Medical Students Who Do Not Match to Psychiatry: What Should They Do, and What Should We Do?

Balon, Richard; Morreale, Mary K.; Coverdale, John; Guerrero, Anthony P. S.; Aggarwal, Rashi; Louie, Alan K.; Beresin, Eugene V.; Brenner, Adam M.

doi:10.1007/s40596-020-01295-w

Cited by 12 publications

(9 citation statements)

References 6 publications

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“…Psychiatry as a field has become more popular as measured by recent increases in students matching to psychiatry residency programs in the US and Canada [ 9 , 27 ]. In Canada the percentage of medical students matching to psychiatry was 7.5% in 2020 [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

A week long “pep” talk – initial and 2–3-year longitudinal data on the Ottawa Psychiatry Enrichment Program (OPEP)

et al. 2022

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Background Recruitment to psychiatry as a career has been challenging in Canada and abroad despite the known shortage and increasing burden of psychiatric issues globally. Deterrents to choosing psychiatry as a career include its negative stigma and paucity of knowledge about the field. The study goal was to evaluate the Ottawa Psychiatry Enrichment Program (OPEP), a one-week extracurricular program about psychiatry as a career for 1st and 2nd year medical students. We hypothesized OPEP would improve students’ attitudes towards psychiatry, and positive changes would be sustained 2–3 years later following their residency match. We hypothesized there would be a high recruitment of OPEP attendees to psychiatry programs. Methods 1st and 2nd year medical students from Canada applied to OPEP. Attendees completed the Attitudes Towards Psychiatry Questionnaire (ATP-30) at three times: before OPEP (PreOPEP), after OPEP (PostOPEP) and after their Canadian Residency Matching Service (CaRMs) match 2–3 years later. OPEP ATP-30 scores were compared to third-year student ATP-30 scores before and after their psychiatry rotation. Data were analysed using Friedman non-parametric ANOVA and post hoc testing by either Wilcoxon rank sum test, Wilcoxon matched pairs signed rank test, or parametric Welch independent t-test as appropriate. Effect sizes of group mean differences were calculated using Cohen’s “d”. Results Between 2017–2018, 29/53 Canadian applicants were selected for OPEP. 100%, 93.1% and 75.8% of OPEP students completed the PreOPEP, PostOPEP, and CaRMs ATP-30 surveys respectively. 43% of OPEP attendees matched to psychiatry. PostOPEP ATP-30 scores (mean = 133, median = 137, SD = 10.6) were significantly higher than PreOPEP ATP-30 (mean score = 121, median = 122, SD = 9.3, p < 0.001) and CaRMS ATP-30 (mean = 126, median = 127, SD = 12.3, p < 0.02) scores. OPEP effect size on ATP-30 scores was large (d = 1.2) but decreased 2–3 years later (p = 0.078, d = 0.44). 97/202 students completed the ATP-30 before and after their psychiatry rotation (clerkship). Clerkship effect size on improvement in ATP-30 was moderate (d = 0.39). There was a non-significant difference between OPEP CaRMS ATP-30 and post clerkship ATP-30 scores (median 127 vs 121, p = 0.056). Conclusions OPEP ameliorated attitudes toward Psychiatry, but improvement deteriorated longitudinally. Strategies for program design, and innovations to boost/retain improvements during clerkship years are discussed.

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Section: Discussionmentioning

confidence: 99%

A week long “pep” talk – initial and 2–3-year longitudinal data on the Ottawa Psychiatry Enrichment Program (OPEP)

et al. 2022

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“…These authors acknowledge, however, that when applicants "suddenly face the overwhelming and distressing reality of not matching, they are under considerable stress and lack information while they must decide what to do next. " 22 For this reason, we would advocate for medical schools to take a proactive approach in advising their students about the prospect of not matching to residency, as well as allowing students the option of opting-in to have medical school staff reach out to them in the event that they do not match. This process would remove the onus from the student to reach out for support during a time of distress and uncertainty, potentially allowing for more timely intervention.…”

Section: Discussionmentioning

confidence: 99%

“The Feeling of Failure Is Immense”: A Qualitative Analysis of the Experiences of Unmatched Residency Applicants Using Reddit

Morrissette

2022

Academic Medicine

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PurposeThe increasing number of applicants who do not match to a residency program has been identified as an issue in Canada and the United States, yet the experiences of those individuals going unmatched have remained largely unexplored. By better understanding such experiences, medical schools will be better equipped to support unmatched graduates. The authors sought to understand the shared experiences of unmatched residency applicants, including those who did not match to American residency programs. MethodThe authors turned to the social media platform Reddit as their source of data to further understand the experiences of unmatched residency applicants, using a thematic analysis of comments posted on the subreddit r/medicalschool. The subreddit was searched for comments containing the term unmatched on August 16, 2021. A total of 206 comments containing content about firstperson experiences of going unmatched were included in the thematic analysis. ResultsThe 206 comments were authored by 124 unique usernames between the years of 2012 and 2021. Two primary themes emerged in the analysis: perceptions of insufficient return for investments made in medical education and concern about the possibility of going unmatched again in the future. Subthemes identified for the first theme were regret for pursuing medical school, perceptions of

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“…To our knowledge, very little research has looked at the effectiveness of various career advising resources 28,29 and strategies 11 to prepare medical students for entering the Match or what students do during the SOAP at baseline. Although a couple of recent articles describe institutional solutions to provide fully unmatched applicants with structured research and skill-building experiences for those seeking a pathway into psychiatry, 30,31 overall additional research is warranted to better understand the options pursued by fully unmatched residency applicants.…”

Section: Medical School Education Leader Commentsmentioning

confidence: 99%

A Transitional Year Residency Program Provides Innovative Solutions for Unmatched Medical Students

Gathright

Hankins

Siddiqui

et al. 2021

Journal of Graduate Medical Education

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Background The transition to residency is competitive with more medical students applying for residency positions than slots available, and some will face challenges securing a position in their desired specialty. Our institution created a transitional year (TY) residency program in 2016 to help meet the needs of our medical students who did not initially secure a position in the main residency Match. Objective This report provides a brief overview of the TY program and analysis of the program's value from the inaugural 3 years (2017–2020). Methods The TY program is based at a midsized, urban, academic health center and features a tailorable curriculum emphasizing preparation for residents' specialty career plans. We used participatory action research and appreciative inquiry strategies as part of the annual program evaluation to examine TY residents' perceptions of the program's value. Stakeholder perceptions were also elicited from a purposive selection of 4 program directors and 2 key medical school education leaders. Results Internal evaluations revealed a high rate of resident satisfaction with the TY program and self-reported benefits such as increased confidence, clinical proficiency, and professional enculturation. Stakeholders valued the program as a potential pipeline for increasing physicians in the state and providing valuable direction to students' career trajectories. Conclusions Creating a TY residency program to meet the needs of unmatched medical students was feasible to implement, acceptable to residents in meeting their academic and career needs, and provided a sustainable institutional solution with benefits to multiple stakeholders.

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Medical Students Who Do Not Match to Psychiatry: What Should They Do, and What Should We Do?

Cited by 12 publications

References 6 publications

A week long “pep” talk – initial and 2–3-year longitudinal data on the Ottawa Psychiatry Enrichment Program (OPEP)

A week long “pep” talk – initial and 2–3-year longitudinal data on the Ottawa Psychiatry Enrichment Program (OPEP)

“The Feeling of Failure Is Immense”: A Qualitative Analysis of the Experiences of Unmatched Residency Applicants Using Reddit

A Transitional Year Residency Program Provides Innovative Solutions for Unmatched Medical Students

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