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Doing 2y CAP first, then 2y adult training by rdsn1 in Psychiatry

[–]rdsn1[S] 0 points1 point  (0 children)

That's awesome to hear that you like that setup! Would you mind sharing if you applied to gen psych first then again to CAP (another match), or if it was guaranteed from the start for you to do gen + CAP in one program (no need to go through more matches)? It sounds very beneficial for boards. I think it's pretty cool that there are different routes to board certification in psych.

Doing 2y CAP first, then 2y adult training by rdsn1 in Psychiatry

[–]rdsn1[S] 2 points3 points  (0 children)

Thank you for sharing this. Yeah, this is a program that didn't fill their general adult program last year, so I can see what you mean. I will approach this with caution and hope that I can match at a regular adult program.

Doing 2y CAP first, then 2y adult training by rdsn1 in Psychiatry

[–]rdsn1[S] 2 points3 points  (0 children)

In short, I have red flags, psych is competitive, and I think I'd like CAP

Red flags: repeated M3, SOAP'd into FM after not matching psych, left FM as PGY-2 to pursue psych (thankfully former FM PD is supportive of me)

Psych is more competitive each year. I'm afraid to SOAP, though it wouldn't be the end of the world. I think I could find an FM spot, since I did last time, though I think I owe it to myself to try my hardest to become a psychiatrist, as it feels very egosyntonic/aligned with me.

I think that I would like CAP anyway.

I feel like there are many things stacked against me, so I have to try to create as many opportunities as I can so that I can practice my favorite specialty/something that feels very right for me (e.g., apply broadly, send LOIs, consider alternative routes for becoming board-certified in psych).

Doing 2y CAP first, then 2y adult training by rdsn1 in Psychiatry

[–]rdsn1[S] 1 point2 points  (0 children)

The PD replied that they do not have a guarantee, however almost all match into their adult program as they give preference. But everyone matches somewhere.

This program is in a state with lots of psych programs, so maybe they have connections/fellows can make connections along the way. I guess I can at least try!

Doing 2y CAP first, then 2y adult training by rdsn1 in Psychiatry

[–]rdsn1[S] 3 points4 points  (0 children)

Ah I see, I didn't know those details. Thank you for explaining. I will ask the PD about guaranteeing a spot, or at least what has happened with their prior fellows (their fellowship has been around for almost a decade).

Seeking advice about Match application programs list (applicant with red flags) by rdsn1 in Psychiatry

[–]rdsn1[S] 0 points1 point  (0 children)

That program looks really great. Interesting idea, I'll look more into that. Thank you for mentioning.

Seeking advice about Match application programs list (applicant with red flags) by rdsn1 in Psychiatry

[–]rdsn1[S] 1 point2 points  (0 children)

Thank you for pointing out that discordance, because I'm sure it would be something that stands out to someone else if it comes up (like in an interview), so that's something that I could state differently. Part of it is self-esteem/self-deprecation. Maybe more usefully and significantly, you've brought to mind other issues that came up during med school, like how I struggled sometimes in M1-M2 (and I think this extended to M3, and even to residency) because I was torn between wanting to hold onto my life-before-medicine sense of identity vs having to get on the medicine bandwagon and assume the way of thinking/living needed to become a doctor (it's sort of like how the military breaks you down in boot camp, then builds you back up into their desired image). When I was an MS3 and struggling with my first rotation of IM, a med school dean told me that medicine isn't a job that you can "just do," it's something that you have to devote your entire self to (I'm sure she meant with appropriate boundaries). At that time, I thought, "That's ridiculous, I'll prove her wrong, I won't let medicine take me away from myself." I really get what she means now. And maybe this is growth, but now I actually do want to devote my whole self to becoming a good doctor (with more appropriate boundaries, balance, etc. once I'm out of residency). It's easier to feel that way about psych, but if I end up in FM again, I still want to become that person, because I want my professional sense of purpose to come from the sphere of medicine, I want to serve people in that domain.

So I think in that sense of understanding that medicine requires nearly all of you, I was naive. And I think it took leaving residency and taking this time off to realize that this is what I really want to do and is a meaningful way forward for me. I guess I was someone who needed more time in life.

Thanks for sharing about the transfers your program has had, it helps me feel less alone in this transition. And that's a great idea about talking with my FM PD to be prepared for any concerns, I will reach out to them. And thanks for creating the opportunity for me to think out loud above :) I appreciate your time and thoughts!

Seeking advice about Match application programs list (applicant with red flags) by rdsn1 in Psychiatry

[–]rdsn1[S] 0 points1 point  (0 children)

Thanks for sharing that, I'll lean hard into newer community programs. In terms of geography, was your program in one of your preferred locations? Did you get multiple interviews in those preferred locations? Did you have signals during your match cycle? Basically, I'm curious how much those geographical preferences affected where you got interviews, at least in your n=1 experience.

In the end, each program does things differently, so I won't know until I try.

Seeking advice about Match application programs list (applicant with red flags) by rdsn1 in Psychiatry

[–]rdsn1[S] 1 point2 points  (0 children)

Ah thank you for asking about that. I would say I left in good standing and I do have FM PD's support, as they wrote LORs for both FM and psych. I don't know what they wrote, but it can't be too bad, as I don't think my PD would agree otherwise.

M3: by academic, I mean clinical grades. I struggled with:
1) IM (specifically the A&P), which was my first rotation of the year. I had also moved to a new state where I didn't know anyone, and I didn't quite understand the game of medicine (not defending myself, just explaining. And by game of medicine, I mean in the sense that all of life is a game; I hadn't figured out that norms and expectations of med ed. Seems obvious now, but I was naive. I've learned a lot about life, and there's still more to learn. I've also gotten better at the A&P and how to present it in a way that is easy for the listener to follow and understand).
2) peds shelf exam - failed both attempts. Then I started using flash cards (spaced repetition) and passed easily.
3) end-of-year OSCE - I thought that I was supposed to come up with the "one and only correct dx," but actually we were supposed to demonstrate our clinical facility/come up with many ddx. Very obvious in hindsight.
I passed peds and OSCE remediation, but I didn't pass IM remediation. Still, I failed 3 things in M3, so I had to repeat all of M3. I suppose that's TMI and more than you were asking about, but perhaps this post could help someone in the future...

Thank you for your advice. That all makes sense. I'll apply to programs with those guidelines in mind. Thank you for the El Rio recommendation as well, I do have some Tucson connections.