagues and a program's "vibe", and after seeking in-person advice, I'm convinced that I'll only really be able to tell this after visiting and talking to people on the interview trail. So I've accepted that I may end up applying to a larger number of places than necessary. But figured it can't hurt to mine the collective wisdom of this forum first.

Thanks so much in advance!

You already answered your question. Cost of living, family support, and significant others can play a role in geography. If you have stellar scores and no strings I would go to California or East Coast no questions asked. Otherwise, do some rotations at some places that look good on paper along with reviews from others you know. Being able to feel the vibe will differ from person to person so unless you rotated there or know others who are similar personalities its a tough call. Its like dating based on whats on paper vs the vibe you get from actually meeting face to face. Only you can really answer that in the moment it happens.

 

[TexasPhysician]

Hi all,

Question as we enter residency application season: With psychiatry placing relatively more weight on an applicant's intangibles and relatively less on one's test scores than other medical specialties, any advice on how one can gauge their competitiveness?

Psychiatry initially copies every other field. Test scores, research, school performance, etc get you the interview. Programs will use cut-offs to weed out candidates.

Interpersonal skills and fit plays a larger role than other fields come interview time.

 

[NickNaylor]

Here's what I did:

1) Get a list of all current psychiatry programs from FRIEDA
2) Eliminate all programs in geographic areas that I did not want to live in
3) Eliminate all programs in geographic areas that my wife did not want to live in (this may or may not apply to you)
4) Eliminate all programs not affiliated with a university that I've heard of

At that point, the list became a bit more manageable, and I started reading about individual programs. Was there something that they emphasized or focused on that seemed interesting to me? I was particularly interested in psychotherapy so that was important to me; programs that seemed to place some amount of emphasis on psychotherapy training "moved up the list." Programs in geographic areas my wife and I would be interested in living in similarly moved up the list.

For me, this left me with a fairly manageable number of programs - something like 20 or so. I ended up applying to essentially all of them because my wife and I were fairly open to living in another area of the country, and it was difficult to really get a sense of a program just from the website. "Prestige" was not an important factor for me and my wife didn't want to live where it was cold or east of the Mississippi, so I didn't apply to most of the "prestigious" programs, which left me with a fairly reasonable list in terms of "competitiveness." I would just make sure that your list isn't comprised only of programs at super well-known institutions (e.g., Harvard-like places). If you have more specific questions, speaking with an advisor about your "competitiveness" and how your program list matches that would be helpful.

If you really have no preferences in terms of where you'd like to end up or things that are "must haves" to you, I would aim to go on something like 10-12 interviews. Some may argue that's too many, and they're probably right, but you will at least get the chance to see a variety of programs. Depending on your competitiveness and the kinds of programs that you're applying to, that may mean applying to something like 15-20 programs, more if you're a "weaker" applicant. Check out the NRMP data to get a sense of where you lie in the pack; while the data is limited, it can nevertheless give you a rough idea about what to expect. I was an above average psychiatry applicant but below average in my class, didn't have anything particularly remarkable about my medical school career, and didn't have any major red flags, and this strategy worked well for me.

It's hard to give advice without knowing you personally or the details of your application.

 

[FlowRate]

You mentioned not feeling like you have any geographical ties. I felt similarly when I was applying to residency. While I think I would have made the same decisions given the interviews I received, I would recommend trying to think of at least a few places you'd like to end up when you're an attending and make sure you apply to those places. Now that I'm looking at trying to get a job in a totally different part of the country, I'm a little frustrated at having gone to residency somewhere I already knew I wanted to leave afterward--I don't have a network of people where I want to be.

 

[TexasPhysician]

You mentioned not feeling like you have any geographical ties. I felt similarly when I was applying to residency. While I think I would have made the same decisions given the interviews I received, I would recommend trying to think of at least a few places you'd like to end up when you're an attending and make sure you apply to those places. Now that I'm looking at trying to get a job in a totally different part of the country, I'm a little frustrated at having gone to residency somewhere I already knew I wanted to leave afterward--I don't have a network of people where I want to be.

Very true. Connections really help in finding the best jobs. Large advantage to training where you want to work.

 

[NickNaylor]

You mentioned not feeling like you have any geographical ties. I felt similarly when I was applying to residency. While I think I would have made the same decisions given the interviews I received, I would recommend trying to think of at least a few places you'd like to end up when you're an attending and make sure you apply to those places. Now that I'm looking at trying to get a job in a totally different part of the country, I'm a little frustrated at having gone to residency somewhere I already knew I wanted to leave afterward--I don't have a network of people where I want to be.

