Should I apply to psychiatry residency programs this cycle or next cycle?

[PsychiatryApplicant456]

Dear Psych SDN,

Bit of an odd situation here, and I wanted yall's input.

I am a 4th year US MD student. I scored a 212 on Step 1. Based on clerkship scheduling, the earliest I can take Step 2 CK is somewhere between September 28-October 21.

I realize that this test date would be pretty late in getting my Step 2 CK score delivered to residency programs since it would be uploaded into my ERAS application sometime in either late October or early November.

Based on my research, the Step 2 CK/interview topic in Psychiatry residencies is a murky subject. It appears that although most programs don't require a Step 2 CK score for an interview, they have a strong preference for it. I've heard lots of anecdotal accounts of people seemingly getting more interviews after their score is in.

So my dilemma is this: I can either apply on September 15 this year and take Step 2 CK in that September-October 21 window and try and match this cycle, or I can wait and apply next cycle (still as US Senior - my school will let me take 1 course to keep my US Senior status).

The pro's to applying this year are financial and starting my career one year sooner. The cons to applying this year is potentially missing out on a lot of interviews due to my Step 2 CK not being scored until late October/early November.

The pro's to applying next year are having a full application in by the time of September 15 and October 1, potentially maximizing application visibility and interview opportunities. The cons are financial and figuring how to justify and explain taking an extra year to programs.

I essentially want to know how much of a risk I'm running getting my Step 2 CK score in so late (submitted to programs in late Oct/early Nov) vs how big of a red flag is it to apply next year and spend this year doing AIs and/or psychiatry research. I'm really not sure.

I'm pretty torn on this issue, and my school doesn't have a ton of info on it. They also think it's a really tough choice. So I'm curious if any one here has any ideas or advice.

Thank you very much.

Tl;dr: US Senior, Step 1 is 212. Should I apply to psychiatry programs this cycle with a Step 2 CK score that won't be submitted to programs until late October/early November or apply next cycle with the potential red flag of waiting an extra year? (US Senior status will apply to either).

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[Merely]

Dear Psych SDN,

Bit of an odd situation here, and I wanted yall's input.

I am a 4th year US MD student. I scored a 212 on Step 1. Based on clerkship scheduling, the earliest I can take Step 2 CK is somewhere between September 28-October 21.

I realize that this test date would be pretty late in getting my Step 2 CK score delivered to residency programs since it would be uploaded into my ERAS application sometime in either late October or early November.

Based on my research, the Step 2 CK/interview topic in Psychiatry residencies is a murky subject. It appears that although most programs don't require a Step 2 CK score for an interview, they have a strong preference for it. I've heard lots of anecdotal accounts of people seemingly getting more interviews after their score is in.

So my dilemma is this: I can either apply on September 15 this year and take Step 2 CK in that September-October 21 window and try and match this cycle, or I can wait and apply next cycle (still as US Senior - my school will let me take 1 course to keep my US Senior status).

The pro's to applying this year are financial and starting my career one year sooner. The cons to applying this year is potentially missing out on a lot of interviews due to my Step 2 CK not being scored until late October/early November.

The pro's to applying next year are having a full application in by the time of September 15 and October 1, potentially maximizing application visibility and interview opportunities. The cons are financial and figuring how to justify and explain taking an extra year to programs.

I essentially want to know how much of a risk I'm running getting my Step 2 CK score in so late (submitted to programs in late Oct/early Nov) vs how big of a red flag is it to apply next year and spend this year doing AIs and/or psychiatry research. I'm really not sure.

I'm pretty torn on this issue, and my school doesn't have a ton of info on it. They also think it's a really tough choice. So I'm curious if any one here has any ideas or advice.

Thank you very much.

Tl;dr: US Senior, Step 1 is 212. Should I apply to psychiatry programs this cycle with a Step 2 CK score that won't be submitted to programs until late October/early November or apply next cycle with the potential red flag of waiting an extra year? (US Senior status will apply to either).

