3rd year and Psychiatry/Residency Questions

[Darkskies]

Hello,

So, I am a DO student and just recently received my COMLEX score of 521 which is actually higher than what I thought I had achieved since I was having some nonacademic issues around the time I was studying before taking it. I still would very much like to take the USMLE step 1 as well during third year and I understand I have to be very disciplined to do so what with juggling rotations. I still have to tackle some of those nonacademic issues that are affecting me although I believe I can potentially do very well on the Step 1 since I scored a 32 on the MCAT(if they're correlated to any extent). My question is, would it be better suited for me to focus on doing well on rotations and blowing the USMLE step 2 out of the water or would it be much better for me to somehow manage rotations and studying for the step 1, take it in January and then focus on the COMLEX Level 2/USMLE step 2? It's hard for me to stay motivated after going to rotations in the morning and coming home around 5-6 PM(and this semester I have the 'lighter' rotations).

I would like to do the best I can and possibly obtain a decent residency position where my training will be excellent. Is that possible to do in psychiatry with only a COMLEX score of 521? The other specialties I'm interested in are Infectious Diseases(I love Microbiology) or Rheumatology/Hospitalist/general IM. Even if let's say I score a USMLE step 1 of 210-220, does that look better than not having any USMLE score? A part of me would hate 'settling' by not taking the USMLE step 1 even if taking it, would not improve my application/or only marginally improve it.

Also, I am currently on my psychiatry inpatient rotation and I have to say I do have some qualms about it. Much of the staff including the social worker and physician gossip and laugh about the patients after team meetings or discussions and it kind of rubs me the wrong way. They say it relieves tension since humor is a mature defense mechanism but I don't know if I just lack insight/experience but I have a hard time buying that.. Also, it seems like in this unit, the objective is to stabilize the patient to make sure they're safe to release or to send to a long term care facility. I just don't think I'm getting exposure to a treatment plan where the core issues are addressed and the patients 'get better'. Are they truly profoundly helping anyone? Sorry if my concerns are completely off the mark but I'm just curious. Am I seeing a skewed perspective of the field? How do I get more exposure, so I can really tell if psychiatry is right for me?

Thanks in advance!

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[Darkskies]

Sorry to bump this but could someone provide some input?

 

[hamstergang]

<COMLEX/USMLE stuff>

No idea.

Much of the staff including the social worker and physician gossip and laugh about the patients after team meetings or discussions and it kind of rubs me the wrong way. They say it relieves tension since humor is a mature defense mechanism

Well I don't think this is uncommon, but also not specific to psych. I think some amount of it is normal and acceptable, but I have seen people cross the line that I would draw. I wouldn't judge the field based on these people.

Also, it's not a defense mechanism, as those are unconscious by definition, and these people seem to be rather conscious that they are using humor to cope (at least they claim it's to cope). Personally, I think this is just how they are and they're using pseudo-psychology to feel justified.

Also, it seems like in this unit, the objective is to stabilize the patient to make sure they're safe to release or to send to a long term care facility. I just don't think I'm getting exposure to a treatment plan where the core issues are addressed and the patients 'get better'. Are they truly profoundly helping anyone?

Well that basically is the purpose of inpatient units. It's not supposed to last very long, so you're just getting them over the hump that brought them in. Working on deeper issues is for the outpatient world, where the patient has more time with the providers and isn't stuck on a restrictive, expensive inpatient unit.

While not the same, this makes me think of the ER. There, the goal is to decide if the patients need admission or can be discharged. Unlike other fields, their goal is not to treat or diagnose, but to make that decision (though certainly treating and diagnosing can help in that decision).

How do I get more exposure, so I can really tell if psychiatry is right for me?

Do more psych rotations??

 

[Dharma]

I say forget the USMLE Step 1 at this point. Maybe take a NBME and see where you're at. They're pretty solid predictors. Having taken the USMLE myself (DO student here) I would say that you really need to be in game mode when you sit for that beast. By that I mean pounding out questions on a daily basis and reviewing thoroughly... FULL TIME. That's pretty much out of the question with clerkships.