Unofficial WAMC Psychiatry Residency Thread 2023

[deleted827530]

Hi! I'm applying psych in the upcoming cycle and am currently trying to formulate my list. Stats aside, I'm curious if anyone is aware of East Coast programs known for good work life balance? On the flipside, are there programs I should be avoiding if I am looking for solid work life balance? Thanks!

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[painballer27]

Hi! I'm applying psych in the upcoming cycle and am currently trying to formulate my list. Stats aside, I'm curious if anyone is aware of East Coast programs known for good work life balance? On the flipside, are there programs I should be avoiding if I am looking for solid work life balance? Thanks!

You shouldn't be concerned with work life balance. You should be concerned with going to a program that will train you to be an excellent psychiatrist. Your question exudes laziness.

 

[jbomba]

@cg718070 please ignore our local med student troll

As a PGY4, my advice is finding a program with good work/life balance is an important consideration.

 

[painballer27]

@cg718070 please ignore our local med student troll

As a PGY4, my advice is finding a program with good work/life balance is an important consideration.

Their post came off as if they are only interested in work/life and said nothing about quality of training. As a student, I don't think we should be solely focused on work life in choosing a residency.

RM

 

[ObsequiousAplomb]

Their post came off as if they are only interested in work/life and said nothing about quality of training. As a student, I don't think we should be solely focused on work life in choosing a residency.

RM

Learning how to ensure you have a healthy work-life balance after training is an expectation that programs have of their residents. The easiest way to learn this in residency is to attend a program that is dedicated to teaching you how to have a healthy work-life balance. Saying that you're interested in a program that has good work-life balance is not the same as saying you're solely focused on it.

As others have said, you will likely have trouble in this field if you remain so antagonistic.

 

[FlowRate]

Hi! I'm applying psych in the upcoming cycle and am currently trying to formulate my list. Stats aside, I'm curious if anyone is aware of East Coast programs known for good work life balance? On the flipside, are there programs I should be avoiding if I am looking for solid work life balance? Thanks!

By East Coast do you mean Northeast or anywhere on the Eastern seaboard? By good work-life balance do you mean relative to other EC programs or some other metric?

 

[psyspy]

M4 here. To be perfectly honest, from what I’ve seen and researched, every major academic (and at least midtier) program on the east coast is a workhorse program for at least pgy1 and 2. Some like duke apparently have lots of workload even after that.

Whether their question exudes laziness is less relevant than the fact that they’re probably not gonna get the work life balance they’re looking for lol. I’ve definitely seen a trend of persistently cushy psych residencies all 4y being in less desirable locations

 

[psyspy]

Learning how to ensure you have a healthy work-life balance after training is an expectation that programs have of their residents. The easiest way to learn this in residency is to attend a program that is dedicated to teaching you how to have a healthy work-life balance. Saying that you're interested in a program that has good work-life balance is not the same as saying you're solely focused on it.

As others have said, you will likely have trouble in this field if you remain so antagonistic.

To be fair that other poster could’ve been a bit more political like he’ll have to be when asking residents this same question irl. “Which east coast programs tend to have better hours but still expose you to enough things in the 4 years?”

 

[ObsequiousAplomb]

To be fair that other poster could’ve been a bit more political like he’ll have to be when asking residents this same question irl. “Which east coast programs tend to have better hours but still expose you to enough things in the 4 years?”

I can guarantee that asking it the way it was asked would not have been taken poorly at my east coast program that has for many years been known for having a great work-life balance.

 

[Ludwig2000]

In terms of what a program can offer, “work life balance” cannot really mean anything other than “less work hours,” can it? They do not vary in how much life they give you apart from how much work they give you. So I don’t actually think the term makes much sense in this context except sounding better than “less work.” However I personally have no problem with people using sdn to ask which programs seem to give you more or less work. Individuals are allowed to factor this in, when they are deciding what their priorities are in work and life. (The individual is the only one who can decide the “balance” of work and other life; they can do this by such choices as, for example, seeking out programs that give them more or less work. Again, programs talking about “work life balance” seems so silly to me, as all it can mean is amount of work, right!? I feel like I’m taking crazy pills).

OK to answer your question, based on my impression of relative call schedules etc at well known programs:

MORE WORK HOURS:
MGH
Hopkins
UMD/Sheppard Pratt
Duke
Emory?

LESS WORK HOURS:
Yale
Brown

I should say I think more work hours is actually a good thing during residency. Also while I get the impression that Yale and Brown are *relatively* cushy out of high tier academics, that they are no slouches and also get v good training.
When it comes to purely low or no call programs, I remember hearing that Palmetto Health in SC had essentially no call, but I know nothing else about that program.

I also think the annual Reddit psych residency spreadsheet (may be more on discord now?) talks a lot about this every year. Cuz the kids, they hate-a the work (shakes fistful of dried spaghetti)

I’m post 24 hr call, night night

 

[ObsequiousAplomb]

In terms of what a program can offer, “work life balance” cannot really mean anything other than “less work hours,” can it? They do not vary in how much life they give you apart from how much work they give you. So I don’t actually think the term makes much sense in this context except sounding better than “less work.” However I personally have no problem with people using sdn to ask which programs seem to give you more or less work. Individuals are allowed to factor this in, when they are deciding what their priorities are in work and life. (The individual is the only one who can decide the “balance” of work and other life; they can do this by such choices as, for example, seeking out programs that give them more or less work. Again, programs talking about “work life balance” seems so silly to me, as all it can mean is amount of work, right!? I feel like I’m taking crazy pills).

OK to answer your question, based on my impression of relative call schedules etc at well known programs:

MORE WORK HOURS:
MGH
Hopkins
UMD/Sheppard Pratt
Duke
Emory?