You’re a USMD with no red flags that thinks they should delay their residency by an entire year because they’re taking ck one or 2 months late? Wtf? No, you should not delay your entire life by a year because you took ck late, people take ck late all the time it’s not a huge deal. Might you get a little less interviews? Yes, but you’re a USMD with no red flags..as long as you’re not a complete *******/creep during interviews you will match.

 

[psychattending]

Dear Psych SDN,

Bit of an odd situation here, and I wanted yall's input.

I am a 4th year US MD student. I scored a 212 on Step 1. Based on clerkship scheduling, the earliest I can take Step 2 CK is somewhere between September 28-October 21.

I realize that this test date would be pretty late in getting my Step 2 CK score delivered to residency programs since it would be uploaded into my ERAS application sometime in either late October or early November.

Based on my research, the Step 2 CK/interview topic in Psychiatry residencies is a murky subject. It appears that although most programs don't require a Step 2 CK score for an interview, they have a strong preference for it. I've heard lots of anecdotal accounts of people seemingly getting more interviews after their score is in.

So my dilemma is this: I can either apply on September 15 this year and take Step 2 CK in that September-October 21 window and try and match this cycle, or I can wait and apply next cycle (still as US Senior - my school will let me take 1 course to keep my US Senior status).

The pro's to applying this year are financial and starting my career one year sooner. The cons to applying this year is potentially missing out on a lot of interviews due to my Step 2 CK not being scored until late October/early November.

The pro's to applying next year are having a full application in by the time of September 15 and October 1, potentially maximizing application visibility and interview opportunities. The cons are financial and figuring how to justify and explain taking an extra year to programs.

I essentially want to know how much of a risk I'm running getting my Step 2 CK score in so late (submitted to programs in late Oct/early Nov) vs how big of a red flag is it to apply next year and spend this year doing AIs and/or psychiatry research. I'm really not sure.

I'm pretty torn on this issue, and my school doesn't have a ton of info on it. They also think it's a really tough choice. So I'm curious if any one here has any ideas or advice.

Thank you very much.

Tl;dr: US Senior, Step 1 is 212. Should I apply to psychiatry programs this cycle with a Step 2 CK score that won't be submitted to programs until late October/early November or apply next cycle with the potential red flag of waiting an extra year? (US Senior status will apply to either).

You appear to have no red flags. 212 on Step 1, while not stellar is still a pass. Apply this year. The only reason to conceivably wait until next year would be that you know that you are going to get some obscenely high score, like above 140. If not, there is zero benefit and just downsides to applying next year.

 

[MacDonaldTriad]

Dear psychapplicant456,

I suppose everyone else has consistently answered this question. Taking a year off for no apparent reason is an order of magnitude worse than getting a step II score late, but on time. Now if you don't pass it, you will be taking a year off for reason and that should tell you something about what taking a year off looks like. Now if you are in a combined PhD, MPH, or MBA program, come into a grant and do research, or even just join the peace corps, a year off is OK, but without a good reason it is a negative.

 

[Taddy Mason]

I was in a similar situation last year, Step 1 was in the 220s but didn't have a CK score until the beginning of November. The late CK hurt a lot... If you have no geographic limitations applying this year is reasonable. I would recommend applying broadly, to a large number of programs, and to programs where graduates of your school have matched in psych previously, or if there are programs that have a strong history of taking grads from your school in other fields. If you can do something productive by extending your graduation by a year (e.g., publishable research, MPH, etc) and be able to talk about how it will benefit your future endeavors that is also reasonable. However, I would only go with the latter if you strongly know you'll have something to show from it. Feel free to PM me if you have questions.

 

[PsychiatryApplicant456]

You’re a USMD with no red flags that thinks they should delay their residency by an entire year because they’re taking ck one or 2 months late? Wtf? No, you should not delay your entire life by a year because you took ck late, people take ck late all the time it’s not a huge deal. Might you get a little less interviews? Yes, but you’re a USMD with no red flags..as long as you’re not a complete *******/creep during interviews you will match.

