All right, good afternoon. Can everyone hear me? So before we get started, we just wanted to, we're educators, so we wanted to know who's in the room first. So if you're a medical student, can you raise your hand? Oh, wonderful. If you're, that's awesome, wonderful. Thank you for raising your hands. If you are a resident of psychiatry, can you raise your hand? All right. And if you are a faculty educator or a psychiatrist, can you please raise your hand? Oh, okay. So there's a hand. Excellent. Welcome, yeah. And is there anyone that I missed? Sort of, if you're. Oh. International medical graduate, welcome. Thank you for coming. Did I miss anyone else? Okay, well, we're just gonna start. I'm gonna do a brief introduction. My name is Lauren Scherer. I'm a psychiatry faculty member at UC Davis. I just wanna start off by saying I did not organize this workshop. I just have the pleasure of being able to moderate it. In fact, Dr. Erin Malloy, who's the president of ADEMSEP, and she'll talk about that, the Medical Student Education Directors Organization, will share a little bit more about this. But each of my colleagues will have a chance to introduce themselves. But as all of you know, especially those of you who are medical students and those of you who are residents or even educators and mentors to our medical students, this is an interesting time, right? We all know that psychiatry has become much more competitive as a field. Our students who are coming into psychiatry, they are into medicine, they care about social justice, they care about serving our patient population. Psychiatry's becoming more popular. So we are gonna talk about supporting our students and medical educators through this process. So none of us have disclosures. And so just to give you a brief overview is really what we're gonna do is Dr. Malloy is gonna start us off to really talk about the American Directors of Medical Student Education in Psychiatry, that organization, and how the use of facilitated peer mentors or that peer mentoring program to enhance professional development and to serve as a network of support for medical educators in psychiatry. So for those of you who haven't heard of our organization, if you are educating medical students, we wanna welcome you and encourage you to come to our meeting and to join our organization because this is a huge part of our work is to think about how we are educating our students and also how we are mentoring them into future psychiatrists or future physicians who know a lot about psychiatry, psychiatric diagnosis, and management. After Dr. Malloy, so we will actually talk about the increasing competitive, you know, competition of the psychiatry match and we'll talk about recent data in terms of the match applications, methods of evaluating candidates and factors complicating advising students pursuing psychiatry. And so Dr. Perchhorn's gonna go through that. We'll discuss emerging models of advising medical students pursuing psychiatry residency from both allopathic and osteopathic medical schools. Dr. Mintle's gonna spend a fair amount of time talking about how, if you're a DO medical student, you know, DO student, you know, what that process is like and we want that to be helpful to everyone as both as educators and students. And then we will also describe the need for supporting medical educators and others involved in supporting medical students through the psychiatry match, which is an important process, whether you're thinking about it as a pre-clerkship student or whether you're coming into it thinking about it during your MS3 year for example, on the clerkships. So that is the brief introduction and now Dr. Malloy will take it away. All right, good afternoon everyone. It's great to see this room pretty full. We weren't sure what to expect. My name is Erin Malloy. I currently am the president of the Association for Directors of Medical Student Education in Psychiatry. It's a really long phrase there, but we call it ADEMSEP for short. Curious as to how many of you know what ADEMSEP is. Anybody heard of ADEMSEP before? Very few. Okay, so I can tell you a little bit about our organization. But before I do that, I'll tell you a little bit more about me. I have been on the psychiatry faculty at the University of North Carolina at Chapel Hill. For now it's 25 years, so I wanted to celebrate that, yay. So I'm a professor there and I also do faculty development. I'm vice chair for faculty development. But for most of my career, I was the director of medical student education. So ran the clerkship for many years, was involved in medical student advising and still am directly for career goal advising and took on a number of roles in the medical school. I find that important though because it really does speak to ADEMSEP because if we were in a room with people who were in psychiatry in this room 10 years ago and we asked, what do you know about ADEMSEP? They would say, oh yeah, that's the organization for people who direct clerkships. And we are a lot more than that and we've really grown into this over the past several years. So we support our educators who, yeah, who run clerkship, sure, but who also run the preclinical courses related to psychiatry, behavioral health, brain and behavior. We also provide support for those who are running electives and different tracks, longitudinal types courses as well. But importantly, we've become involved in a number of different endeavors that people who teach medical students are more and more involved in. And that includes preparing our students for the residency match. Out of you who are students, how many of you approached somebody who taught you in medical school to ask them about matching into psychiatry? If you're a student, how many of you did that? Yeah, I mean, so again, it's a common thing to do. And so we wanted to be sure that our educators are prepared for this. And you're gonna hear a lot more about it. I'm not gonna share too much on my colleagues' presentations, but also another thing that we have found to be important, and we found this more so through the pandemic, was the need to be able to build a community of medical educators that felt supported. And Adams Step is really known for its collegiality and its ability to bring people together. And so with that, we developed a mentoring program for our membership that is novel, and it's not anywhere else in academic medicine. And so we're gonna share a little bit about that with you. We're gonna do that first, and that way we can get into the, maybe a more exciting topic of matching into psychiatry. So what are we gonna do in this first little talk? We're gonna discuss the benefits of peer mentoring and of our facilitated peer mentoring model as a component of personal professional development. And then we're gonna talk about getting an understanding of the benefits of group and peer mentoring in the context of a professional medical organization. And then you can think about ways that this could apply to you in your own personal development as you form relationships as students with other students, students with residents, residents, and also with the faculty that you work with. These names are our team that have really helped carry forward the project of evaluating our mentoring program. All of these names are people who participated in our program the first year, and they're actually my peer mentoring group. And we got so excited about it that we wanted to do some research on the topic. We also have huge gratitude to Lindsay Pershern, who's right behind me here. She was one of the co-chairs of the Faculty Development Committee of ADEMSEP, who really helped us move along and gave us the space to be able to, and support to be able to grow this program. In addition to that, Gaurava Agarwal was the co-chair of that committee that helped out a great deal with our first year. And everyone else on this, Marion Fireman and Sindhu Adikula, participated in the program. Nancy Harker was our administrative director, and we have a lot of mentors and mentees, so I wanna thank all them. So when we think about mentoring, there's actually a literature on mentoring. I think, you know, just we can intuitively say, oh yeah, it helps people get through their careers, and things like that. There's actually research that supports this. So in meta-analyses and systemic reviews of the literature and research that's been done on mentoring, it shows that for mentoring in academic medicine, that it increases research productivity. It also improves retention of faculty in academic medicine settings, and it enhances career satisfaction, among other things. Sounds good, right? So what is the problem? So why are we doing all this? And it's because what we have found also, what these same systemic reviews show, systematic reviews show, is that many faculty at U.S. medical schools really feel like their mentoring is infrequent, not adequate, and there are problems with access to quality mentoring. And we see this especially in women and others who are underrepresented in academic medicine. And also, oftentimes the mentoring that is available may not address those specific needs for those groups. So part of the work that I have done in my research outside of ADEMSEP is really looking at what sorts of mentoring and support works for women and for others who are underrepresented in academic medicine and also in higher education. And so in some of the reviews, there's actually on the left-hand side of your screen is a review of, a systematic review of what works for mentoring for women and underrepresented faculty members in academic medicine. And some of the take-homes from that study showed that really it's aligning mentoring programs with what the institutional goals and resources are. So a lot of times people will say, let's get this program together, and they try to deliver it, but the actual resources don't exist. The goals of the institution may be different. So you have to work within that construct in order to build something that is effective. And that really applied to us as we built our program at ADEMSEP. Also, programs should be tailored to what the institution needs. So for some, it is retention of faculty. For others, it is increasing the research footprint. For others, it's other things as well, there's also for ADEMSEP, it was promoting connection with each other at a time during the pandemic where people were feeling very burned out and disconnected from each other. And that was one of our main reasons as well. And also what they found too in this systematic review is that there did not seem to be an adverse effect when the mentor and mentees identities didn't match. It was more about understanding and listening to the experiences of each other and the qualities of being a good mentor that made the biggest difference. So that's an important point. When we