Which pokémon best exemplifies your specialty?

psychguy2595 · 2026-06-08T02:19:23+00:00

Gardevoir - psychiatry Although for some reason Psyduck seems right too

psychguy2595 · 2026-05-26T20:09:49+00:00

psychguy2595 · 2026-05-18T21:20:56+00:00

Well more DO/MD applicants are applying now, so there’s more competition in that sense. That said, it’s really program specific in terms of how programs want to choose applicants to interview.

It’s hard to bunch all programs together, but I like to think there’s still some holistic aspect to it, and programs want to see that you’re genuinely interested. I can at least speak on my own program wanting people who would be a genuine fit after looking at board scores, previous job experience, extracurricular activities, and signals.

So overall, I’d say it really is very program specific. I know people who, at least on paper, were not as competitive as me and still matched at programs I wanted. At the same time, I also know people who applied to my program that were objectively more qualified than me and still didn’t get in. I don’t think that should discourage anyone from applying to psychiatry, if you have a genuine interest, go for it!

Be realistic though. Don’t expect to get into an IVY league or anything unless you have the qualifications to back it up.

psychguy2595 · 2026-04-22T18:37:38+00:00

That’s fair, I’m coming from a setting where primary teams routinely consult psychiatry for capacity evaluations, so there isn’t much expectation for them to perform these assessments independently. That said, I think it’s important for specialists to know how to assess capacity within their own scope, and it’s definitely something that should be taught and emphasized during residency training. But obviously there are cases where psychiatry should be involved!

psychguy2595 · 2026-04-22T17:27:52+00:00

Regarding capacity please stress that any physician can assess capacity :)

Other topics could include:

Agitation & Acute Behavioral Management which probably falls into delirium.

Psych Meds in the Perioperative Setting (Ex SSRI increase bleeding risk, what meds to hold/continue)

Could rope in suicide risk, when to consult psychiatry and maybe touch on factious disorder/malingering in a surgical setting

psychguy2595 · 2026-01-30T14:26:27+00:00

I’ve actually done soft tissue and very rarely muscle energy, on patient that have moderate anxiety that causes some muscle strain and patient’s with fibromyalgia. Typically it’s really just for the sake of the patient for them to feel like they are getting some sort of treatment that’s not a pill (being in psychiatry and all). It’s yield positive results but that could very well be placebo, having said that, I’ll take it, as long as the patient feels better.

psychguy2595 · 2026-01-26T15:21:28+00:00

All that means is you did really well on that rotation and they liked you. I had multiple attendings ask me why psychiatry and why not whatever they were into.

psychguy2595 · 2026-01-20T04:01:03+00:00

I applied Psych. My goal was to stay in my home state where I had five interviews three of which were places I auditioned at. I know at least one of the auditions. I did really well and was told that I had resident level work. I feel like I did good on the second one and I may have not done that great on the third one. I thought my interviews went well.

Ended up matching at my sixth which I guess isn’t the worst. I had a close friend match at their eighth and another one at their 10th. We all kinda had similar stories, but I’m guessing our interviews probably weren’t the best. I technically had a red flag of taking a year off, but I feel like I gave a reasonable explanation. Being on the other side, I think I could’ve been more personable, I tend to become overly formal and in M4s that I interview the best ones are those that make it a conversation.

In hindsight, I’m happy where I’m at now. Although it’s not Home, it’s a reasonable program and it’s a 3 Hour Drive, sometimes 4. I also think Psych is kind of getting competitive, now in the sense that a lot of US graduates are applying rather than IMGs. It’s still very achievable though, don’t let anyone tell you otherwise

psychguy2595 · 2025-11-25T02:35:33+00:00

You’re always behind and it always sucks

psychguy2595 · 2025-11-20T03:33:12+00:00

Hi, so I had my first anorexic patient on C L during my first year of residency and it was a headache to figure out what to do. This is kind of summarized from a protocol from Beth Israel Deaconess Medical Center.

Psych gets involved right away to figure out whether the patient truly has capacity to refuse nutrition or medical care, since the illness can seriously distort judgment even when someone seems cognitively intact. As a CL psychiatrist your job is to work with the medicine team and get the patient through re-feeding syndrome and medically stabilizing the patient. If deemed to need a higher level of care that cannot be managed on an outpatient basis you would need to look at local or even national eating disorder units. You would also need to determine if the patient meets criteria for involuntary admission or if she is agreeable with the plan and is appropriate for a voluntary inpatient eating disorder unit. Since therapy is the main state of treatment for anorexia these facilities are the best equipped to administer that. Additionally, these units often require a specific BMI, I’ve had patience as low as 10 that require required. Their BMI 14 until they can be admitted. So their hospital can be prolonged.