LESS WORK HOURS:
Yale
Brown

I should say I think more work hours is actually a good thing during residency. Also while I get the impression that Yale and Brown are *relatively* cushy out of high tier academics, that they are no slouches and also get v good training.
When it comes to purely low or no call programs, I remember hearing that Palmetto Health in SC had essentially no call, but I know nothing else about that program.

I also think the annual Reddit psych residency spreadsheet (may be more on discord now?) talks a lot about this every year. Cuz the kids, they hate-a the work (shakes fistful of dried spaghetti)

I’m post 24 hr call, night night

Things that contribute to good work-life balance:

- total numbers of hours expected per week
- quality of educational experience for worked hours
- distribution of call days / weekends worked throughout residency
- total number of sick, personal, or other leave days
- ease / flexibility in requesting leave / having it approved
- total salary
- health insurance
- geographic / regional opportunities to practice your preferred lifestyle (e.g. owning a home, hiking, skiing, sailing, climate, proximity to family). Does compensation make this feasible in that area?
- culture at the institution of being more scut-work, clinical work, shadowing, or more didactic heavy
- schedule availability (electives in PGY-4 only or earlier?)
- sole days dedicated to didactics or do you have one class every day for lunch?
- opportunities to moonlight
- moonlighting internal only, external only, or both
- competitive compensation for moonlighting
- moonlighting opportunities that are educationally/professionally meaningful experiences vs cash grabs
- is there 24 hour call, short call, night float, home call?
- is call all for one service or does the schedule rotate throughout the years among multiple settings, health systems, and schedules?
- does 4 residents mean Q4 24hr call, down to Q3 if a colleague is on extended leave?
- expectation for didactics on post-call days?
- does the program offer rotations in your preferred setting? Or will you need to work hard to get that PHP/IOP/ state hospital rotation?
- average length-of-stay for units
- cross-coverage requirements
- are clinical services using you to make megabucks for a system or do they focus more on teaching, supervision, and introspection?
- opportunities to rotate with residents from other programs or disciplines
- are residents unionized?
- how responsive is administration to resident concerns?
- work space for residents: dedicated, shared, take-what-you-can-get?
- availability of access to library time/space and librarians
- nursing ratios / shortages
- nursing administration culture
- working alongside mid-level, working under mid-levels, or not working with them at all
- medical students and whether the system makes them a burden, a benefit, or allows you to control your level of interactions with them
- emphasis on psychotherapy
- program motivation to assist you with access to psychoanalysis / will they work with you on a planned time limitation for rotations
- IM rotations for 4 months straight @80 hours a week?
- IM rotations include ICU?
- IM rotations include OP? UC?
- IM rotations include consult specialties?
- IM rotations at same site or different hospital system?
- Amount of dedicated exam leave
- realistic schedules for exam leave?
- university affiliated or not?
- mostly public or private?
- Medicaid? (Surprising number of residencies don't have Medicaid patients on their IP units or the OP clinics)
- mix of public and private, cash-pay, private insurance, and Medicaid?
- chief resident to PGY-4 ratio
- rates of fast-tracking to child or research
- dedicated research blocks? Or are you expected to publish but not given any time to work on actual research, thus increasing the number of hours per week?
- attrition / graduation rate
- reasons for the attrition rate
- length of parental leave, compensation during parental leave
- committee opportunities / requirements
- is there a fellowship in a specialty you are interested in? Are residents allowed to attend fellow didactics?
- does the hospital have a cafeteria (a surprising number do not)? If there is one, do you get a food stipend / funds? What's the food like at the cafeteria?
- will you be going through a metal detector every day / not allowed to bring in metal spoons?
- unit size, team size, censuses, division of labor
- training-level appropriate levels of supervision? Too much handholding? Not enough access to attendings when needed?


I'm sure there are plenty more. This was just off the top of my head and only a handful are related to wanting to work less.

 

[BobbyKoch]

Red flags: No research, no pubs, no awards
Undergrad: Anthropology and Art
School: Original 5 DO school
Preclinicals: Top half of my class
Clinicals: pass on everything. School does H/P/F based solely on COMAT scores. Glowing eval comments.
Step 1: 223 (level 1 480…)
Step 2: 231 (Level 2 592)
LOR: 2 from psych attendings. One with university affiliation but not a chair or PD. 1 from ID rotation—very strong letter.
Research: none(!)
Other: Non trad student. Worked in hospitality, construction, landscaping and as a professional musician. Interested in addiction medicine. Will have done 2 psych subis at university and communiversity programs before eras is due. Have two more at university programs I’m interested in later in the year (well before rol is due).
EC: volunteered with inner city substance use harm reduction program, dog foster, COVID vaccine administration, EMTb.

So, I’m posting due to my anxiety regarding having no research experience, pubs or awards. I’m targeting the northeast, specifically western NY programs. Dreaming of UofR and have a rotation there and ties to the area. Would be happy with a community program with strong teaching and exposure to psychotherapy and/or decent addiction training. Obviously will apply to all my sub-I programs, unless I really hate them, and the program associated with my school. Otherwise, any suggestions for programs to target? Advice? Reassurance? Number of programs to apply to? Do I need to apply fm for backup?