think about our women and underrepresented faculty who are in institutions that don't have a lot of people who look or have had the same experiences like they have. And then this underscores the importance of quality training for mentors. On the right hand side is the work that I've been involved with at the University of North Carolina at Chapel Hill. We have an advanced grant from the National Science Foundation. And our grant was called, is called still Targeting Equity and Access to Mentoring. And with this, we actually, this was happenstance. This study on the left was going on at the same time we developed and got our grant and started to roll out our project. But I found it really interesting that a lot of what we did actually lined up with what was found in the literature. And so you can see on this circle which has four quadrants in it that we really did take a systematic review to this. If you look on the lower, the lower quadrant, it is actually having somebody in our provost office. So in universities, the provost is the chief academic office, officer. And so having somebody associated with the provost office that could actually guide these programs is really important. And then also if you go counterclockwise, resources for chairs and deans and those leaders who are going to be people who can ensure that mentoring is happening for all of their faculty. And they need guidance in order to create programs that are gonna work and that are gonna be able to be an appropriate use of the resources available. And then up in the upper right corner, it's how do we develop, how do we train those faculty mentors? And that was a big piece of what we ended up doing with our grant. And then lastly, thinking about novel models to support early career faculty and mid-career faculty. So really being creative about how we did that. So what do we know about peer mentoring? Because this is what we ended up doing for our early career faculty. It ended up being the basis for which we built the ADEMSEP program. And until around the year 2000, when you thought about mentoring, the concept was a mentor up here and a mentee down here. Mentor, mentee, and that's about it. But over this past 23 years or so, more models are being developed, including peer mentoring models, other team type mentoring models where there's several mentors per mentee. There's a model called Cascade, which is something that you have kind of a lead mentor who mentors somebody who's more junior, who mentors a couple others a little more junior, and so on. And that way it spreads out the senior person's wisdom in a lot of different ways. And then facilitated peer mentoring. And this is where we got excited, both in the research grant we did at UNC, but also with ADEMSEP. One of the things we did know is that we did a literature search on professional societies in academic medicine particularly, and found that there really wasn't anything like what we were trying to do. We wanted to be able to have something that was available to every member of ADEMSEP, which is kind of a big ask. Most professional organizations will put together one group of people who are going to be mentored, and they do it really well. A lot of them do it really well. But it wasn't available to everybody, but we made ours available to all our members. So our program is novel. And what we found though is that we wanted to use facilitated peer mentoring. And why we did that is because this is a program to develop educators in psychiatry. And so we wanted to leverage the senior members of ADEMSEP to be able to share their wisdom, but then also have the opportunity for people to learn from each other at whatever career stage that they were. So that's why we did that. Oops, sorry, backward. All right, so what are our goals? Our goals were to promote the professional development of our members, to promote connections, and to reduce isolation, particularly in the pandemic. We used the Faculty Development Committee at ADEMSEP. Thanks again, Lindsay, for that. And we also, like we said earlier, we based this off of this peer mentoring program that we have at UNC. We formed eight groups, and each of those groups had two senior ADEMSEP mentors, and then around five to six earlier mid-career mentees in each group. And so another reason, this kind of goes back to what I said earlier about you gotta work with what you have, right? And so when we first put the call out for do you want to be a mentor, do you want to be a mentee, we had a huge response, as you might expect, of people who wanted to be mentored. They wanted to be a mentee. We did not have as robust a response from senior people saying, I wanna be a mentor. And so, and how do you work with that construct? So this actually worked really nicely to be able to leverage the expertise of senior mentors who wanted to do it, not just assigning people to do it, but people who wanted to do it with a group of mentees, and we were able to meet the needs of everyone who wanted it. So how did we do this? So we recruited, again, by just doing an interest survey, and then we did a, once we got a collection of names, we did a more specific targeted survey to look at what people wanted to get out of the program, to understand where they were in their career and what their academic interests were, and then we used that to match them into groups. We did an orientation with all of our senior mentors first, and we kind of gave an outline as to how do you build a community of early career folks? How do you create a safe space? How do you do things like think about, how do you manage when people disagree? You set your sort of group norms and ground rules, and then how do you listen effectively using active listening, appreciative inquiry, to be able to understand what everybody would like to get out of the program? And then we let the mentors take it in whatever direction that they and their group wanted to do it. So it was very interesting to hear the ways that the groups formed and the ways that the development happened. I'll talk more about that in a moment. The format, all virtual, obviously. At the time, it was during the pandemic, but it makes sense when you have a national organization that it's gonna be hard to meet in person. So these were all done on Zoom, and the frequency varied from between every month to every quarter. And when we show some results in a moment, you'll see that those who met more frequently seemed to enjoy the program more. The structure varied, and for example, in my group, we talked a lot about our academic progression and finding research interests, and ended up doing some scholarly work together. In one of the other groups, they brought in guest speakers each time to talk about different topics related to career development in psychiatry and medical education. And so again, whatever worked best for each group is what we did. And then we did some assessment by checking in regularly with the mentors to see how things were going, and did a survey at the end of the first year. And so this is a lot of information about the survey, was IRB approved, and we surveyed mentors, mentees, anybody who participated in the program. So what did we find? So what we found, we had a total of 31 survey respondents that were 14 mentors and 15 mentees, two were incomplete. And we found that the roles in undergraduate and graduate medical student education were equivalent between the mentors and mentees, and that academic rank differs with mentors, primarily professors and mentees, who were, the mentees were primarily assistant professors. All right, so what did, how successful was your mentoring group? That's one of the questions we asked. So look closely at this. This is a Likert scale from zero, like it was not at all successful, to five, meaning it was like wildly successful. And you can see that the most common response was a five, followed by a three and fours right there in the middle, and then there's a smaller response that looks like one person put a zero, one person put a one. And so overall, it looks pretty good. The mean was 3.92, and standard deviation 1.35. So characteristics, let's talk about successful groups. We're gonna look at that sort of higher end of the scale now and we defined low versus high success groups. So what we did is we took any, anybody whose overall score on that question was between a zero and a three. Zero and a three. You saw that there's, you know, the skew on the right and then the lower on the left, but we actually included threes in low successful, low success. They were defined as a low success group. Those who put a four or a five were defined as a high success group. So if you look at the green as low success and blue is, or purple, whatever it looks like to y'all, is high success. And what we found, what was common, what we found is the high success groups had more in common with each other than the low success groups. And sometimes groups had to find that out once they started meeting. And so that's a key thing to find out too. But what we found particularly, like all parents was one of the groups that was really successful. Gender matching was also somewhat successful as well. But you can see when there was no, nothing in common on the right hand side, was more likely to be a low success group. There are a number of factors that contributed to success. I'm not gonna go through all of them here, but a little more structure, doing some ground rules at the beginning, meeting more frequently, and really leveraging what you have in common. Lots of themes discussed. And some of the ones that were the most common ones are balancing work and life outside of work. Other ones were professional development, promotion and tenure, getting effective mentoring outside of your group as well. There's also a lot related to COVID was there too, some, and scholarly projects. Lots of benefits too, that you can see here. New perspectives. Other ones are social connection, which is what we wanted to see more social connection. Individual wellbeing. And you can see the blue ones are where, you know, the high success groups. But a lot, the biggest one though, is new perspectives by interacting with others. So when we look at the mentor versus mentee responses, the mentors gave an average rating of 3.5, and the mentees though seemed to think more highly, you know, they gave 4.2. When we look at the benefits of participating, there are different benefits that the mentors had and the mentees had as well. We were more focused, though, on the benefits for the mentees. But we saw that the mentors also, if you look in that middle one, social, that is the social connectedness, that they actually experienced that as well. And then also, this is another slide that looks at what made it success, what defines success for the mentors versus the mentees. And so ways to improve, though. We also