You appear to have no red flags. 212 on Step 1, while not stellar is still a pass. Apply this year. The only reason to conceivably wait until next year would be that you know that you are going to get some obscenely high score, like above 140. If not, there is zero benefit and just downsides to applying next year.

For additional context: I took of a 3 month leave of absence to study for Step 1. That is what has pushed some of my clerkships into 4th year and why my whole Step 2 CK timeline is being pushed back.

I've passed every pre-clinical course (P/F system), I've High Passed Psych and Surgery, and I passed the rest of my clerkships. My EC's are probably average, my volunteerism is good, and my letters of recommendation are probably average to good.

Essentially, I'm trying to figure out how much it's going to hurt me to take Step 2 CK in October and not have that score back until early November. I'm worried that I'm going to miss out on a lot of interviews from programs that want a Step 2 CK on file. I want to avoid a situation where it's November and I'm desperately trying to call programs telling them my Step 2 score is in, my application is updated, and that I'm interested in their program. I've heard many programs don't update applications after October 1st much unless they do so manually, so I could be filtered out of a lot of places or just not looked at for an interview.

I'm also unsure what kind of risk is carried with waiting a year. I'm not sure what I'd do that year. I'd be interested in something clinical and working with people, but I'm also open to the idea of psych research. Behavioral therapy and counseling interests me, so I imagine I might looking into doing something around those lines.

Dear psychapplicant456,

I suppose everyone else has consistently answered this question. Taking a year off for no apparent reason is an order of magnitude worse than getting a step II score late, but on time. Now if you don't pass it, you will be taking a year off for reason and that should tell you something about what taking a year off looks like. Now if you are in a combined PhD, MPH, or MBA program, come into a grant and do research, or even just join the peace corps, a year off is OK, but without a good reason it is a negative.

I'm primarily worried about the interview situation with such a late Step 2 score. Low step 1, leave of absence, Step 2 score released in early November...I'm worried that this combination might make interviews few and far between during those first few months and maybe even after that. Historically, it looks like 62% of psychiatry interviews are extended before November. I'm not sure how many programs require a Step 2 CK score for an interview, but it certainly seems like a strong preference.

I was in a similar situation last year, Step 1 was in the 220s but didn't have a CK score until the beginning of November. The late CK hurt a lot... If you have no geographic limitations applying this year is reasonable. I would recommend applying broadly, to a large number of programs, and to programs where graduates of your school have matched in psych previously, or if there are programs that have a strong history of taking grads from your school in other fields. If you can do something productive by extending your graduation by a year (e.g., publishable research, MPH, etc) and be able to talk about how it will benefit your future endeavors that is also reasonable. However, I would only go with the latter if you strongly know you'll have something to show from it. Feel free to PM me if you have questions.

I do not have any geographic limitations. I'm from Texas and would prefer to stay here, but I'm willing to apply very broadly. I'm still doing research to find out which programs I should target, but I estimate it will be somewhere on the order of 60, probably more.

As far as what I'd do that year, I was considering doing something with counseling or psychiatry research, but I'm not sure. I'm more inclined to do something with people than more schooling, but I don't know what's best.



I just want to say thank you to all the responses so far. I'm really not sure what to do, so I appreciate the advice. My school seems to be puzzled on how to advise me on this issue, too. Thank you.

 

[Taddy Mason]

For additional context: I took of a 3 month leave of absence to study for Step 1. That is what has pushed some of my clerkships into 4th year and why my whole Step 2 CK timeline is being pushed back.

I've passed every pre-clinical course (P/F system), I've High Passed Psych and Surgery, and I passed the rest of my clerkships. My EC's are probably average, my volunteerism is good, and my letters of recommendation are probably average to good.

Essentially, I'm trying to figure out how much it's going to hurt me to take Step 2 CK in October and not have that score back until early November. I'm worried that I'm going to miss out on a lot of interviews from programs that want a Step 2 CK on file. I want to avoid a situation where it's November and I'm desperately trying to call programs telling them my Step 2 score is in, my application is updated, and that I'm interested in their program. I've heard many programs don't update applications after October 1st much unless they do so manually, so I could be filtered out of a lot of places or just not looked at for an interview.

