Deciding to pursue a residency in psychiatry was a little scary for me. I figured out I wanted to go into psychiatry pretty much at the end of my third year (it was my last rotation, and I thought I wanted to be a pediatrician up until that point) and I have not looked back since! Below, I will talk about what I believe were some of the most important factors in securing my psychiatry residency. The factors themselves can really be applied to matching in any specialty, but I will discuss the specifics of each as it pertains to matching in psychiatry.
It’s often believed that you just have to pass Step 1/2 and that is good enough to secure a psychiatry residency. While many programs will say that they will still consider an applicant that has failed Step 1 or has a low passing score (there was almost never a cutoff above a passing score when I did my research on programs), the truly competitive applicants were the ones that at least met the average, and passed Step 2CK/CS (especially needed when you’re an IMG). Though the scores don’t necessarily “make or break” you, they are important as they are usually still used to help decrease the number of applications that are actually looked at. You should aim to score above the national average at least, and above the NRMP reported average scores for the previous year.
Rotations and Letters
Schedule electives! In addition to making sure that this is really a specialty that you want to pursue, scheduling electives will help show programs you have a genuine interest in the subject (read: I am not using this as a back up). Through my time as a medical student I did electives in Consult and Liaison, Child and Adolescent Psychiatry, and a Sub-I. This showed a vested interest in the subject on my part, leaving really no doubt to programs that I was committed to the field and sure of my decision.
In addition to the experience from electives, I was able to get my LORs done as well. I would say that my LORs were extremely important in my success at getting a psychiatry residency. The letters let the programs see that you have what it takes, not only to be a great resident, but a contributing member to the field through the eyes of an actual psychiatrist instead of just yourself. Make sure you work hard during your rotations, and make it known to your attending as soon as possible that you are considering pursuing a psychiatry residency and would like to ask for a strong letter at the end of the rotation if possible. That way your attending is aware that they may need to write one and can (hopefully) be keeping mental notes on all your hard work!
This was brought up quite a bit during my interviews, but I cannot say for sure if it was because it was normal line of questioning or if it was because it was already on the application. Many of the programs that I interviewed at said that research was mostly what you wanted to make of it –- if it interested you then there were always opportunities for it– and if it didn’t that was OK too. I think that it helped to have it on my application as it showed my genuine interest and commitment to the field, and it was a great talking point during my interviews. Whatever you decide to do, make sure you can talk about it enthusiastically.
The Personal Statement
Use this wisely! Talk about yourself as a person and your experiences, tie it back into why that would make you a great resident and psychiatrist, and really sell yourself. You need it to be concise and get your point across, no one wants to read a long narrative about all of your accomplishments when they can easily get that out of your application. Psychiatry programs want to see who you are as a person and if you have the attributes of a great future psychiatrist. Can you be empathetic? Can you handle pressure? Can you work well in a team? There are many ways you can accomplish this in your statement and it mostly depends on what you’re comfortable with. When you’re done have someone read it! Edit it until you’re saying exactly what you mean to say. After 6 rounds of editing, I had mine down to under a page and not a single sentence was wasted. I was told on a few of my interviews that there wasn’t much that was left to ask about me after reading my personal statement because it was well written, concise, and addressed the points that they wished to discuss.
Applying – Do your research!
This is especially important for IMGs. Know the programs you are applying to! What are their requirements, what are their deadlines, where are the current residents from, do they offer fellowships, what did their residents do after they graduated. Pretty much all of this can be found on a program’s website. Check match lists for your school to see which psychiatry programs people matched into and check the lists for the other big Caribbean schools as well. If no one on the lists has gotten into that program in the last 3-4 years, chances are they just don’t take IMGs! Many programs will list on their website that they accept applications from IMGs, but a quick review of their current resident list will show that there are none on staff. This does not mean that it is impossible, but when considering where to put your money it is better to invest where your odds are better. If there is a program you have your heart set on, go for it! If they don’t have your application, they can’t consider you. Be proactive about emailing and following up with the programs throughout interview season as well.
I got my interview-Now what?
Congrats! You landed an interview and now it’s time to prepare. After researching all those programs when applying, you probably forgot what was so unique about this particular one. Go back through the website, take notes on the program, and make sure to review it before your interview. It was amazing how impressed some interviewers were when I mentioned something I saw on the website. Apparently not a lot of interviewees did it, and if they did they did not talk about it. Also, pay close attention to the presentations if they are before your interviews. You can use these to ask your interviewers questions later on, or ask them to elaborate. Even if I did not have a specific question about the program, I always had a few general questions to help start the flow of conversation, which I found was important in my interviews. The interviewer really wants to know more about you as a person, they want to see what your personality is and if you would fit in well. They can gauge your interest in the field by how you talk about your past experiences, and yes, they will analyze you some – but it wasn’t that bad.
Be yourself, be enthusiastic, and put your best face forward. Smile, ask questions, look interested, and be informed. Do NOT act cocky/arrogant, disinterested, or ask about things that have been explained well or easily found on the website. By the end of interview season, you might be tired of asking and answering the same questions over and over again, and it will show if you are not careful so be aware of it!
There are no hard and fast rules to matching, what worked for one person may not work for the next. But hopefully these can help to guide you when preparing. Good luck!