asked, how would you improve the program? The most common response was set a regular meeting schedule. You know, we saw that in our low success groups, that those that didn't meet as frequently did not seem to rank, you know, success as high. Having the opportunity to replenish group members when there was attrition. And then the timing. But what contributes to group success? For both groups, it was meeting during both the low success and high success, meeting during work hours was successful, focusing on the important themes that were chosen amongst the groups, and again, the meeting schedule. And then the high success group, in particular, said having things in common with other members of their group. Almost everyone benefited. So if you look at the high success group, 100% of them reported benefits from the program. Even when you looked at the low success groups, 75% of them said that they experienced benefits from the program, too. So almost everyone benefits. For our second year, so we're in our second year now, and we're dealing with some bumps in the road, but we still have some groups that are going strong. But we had 24 people in the program that continued with the program as mentees. And 13 of them wanted to be in the same group. And there were 19 people who joined this year as mentees as well. So we had 24 plus 19 in there as well. Nine of our mentors from the first year decided to continue. We also were able to recruit eight new mentors to our cadre as well. We formed seven groups. Some of the groups have three mentors this year instead of just two. And we actually did things like made attention to where people lived in the country so that they could schedule easier. We had some trouble the first year with somebody in New York paired with somebody in LA. And finding a time, it was much more difficult. So we actually tried to correct that this year. We also had specific groups going on the finding things in common. We tried to match groups better with things that they had in common. And this year we're doing qualitative study, too. So we're doing some focus groups to try to look at that in addition to the survey. So these are discussion questions that we're not going to get into here. But think about those if you have questions at the end. But things that we have thought about is what does make a peer mentoring group successful? What is the secret sauce? And also how can peer mentoring enhance other mentoring relationships? That's one of the things we're interested, too. And what are the best topics? You know, lots of different things there. So with that, I wanted just to share with you that, you know, this is one of the things we're particularly proud of is being able to support all of our members who want this kind of support in our program. And it's something that I think is very scalable. You know, we started it at UNC in a different way, a little different way, but we've been able to adapt it to this model as well. A lot of resources here. So I'm going to pass it off to my colleague, Lindsey Pershern. And now we're going to move into another area that ADEMSEP has gotten into much more significantly over the past couple years. And that is helping our students be prepared for the match. Thanks y'all. All right. Thanks, Aaron. I certainly appreciate the shout outs, but myself have been really thankful for the mentorship within ADEMSEP. And I think a good model for thinking about the value of mentorship as faculty. So I'm Lindsey Pershern. I am the, I don't need it, but I'm a member of ADEMSEP. I'm also both someone with experience in medical student education and psychiatry and currently a program director. So I'm the program director at Baylor College of Medicine in Houston, Texas. So it's been a really helpful perspective to have and most of a lot of medical students in the room thinking about the landscape of psychiatric recruitment, which I'm going to talk about next. So I'm going to give you guys, for those of you who have not applied to residency recently, a little bit of by the numbers view of where we are. Most of the data is referenced, it's from data from the NRMP, the National Residency Match Program and the match. So these are the results for the 2023 match, which you guys can maybe this little PTSD, but mid-March is when the match happens. So this year, 2,143 psychiatry positions were filled, 62.6% by MD seniors, 1.5 by MD graduates. That would be people who are not currently in their fourth year of medical school in an MD school, 18.8% DOs, DO seniors, 0.6 DO graduates, 9.4% international medical graduates and 6.9% non-U.S. international medical graduates. So U.S. IMGs means that they're U.S. citizens who trained in medical schools outside of the U.S. So unmatched rates, psychiatry is very competitive, that's the yield of this slide. 14% of MD seniors went unmatched in the 2023 match, 5.3% MD seniors, 28% DO seniors went unmatched applying into psychiatry and 8.4% for all specialties. So if you look at that, psychiatry compared to all other specialties had a much higher rate of unmatched MD and DO seniors. The mean number of ranked programs for matched applicants is 12. So at least for me, for those of you who applied to psychiatry before the era of the level of competition that exists right now, having interviewed and ranked 12 programs probably seems like a huge number. But that is the average number of ranked programs for matched applicants. So what the landscape of psychiatry advising recruitment and match rates really informs for us in ADEMSEP the way we advise. That's why we're talking about it here. It's actually why we have focused in ADEMSEP on faculty development opportunities and active efforts to support advisors of medical students. A lot of you are medical students, so these numbers probably look kind of scary. What they should inform us as psychiatrists and those helping you all get into positions in residency is how do we help advise you the best we can. And from our standpoint, for myself both as a program director and as somebody in national leadership around medical student educators, is we need to prepare all advisors to help our medical students get to the right program but also be successful in the match. There are a lot more psychiatry positions. So I think we all know there's severe workforce shortage issues across our country of psychiatrists. So we're not, the bottleneck is going to be that we have to have more GME positions. So for a while we've had more medical students wanting to go into psychiatry than in the past, but thankfully GME and states and national funding is now helping answer the problem. If we don't have residency positions, we can't produce more psychiatrists. So you can see how much this expanded over the last five years, at least on this slide. In 2019, there were 1,740 positions. In this year's match, 2,164. So more than 400 more positions in psychiatry residency GME positions over five years. So that's the good news, right? But you can also see there the positions filled. So it's also just true that for the last five years, there's been no more than 20 empty psychiatry positions in the country. So after match, there used to be a process called the scramble. Now it's called the SOAP, which is the process where unfilled positions in any specialty can be pursued by unmatched applicants. And in psychiatry, there have been less than 20 available unfilled psychiatry positions in the match. So we do not want our students to not match in the match, because if they don't match, it's very hard to find an open position through what used to be called the scramble or the SOAP. So it means start early, know your data, I'm going to tell you where to find that, and support the students to match. We don't want people to be unmatched. You can also see then there's more positions, but there are astronomically more programs, twice as many programs in the last 20 years. So in 2003, there were 178 psychiatry programs, and in 2023, 379 programs. So not only are there more positions, but there are more programs. And that means actually more variety. So not only institutional programs, we're all at major academic institutions, but community-based psychiatry programs. So the landscape in terms of fit, helping people you're advising and you as medical students knowing what are the aspects of programs that make me a good fit, is a good fit for me? Is it where I want to be? But also then crafting your application in a way that signals that you're a good fit for a program. So there's a lot more diversity in terms of programs, and obviously a lot more number of programs. Here's the explosion of the number of applications, and I'll talk about, I think Linda and I will both talk about the impact of virtual recruitment on the landscape of recruitment. The average number of applications per applicant from five years ago till this past year. In 2018, the average number for MD medical students was close to 40. Now it's more than 60 programs applied to. For osteopathic medical students, 80 is the average number of applications they submit. For international medical graduates, 62 and a half. So again, a very big increase from, especially, I applied to 15 programs. Four times as many. That's money, right? But it also means on our side as a program director, an explosion of the number of applications that I have then to review as a program. And that leads to a lot of anxiety certainly for medical students and programs, but fitting together this really explosion and tidal wave of applications. The average number of applications per program for MD applications is 360. This is again for program directors and programs, what they see, an average of almost 400 applications for MD applicants, 140 for DO applicants, and 145 for international medical graduates. So these numbers are still increasing, and I don't have a sense that that's going to change anytime soon. We do hope in advising that we help advisors advise students in a way to not over-apply, but also to be strategic. So we'll talk about that in a second. So that's the landscape of competition for the number of psychiatric applicants and the number of applications per candidate. I want to talk briefly about how the pandemic did affect recruitment for medical students in residency programs. Programs in psychiatry. So we're talking about the Association of Directors of Medical Student Education and Psychiatry, ADMSEP. There's another word salad organization called ADPERT, which is the American Association of Residency Directors in Psychiatry. So ADPERT, we have a strong national organization that has been pretty clear in maintaining guidance for residency programs around virtual versus in-person recruitment. All programs are doing virtual recruitment in 2020, right? But in psychiatry programs, the strong encouragement has been that we continue to do virtual recruitment, and I think