Thank you, psych fam

 

[psyspy]

Important question: what are some soft cutoffs for programs? The only rule I’ve heard is steps need to be 240+ for top programs. And then some schools may specify some minimum score on their website or something

 

[Ludwig2000]

Things that contribute to good work-life balance:

- total numbers of hours expected per week
- quality of educational experience for worked hours
- distribution of call days / weekends worked throughout residency
- total number of sick, personal, or other leave days
- ease / flexibility in requesting leave / having it approved
- total salary
- health insurance
- geographic / regional opportunities to practice your preferred lifestyle (e.g. owning a home, hiking, skiing, sailing, climate, proximity to family). Does compensation make this feasible in that area?
- culture at the institution of being more scut-work, clinical work, shadowing, or more didactic heavy
- schedule availability (electives in PGY-4 only or earlier?)
- sole days dedicated to didactics or do you have one class every day for lunch?
- opportunities to moonlight
- moonlighting internal only, external only, or both
- competitive compensation for moonlighting
- moonlighting opportunities that are educationally/professionally meaningful experiences vs cash grabs
- is there 24 hour call, short call, night float, home call?
- is call all for one service or does the schedule rotate throughout the years among multiple settings, health systems, and schedules?
- does 4 residents mean Q4 24hr call, down to Q3 if a colleague is on extended leave?
- expectation for didactics on post-call days?
- does the program offer rotations in your preferred setting? Or will you need to work hard to get that PHP/IOP/ state hospital rotation?
- average length-of-stay for units
- cross-coverage requirements
- are clinical services using you to make megabucks for a system or do they focus more on teaching, supervision, and introspection?
- opportunities to rotate with residents from other programs or disciplines
- are residents unionized?
- how responsive is administration to resident concerns?
- work space for residents: dedicated, shared, take-what-you-can-get?
- availability of access to library time/space and librarians
- nursing ratios / shortages
- nursing administration culture
- working alongside mid-level, working under mid-levels, or not working with them at all
- medical students and whether the system makes them a burden, a benefit, or allows you to control your level of interactions with them
- emphasis on psychotherapy
- program motivation to assist you with access to psychoanalysis / will they work with you on a planned time limitation for rotations
- IM rotations for 4 months straight @80 hours a week?
- IM rotations include ICU?
- IM rotations include OP? UC?
- IM rotations include consult specialties?
- IM rotations at same site or different hospital system?
- Amount of dedicated exam leave
- realistic schedules for exam leave?
- university affiliated or not?
- mostly public or private?
- Medicaid? (Surprising number of residencies don't have Medicaid patients on their IP units or the OP clinics)
- mix of public and private, cash-pay, private insurance, and Medicaid?
- chief resident to PGY-4 ratio
- rates of fast-tracking to child or research
- dedicated research blocks? Or are you expected to publish but not given any time to work on actual research, thus increasing the number of hours per week?
- attrition / graduation rate
- reasons for the attrition rate
- length of parental leave, compensation during parental leave
- committee opportunities / requirements
- is there a fellowship in a specialty you are interested in? Are residents allowed to attend fellow didactics?
- does the hospital have a cafeteria (a surprising number do not)? If there is one, do you get a food stipend / funds? What's the food like at the cafeteria?
- will you be going through a metal detector every day / not allowed to bring in metal spoons?
- unit size, team size, censuses, division of labor
- training-level appropriate levels of supervision? Too much handholding? Not enough access to attendings when needed?


I'm sure there are plenty more. This was just off the top of my head and only a handful are related to wanting to work less.

Things that contribute to good work-life balance:

- total numbers of hours expected per week
- quality of educational experience for worked hours
- distribution of call days / weekends worked throughout residency
- total number of sick, personal, or other leave days
- ease / flexibility in requesting leave / having it approved
- total salary
- health insurance
- geographic / regional opportunities to practice your preferred lifestyle (e.g. owning a home, hiking, skiing, sailing, climate, proximity to family). Does compensation make this feasible in that area?
- culture at the institution of being more scut-work, clinical work, shadowing, or more didactic heavy
- schedule availability (electives in PGY-4 only or earlier?)
- sole days dedicated to didactics or do you have one class every day for lunch?
- opportunities to moonlight
- moonlighting internal only, external only, or both
- competitive compensation for moonlighting
- moonlighting opportunities that are educationally/professionally meaningful experiences vs cash grabs
- is there 24 hour call, short call, night float, home call?
- is call all for one service or does the schedule rotate throughout the years among multiple settings, health systems, and schedules?
- does 4 residents mean Q4 24hr call, down to Q3 if a colleague is on extended leave?
- expectation for didactics on post-call days?
- does the program offer rotations in your preferred setting? Or will you need to work hard to get that PHP/IOP/ state hospital rotation?
- average length-of-stay for units
- cross-coverage requirements
- are clinical services using you to make megabucks for a system or do they focus more on teaching, supervision, and introspection?
- opportunities to rotate with residents from other programs or disciplines
- are residents unionized?
- how responsive is administration to resident concerns?
- work space for residents: dedicated, shared, take-what-you-can-get?
- availability of access to library time/space and librarians
- nursing ratios / shortages
- nursing administration culture
- working alongside mid-level, working under mid-levels, or not working with them at all
- medical students and whether the system makes them a burden, a benefit, or allows you to control your level of interactions with them
- emphasis on psychotherapy
- program motivation to assist you with access to psychoanalysis / will they work with you on a planned time limitation for rotations
- IM rotations for 4 months straight @80 hours a week?
- IM rotations include ICU?
- IM rotations include OP? UC?
- IM rotations include consult specialties?
- IM rotations at same site or different hospital system?
- Amount of dedicated exam leave
- realistic schedules for exam leave?
- university affiliated or not?
- mostly public or private?
- Medicaid? (Surprising number of residencies don't have Medicaid patients on their IP units or the OP clinics)
- mix of public and private, cash-pay, private insurance, and Medicaid?
- chief resident to PGY-4 ratio
- rates of fast-tracking to child or research
- dedicated research blocks? Or are you expected to publish but not given any time to work on actual research, thus increasing the number of hours per week?
- attrition / graduation rate
- reasons for the attrition rate
- length of parental leave, compensation during parental leave
- committee opportunities / requirements
- is there a fellowship in a specialty you are interested in? Are residents allowed to attend fellow didactics?
- does the hospital have a cafeteria (a surprising number do not)? If there is one, do you get a food stipend / funds? What's the food like at the cafeteria?
- will you be going through a metal detector every day / not allowed to bring in metal spoons?
- unit size, team size, censuses, division of labor
- training-level appropriate levels of supervision? Too much handholding? Not enough access to attendings when needed?