I'm also unsure what kind of risk is carried with waiting a year. I'm not sure what I'd do that year. I'd be interested in something clinical and working with people, but I'm also open to the idea of psych research. Behavioral therapy and counseling interests me, so I imagine I might looking into doing something around those lines.



I'm primarily worried about the interview situation with such a late Step 2 score. Low step 1, leave of absence, Step 2 score released in early November...I'm worried that this combination might make interviews few and far between during those first few months and maybe even after that. Historically, it looks like 62% of psychiatry interviews are extended before November. I'm not sure how many programs require a Step 2 CK score for an interview, but it certainly seems like a strong preference.



I do not have any geographic limitations. I'm from Texas and would prefer to stay here, but I'm willing to apply very broadly. I'm still doing research to find out which programs I should target, but I estimate it will be somewhere on the order of 60, probably more.

As far as what I'd do that year, I was considering doing something with counseling or psychiatry research, but I'm not sure. I'm more inclined to do something with people than more schooling, but I don't know what's best.



I just want to say thank you to all the responses so far. I'm really not sure what to do, so I appreciate the advice. My school seems to be puzzled on how to advise me on this issue, too. Thank you.

I also had a LOA. I’d lean towards taking an extra year if the odds are in your favor of gaining something tangible from it. Otherwise, I would recommend applying to FM/IM/Peds as backups if you want to avoid SOAPing.

 

[Merely]

For additional context: I took of a 3 month leave of absence to study for Step 1. That is what has pushed some of my clerkships into 4th year and why my whole Step 2 CK timeline is being pushed back.

I've passed every pre-clinical course (P/F system), I've High Passed Psych and Surgery, and I passed the rest of my clerkships. My EC's are probably average, my volunteerism is good, and my letters of recommendation are probably average to good.

Essentially, I'm trying to figure out how much it's going to hurt me to take Step 2 CK in October and not have that score back until early November. I'm worried that I'm going to miss out on a lot of interviews from programs that want a Step 2 CK on file. I want to avoid a situation where it's November and I'm desperately trying to call programs telling them my Step 2 score is in, my application is updated, and that I'm interested in their program. I've heard many programs don't update applications after October 1st much unless they do so manually, so I could be filtered out of a lot of places or just not looked at for an interview.

I'm also unsure what kind of risk is carried with waiting a year. I'm not sure what I'd do that year. I'd be interested in something clinical and working with people, but I'm also open to the idea of psych research. Behavioral therapy and counseling interests me, so I imagine I might looking into doing something around those lines.



I'm primarily worried about the interview situation with such a late Step 2 score. Low step 1, leave of absence, Step 2 score released in early November...I'm worried that this combination might make interviews few and far between during those first few months and maybe even after that. Historically, it looks like 62% of psychiatry interviews are extended before November. I'm not sure how many programs require a Step 2 CK score for an interview, but it certainly seems like a strong preference.



I do not have any geographic limitations. I'm from Texas and would prefer to stay here, but I'm willing to apply very broadly. I'm still doing research to find out which programs I should target, but I estimate it will be somewhere on the order of 60, probably more.

As far as what I'd do that year, I was considering doing something with counseling or psychiatry research, but I'm not sure. I'm more inclined to do something with people than more schooling, but I don't know what's best.



I just want to say thank you to all the responses so far. I'm really not sure what to do, so I appreciate the advice. My school seems to be puzzled on how to advise me on this issue, too. Thank you.

Sdn is filled with people that will make you nervous for no reason. Ignore them. You’re a USMD with no red flags. This is not derm you’re applying to. If you apply broadly with a reasonable interview you will match. Do not take a year off due to taking the test 2 months late that is foolish. If you really don’t care about the extra year, you could spin it into a weird research year or something but it is definitely not advisable.