that that will stay the same for a while. There is clear advantages from an equity perspective to maintaining virtual recruitment. So there are people applying to residency programs and interviewing in residency programs that in the past, I really had to be strategic about where I wanted to go because it was expensive. And what that means is that not everyone then has access to all programs. I think from an equity standpoint, virtual recruitment is here to stay, at least an element of it. And ADPERT will tell us as psychiatry training directors what we should be doing. That's not true in all specialties, but that's helpful. There may be hybrid recruitment in the future, but I do think that there's going to be an aspect of virtual recruitment that stays around, and I think that's a good thing. The biggest challenge for programs and for students is that you then don't have the experience of a program in person. But I'll say that over the last few years, people who have matched into our program who were in Houston, which is actually not a bad place to visit in November, December, or January compared to Chicago, where I at least went to Chicago and went, I could not live here. I'm a native Texan because of the cold. Many other reasons. It's a wonderful city, but I can't do ice and snow. But we had people who joined our program, moved to Houston in June, and had never been there before, and they were sweaty. But I do not think that there is as much as I think we all appreciated the idea of what is this place like, what does it look like, what's around me. I think that the lack of in-person experience with programs has not meant that people have a harder time acclimating, at least to environment or climate. So I think the advantages far outweigh some of the things we lose. And then obviously, around advising, the challenge also is through a virtual interaction with a program and with an applicant, making sure that we have optimized ways for applicants and programs to meet and get to know the people they're interviewing. One of my residents. Hi, Vincent. We also have, we saw, this is actually data from the NRMP as well. I did a survey last year. 99% of psychiatry programs conducted virtual interviews. Again, not everybody aligns with the national organization recommendation. A lot more utilization because of the issues I just brought up. If you don't have a full day and even a night before dinner to experience a program fully and meet many people in the program, a lot of programs are utilizing virtual engagement strategies. The primary being enhancement of their websites, which is a good thing. Having other activities and ways for applicants to engage with the program, like virtual open houses, residency fairs. So ADPERT has now a very robust residency fair. If you guys aren't on or don't follow, first of all, get on Instagram. Look at Twitter, see what the programs that are representing themselves through social media, what they're representing and how they're representing it. But look for opportunities for these virtual open houses. So ADPERT will have virtual residency fairs. So does PsychSign, which is an APA organization. So if you're not a member of PsychSign, certainly subscribe to the announcements so you can see when the PsychSign residency fairs. SNMA, the Student National Medical Association, LMSA, I'm giving a lot of acronyms today, the Latino Medical Student Association. All of those groups had virtual recruitment opportunities for applicants to engage with representatives of residency programs. And then again, social media. There's also online databases we can talk about where programs can give their information and applicants can review. Again, the whole idea is what is this program about, what are the components of the program, and does it fit with and align with the values and my goals for residency training. The other hot topic, and I have a slide to talk about it, is a lot of the programs in the area of pandemic, also what happened in 2020 was a huge, wonderful shift in our nation toward thinking more actively about diversity, equity, and inclusion. So along with that came a really large push toward holistic review. What also impacted that is the movement of the STEP exam, I don't know how many know, but moving to pass-fail. So in the past, even though I've done a lot of focus group kind of data, I don't think psychiatry program directors were as fixated on STEP scores and mins and maxes, but still utilized the STEP score for filtering and also sorting of applicants. But there was definitely a movement toward grades and discriminatory data being less available and, through holistic review, less prioritized. So these are the principles of holistic review. The goals are for a program to align its mission and create a review process for looking at an applicant's application of what are the attributes of the program, what are your goals as a residency program, and how do you then look for and utilize application experiences, applicant attributes, and academic metrics. Again, we have fewer of them, but what you do have available in an application to align with the holistic view of the applicant, right? So this is very different than we're just going to invite the people with the best grades and the best STEP scores, right? I mean, it's very clear to us in residency training that the best STEP scores do not make the best resident, right? It doesn't mean it makes a bad resident. It doesn't work in reverse, but there's a lot of other attributes of applicants and medical students that lead, that indicate success, and especially aligned with who's going to be successful here, right, in my program, and who is going to be the type of resident in our program who is successful for themselves, right? So it's really a great move. It creates a lot of challenges on the program side of how do we do this well? How do we learn enough about an applicant from their application and the interview day to look at them holistically? But I think the effort is valiant, and it's also continuing to improve in advance. The other piece of holistic review that I think most programs are intent on assessing is the role of implicit and explicit bias in every step of this evaluation phase. So one thing we do in our program, which is really there's a lot of great literature here. I don't have... Actually, the wmc.org holistic review section basically has a toolkit and a lot of references from research that shows that there is bias in the selection of candidates and some recommendations of how to mitigate that bias. One is bias training. So in our program, everybody who's involved with the recruitment does go through bias mitigation training. It's about awareness. It's about mitigation and active efforts. The other thing we do is that we don't include photographs of any of the applicants when we're reviewing their applications. There are ways to try to undo some of the potential contributors to bias in the process. So ERIS, the Electronic Residency Application Service, is still the mechanism where applicants put their application in and applications are then delivered. This past year, and Linda, you're going to talk about the supplemental application in some ways. We're not using it so much. This past year, ERIS used the supplemental application. It's shifting a little bit, but these are ways through the application system to highlight some of the priorities that we want to see to really be successful in holistic review. Two of the mechanisms that will stay optional in the ERIS system is the utilization of program signals. So applicants this past year in psychiatry, they had had this opportunity in other fields in years past, but it was piloted and now utilized. Applicants can signal five programs. Psychiatry uses five program signals. And basically what that signal is, is a token that indicates who are your top five programs. So if most applicants are, let's say, MD seniors, sending 60 applications to programs, this is a way to prioritize the five programs that they want to see their application. I think it's a very successful initiative. It's going to be integrated and offered. The other parts of the supplemental application that now are actually part of the core part of the application is the opportunity for applicants to talk about meaningful experiences. So not just a CV, but to be able to indicate in their application what are the things that they think are most meaningful to them. 90% of psychiatry programs opted in to receive program signals. Geographic preferences I didn't mention, but applicants also have the ability to indicate the geographic region in our country where they prefer, three, geographic regions where they would prefer to train. And the regions were created based on census data. Most states like Texas were paired with a couple other states. So it's basically what area of the country do you think you'd want to train in. From the survey of applicants, program directors, and advisors, the advisors, this was a AAMC survey, the advisors of medical students identified that the biggest challenge with this new thing, anytime we use something new there's going to be challenges, is really lack of understanding about how to advise their students around program signals. Right, so again we're doing something new, we need to look at the data, but the advisors, especially that first year, didn't really know how to advise them. What also was true is that there was a lot of inconsistency with how programs were advising and student affairs deans were advising students. So I know we have actually someone in our organization who shared, we had a town hall on this subject in the fall, he said our deans of students asked that our institution could, would they require their own medical students to signal their institution. And in our program I think a lot of them said no I'm going to interview all the students from my institution anyway, but he said actually our institution said no they have to use one of their signals on us. So it's really hard as an applicant and as advisor to know how to advise your student when there's a lot of inconsistencies with how the program signals are going to be used. And then how to use geographic versus program signals. I have heard anecdotally, although the survey didn't really address it, people who have very different ways of approaching. If someone didn't say they want to come work, and this is going to be so different in different parts of the country, right, golly I'm not going to get political, but Texas my goodness. Do you want to be in Texas, do you not want to be in Texas? And so if they program signaled but they didn't geographic signal does that mean somehow that is that integrated into the decision. So it's it's still going to be I think very interesting as the years come of how how program signals are utilized and how to advise residents. One