I'm sure there are plenty more. This was just off the top of my head and only a handful are related to wanting to work less.

I would divide that list into 2 types of factors: (1) things that directly impact how many hours you are working or (2) things that affect happiness/fulfillment in work and/or life.

Does “work life balance” really just mean “happiness”? Why not just say that?
Or in healthcare newspeak, does “work-life balance” mean the opposite of “burnout”?

Why use language that implies a scale with work on one side and life on the other?

 

[sillypsych]

Things that contribute to good work-life balance:

- total numbers of hours expected per week
- quality of educational experience for worked hours
- distribution of call days / weekends worked throughout residency
- total number of sick, personal, or other leave days
- ease / flexibility in requesting leave / having it approved
- total salary
- health insurance
- geographic / regional opportunities to practice your preferred lifestyle (e.g. owning a home, hiking, skiing, sailing, climate, proximity to family). Does compensation.....

These are all things that are important for "work/life balance" or "quality of life." A question I suggest you ask the residents is: "how does the program handle it/what do you do when/if you get really sick?"

The correct answer to that question, if you want quality of life (and, in my opinion, good training, because nobody really learns well when they're miserable and exhausted), is "you tell your attending and then you go home." Especially since COVID, any place worth considering is going to do what they can to keep sick residents off the wards and getting the care they need. You can also ask if the services are resident-dependent, but I honestly find that less telling because most programs are at least somewhat resident-dependent and the attitude is what matters much more.

For example, at my residency program, we all got the first round of COVID vaccines on the same days, not anticipating that most of us would be absolutely destroyed the day after the second dose (since the vaccines had just been released, we didn't know about the potential severity of the side effects). Those of us on resident-dependent services figured out who was physically capable of getting there, and those people went in; if they were still ill, they got to go home immediately after rounds, notes, and orders were done, with the expectation of answering issues by phone if necessary. There was no questioning or anger from the attendings about this. I personally was INCREDIBLY sick for 3 days, and tried to go back in on the third day, but when I got there my attending took one look at me and said "no, you're too sick, go home." (My co-resident said I looked like "the person in a zombie movie who's been bitten but is trying to hide it." He was not wrong.) I was not penalized for this in any way, and neither were any of my co-residents. Our program worked to get 2 days of extra leave granted so we wouldn't lose vacation or personal days. Nobody was upset that they were back a day earlier than other people or whatever, because they know that if they need help at some point, the rest of us will pitch in.

At other programs that are roughly equally resident-dependent in terms of service, I've had friends tell me they were forced to stick out full shifts with high fevers/while projectile vomiting/etc, beyond the necessary work to keep patients cared for. There's conflict and resentment between residents any time someone needs coverage. They're not learning any more from this, just suffering.

Yeah, there are long hours and really crappy tasks sometimes; that's the nature of residency. Are there problems with my program? Obviously. But my attendings and program director/APD/coordinator care about me and the other residents as human beings and treat us well, and that's the most valuable thing to me. I got great training and didn't get abused. There's absolutely nothing wrong with wanting to be treated with respect and care by the people who are supposed to be teaching and guiding you.

 

[Sparky23]

Red flags: Failed my OB shelf twice, passed 3rd time but shows on MSPE as PX (passed with remediation). No pubs, one poster and a few presentations.
School: DO school with no reputation
Preclinicals: 3rd quartile
Clinicals: Honors in Psych, Surgery, and IM, pass all others (with px in OBGYN)
Step 1: 216, Level 1 511
Step 2: 255, Level 2 620
LOR: 2 solid from psych attendings. 1 from peds.
Research: 1 poster (psych related), 1 other undergrad project, no pubs
EC: Plenty of volunteer experiences, and leadership opportunities.

I would really love some advice as to whether I should address my px in OB due to my failing the shelf 2 times. That test is some BS and I passed the 3rd attempt in the 87th percentile (different form). I'm hoping that this shelf failure, and my low step 1 will be minimized by my high step 2 which I think shows that I can take a test and shouldn't be a risk during residency. I have done 2 sub-I's at programs that I feel confident will rank me highly, but I have this fear that every other program that doesn't know me and sees my px and low step 1 will not be interested in interviewing. Thanks for any advice.

 

[psyspy]

Red flags: Failed my OB shelf twice, passed 3rd time but shows on MSPE as PX (passed with remediation). No pubs, one poster and a few presentations.
School: DO school with no reputation
Preclinicals: 3rd quartile
Clinicals: Honors in Psych, Surgery, and IM, pass all others (with px in OBGYN)
Step 1: 216, Level 1 511
Step 2: 255, Level 2 620
LOR: 2 solid from psych attendings. 1 from peds.
Research: 1 poster (psych related), 1 other undergrad project, no pubs
EC: Plenty of volunteer experiences, and leadership opportunities.