 

[Taddy Mason]

Sdn is filled with people that will make you nervous for no reason. Ignore them. You’re a USMD with no red flags. This is not derm you’re applying to. If you apply broadly with a reasonable interview you will match. Do not take a year off due to taking the test 2 months late that is foolish. If you really don’t care about the extra year, you could spin it into a weird research year or something but it is definitely not advisable.

Care to offer any personal experience or objective data to support this advice?

 

[PsychiatryApplicant456]

Sdn is filled with people that will make you nervous for no reason. Ignore them. You’re a USMD with no red flags. This is not derm you’re applying to. If you apply broadly with a reasonable interview you will match. Do not take a year off due to taking the test 2 months late that is foolish. If you really don’t care about the extra year, you could spin it into a weird research year or something but it is definitely not advisable.

Psych isn't derm, but it's certainly gotten a lot more competitive. 13.7% of US Seniors who applied to psychiatry last year went unmatched, which was more than any field based on the 2018 NRMP data. That doesn't mean psychiatry is the most competitive field, but it is getting more competitive.

I do have a red flag. I took an LOA for Step 1. I'm also worried about how not having a Step 2 CK score on file until early November will affect interview invites. Digging through SDN and reddit threads, and also talking to psych residents, a lot of them gave me the impression that having that Step 2 CK score on file is a really important thing.

Historically, 62% of psychiatry interviews are offered before November. Not every program requires Step 2 CK for an interview, but I think it's reasonable to assume most prefer it. If I apply this year, I could be in for a really rough cycle with not many interviews based on my Step 1 score and a late Step 2 CK score. And I'm not sure how being a re-applicant the following year would hurt me vs taking a year to do something else to make my application more competitive and apply with a completed application right out of the gate.

I'd also have another month to study for Step CK, which could increase my score. My Step 1 is already low. But then again, I could also see how taking a year to do something else could look bad, even if I'm still classified as a US Senior. So I'm pretty torn.

 

[Taddy Mason]

@PsychiatryApplicant456 PM me. I can’t message you because of your user settings. Your situation is very similar to mine when applying last year.

 

[MacDonaldTriad]

Do not take a year off due to taking the test 2 months late that is foolish. If you really don’t care about the extra year, you could spin it into a weird research year or something but it is definitely not advisable.

This is exactly what most PDs would say I believe. Besides, if you do apply and not match this year, how are you any worse off than if you don't apply? Maybe you will save some time and money, but you will not have to pay to go to interviews you don't get and if you get interviews, you should go and look.

 

[FlowRate]

It really comes down to what you want to accomplish with your residency application. Are you happy going literally anywhere to be a psychiatrist? Do you have important obligations that keep you tied down geographically? Are you hoping to go to a "prestigious" residency for some reason (good or bad)?

You could always apply this year, only to places you think you'd want to go, rank only places you'd be happy attending, and then see how things pan out. You could start setting yourself up for a research year or extra degree now (at my institution, this was around the time of year to start getting the ball rolling for the more well funded opportunities) in case you don't match.

 

[PsychiatryApplicant456]

This is exactly what most PDs would say I believe. Besides, if you do apply and not match this year, how are you any worse off than if you don't apply? Maybe you will save some time and money, but you will not have to pay to go to interviews you don't get and if you get interviews, you should go and look.

If I apply this year and don't get in, I think I could be worse off next cycle because I believe I would lose my application status as a graduating US senior. I'd be a re-applicant, which I've heard carries decreased chances outside of the application factors that hurt the applicant the first time around (the status alone of being a re-applicant is unattractive to programs).

I'm thinking I should apply as a graduating US senior with my best application and everything in on time to maximize interview opportunities. I'm worried I won't get many interviews with a Step 2 CK score not coming back until November. Anecdotally, this seems to be the case. So I'm essentially worried that applying this cycle and being unsuccessful could potentially hurt me even worse next cycle for multiple reasons.

Can you speak to this at all? Thank you.

It really comes down to what you want to accomplish with your residency application. Are you happy going literally anywhere to be a psychiatrist? Do you have important obligations that keep you tied down geographically? Are you hoping to go to a "prestigious" residency for some reason (good or bad)?

