Interviewing for Psychiatry Residencies

Alright, all 2% of our readers that are seriously considering pursuing Psychiatry Residencies. Please sign in at the front door, make sure you haven’t lost your mind, and proceed to enter the world of neuroses, psychoses, and wandering thoughts. If you have been mindlessly paying attention, you will know that I am really into psych and am super excited about entering into this field. This is not a backup plan for me, this is THE plan. My goal as a psychiatrist is to work with chronically, severely mentally ill persons in a community behavioral medicine setting (hopefully with integrated care) and to work in psychiatric emergency services. I have completed the psych interview trail and recently put together my unofficial rank list. I come here to give you tips on how to best approach this messy year and am most helpful to you if you are interested in psych. But feel free to ask general residency application questions.

  • Psych Residencies in General:
    • Psych is one of the less competitive specialties. Poor reimbursement matched with the fact that mental illness is stigmatized and worsened by the belief that psychiatrists aren’t real doctors.
    • Psych is a 4-year residency with a lot of Fellowship opportunities:
      • Child & Adolescent
      • Psychosomatic
      • Forensic
      • Geriatric
      • Addiction medicine
  • Decide if you are going NRMP (MD) vs AOA (DO) Match. 
    • I applied to both initially because I wanted to take advantage of dually accredited psych programs. Unfortunately, there are not very many of these available and I only ended up applying to one and pulling out of the AOA match.
    • If you go NRMP: 
      • There are 204 psych residencies and they range in size. Some of the largest programs are 16 residents, smallest I’ve seen were 4 residents. Most are tied to large academic institutions and are centrally located in suburban or urban settings.
      • TAKE USMLE STEP 1. At the very least. I know programs accept COMLEX scores, but in my experience it really helps taking USMLE Step 1 to get one foot in the door. If you take USMLE Step 2, you may get both feet through. I took both USMLE Step 1 and 2 and think this really helped me get some solid interviews because it put me in the running with MD applicants.
      • *Dually accredited programs accept COMLEX scores, so no stress with these ones.
    • If you go AOA: 
      • There are 24 psych residencies and they are small. I am not sure about all of them, but the ones I looked into accepted 2-4 residents/year. Most are community-based which is really nice but in more isolated locations.
      • No need to take USMLE Step 1 or 2.
      • I’ve heard rumor on the interview trail that there are certain AOA programs that are more malignant than others, be on the lookout for these ones.
  • The Magic Number.
    • 9 if you go NRMP. I think people can typically match within their top 5 and most will match if they have at least 4 programs ranked.
    • No idea if you go AOA. I would guess 4.
  • Write a SOLID personal statement. NO Crap.
    • No joke, I got interview invitations off of my personal statement. The idea here is that if you meet a minimum requirement in your grades, clerkships, board scores, etc. you are seen as a decent applicant. But your personal statement is what will set you apart. No need to be a prolific writer, but have a story and be passionate. I had a lot of program directors directly ask me to talk about parts of my life based off of my personal statement. In psychiatry, this matters more than other specialties because programs want to see that you are truly interested in psych and why this field matters to you.
  • Doing Sub-I’s/Aways/Acting Internships:
    • I would recommend doing an elective rotation at a program that you are really interested in but don’t have regional ties to or for programs that are notoriously competitive. It also shows programs that you are legit interested in psych. I had a lot of faculty and program directors ask me about what type of psych rotations I’ve done and what I’ve learned from these experiences, etc. I think it makes for good conversation.
    • A lot of 4th year medical students don’t do away rotations in psych as they don’t see it as being necessary.
  • If you have RED FLAGS* on your application:
    • Still apply broadly. Be mindful of programs that require you to pass without any failure attempts and apply to the rest.
    •  *failed any board exams or clerkships or classes

I think I’ve exhausted my focus for the evening. If you have any questions please feel free to comment. I am happy to be a resource for all you.

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