I would really love some advice as to whether I should address my px in OB due to my failing the shelf 2 times. That test is some BS and I passed the 3rd attempt in the 87th percentile (different form). I'm hoping that this shelf failure, and my low step 1 will be minimized by my high step 2 which I think shows that I can take a test and shouldn't be a risk during residency. I have done 2 sub-I's at programs that I feel confident will rank me highly, but I have this fear that every other program that doesn't know me and sees my px and low step 1 will not be interested in interviewing. Thanks for any advice.

Apply very broadly. Ngl, from what I’ve learned talking to residents, school rep and lack of visible red flags are the most influential factors

 

[Dr.Borsht]

I don't mean to scare the OP, because I agree that they will likely match somewhere, especially with respect to the advice given earlier in this thread. That said, I also agree with the person you're replying to.

I can't speak to the national statistics, but the program I work with is also not at all a high-tier program. It's a community program that is the lowest paid and possibly has the lowest reputation in this major metro in recent years. Every person who matched this year had a Step 1 score > 241. You had to have a very compelling reason to get an interview without it, and apparently none of those people ended up matching. This is a program that historically had at least half of its residents as IMGs (this year 3/8 were extraordinarily well-qualified IMG/FMG candidates, like step 1 > 270, 10+ publications, was a practicing psychiatrist in their home country, etc).

The past two years have been a major anomaly for this type of program.

Not sure if I'm allowed to ask but is this in DC?

 

[ObsequiousAplomb]

Not sure if I'm allowed to ask but is this in DC?

You can ask me in a private message about where it is.

 

[BobbyKoch]

Red flags: No research, no pubs, no awards
Undergrad: Anthropology and Art
School: Original 5 DO school
Preclinicals: Top half of my class
Clinicals: pass on everything. School does H/P/F based solely on COMAT scores. Glowing eval comments.
Step 1: 223 (level 1 480…)
Step 2: 231 (Level 2 592)
LOR: 2 from psych attendings. One with university affiliation but not a chair or PD. 1 from ID rotation—very strong letter.
Research: none(!)
Other: Non trad student. Worked in hospitality, construction, landscaping and as a professional musician. Interested in addiction medicine. Will have done 2 psych subis at university and communiversity programs before eras is due. Have two more at university programs I’m interested in later in the year (well before rol is due).
EC: volunteered with inner city substance use harm reduction program, dog foster, COVID vaccine administration, EMTb.

So, I’m posting due to my anxiety regarding having no research experience, pubs or awards. I’m targeting the northeast, specifically western NY programs. Dreaming of UofR and have a rotation there and ties to the area. Would be happy with a community program with strong teaching and exposure to psychotherapy and/or decent addiction training. Obviously will apply to all my sub-I programs, unless I really hate them, and the program associated with my school. Otherwise, any suggestions for programs to target? Advice? Reassurance? Number of programs to apply to? Do I need to apply fm for backup?

Thank you, psych fam

Bumpski... @Stagg737

 

[FlowRate]

Bumpski... @Stagg737

My perspective is from someone familiar with the processes at a top 10 residency. I honestly don't think research matters anywhere other than research-focused institutions. Even if you are at a research institution, it matters most either as an applicant for a specific research-track position or if your angle/value proposition as a potential resident is geared toward being productive with research. There are many psych applicants with minimal research experience. Trying to phrase another way, we mostly debated research productivity and fit for research-track applicants and I don't recall a lack of research ever being mentioned in a negative way for non-research-track applicants.

 

[BobbyKoch]

My perspective is from someone familiar with the processes at a top 10 residency. I honestly don't think research matters anywhere other than research-focused institutions. Even if you are at a research institution, it matters most either as an applicant for a specific research-track position or if your angle/value proposition as a potential resident is geared toward being productive with research. There are many psych applicants with minimal research experience. Trying to phrase another way, we mostly debated research productivity and fit for research-track applicants and I don't recall a lack of research ever being mentioned in a negative way for non-research-track applicants.

That’s very reassuring. I was worried looking at the research experiences reported on residency explorer. Appreciate your input.

 

[psyspy]

My perspective is from someone familiar with the processes at a top 10 residency. I honestly don't think research matters anywhere other than research-focused institutions. Even if you are at a research institution, it matters most either as an applicant for a specific research-track position or if your angle/value proposition as a potential resident is geared toward being productive with research. There are many psych applicants with minimal research experience. Trying to phrase another way, we mostly debated research productivity and fit for research-track applicants and I don't recall a lack of research ever being mentioned in a negative way for non-research-track applicants.

How much help can we get if we sell ourselves partly by our research experience? That's what I'd like to do because my class rank and board scores aren't that great. Board score are a bit below psych average. Psych and related clerkships were good

 

[splik]

How much help can we get if we sell ourselves partly by our research experience? That's what I'd like to do because my class rank and board scores aren't that great. Board score are a bit below psych average. Psych and related clerkships were good

It depends on how good your research experience is. Remember non-research focused programs will not really care about your research and the top programs will have many people with PhDs, multiple presentations and publications, publications in high impact journals like Science, Nature, Cell etc. Having research experience in itself does not matter much (though if you have psych research experiences then that will show a commitment to speciality), but having publications and presentations will definitely be looked upon favorably at academic programs. There are certainly programs (including top programs) with residents who don't have great board scores but are impressive in other ways.

Psychiatry is not like competitive specialties (e.g. derm, ophtho, plastics etc) where you have to have done substantial research to match. Even at top programs (unless they are getting dud residents), they will have a diversity of residents with different strengths. The top programs are looking for residents who are going to be leaders in the field. That could be in research, or it could be in medical education, administration, innovation, policy, clinical excellence, community and public service, global health, DEIA etc. The class rosters of such programs will reflect a mix of people some of whom have impressive research accolades, and others who would be impressive in other ways.