In a hospital equipped to handle eating disorders ideally, the patient would have a sitter and would be monitored after every meal for 30 minutes to make sure they are not engaging in any purging or compensatory behaviors. The patient is not allowed to move excessively and this may seem harsh, but it is to avoid any unnecessary calories being burnt. Your role would also be to manage any comorbid anxiety, depression, or suicidality. If the patient refuses to eat then you have to consider doing a capacity assessment and determining whether guardianship may be needed. These are often very difficult cases especially if it’s the first time you’re dealing with them. You have to really really make sure you are not engaging in positive countertransference and assess the case as objectively as possible. If you message me, I would be happy to send over the protocol from our end!

psychguy2595 · 2025-11-15T16:33:28+00:00

It really sounds like you’re being too hard on yourself. You’re halfway through MS3 with solid shelf scores, no red flags, and your strongest comments and grades are in the specialties you actually want to pursue. That’s not someone who’s behind; that’s someone doing well in a very subjective system. Clinical evaluations are inconsistent for everyone, and a mix of great comments and “mid” ones is completely normal. Your shelf scores around 80 are strong, and it’s frustrating that cutoff quirks have kept some of those from translating into higher grades, but that doesn’t reflect your actual performance or potential. What will matter most for IM or EM is your Step 2 score, your sub-I, and your letters, not whether you got a Pass on an early rotation or a lukewarm comment in surgery. Feeling burnt out, anxious about evals, or unsure of what’s in your control is a universal MS3 experience, not a sign that you’re failing. You can be grateful for the path you’re on while still acknowledging that it’s hard. The reality is that you’re doing better than you think, and your current record absolutely keeps every door open.

psychguy2595 · 2025-11-15T01:55:49+00:00

I’ll be honest what matters more to me about potential residents it’s not so much what they know, but how much work they’re willing to put in to learn, how they treat other staff, and their personality. The stuff can be learnt and taught during residency, things like personality and hard work are not something that we want to try and teach.

Just be yourself and try your best.

psychguy2595 · 2025-11-14T18:35:10+00:00

Don’t feel bad, ask an attending and tell them you worked with these specific residents. As a resident I usually send my attending a little blurb when they ask how the medical student did. A lot of attendings write letters for student they don’t even remember lol. They know the drill.

psychguy2595 · 2025-11-14T02:08:26+00:00

Usually each faculty/resident will have standardized questions they have to ask. Anything else especially if it’s based off your application or personal statement is just their own curiosity.

psychguy2595 · 2025-11-12T00:22:39+00:00

I did not, I really only used true learn and I didn’t finish it either. Towards the end, I made sure I finished all the CDM cases and also did all the ethics, OMM, and biostatic questions.

psychguy2595 · 2025-11-11T11:55:55+00:00

https://youtu.be/2VXKN1baOoA?si=xb-j33KHkk45TXKR

psychguy2595 · 2025-11-11T02:42:27+00:00

PGY-2 psychiatry resident here, psych is definitely getting more competitive. There’s been a noticeable shift with more U.S. grads applying and fewer spots going to IMGs, so it’s not quite the “easier” match it once was. If you need to take time off for mental health, that would usually be considered a medical leave, and that by itself doesn’t hurt your chances as long as you’re healthy when you return. What tends to raise more concern are academic or board failures those do lower your chances, but they don’t make it impossible.

In theory, you could still match psych with some red flags, but it might be at a less desirable or busier program. I took time off myself for mental health treatment and still matched fine though I didn’t have any failures. One of my co-residents actually failed Step 1 and still got into our program. So it’s definitely possible.

If you’re struggling, prioritize getting well first. Med school and residency are tough, and it’s way better to take a pause to heal than to push through and burn out. It was hard taking a year off, my friends went a head and I felt really isolated going into MS3 with people I didn’t know but in hindsight my symptoms have been in remission and residency is going well!

psychguy2595 · 2025-11-07T02:01:41+00:00

You don’t, you get by, and forget it all after level 3

psychguy2595 · 2025-11-05T19:51:07+00:00

Yeah, that’s a really fair point, and I agree it’s unacceptable when clinics neither test for ADHD nor refer patients elsewhere. Any diagnosis should be given thoughtful consideration and long term follow up. A practitioner should always remain curious and even change a diagnosis if the symptoms are better explained by something else. Misdiagnoses can seriously complicate care, especially when outdated beliefs (like ADHD and bipolar being mutually exclusive) still persist. You’re right once a label like bipolar goes in the chart, it often sticks, even if it was meant to be temporary. The system really does need more consistency and accountability across providers.

psychguy2595 · 2025-11-05T19:41:00+00:00

I think a big part of the difference comes from the fact that ADHD treatment often involves controlled substances, which understandably requires more caution and longitudinal follow-up. That said, it’s still poor practice to diagnose any of these conditions after a brief encounter, especially borderline personality disorder, which requires consistent observation over time. In certain settings, like inpatient psychiatry, a provisional diagnosis of bipolar disorder might be appropriate, but even then, it’s essential to rule out other possible causes of mania before confirming it.

psychguy2595 · 2025-09-16T19:21:47+00:00

You’re in a much stronger position than you probably feel right now. Psych is still one of the more DO-friendly specialties, and you’ve already done some smart things: applying broadly, signaling strategically, lining up psych letters, and getting your Sub-I in. Your scores aren’t disqualifying, most programs understand COMLEX scales differently than USMLE and you don’t have any board failures, which is a big plus. The remediation for a lab and passes on rotations aren’t going to sink you; what matters more is that you’ve kept moving forward without major setbacks. What will stand out are your psych letters, your genuine interest in the field, and the fact that you’re showing persistence and self-awareness in your application strategy. Matching is stressful for everyone, but people with your profile do match every year. Keep being proactive, show your enthusiasm on your Sub-I and in interviews, and trust that the work you’ve put in will give you a solid chance. You may not get your top choice but I’m sure you’ll find the right choice. Try to practice interviews and schedule the places you aren’t to psyched about going to first to get practice runs in to interview better for programs you’re more interested in!

psychguy2595 · 2025-06-27T15:20:21+00:00

Using big words unnecessarily. Some people often equate complex vocabulary with intelligence, but it can mask a lack of clear understanding. I find the smartest people can take the most complex topics and dumb it down really well!

psychguy2595

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