A Roadmap to Psychiatry
Outlined below are several sections that highlight important milestones in pursing a career in psychiatry. Your journey awaits!
Preparing for a Career in Psychiatry
In medical school, a psychiatry clerkship/rotation + electives will give you the best sense of whether psychiatry is the right fit for you.
Strong therapeutic relationships with patients signal success. Meet with your psychiatry advisor early. They'll help confirm your interest and plan your application strategy.
When applying - psychiatry residencies, consider the applicant holistically - Holistic review considers more than scores. Programs seek passion, commitment, and unique contributions.
Planning Your Fourth Year
1.) Complete Requirements: Start with school requirements. Add 2-3 psychiatry rotations including sub-internships.
2.) Take Step 2/COMLEX: Schedule early in fourth year. Allows time for retakes if needed.
3.) Consider Away Rotations: Not required but helpful. Apply 3+ months in advance. Budget for travel costs.
4.) Schedule Interviews: Mid-October to February. Plan flexible rotations during peak season.
Choosing Where to Apply
Key Factors to Consider:
Location and cost of living
Program size and resident morale
Clinical opportunities and patient diversity
Work-life balance and call schedule
Diversity, equity, and inclusion initiatives
Post-residency career paths
Deeper Dive into Residency Applications and Signaling
How Many Programs to Apply To :
MD students applied to 63 programs in 2024. DO students averaged 81.
Matched students received median of 13 interviews across both MD and DO.
MD students with 8 contiguous ranks had 90% match rate. DO students needed 10.
What are Signals and how do you use them?
As of 2026, applicants have 10 signals which they can use- a signal demonstrates significant interest in a program and can be used strategically to increase odds of receiving an interview from a signaled program
Consider location, your fit with the program’s structure and your own goals when sending your signals!
Rely on advisors and faculty to personalize your signal list to make the most of your limited signals!
Navigating ERAS
Components to Consider:
MSPE - your school’s dean will write a summary evaluation- usually a conglomeration of past evaluations from previous core rotations. (Most schools allow you to factually correct this document before uploading it)
Geographic Preferences - Choose up to 3 regions. 16% interview rate from aligned programs vs 4% non-aligned
Experiences - Share up to 10 experiences, 3 most meaningful. These should complement your CV and personal statement
Personal Statement - Highlight why psychiatry and ultimately why you are a good fit for the specialty - this could weave in aspects of your journey so far and special experiences that have motivated you to pursue this field
Letters of Recommendation - LORs are usually more important than test scores in interview decisions! Choose writers who know you well and can speak strongly for you. Most programs require 3-4 letters (At least two from psychiatrists recommended) Ask early - give writers a minimum of 4-6 weeks, ideally more. Provide both CV and personal statement draft at the time of letter request
Interview Day and Rank List
Before- Review program website. Prepare questions. Test technical setup. Do mock interview
During- Be authentic and professional. Ask thoughtful questions. (At this point you have received an interview out of genuine interest from the program- remember that you are here for a reason!)
After- Take detailed notes. Record your impressions. Update running rank list immediately
Rank List - this will eventually be the order of your preference, in terms of residency programs you have interviewed for. You want to create this rank list based on how good of a fit the program is for you! Only rank highly if you genuinely can see yourself accomplishing your goals at that program!