 

[FlowRate]

That’s very reassuring. I was worried looking at the research experiences reported on residency explorer. Appreciate your input.

The irony of many of the top residencies is that they're also generally higher workload programs. That's even true for a lot of other specialties. Which makes research productivity difficult unless you're in a true research track with protected research time.

How much help can we get if we sell ourselves partly by our research experience? That's what I'd like to do because my class rank and board scores aren't that great. Board score are a bit below psych average. Psych and related clerkships were good

I completely agree with what splik said. To try and add a bit, if you're going to market yourself as a researcher then the ideal is to have evidence of research productivity (publications), relevant research interests (able to explain which faculty you would like to meet/potentially work with), and a realistic vision for what sort of project(s) you would work on during residency and how you would be able to do it in the limited time afforded by residency. People can certainly be successful applicants for research positions without all of those factors, but it seems to be the ideal.

And, like splik said, this is only relevant if the institution you're applying to is interested in supporting/recruiting residents interested in research, in the first place.

 

[jecki46]

Hey y'all. Has anyone started a spread sheet for interviews, invites etc yet for this cycle? I can't find anything. Wondering which programs have sent out invites so far.

 

[BobbyKoch]

It’s on reddit

 

[PsychSike]

Red flags: None
School: Lower-tier MD
Clinicals: Honors in all rotations (6/6)
Step 1: Pass
Step 2: High 260s
LOR: 1 from psych chair, hoping to gather others throughout aways. Possible letter from M3 IM Preceptor
Research: Multiple posters (a couple psych related with COVID), majority of research micro-related, 3 pubs all micro-related
EC: Strong emphasis on free clinics, teaching/mentorship programs, and involvement in AAFP at a national level. Also volunteering for crisis text line.

Hoping to match at a program with strong psychodynamic training, example would be CHA. I feel that I have the scores for these types of programs, but not sure my research/ECs are enough to seal the deal or get noticed for an interview. Any thoughts?

 

[BobbyKoch]

Red flags: None
School: Lower-tier MD
Clinicals: Honors in all rotations (6/6)
Step 1: Pass
Step 2: High 260s
LOR: 1 from psych chair, hoping to gather others throughout aways. Possible letter from M3 IM Preceptor
Research: Multiple posters (a couple psych related with COVID), majority of research micro-related, 3 pubs all micro-related
EC: Strong emphasis on free clinics, teaching/mentorship programs, and involvement in AAFP at a national level. Also volunteering for crisis text line.

Hoping to match at a program with strong psychodynamic training, example would be CHA. I feel that I have the scores for these types of programs, but not sure my research/ECs are enough to seal the deal or get noticed for an interview. Any thoughts?

I think if you have an average to above average personal statement and can somewhat eloquently describe your motivation for psych and psychodynamic training, you’re going to be overwhelmed by interviews. Definitely target top programs if they interest you. Basing this solely on my experience which was sub average Step, no research, no honors, middling class rank, and I was lucky enough to get 15 interviews.

 

[psyspy]

Honestly given how fast chatgpt is improving, I don’t know if I’d prioritize psychotherapy training in a program…

 

[ObsequiousAplomb]

Honestly given how fast chatgpt is improving, I don’t know if I’d prioritize psychotherapy training in a program…

Lol what? AI is far more likely to master the basic pharmacology than psychotherapy

 

[Stagg737]

Red flags: None
School: Lower-tier MD
Clinicals: Honors in all rotations (6/6)
Step 1: Pass
Step 2: High 260s
LOR: 1 from psych chair, hoping to gather others throughout aways. Possible letter from M3 IM Preceptor
Research: Multiple posters (a couple psych related with COVID), majority of research micro-related, 3 pubs all micro-related
EC: Strong emphasis on free clinics, teaching/mentorship programs, and involvement in AAFP at a national level. Also volunteering for crisis text line.

Hoping to match at a program with strong psychodynamic training, example would be CHA. I feel that I have the scores for these types of programs, but not sure my research/ECs are enough to seal the deal or get noticed for an interview. Any thoughts?

Your app seems strong overall but has more of an med/psych feel from the letters, posters, and research you've done. My biggest question would be why you want strong psychodynamic training. Presenting a cohesive picture with your application is important, and explaining why you're interested in a program with significant psychodynamic focus when your other ECs and research seem to be more focuses on basic and clinical sciences should be clear.

Not saying you can't get into these programs, but you should make sure those programs know why you want that type of training since if it's not obvious in the rest of your application.

 

[PsychSike]

Your app seems strong overall but has more of an med/psych feel from the letters, posters, and research you've done. My biggest question would be why you want strong psychodynamic training. Presenting a cohesive picture with your application is important, and explaining why you're interested in a program with significant psychodynamic focus when your other ECs and research seem to be more focuses on basic and clinical sciences should be clear.

Not saying you can't get into these programs, but you should make sure those programs know why you want that type of training since if it's not obvious in the rest of your application.

Definitely agree, I am hoping that my personal statement can help convey that to the programs. I am trying to do some aways this summer too with more of an emphasis on different psychotherapy techniques so it is an easier sell. The desire for psychodynamic specifically comes from some personal practice goals I have developed, but also going to try and communicate I have an interest in other therapy modalities as well.

I think if you have an average to above average personal statement and can somewhat eloquently describe your motivation for psych and psychodynamic training, you’re going to be overwhelmed by interviews. Definitely target top programs if they interest you. Basing this solely on my experience which was sub average Step, no research, no honors, middling class rank, and I was lucky enough to get 15 interviews.

I appreciate the insight into your experience and I am hoping you are right! Personal statement is definitely getting my full attention right now to make sure my story makes sense.