product of a really strong collaboration between ADEMSEP, PsychSign, ADPERT, here's another one AAP, and APA is the production of a roadmap to psychiatric residency. So for those of you who might advise students or for the students who are going to psychiatry, if you don't know this exists you need to google it and go find it. It's on the APA website. It's a very very valuable resource, again produced by people who are on the side of reviewing applications and accepting and inviting people to interview, and medical student educators, and national educators, and students. So the topics in this document are how to prepare even early in training. So you know you aren't just thinking about what do I need to do to be a strong applicant to a psychiatric residency in your MS 3 year. You're thinking about it early. What to do in MS 1, what classes should I take, what extra experience should I pursue, how to expand my scope of psychiatry, should I do an away elective, should I not do away elective. And this doesn't have all the answers because there's a lot of heterogeneity, but it does at least help you scaffold and think about the steps. And for both students and advisors it's a really valuable resource. It talks about a timeline, how to craft your MS for a year, how to think about which programs are right for you, concepts with personal statements, letters of recommendations, interviews, utilizing advisors, making your rank list, participating in the SOAP process, and even some of the things Linda's going to talk about, which is kind of differential issues for osteopathic medical student applicants, international medical graduates, and couples. How am I doing on time? I'm almost done. Okay. Okay. The last initiative I want to talk about before handing it over to Linda, and we're gonna have time for questions at the end. I realize you guys might have a lot, so hold them in mind and then we want to be here to serve as a resource for all of you. And the other issue that's been identified actually by a group within our program, there's a paper written on program directors' appreciation for different parts of the application and what's useful, what's not useful, and what could be improved. And one of those things is letters of recommendation. So it's pretty obvious through the survey that program directors in psychiatry actually just had lunch with a fellow PD and she said letters of recommendation are useless. I mean she said that out loud. And because a lot of it is that they all look the same, they all are glowing, there is nothing in it that helps me actually understand this student and their performance. So not everybody feels that way, but we have a hopefully a way, an intervention to improve the value of the letter of recommendation. So in the survey that's published by our colleagues, one of them Leah Thomas, the president-elect of ADEMSEP, one of the criticisms from program directors on the current landscape of letters is that they're not objective or distinct. They all look the same. They don't feel like they really distinguish any, what are the attributes of this student that again we want to know if they're going to be a good fit for our program. 73% consider the letter of recommendation and 59% consider when inviting people to interview in the first pass review and 59% consider them when ranking. But again if they're not contain the information that program directors need, we have a way for us to hopefully focus and improve. So ADEMSEP created what we're calling the standardized, and I can't take credit for this, we have a group, the SLOR work group, is that the right phrase? There's actually an article in the Psychiatric Times just from this past month for people who want more information. There's lots of information on our website. But they've created the standardized letter of recommendation. This is a little bit built off of what emergency medicine has done for a while using the SLO, which is the standardized letters of evaluation. But this is a way to provide some structure for letter writers around what program directors are going to see as valuable in a letter of recommendation. So the template is there for you all to see and peruse and hopefully start to use. It has sections for speaking to the applicants characteristics and qualities, their clinical skills, areas for growth, unique qualities, and their preparedness and sustainability for residency. So as you might imagine, man those are five things I definitely want to hear about with candidates. And we're hoping, this is again full support with ADPERT and other national organizations, this year we're going to be piloting the SLOR. So asking people and asking students to consider asking your letter writers to utilize this template. Asking advisors and faculty to utilize the template. And we're going to be gathering data from program directors and obviously you know both quantitative and qualitative data to inform iterations or edits to the SLOR. So our hope is that it creates another mechanism for this process to be easier, more accurate in terms of what our goal is, which is making sure every medical student ends up in the right psychiatry residency program for them. So that's the SLOR. I think we'll have now Linda talk about the landscape, the frontiers in medical student advising across osteopathic medical students and then we will take time for questions after. Okay. So just just to sort of give a transition to this, so I hope you understand that so much of what is being proposed and is being talked about is so that we can get a better feeling of who you are. So so much of the advising, when we're doing advising and I do advising for all the DL students in psychiatry, so much of what we're trying to do is try to say they want to know who you are because they're looking for a good fit. So the match feels like when you're a student that it's will they choose me, will they choose me, but for the student the also the fit is do I want to choose them? That's why it's called the match, right? So part of this is so that you can get a better idea and so much of this holistic sort of review that we're moving more towards is to get you really thinking about what are your strengths, what are your weaknesses, what are the characteristics that I bring to the table that would be helpful to this program and what do I want to learn from this program and does the program have a wonderful mentoring program? Maybe that's very important to your personal goals. So so much of this is really to look at ways that we can get to know you, who you are, and to see if you're a match and then for you also to see if you're a match to that program as well. I'm going to talk a little bit about the DO side of this because the DOs are a force in the US medical system, right? So 25% of people choose to stay with the mic, 25% of people have to choose whether they're going to a DO program and part of the reason for that is the osteopathic philosophy which I feel is very strong for psychiatry. So the whole osteopathic model is built on this holistic unit of body, mind, and spirit. So it's a very good natural fit for this particular profession and I don't know that people always think about that. So that's what that's what draws people to osteopathic schools is the osteopathic philosophy and the idea that a body can be self-healing and self-regulated and there's this reciprocity in terms of systems and all of that. But all of that brings to mind then that this is ripe for a psychiatry residency. So as you look at this the numbers have actually gone up since I submitted these slides so now we have 40, I believe it's 40 programs that have now started and then the other number is up to 64 in different locations and I will say that these programs are growing by the moment. I mean every time I turn around there seems to be a new osteopathic school opening someplace but part of that is is because the need in osteopathic historically have been a lot of the physicians that go to osteopathic programs are very interested in community work and they will go into rural and underserved and under resourced areas and this is part of the mission of a lot of osteopathic schools and so we want students like in our school we want students who are called to go into some under you know resourced areas and rural communities where psychiatrists are very scarce but they're very needed. So that is one of the reasons why I think some of these schools are beginning to you know populate even more and more plus as as Lindsay said there's a shortage in the workforce so we need more schools to meet that predicted shortage that is on here 122,000 physicians by the year of 2032 which makes me nervous because I'm going to be needing those physicians to take care of me so I'm thinking about that. There as she already mentioned there's a lack of a number of you know the number of residency slots that we need although more and more are freeing up I know for years there was this law where you couldn't open up if you had one resident 25 years ago you couldn't you couldn't have a residency program and a lot of the legislative people are trying to overturn those things so that we can open up more programs in more areas particularly in some of those community hospitals because part of the draw so if you're looking to you know go into psychiatry and you really want to do this part of the draw to a residency program is they're going to be looking at it and saying are you interested in not only coming to our residency but can we then recruit you to stay in your area our area so that's one of the reasons why those geographic you know preferences are really helpful because if you're talking to a residency program you know if you're talking to them and you're saying you know I was born and raised in Michigan I want to stay in Michigan this is where I want to practice medicine I want to be here that's going to be something that they're going to perk up about and say oh okay so there's a tie there so all of these little things there's so many little strategies like this that become very important when you're going through this process there's actually a lot of psychology to the whole process if you think about it okay this is a graph it's very similar to what Lindsay was saying but you can see I just I want to give you a little bit of the history here so as you can see prior to 2020 deal students could participate in the AOA match so they actually deal schools had their own match that we did prior to actually when the NRMP match began or they could go into the NRMP match yet the number of residency programs duly accredited by the ACGME and the AOA was relatively small so when the single accreditation system got underway the number of positions in the NRMP match offered by osteopathic programs really began to grow and the inner NRMP increased its commitment to support deal learners and they