Specialty Choice: Psychiatry
A psychiatrist specializes in the prevention, diagnosis, and treatment of mental, behavioral, addictive, and emotional disorders such as schizophrenia and other psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders, and adjustment disorders. Most psychiatrists use some form of discussion (individual or group therapy, psychoanalysis, or behavior modification) to evaluate and treat problems, in addition to using pharmacological treatments. (Source: AAMC Careers in Medicine)
- American Psychiatric Association
- American College of Psychiatrists
- American Academy of Child and Adolescent Psychiatry
The following information comes from the National Resident Matching Program's Charting Outcomes in the Match 2014 (PDF) based on matched applicants in the United States.
- Step score averages:
- Mean Step 1 of U.S. Matched Applicants: 220
- Mean Step 2 CK of U.S. Matched Applicants: 233
- Average number of research experiences: 2.5
- Average number of abstracts, presentations and publications: 3.8
- Work and Volunteer:
- Average number of work experiences: 2.9
- Average number of volunteer experiences: 6.6
- Mean number of contiguous ranks of U.S. matched applicants: 9.6
Advice for MS1 and MS2 Students
Q: What particular activities should first and second year students get involved with who are interested in pursuing this specialty?
Join the psychiatry interest group, shadow psychiatrists, get involved with research projects, be active in the community.
Q: Are research experiences important in your specialty?
Research projects are not required but can help strengthen your application. If interested in an academic career this can be helpful further down the road. Research is not necessary for matching at the program of your choice.
Q: If so, do these need to be specialty specific research experiences?
Research in any area would help strengthen your application for a psychiatry residency.
Q: Does class rank matter?
Not particularly but doing well in the first two years of medical school is always looked on favorably during residency interviews and prepares you to do well on your Step 1 exam, 5 percent of matched U.S. seniors are in AOA.
Advice for MS3 and MS4 Students
Q: When should I ask for letters of recommendation (LORs)?
Ideally you should ask for letters in May but absolutely no later than July, allowing your letter writers adequate time to upload your letter prior to the ERAS application submission date of Sept. 15. Your personal statement and CV should be ready as well as many letter writers will request this in order to write you a strong letter.
Q: How many LORs do you need?
Minimum of three.
Q: Is a letter from a chair required?
This is program dependent.
Q: Do all letters need to be written by members of this specialty?
No, but at least two should be from psychiatry and one from medicine or pediatrics.
Q: Do any letters need to be written by external institutions?
Q: Does your Step 2 CK score matter?
Yes. It is program dependent, but most programs like to see your Step 2CK score prior to inviting you for an interview.
Q: What electives would you recommend for someone who is interested in pursuing this specialty?
You should do at least one psychiatry elective early in your fourth year to demonstrate interest. Electives that allow you to experience outpatient, inpatient and emergency psychiatry can be helpful to give you exposure to the full spectrum of care.
Q: Should a student interested in this specialty do away rotations?
It’s not necessary. However, if you are particularly interested in a program and you are prepared to do exceedingly well then it can be an opportunity to learn more about a program and the details of a place that you might otherwise not have a chance to learn about on interview day. Programs located on the east and west coast tend to be more competitive and thus it is recommended you seek guidance from current residents or alumni who successfully matched or interviewed at these programs.
Q: If so, how many “aways” do you recommend and when should they be completed?
Q: Which month is recommended to take off to interview?
Mid-October through the end of January. You will have the option to pick an interview date so if you take time off for interviews try to schedule all your interviews during that month as your interview offers come in. There is typically flexibility in choosing your interview date.
Similar Specialties to Consider
- Family Medicine
- Length of program: Four years.
- Number of accredited programs: 203
- Transitional year needed: No
- Combo programs: Family Medicine/Psychiatry, Medicine/Psychiatry, Pediatrics/Psychiatry/Child and Adolescent Psychiatry, Neurology/Psychiatry
- Common variations among programs:
- Academic program vs. Community program
- Psychopharmacology and psychotherapy emphasis of the program
- Available fellowships at the same training site
- Availability of VA training
- Residency class size
- Child and Adolescent Psychiatry
- Forensic Psychiatry
- Geriatric Psychiatry
- Addiction Psychiatry
- Psychosomatic Medicine
Looking into the Future/Changes in Health Care
1. Earlier diagnosis and early intervention. The past decade has witnessed a surge of progress in identifying individuals at high risk for psychosis or mood disorders. The “prodrome” has become a fertile area of research, with a focus on early “treatment” even before the clinical syndrome of schizophrenia or mania appears. The goal is to try to delay, modify, or ameliorate incipient serious mental illness by using both pharmacotherapy and psychotherapy.
2. A tsunami of genetic discoveries. Almost weekly, psychiatric geneticists are discovering genes associated with serious psychiatric disorders…Ultimately, these genetic discoveries will provide clues to the molecular pathophysiology of major mental disorders, leading to the holy grail of psychiatric treatment: specific, biotechnology-driven, disease-modifying pharmacotherapeutics rather than merely symptom-control agents.
3. Neuroplasticity as treatment target. Over the past few years, structural atrophy of the brain at the cellular and molecular levels has been documented in psychosis, mania, depression, and anxiety. These findings have shifted our perspective of mental illness beyond the simplistic notions of “chemical imbalance.” The new model is progressive neuroplasticity changes in neurons, dendritic spines, neurite extensions, and synapses, (ie, the neuropil), with both grey and white matter reductions impairing brain connectivity and functioning.
4. Neurostimulation for brain repair. Electroconvulsive therapy has been an effective (though sparingly used) psychiatric treatment for decades. Now, a new era of brain stimulation for psychiatric disorders is evolving with the FDA-approved modalities of repetitive transcranial magnetic stimulation (rTMS) and vagal nerve stimulation (VNS). But the next “big thing” may be deep-brain stimulation (DBS), which is becoming a routine treatment for neurologic conditions such as Parkinson’s disease. DBS has potential to provide major treatment breakthroughs, and DBS research is progressing rapidly. (Source: Nasrallah, 2009)
- Career Services Focus Newsletter: Psychiatry
- Boonshoft School of Medicine Residency Program
- Boonshoft School of Medicine Residency Program Director: Randy Welton, M.D.
- Boonshoft School of Medicine Department Chair: Igor Elman, M.D.
- BSOM Psychiatry Student Interest Group Network (PsychSIGN)
- Search for recent Wright State graduates who matched in psychiatry
- Association of American Medical Colleges Careers in Medicine: Psychiatry
See the Career Essentials Pilot Page regarding specialty specific advice for more detailed information and resources.
- American Psychiatric Association medical student page.
- Nasrallah, Henry A. Psychiatry’s future is here. Here are 6 trends that will affect your practice. Current Psychiatry, Vol. 8, No. 2 / February 2009.