You could always apply this year, only to places you think you'd want to go, rank only places you'd be happy attending, and then see how things pan out. You could start setting yourself up for a research year or extra degree now (at my institution, this was around the time of year to start getting the ball rolling for the more well funded opportunities) in case you don't match.

I'm happy going anywhere to be a psychiatrist. I don't have any important obligations that will tie me down geographically. I'm not hoping for a prestigious residency, I just really want to be a psychiatrist. I'm not picky - I know my application isn't that great.

I'm just afraid that with my low step 1 score, a late step 2 CK score, and an LOA, I'm going to have a hard time getting interviews this cycle. I suppose the key question I have now is how re-applicants are viewed and how the graduating US senior status applies to the match. I was under the impression you lose that status after you apply to the match once, but I'm not sure.

 

[MacDonaldTriad]

If you call yourself a graduating US senior or not doesn't equate much to a PD. It will have taken you 5 years to finish either way so it is seen as the same. I guess there is a ERAS data base that indicates % of US seniors matched, but so what. Out of the hundreds of applicants with an extra year, none have told me that they took a year off because they weren't going to get Step II until Nov. There are a lot of people without step II in Sept. Two years ago on SDN students were telling each other to delay taking step II in case they blow it. I suggest you not cut your foot off because it has a blister. Taking a leave, but graduating on time is different than taking a leave and delaying a year. The disclaimer is that leaves can be very legitimate and taking one can be the responsible thing, but this is different than taking a leave for no described reason.

 

[FlowRate]

I'm happy going anywhere to be a psychiatrist. I don't have any important obligations that will tie me down geographically. I'm not hoping for a prestigious residency, I just really want to be a psychiatrist. I'm not picky - I know my application isn't that great.

I'm just afraid that with my low step 1 score, a late step 2 CK score, and an LOA, I'm going to have a hard time getting interviews this cycle. I suppose the key question I have now is how re-applicants are viewed and how the graduating US senior status applies to the match. I was under the impression you lose that status after you apply to the match once, but I'm not sure.

Your institution won't let you extend a year of status if you apply via ERAS?

Reapplying doesn't hurt so long as it's for the reason that you didn't match.

I don't recall whether being an independent applicant actually hurts you any. MDT seems to be indicating it does not and is a greater authority than myself about these things.

 

[Merely]

Dude we already answered your question you’re just looking for people to tell you you should take the year off. No one cares, go do what you want. We already told you it’s not the smart move because taking step 2 ck late given your application is not a huge deal and taking the year off will be very strange and probably look worse because it shows you’re naive. At the end of the day you can do whatever you want but your question has been answered several times.

 

[Taddy Mason]

Dude we already answered your question you’re just looking for people to tell you you should take the year off. No one cares, go do what you want. We already told you it’s not the smart move because taking step 2 ck late given your application is not a huge deal and taking the year off will be very strange and probably look worse because it shows you’re naive. At the end of the day you can do whatever you want but your question has been answered several times.

Just. Stop. Unless you’ve actually gone through the match, are on the interview side of things, or have talked with PDs and can offer specifics of what insight they’ve offered and aren’t just echoing generalized statements made from an internet forum there’s no reason to callout OP, use that tone, or take such a staunch opinion regarding OP’s situation. Also, OP never said he/she was going to just take a year off. She/he specifically stated that he/she would likely do something productive during that year in addition to wrapping-up loose ends in regard to Step 2 if that’s the route OP chose.

 

[psychattending]

If I apply this year and don't get in, I think I could be worse off next cycle because I believe I would lose my application status as a graduating US senior. I'd be a re-applicant, which I've heard carries decreased chances outside of the application factors that hurt the applicant the first time around (the status alone of being a re-applicant is unattractive to programs).

I'm thinking I should apply as a graduating US senior with my best application and everything in on time to maximize interview opportunities. I'm worried I won't get many interviews with a Step 2 CK score not coming back until November. Anecdotally, this seems to be the case. So I'm essentially worried that applying this cycle and being unsuccessful could potentially hurt me even worse next cycle for multiple reasons.