added a permanent position I just wanted to mention this on the board they have a deal represent to representative now on the board so that voice is being heard because it represents 25% of the physician workforce so we need to get working together is kind of the the message here and one of the beautiful things about Adamsep that I really love coming from an MD school I've noticed that now that I'm in the do world I've been in the deal world for the last decade that there are very few deal schools participating and yet it is the organization is so helpful because they do workshops on personal statements and letter writing and all the different applications and the things that you need to know for advising so if there's any do people in the audience I would really push you to join the organization because it's just it's it's a real collaborative group to a group that shares information helps you out you can call anybody any of our colleagues and they're quick to answer questions and help you and the listserv is very helpful as well but you can see then as things started to move things got much more competitive Lindsey's already gone through that I stopped at 2022 because I got this from AAMC and they but I didn't put the 2023 data so I think it's up to 400 and some now in 2023 so the numbers just continue to grow above this all right so this is very interesting so now we're looking at the whole idea of what do you have to do to get interviewed and what what is important in terms of that process so this looks at a survey by the NRMP program directors in 2022 and it showed that 31% of program directors require deal applicants to pass the USMLE step one okay why is that important well it's because why is it an issue I should say it's because the the osteopathic programs have their own licensing exams are called the comlex and so the comlex has its own accreditation board coca is our accreditation board it's very similar to LCME but it's the osteopathic version of that so there's a real dilemma here because the exams are a bit different I took the comlex and there's a lot on muscular skeletal because they do 200 plus hours on muscular skeletal because of the osteopathic manipulative treatment that do's have to provide so there's a lot more emphasis on muscular skeletal and the on the whole OMT part of that exam but students feel very pressured I'm going into an MD program because most of these residencies in psychiatry are run by MD schools so then they're like okay so they won't accept my exam or will they accept my exam as being legitimate I'm going to talk about that in a moment but if you look at this they prefer to the MD schools prefer to have USMLE step 134 percent prefer but do not require it but 20% required the target score okay so there's a range of scores that you can look up and it shows you about where psychiatry is I think it's somewhere in the mid 500s I think when we used to have the step one or in comlex that's that's complex so you wouldn't know what the conversion score of that is but there are these scores and conversion tables that you can look at and you can see am I in the range of the competitive you know student and again we don't place as much emphasis on the scores as like ortho or derm or some of those other people do you know the other groups but there is sometimes this idea that like I had one student who was going for a position in the Northeast where there were four slots and there were 3,000 applications for four slots in psychiatry so the question was you know what distinguishes you so sometimes the scores on complex two or step two in the USMLE sometimes those scores are looked at when you're looking for distinguishing factors but again there's not really a correlation between what makes a good physician and some of those scores in this field so you know it's it's just a data point but sometimes when there's so much competition that one data point can make a difference and that's one of the reasons they continue to use them. Osteopathic students as I said are required to take the comlex USA to graduate from medical school and there's a lot of pressure on them for residency selection in terms of taking both exams and I really want to I'm going to spend another slide on that because this is what you need to see so since the single accreditation when everybody went into this single match together DO's taking the USMLE as well as the comlex has in has gone up 26% that's quite a bit if you look at those data that data and why is that a problem well it's a costly those are costly exams and we're talking a lot about ways we can save money with virtual you know interviews and those kinds of things but these exams are long they're exhausting and usually what happens is they will take one and then a couple of weeks later they'll take the second one and so the cost of all of that and the stress there's a lot of stress on taking those two big high yield getting a lot of nods for that two big high yield exams right so that is an issue that we have to think more about all right another slide data from the NRMP program director survey also showed that while 73% of psychiatry program director respondents interviewed USDO seniors so 73% interviewed them 27% seldom or never so they don't even get an interview and then that's compared to 3% of MD so there's a bit of a disparity there right between the MDs and the deals there 20% of psychiatry program directors respondents indicated that they seldom or never rank deal seniors compared to 1% so that's a huge difference from 20% to 1% so when we're talking about getting an interview and then also being able to rank that program that's a there's a big disparity between those two groups all right and this is just showing it a little different some of these numbers are not quite the same when I was looking at these they're not quite adding up but 32% of residency directors said they never or seldom interview do so that's almost a third of residency directors and then 56% of residency program directors that did interview do's did require the USMLE so here's the dilemma for almost all my students dr. mental which exam should I take well you have to take complex so you don't have an option there right you have to take it to get licensed if you want to be a licensed physician eventually and everybody of course does but then which one do I take it's really hard to know based on who's going to want that and who doesn't who's going to use the conversion tables all right so there's a lot of challenges for the do side of this and one is the pressure to over-submit applications and when you were saying that I she was right on in those numbers I tell my students 70 to 80 and that is if you have no red flags you have no leaves of the absence you have no failures nothing I was in one meeting where they said any failures we're not we're not going to look at them now I know that's not true in terms of my experience that sometimes we can overcome a failure or a board exam failure it's harder because it's so competitive now in terms of who's who's doing this but there again there's a lot of other factors that we can we can shine and you can shine in that can make you a good candidate the other thing with with deal students is we have a distributive model so we're not always tied most of the time we're not tied to a teaching hospital so I came from an MD school with a teaching hospital right so we knew our we knew that students that wanted to go into psychiatry and we're going to interview there well do students have to go out in their fourth year and go to all different electives away so all the electives can typically be away and so there's a lot of cost around that there's a lot of stress around that they have to get affiliate they have to make sure the hospital or wherever they're going has an affiliation agreement they do more audition rotations as a result of that because they want to get in front of those programs and be seen and it's a job interview right to do an audition rotation here's a quote from one of the students and osteopathic medical students suffer additional stress it takes extensive research time for future do's to answer the question should I even apply here so a lot of times what our students what I'll tell them to do is look on the websites are there do's in the program if there are deals in the program then they're probably deal friendly right do they require the USMLE I don't know I know now from different programs that I've worked with over a decade but I'm not so sure about all of the programs so then they have to sort of do some due diligence right you know trying to find out do I need to take both exams but the problem is with the timing because you have to decide that pretty early on before you go into that those fourth year so you have to know pretty early on kind of where you want to go what programs are going to maybe be your top five that you're going to signal and then you have to look at that and that will kind of help you make that decision on the front end I would like it to be that we don't have to take both exams so that's where I would like it to go I tell my students all the time if you pass these exams these are licensing exams they were never intended to put you as a resident in a program. So this is to say you have competency, you can become a licensed physician when you take all three exams. But the problem is that we know these are used in different ways, and so I would like it to move to osteopathic students can take the COMLEX, people can use the conversion tables and feel good about their scores based on the conversion tables. That's where I'd like it to go. All right, then the supplemental application. It's interesting, we're gonna do a workshop on this and in ADEMSEP, and we had so many different reactions to the supplemental last year. Students came back and said some programs didn't even mention it, some didn't use it. The military doesn't use it, so that's a real benefit if you're a military student, you don't even have to worry about it. But there was a lot of mixed reaction about programs going, I'm not sure what to do with this, what does this actually mean, how do I use this, what are the issues? So I think the whole idea of looking at all of this since it was a big change, and now it's changing again this year. So if you're going up now this year, you're not gonna have that same supplemental application that the students last year did because it's all being sort of, it's being integrated into the ERAS application. So it's very different this year. And so now we're trying to re-strategize again. So how much importance is it gonna be on the meaningful experiences? What are my top three experiences? How do I use that? Which of these things is the most important? I will tell you from the literature search that personal statements are very important in psychiatry. Sometimes