Very true. I would not have current gotten my current position if I hadn't gone to residency here. It happened to be a "right place, right time" kind of situation that I likely would not have been aware of had I not been a trainee at the same institution.

 

[lockian]

I was on my residency's selection committee, and I can speak in generalities. I was also in the same boat as you when applying to residency, but ultimately geography and social support made the difference.

First, about you. Put some thought into what kind of work you want to do and what populations you want to work with. If you want to work with a diverse population, choose a big city. If you want to have the option to teach, do research, and specialize or do something niche that may or may not require fellowship, choose an academic center. I also recommend bigger programs because there are more people to share call duties with. Also, bigger and/or academic program in a bigger city and/or with a big catchment (sp?) area = more chances to find something you want to do that you didn't realize you loved.

Second, about what residencies want. This will vary to some extent based on program's goals, which may or may not be immediately obvious. Some programs have a mission to be very service-oriented and will look for people who have the "do-gooder" background with lots of volunteering and peace corps type stuff. However, being a service-oriented individual is good for both academic and community programs. Some programs will want to develop their academic side so they'll look for someone with that background and interest. These are often the less prominent research centers.

The most desirable candidates in general are those who have 1) at least some research 2) something they did that shows they're a self-starter and capable of CREATING opportunities for themselves, not just taking advantage of whatever's already available 3) something that shows they have unique skills or experiences that few others have.

About academics - you'll stand out and likely get a boost if you're AOA or in the top 5% of STEP scores. Failures in class or steps will make you less desirable and/or can be a deal breaker. Otherwise, academics are probably not going to make or break you unless you're applying to the very top ranking programs.

I'm happy to answer any other questions.

 

[PsychApp777]

About academics - you'll stand out and likely get a boost if you're AOA or in the top 5% of STEP scores. Failures in class or steps will make you less desirable and/or can be a deal breaker. Otherwise, academics are probably not going to make or break you unless you're applying to the very top ranking programs.

Thank you for letting us know that a psych applicant with a 260 step 1 will likely get a boost.

 

[lockian]

Thank you for letting us know that a psych applicant with a 260 step 1 will likely get a boost.

I see you trolling. Have a nice day.

 

[444jz]

The most desirable candidates in general are those who have 1) at least some research 2) something they did that shows they're a self-starter and capable of CREATING opportunities for themselves, not just taking advantage of whatever's already available 3) something that shows they have unique skills or experiences that few others have.

What are some tips you have in creating these opportunities? As a student who attends a suburban MD school that is an hour out from a major city and is rather deficient in several resources, it is difficult for me to gauge what I know or don't know is already available.

 

[NickNaylor]

What are some tips you have in creating these opportunities? As a student who attends a suburban MD school that is an hour out from a major city and is rather deficient in several resources, it is difficult for me to gauge what I know or don't know is already available.

For what it's worth, I disagree with the previous comment. Sure, all those things are great, but they aren't necessary to match and you will be a perfectly competitive applicant and likely match at a great program if your application is otherwise in order without those things. For those aiming for the most "prestigious" programs, sure, those things are necessary. But they are by no means necessary if you're simply wanting to get into a "good enough" program.

This also comes from someone with a year on our program's selection committee.

 

[PsychApp777]

For what it's worth, I disagree with the previous comment. Sure, all those things are great, but they aren't necessary to match and you will be a perfectly competitive applicant and likely match at a great program if your application is otherwise in order without those things. For those aiming for the most "prestigious" programs, sure, those things are necessary. But they are by no means necessary if you're simply wanting to get into a "good enough" program.

This also comes from someone with a year on our program's selection committee.

Indeed. Your position is more consistent with the only real data we have (Charting Outcomes), which show that you can predict your competitiveness quite accurately with the basics (med school category, step 1, step 2).

 

[When is graduation again?]

What are some tips you have in creating these opportunities? As a student who attends a suburban MD school that is an hour out from a major city and is rather deficient in several resources, it is difficult for me to gauge what I know or don't know is already available.

Depending on what year you are in med school, there are scholarships and fellowships that could allow you to gain experiences your med school doesn't cover. There were a ton of summer programs in MS1 and MS2 years. I got a scholarship to conduct a CVD and media research project as an MS1. I used to know the names of specific scholarships, but I'm too far removed now. There are also things like the APA's HIV Psych elective.

You should ask your school academic/student affairs if they know of any of those programs. You could also probably try Google.