Can you speak to this at all? Thank you.



I'm happy going anywhere to be a psychiatrist. I don't have any important obligations that will tie me down geographically. I'm not hoping for a prestigious residency, I just really want to be a psychiatrist. I'm not picky - I know my application isn't that great.

I'm just afraid that with my low step 1 score, a late step 2 CK score, and an LOA, I'm going to have a hard time getting interviews this cycle. I suppose the key question I have now is how re-applicants are viewed and how the graduating US senior status applies to the match. I was under the impression you lose that status after you apply to the match once, but I'm not sure.

To my knowledge application status is driven by when you graduate (information provided by medical schools) and not whether you have applied to ERAS before.

I believe waiting a year is a mistake on your part and will produce a substantially weaker application. 5 years to complete a MD is already a bad sign, that can be mitigated in depending on the circumstances. Doing so out of fear of not matching is even worse in my book as the reason is not a legitimate one.

 

[Taddy Mason]

To my knowledge application status is driven by when you graduate (information provided by medical schools) and not whether you have applied to ERAS before.

I believe waiting a year is a mistake on your part and will produce a substantially weaker application. 5 years to complete a MD is already a bad sign, that can be mitigated in depending on the circumstances. Doing so out of fear of not matching is even worse in my book as the reason is not a legitimate one.

If OP delayed graduation he/she would be using that year to either get an MPH or as a research year, both of which aren’t that uncommon and different than just taking a straight-up LOA.

 

[psychattending]

The helpfulness of having a MPH (or a research year) has in my estimation plummeted as I have determined that med schools are using this to cover up performance issues. It is being seen more and more as a red flag by me, especially when the applicant can give no coherent answer for why out of the blue he/she did a MPH as a 5th/last year.

 

[Taddy Mason]

Obviously it’s not worth it if you assume the extra year in and of itself is enough and can’t provide a meaningful explanation as to why and when you took a research year or got an MPH and how it will serve your future endeavors.

 

[MacDonaldTriad]

The helpfulness of having a MPH (or a research year) has in my estimation plummeted as I have determined that med schools are using this to cover up performance issues.

This.

I see Taddy Mason's point about tone, but Merely isn't that out of line. All of us except Taddy have told psychapplicant456 not to take a year off and he/she seems to be still trying to rationalize taking a year off. Here it is concretely as this conversation has be saying 90% of the time. Psychapplicant456, if you can't match this year with a late step II, it will be even harder to match next year with an early step II and a year off. If this does happen to you, I strongly suggest you take step III before your application goes in next year and we really think you should put your hat in the ring this Sept. 15th.

 

[PsychiatryApplicant456]

Hello, everyone. Thank you for all of the responses.

I honestly wasn't leaning one way or the other. Pretty torn on the subject. I just wanted to collect information about both choices (how a late Step 2 score will affect interviews vs how programs view an extra year).

Based on the advice here, I think I should go ahead and apply this year. The big unknown for me was how the US graduating senior status applies in the match and how much stock PD's put into that. I was under the impression that it was a semi-big deal and that being a re-applicant was a red flag, but perhaps taking an extra year is a bigger red flag in itself.

If I did take the year, I wasn't planning on doing an MPH. I like working with people, so I was going to look into something with counseling or mental health in addition to some psychiatry ethics research I've been helping some residents with. I'm not sure how programs would view that vs an MPH or another degree.

I just think having all my application and scores in on time, in addition to some extra things on my CV, could result in a better interview season, even with the extra year. An acquaintance of mine who applied to psychiatry last year in a very similar situation with higher step score than me that also got their Step 2 score back in November had a really rough interview cycle (only 3 interviews), but they still matched. 3 interviews puts you at about a 70% chance of matching, which isn't awful, but it isn't good, either. I'm worried that's what will happen to me (or worse, my Step 1 was ~10 points lower).