the letters. I encourage students to get letters to ask their letter writer, can you give me a strong letter and can you give me a strong letter with a lot of personal information? Because I've been on the residency side, I'm now in the undergrad, but I've been on the residency side and I remember reading so many of these that were like vanilla. It's like they all say the same thing. But when you get a good letter writer who can really talk about your characteristics and who you are and have worked with you and knows your clinical skills and all of that, that's what's being incorporated into that slur. So that's why that's being changed so that we can get a much better evaluation of who you are. But make sure you talk to the people who are writing those so that you know that they're a good letter writer and that they're gonna talk about the things that are in there. All right, oh, I'm using this, okay. I'm not used to the piece, it's a Mac, okay, it's good. All right, so a few more challenges. There's certain uncertain eligibility. So everything, and I shouldn't say everything, a lot of things that come out do not tell you whether they're okay for DO students. So there'll be fellowships and scholarships and summer programs and all kinds of things. And I gave you an example, they'll say on the one side that says medical students currently enrolled in U.S. AAMC accredited programs who are citizens or non-citizens, national or permanent residents. So a lot of times the DO students will read that and go, well, I'm not qualified because I'm not in an LCME program, I'm in a DO program. But when you call them, and I've done this multiple times and our president of AACOM, which is our parallel to AAMC or AACOM, our president, he will call a lot of times and say, do you take DO students? A lot of times they'll go, oh, yeah. Oh, we just didn't think about changing our language. So if you're in that situation, don't give up. Maybe find and call and see if they'll actually take you. But the language is a little bit uncertain. School prestige or reputation. You know, we would like to think that everybody's equal. We know that's not true. Certain schools have good, strong reputations. And one of the things that DOs suffer from is that a lot of the schools are newer and they're not as well known. And then there is kind of a lack of connection with the MD counterparts. And that's why we're trying to bridge that gap with the ADEMSEP initiatives that we've been doing with AACOM to try to say, let's all work together since we're all part of that same workforce. And then finally, all right. So this is a picture of my son, Matt, when he was five, and my daughter, Katie, when she was three. Matt is a great kid, and almost every, since he could talk and walk, he would come in every night when he was, he's very inventive, and he would come in and he'd say, dad, I have a plan. And we'd always listen to his plan, whatever it was, to do anything. So this is a picture of the two of them. He's five, she's three, they're at Disney World. And they're overwhelmed by all the choices that they can do, and they're trying to figure out where am I gonna go in Disney World and make the most of my time, right? So what does he say? He sits his sister down, and he says, Katie, we need a plan, right? Well, it just was such a great metaphor for advising and what the students feel like when they're looking at all of this. There's so much to consider in this process of advising. So one of the things that we're moving to, and I think it's good advice maybe for a lot of programs, is that we wanna become more longitudinal. We wanna start right away in the first year. And what I did this year is I wrote a program for first, second, third, fourth, because what I was noticing was a lot of students would get to the end of their third year, and they go, oh my gosh, I looked at the NRMP data. I need 3.2 research experiences, because that's the average, and I've got none. And I'm like, it's the end of the third year. We don't have a whole lot of time to get IRB approval and move through these things. So part of it is looking at backing everything backwards, reverse engineering is the way business world talks about this, where you start early. And if you're at that stage where you don't have a lot, you just need to think creatively. So I would tell a lot of students, I say, well, you're at a hospital. They have an IRB there, they have the policies. Is there some community program you could do while you're on your IM rotation, something to do with adherence to diabetes or taking your medication or your insulin? Something that you could do that could be scholarly. So again, I'm trying to also help people understand that scholarly doesn't always mean IRB quantitative research. There's a lot of scholarly projects, and in fact, some of these have carried over to the QI, the quality programs that you do in residency. Some of them have carried over even and have blown those up from their undergrad years. So I would just say that it's a good thing to get early identification in programs. Get those students to get to know you. And then I always say, introduce yourself to the psychiatrist right away and say, I'm not really sure, I'm only a first year, but I think I'm gonna go into psychiatry. Get to know that faculty and start building relationships because they have a lot that they can tell you, especially in those academic centers. And then highly structured tasks and timelines. So I know students don't like always to be so structured, but we have to keep that up because that'll be your whole life. Hospitals will structure you, everybody structures you, but if you can have the timelines in mind, and those of you that have time management problems, this is a good thing to work with an advisor because they'll put you on a timetable so that everything is done so that you get everything ready. And then reviewing all your materials and looking at the things that you're writing. So here's the biggest thing I think I bring value to our students is that I've written a lot in my lifetime. I've got books and all kinds of stuff. I've worked with editors from all kinds of publishing companies, and I know what a good statement looks like. So it needs to be a story, it's a narrative. There needs to be a beginning, a middle, and an end, right? In the story. And the one thing that drove me crazy when I read those statements would be if they were all over the place and they weren't making a whole lot of sense and I couldn't get a sense of who the student was. So I always tell the students, if I read this and I get excited about you and I wanna hire you for a job, it probably means it's a good statement. So you really need to think about your writing. And one of the problems in medical school is we don't do a lot of narrative writing, right? So a lot of times you get to this stage and suddenly you have to be self-reflective and you have to write all these things, but you need to work with people to make sure that that writing is good. So I just think it's a good idea to review your materials, get a second set of eyeballs on those materials before you send them in. I know we work across discipline, and that's one of the bullet points of my next slide. We work across different disciplines and a lot of time we'll pass them around just to see for the writing, do you get a sense of this student? Do you get a sense of their goals? Do you get a sense of who they are? Just to kind of help with that. And then have regular check-ins with your leader, your specialty advisor, and we're stressing really specialty advisors because as I don't remember which of the two mentioned it, but there are a lot of people out there that went through the match a long time ago and they're giving them sort of, I would say even misinformation or wrong information that a lot of times we have to undo because of the way it's changed so much. So you need to have people who are up to date in academic medicine who understand how the match works and pay attention to their own specialty, and in this case it would be psychiatry. So finding those people. And then monthly check-ins with the clerkship advisors of all specialties. So we, it happens to be clerkships, I shouldn't have put that in there because it's clerkships in our school, but whoever's doing the advising, again, we meet with everybody, OBGYN, surgery, all the disciplines, we meet and we go, where are we running into problems? What are we all seeing? Because we've learned from those other disciplines how to do sometimes things better. So I think that's a really good plan as well. All right, am I doing okay? Am I, do I have to stop? Okay, okay, I'll do this real quick. I mentioned most of this, faculty development, we've talked about that. Post-mortem review, if you're doing this, you should be sitting down after the match and looking at what happened and what you can fix and what you can do better. And then I think that was me, so I'll stop it right there. I won't go through that last slide. All right, thank you. So I also want to thank our panel. What a wealth of information for our students in the room, for our faculty in the room. So now we have about 10 minutes for Q and A and there are two microphones in the center of the room and so we want to encourage you to use those. If you have a question, please come up to the microphone. But I'd actually like to kick off the Q and A with, you know, it looked like about two thirds of the folks in the room were medical students. So if you're a medical student in the pre-clerkship curriculum of your medical school, my question for the panel, and this could really be from anyone, is if I'm a pre-clerkship student and I'm thinking about psychiatry but I'm also thinking maybe about family medicine, internal medicine, I'm not sure, where do I start? Yeah, I can speak to that. But I also just want to check in with the medical students. I found myself going, I wonder if we're creating a lot of anxiety in the room. So I hope you're all doing okay. Hopefully the emphasis here is that we want to be a resource to students as they're going down this path and we're so excited for medical students to want to go into psychiatry. So I think if, I mean, obviously we need, what you're asking is how do we make sure they find the light? Because there is no better field of medicine to pursue than psychiatry. I would say it's about exposure. You know, at each different school, you're going to have different structures for things like shadowing or observerships. I think in most pre-clinical years, you're going to have resources at your institution for what are people who are doing the kinds of work I think I'd like to do. This is before you're in clinical settings, right? So the connecting with mentors. I think one lovely thing we have at my institution, at Baylor, is a student interest group in