 

[PsychSike]

Honestly given how fast chatgpt is improving, I don’t know if I’d prioritize psychotherapy training in a program…

It may be naive of me, but I am not on the "AI is medicine's downfall" train. Doubly so regarding something that requires a higher level of emotional intelligence and nuance like therapy.

I have never understood why medicine as a whole has been the target of the argument of AI replacing jobs, considering it is one of the professions requiring the most training and higher thought processes.

 

[psyspy]

Lol what? AI is far more likely to master the basic pharmacology than psychotherapy

Technically pharmacology refers more to actions of specific drugs rather than the treatment choice itself.

AI will never get prescriptive authority for a while. Also the actual medication choice in psychiatry is a gray area oftentimes.

People are already turning to chatgpt for psychotherapy questions that they are hesitant to tell some other human in person who may or may not deliver good care.

Honestly even outpatient psychiatry could be at risk to an extent. I think inpatient, CL, and psychED will be safer from it, whereas outpatient could easily be replaced by a psych NP using chatgpt once the application improves

At least for now though, it can’t diagnose for jack. It can only summarize and provide common knowledge

 

[bGMx]

We take at least 8 years to *approach* mastering what is essentially a library of knowledge, using a biologic memory system that is far from perfect or exact. An AI can access that fund of knowledge without training, constantly and instantaneously incorporate new knowledge, and apply it more holistically, with greater precision + accuracy, in the most non-judgmental humanistic way possible. You could code an AI to abide by the UN Declaration of Human Rights with the persona of Carl Rogers and the patience of Nelson Mandela, all while being deeply tuned in with the behavioral patterns of the patient who uses it and their specific needs.

 

[ObsequiousAplomb]

Technically pharmacology refers more to actions of specific drugs rather than the treatment choice itself.

AI will never get prescriptive authority for a while. Also the actual medication choice in psychiatry is a gray area oftentimes.

People are already turning to chatgpt for psychotherapy questions that they are hesitant to tell some other human in person who may or may not deliver good care.

Honestly even outpatient psychiatry could be at risk to an extent. I think inpatient, CL, and psychED will be safer from it, whereas outpatient could easily be replaced by a psych NP using chatgpt once the application improves

At least for now though, it can’t diagnose for jack. It can only summarize and provide common knowledge

This post is a pretty classic "tell me you aren't a psychiatrist and have never practiced in psychiatry without telling me that you haven't." I hope that when you start residency you go into it with the expectation that you will only do IP and CL, because that means more OP work for me.

 

[Celexa]

This post is a pretty classic "tell me you aren't a psychiatrist and have never practiced in psychiatry without telling me that you haven't." I hope that when you start residency you go into it with the expectation that you will only do IP and CL, because that means more OP work for me.

Seriously. Nothing shows ignorance faster than thinking outpatient is somehow easier or simpler than inpatient psychiatry.

I think outpatient and CL both draw from the largest knowledge bases and are arguably the hardest to do well. ED is about 95% dispo and inpatient in most places has been hollowed out to warehousing of the most psychotic and pumping them back full of antipsychotics. It's why genuinely good inpatient psych nurses turn into terrible outpatient NPs--they think they have a lot of psychiatry knowledge when what they actually have is familiarity with one narrow, atypical psychiatric treatment setting where the focus is on medicating and getting people "better enough" ASAP.

 

[psyspy]

I’m not speaking from my own perspective. I’m saying from that of hospital admin and insurance companies…and from some pgy3+4’s as well who are concerned for the future. I don’t agree with completely replacing psychiatrists in any practice setting with AI whatsoever, and think outcomes will suffer from it. AI should remain as a tool at most for the sake of outcomes

I never suggested OP is de facto easier than the rest

That said, ask around to therapy patients or former therapy patients if you ever get the chance, see what their thoughts are on supplementing or even replacing talk-therapy with chatgpt. I’ve been surprised by some responses (in a bad way)

I do think that patients in inpatient settings will be far less receptive to a deepfake physician or a wholly AI physician. That said, in many states for inpatient, there is little stopping an independent NP in an inpatient psych setting from introducing themselves as a doctor, taking whatever notes they want, and using chatgpt to at least help with an assessment/plan. I don’t actually know how accountable psych NPs are held for their A/P in any practice setting.

Someone correct me if I’m wrong

 

[ObsequiousAplomb]

I’m not speaking from my own perspective. I’m saying from that of hospital admin and insurance companies…and from some pgy3+4’s as well who are concerned for the future. I don’t agree with completely replacing psychiatrists in any practice setting with AI whatsoever, and think outcomes will suffer from it. AI should remain as a tool at most for the sake of outcomes

I never suggested OP is de facto easier than the rest

That said, ask around to therapy patients or former therapy patients if you ever get the chance, see what their thoughts are on supplementing or even replacing talk-therapy with chatgpt. I’ve been surprised by some responses (in a bad way)

I do think that patients in inpatient settings will be far less receptive to a deepfake physician or a wholly AI physician. That said, in many states for inpatient, there is little stopping an independent NP in an inpatient psych setting from introducing themselves as a doctor, taking whatever notes they want, and using chatgpt to at least help with an assessment/plan. I don’t actually know how accountable psych NPs are held for their A/P in any practice setting.

Someone correct me if I’m wrong

I will gladly correct you because you are wrong. I mean seriously, do you listen to yourself when you say these things?

The exact same things are stopping physicians from doing what you just said.

There's no reason to need to use AI to write an inpatient assessnt and plan.

"They are floridly psychotic and a danger to themselves and others. Titrate Risperdal" doesn't exactly require an AI.