Other psychiatry residents at two institutions have told me that my app won't even be looked at for an interview at most places without a Step 2. And by November, approximately 60-70% of all interview invites will be gone based on historical data, so I'd be in a potentially bad situation of desperately trying to send letters/emails to programs saying I am interested in their program and that my application is updated. Perhaps most programs will have already sent most of their invites out or don't check for updates that late in the cycle. That's why I posed this question because I wanted to get some more perspective on this decision.

However, it seems to me that US senior graduating status or not, my best chances of getting into psychiatry would be applying this year + potentially next year vs only applying next year. So I mine as well go for it this year. Of course, the con to this plan is money for applications and travel, but I'm willing to do that.

I plan on applying very broadly, so if anyone else has some ideas of programs that I should apply to or resources I should look at to help with me my program list, please let me know. Also, if anyone has any advice on what's the best way to express interest in programs later on during interview season or how to let programs know that their application is updated, I'd also appreciate some advice on that subject. I'm anticipating a pretty rocky interview season but hoping for the best.

 

[MacDonaldTriad]

Good luck PsychiatryApplicant456. I wish you the best and I hope you have to keep costs down by turning down some interviews.

I think this discussion was illustrative of both some applicant miss information, and some of the more recent sea changes in program thinking. For instance,

"I was under the impression that it was a semi-big deal and that being a re-applicant was a red flag, but perhaps taking an extra year is a bigger red flag in itself."

Yes. ERAS has no flags about who is or isn't a re-applicant. We only see if you extended medical school, and the date of graduation. We can look up your application history on NRMP, but that takes time we don't want to spend unless you are going on our rank list.

"Let's see, this one took and extra year, let's see why... explanation is vague, and not in the essay, guess we wait for the Dean's letter and see if that tells us".

I just think having all my application and scores in on time, in addition to some extra things on my CV, could result in a better interview season, even with the extra year.

No. Having step II late because you had an academic stumble isn't fun because it is a concrete reminder of a short coming. Having step II late because you just didn't prioritize it enough to get your act together isn't a plus either. All of this is true, but having "everything in on time" doesn't neutralize having everything a year late without explanation.

Be careful of how you present your legitimate reason for a 5th year. Psychattending put it best:

"The helpfulness of having a MPH (or a research year) has in my estimation plummeted as I have determined that med schools are using this to cover up performance issues. It is being seen more and more as a red flag by me, especially when the applicant can give no coherent answer for why out of the blue he/she did a MPH as a 5th/last year."

Planed combined programs are generally MS1, MS2, PhD, PhD, MS3, MS4. Not MS1, MS2, MS3, MS3.75, online PsyD course, MS4. PDs have been in medical education for their entire career and the odds of figuring an angle out that hasn't been tried isn't likely. Sometimes the cover up is worse than the crime. Often being honest about what life circumstances made you trip hurts less than "I really was going to finish on time, but I became fascinated with something so I took a year off to write a review paper on the virtues of CBD."

Finally,

However, it seems to me that US senior graduating status or not, my best chances of getting into psychiatry would be applying this year + potentially next year vs only applying next year.

This seems so obvious to me, but maybe there is a lot of heterogeneity in the advice Deans are giving to applicants. Maybe other specialties care, but I have never heard of graduating status as a statistic that is heeded. Years out of medical school, yes. Years to finish medical school, yes.
Two independent throws of dice to obtain one outcome are additive. Being a fifth year MS4 vs an applicant who is a year out seldom are different enough to give up the chance to match on time even with a late step II.

Again, if you are in a combined program, or if you had a legitimate crisis that needed a year off, don't freak out. I'm just discouraging the trend to take time off lightly. Medical schools are expanding and the objective measures are becoming less discriminating. This leads to an increased emphasis on concrete information that can't be hidden. Don't leave reasons for variation to our imagination. Our risk aversive natures will think of much worse things than the reality in most cases.

Who knows, maybe in ten years "Of course I took a year off... can you believe they took away our summer vacations" may become the new norm. On the other hand, you are all moving towards a well paying, difficulty, but very secure and rewarding career path that many people would do a lot to be able to get. This is why it can be difficulty and sometimes unreasonably so.