psychiatry. They're very well connected, actually, with our residents. Not that long ago, our residents did a session for students who are interested in psychiatry. So I think that exposure and experiences and ultimately what inspires people to become psychiatrists is the position that we are in to help people holistically, to think about where, I love, Linda shared with us recently how she comes in and talks in each pre-clinical, you're probably going to say this, I'm just going to say what you were going to say, but she goes into each pre-clinical course for a session when you're talking about, you know, renal, right? And the renal block and talking about the impact of living or the impact of being on dialysis. I don't know how many patients I have helped who are suicidal because their life is so impacted by three times, three days a week dialysis. So the ability to connect the dots and help students see the privilege that we have and the needs of our community and also what the life of a psychiatrist looks like. I think that's what I would say. I'd like to add to that, actually. Picking up on the perceived possible anxiety in the room, I know, apologies for that. I think our intention was to show you how dedicated we are at ADEMSEP to develop the advising that's going to be necessary to deal with this exciting opportunity of more people going into psychiatry. So I want you just to be just totally aware of that too. The other thing too is that those of you who are getting to know psychiatrists at this meeting, it may feel kind of hustle and bustle and lots of crowds and things like this, but in general, psychiatrists are really easy people to reach out to and they're usually really responsive and if it's not, it's just because they're super busy and the second email will work. But in general, I mean, these are the type of people who are really open, people who will share with you their experiences, people who really want to be helpful. So really, it's not an intimidating group. So suffice it to say, anyone that you come in contact with from psychiatry, it might be somebody who comes in like Linda Mintle and does the lecture, the one lecture in your cardiovascular block. I bet if you cold called that person, they would be so excited to hear from you, particularly in that context. Use your interest groups. So most schools do have an interest group for psychiatry, but that's another way to approach this as well. Absolutely, thank you, thank you very much. I see someone inching towards the microphone. Yes, thank you. I'm actually not a medical student and maybe one of the few in here and I'm at the University of Alabama. So I wanted to come to this session because I'm at a regional campus and we have over the last few years, we've had an explosion in the number of students wanting to go into psychiatry. So I'm writing a lot of letters of recommendation, I'm an advisor and I realized I was giving inaccurate information in the last few years. So I'm up to speed now because they come to me very, very anxious and saying I need to do all this stuff and it was totally different than when I went through, right? So when we had paper applications and all of that. So anyway, so my question is now that step one is pass fail and I think this is the first group now that just is going through it. They all think they have to, I feel like we're creating a whole nother set of anxiety for the kids and I just don't think it's healthy. But anyway, they think they have to do about 10 research projects. And so I'm sitting here thinking, I'm not even doing that much as a faculty and I know we have scholarly projects and so they're not all going to be like you said, IRB approved and so we're trying to get these students from the beginning, but then it's like you have to walk them off the cliff, they're so anxious about this. So I guess how many, because they all ask me how many research projects, scholarly projects do I have to do to be competitive? So I don't know what to tell them and then I try to tell them, it doesn't have to be some major paper that you get published. It can be a case review. It can be a poster. It can be working with a group about how many and then also I just wanted to mention about how I advise and I think it's really important is I try to sit down and do, this is because we're psychiatrists, what's important to you, what's your family situation? I'm in the deep south and I'd say it's really interesting because these are amazing students and they almost all want to be near their family. We have found most people stay regionally even though they could probably match somewhere else but they end up deciding to be within like three hours of their family because they don't want to go far away. I know everybody's situation is different but there are a lot of situations that you have to take into account. Anyway, that's it. So how many research projects and how important do you think the step two score is going to be? And then like the letter of recommendation by the medicals, you know how there's like the person who's the head of the third year writes that big integrated letter. So is that more important than the individual letter of recommendation? Because these are the questions they're asking. Yeah, great. I mean, this is exactly why we're here. So I think and what you're referring to, Linda mentioned it too, is the residency navigator. So there is a tool that if you guys aren't on it, you can use that basically you input the schools you want to go to and it will tell you 3.2 I think average research activities. So what I would say to that is that I think especially in the era of holistic review, it's important for the students to think about where they want to be. So just to challenge the idea that people are adding up how many, if you have a very, if you want to go to an academic very research focused program, they're going to want to see scholarship, right? They're going to want to see research activity, right? If you're going to a program, a community based program where care of the underserved is their priority, they're going to want to see dedication to an advocacy around care for the underserved, right? So remember that it's not so much how much, but what and how those things are aligned with, this is why we tell students, this is in the road back, look at the programs you think you're interested in and the regional thing is hard because they may be like, I want to be in Birmingham, I want to be in Alabama, I don't have many options and they may all be kind of the same. But if you're really looking to a program, you want to align your experiences with what they are going to find important. So not all programs are looking for four publications. It's also not just the number, but what is it? So I think integration of experiences is really important to me. So if it's four things that all look pretty disparate and I'm like, I can't tell from the rest of this application why they're doing these things, it doesn't hurt them, but it doesn't necessarily make sense to me, then like, wow, there is just a very clear track and integrative exposure of the student of the things that they're passionate about. And they can talk about that in their personal statement. I grew up here. I have a heart for this type of person or individual or this population. And it really has driven their volunteerism, their leadership experiences in medical school, the stuff they did before medical school, their awards. And it certainly could then align. I mean, I'm all about multipurposing the work you're doing into scholarship and also aligning the things you're doing. If it is not something that you care about, it doesn't feel like something, it's a check mark, right? So really, and that is gonna come out in the interview if I'm asking you, hey, how did you get involved in that thing? And it's like, oh, what thing? Was number four. Oh, I don't really remember that. It was just, I had this research mentor and they put me on a paper. I'm like, great, good work. But when it's something that they go, I have for 10 years really wanted to know how can I serve my community in this way? And I did research on it. So I think it's not number as much as alignment. And for students, it's like, do the things that fill your bucket, right? The things that are aligned with who you are as an individual. And that needs to shine through in your application. And I wanna leave time for one more question as well. And then I think we have to, no, it's okay. And we'll be here for a little bit so we can take, folks can come ask us questions, but I see that you're up there, so. Hi, I am an IMG and I was wondering if you guys have an IMG representative. You were mentioning that you just put a DO in the board. Do you also have an IMG? In our organization? Yes. Definitely. The other, so representation of international medical graduates, I think is a little bit more formalized within ADPERT. So if you guys are familiar with the Association for Directors of Residency Training and Psychiatry, they have certainly, from a diversity, equity, inclusion perspective, they have an IMG caucus. They have IMG representation. We don't have, our organization is small enough that we haven't really, you know, I mean, we don't even have a DO caucus, right? But we wanna serve people from different backgrounds. We're, you know, medical student educators in psychiatry are going to be within US medical school systems. But the resources that I talked about, at least in my slide sets, are certainly applicable and valuable for IMGs. The other resource for IMGs is there are national mentoring programs. So in Texas, we have one called the Texas Health Equity Minority Mentoring Network, where a lot of international medical graduates can get mentors. So it's not the same as an advisor, but a mentor to help you kind of around advising topics if you didn't go to medical school in the US. So it's a little bit where the scope of our work, because we are, our membership are people who are actively working in medical schools. Does that answer your question? Yeah, kinda. It's that I was just wondering, since the OS now and IMGs. Yeah, we do have, obviously, in every medical school in our country, there are people who trained elsewhere. And that's really, really important for us to have. I think the community of providers we have, we want more and more people. And that's an important point. Many psychiatry faculty members at your institution, they may have trained in another country and also serve as a resource for IMG students as well. So we are over time. Can we thank our panelists and speakers one more time? Thank you.

psychiatry residencies

medical students

mentorship

competitive landscape

UC Davis

ADEMSEP

peer mentoring

holistic review

virtual recruitment

osteopathic students

international medical graduates

residency application

match success