I talk to plenty of people about AI and therapy. Never met anyone who preferred to talk to chatbots over therapists. Perhaps the people you're hearing this from (and the times you have seen it) have had providers so severely bad that a bowl with folded up scraps of paper covered with platitudes would have outclassed them.

 

[Celexa]

Perhaps the people you're hearing this from (and the times you have seen it) have had providers so severely bad that a bowl with folded up scraps of paper covered with platitudes would have outclassed them.

To be fair, this describes a LOT of therapists.

 

[psyspy]

I will gladly correct you because you are wrong. I mean seriously, do you listen to yourself when you say these things?

The exact same things are stopping physicians from doing what you just said.

There's no reason to need to use AI to write an inpatient assessnt and plan.

"They are floridly psychotic and a danger to themselves and others. Titrate Risperdal" doesn't exactly require an AI.

I talk to plenty of people about AI and therapy. Never met anyone who preferred to talk to chatbots over therapists. Perhaps the people you're hearing this from (and the times you have seen it) have had providers so severely bad that a bowl with folded up scraps of paper covered with platitudes would have outclassed them.

Ok

Now going slightly on a tangent, how accountable have you seen psych NPs held for their decisions?

 

[ObsequiousAplomb]

Ok

Now going slightly on a tangent, how accountable have you seen psych NPs held for their decisions?

Just as accountable as the physicians. Plenty of absolutely God awful physicians out there.

 

[deleted939704]

Red flags: None
School: T40
Clinicals: mostly honors, couple high pass
Step 1: Pass
Step 2: 260+
LOR: 4 Psych
Research: couple basic science posters, couple basic science pubs, working on two clinical research projects at the moment
EC: free clinic, some teaching/mentoring, and just a bunch of hobbies.

want to match at top program in west coast. any thoughts for how many programs i should apply to?

 

[Ludwig2000]

Red flags: None
School: T40
Clinicals: mostly honors, couple high pass
Step 1: Pass
Step 2: 260+
LOR: 4 Psych
Research: couple basic science posters, couple basic science pubs, working on two clinical research projects at the moment
EC: free clinic, some teaching/mentoring, and just a bunch of hobbies.

want to match at top program in west coast. any thoughts for how many programs i should apply to?

I think you'll be very competitive for top programs. But because there are always unknowns and since you have a clearly defined geographic area, I say apply to all the top programs on the West Coast and some "upper-mid" tier programs. If you need a number, I guess I'll throw one out.... 20? This is based on my limited experience that sometimes even stellar candidates only seem to get interviews at ~50% of top programs and you probably want >=10 interviews. But, hard to say how you could get much more competitive (other than being from a T20 school instead of a T40? The other thing I sense about top programs is that they want their "Current Residents" page to have elite schools).

Also, at least when I applied 4-5 years ago, I think some programs wanted at least one LOR from a Medicine or Pediatrics attending? Is that still the case? Might want to try to cozy up to an IM attending (or Peds if your app is otherwise child/adolescent focused) and get that letter in your quiver.

 

[mistafab]

Red flags: None
School: T40
Clinicals: mostly honors, couple high pass
Step 1: Pass
Step 2: 260+
LOR: 4 Psych
Research: couple basic science posters, couple basic science pubs, working on two clinical research projects at the moment
EC: free clinic, some teaching/mentoring, and just a bunch of hobbies.

want to match at top program in west coast. any thoughts for how many programs i should apply to?

There are not many “top” programs in the west coast. So apply to all of them.

 

[MacDonaldTriad]

There are not many “top” programs in the west coast. So apply to all of them.

U Wash, UCSF, Stanford, UCLA, OHSU, UCD, USC, and UCSD would argue differently.

 

[mistafab]

U Wash, UCSF, Stanford, UCLA, OHSU, UCD, USC, and UCSD would argue differently.

That’s my point, it’s maybe ten “top” programs on the west coast. They need to apply to all of them. And if they want to keep west coast restricted as a priority over going to “top schools,” then they also need at least a dozen additional programs.

If “top program” is more important than the west coast restriction, they should apply elsewhere as well. 10 or less is too low for applications.

Don’t suicide match your good application.

 

[MacDonaldTriad]

Maybe I was over reacting, but if you can look at your content a little bit, you may have offended some impressive programs. You did say that there are not many "top" programs in the west coast. I would suggest that you say on the "West coast", and capitalize a cardinal direction. There are multiple examples of West coast programs that are firmly in the top ten.

Unless some very talented spin doctors are fooling me, grant dollars and publications lists are confirming what I am saying. I have experienced the East coast, but there is nothing "restricting" about the West coast. I guess if you don't like blue states, that could be an issue, but New England is fairly blue as well.

 

[Celexa]

Maybe I was over reacting, but if you can look at your content a little bit, you may have offended some impressive programs. You did say that there are not many "top" programs in the west coast. I would suggest that you say on the "West coast", and capitalize a cardinal direction. There are multiple examples of West coast programs that are firmly in the top ten.

Unless some very talented spin doctors are fooling me, grant dollars and publications lists are confirming what I am saying. I have experienced the East coast, but there is nothing "restricting" about the West coast. I guess if you don't like blue states, that could be an issue, but New England is fairly blue as well.

This is a conversation in which people are talking past one another. I believe mistafab's main point is simply one of numbers, in that the match has changed so much on competitiveness most applicants aiming for a large research instition should not hang their hat only one such programs on the west coast. This is fair advice. Several strong applicants in my medical school class tried to match to the west coast and were unable to, although they still matched well. That was several years ago and it hasn't gotten easier since then.

I don't think there is any dispute that there are numerically more programs in the east than the west?