So I am now in the midst of my 3rd year clerkship in psych and I really like it. So much so that I am now seriously considering it as a career choice. Most of my efforts to this point have been geared toward OB (i.e. research, ECs ...). I will be able to get a great psych LOR from my attending but as far as 4th year may only be able to do one sub-I late in the season (December). I have several good LORs from IM, FM and OB attendings. Will that be enough? Should I even try and do a sub-I in December?
3rd Year Newly Interested in Psychiatry
- Thread starter Dotsero
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Hi there,
So happy you're interested in psychiatry! It's a wonderful field. I was thinking about another field before psychiatry (surgery), but decided the end of third year. I'd had some research in psychiatry before then, but overall, I don't think it's necessary. I think if you get a good rec from your attending on your third year rotation and interview well I think you'll be okay. As long as your other rotation evaluations speak to your ability to listen to patients in a sensitive manner/be appropriately empathetic. I'm assuming you can't do a sub-I earlier because of requirements? If not, just make sure you do well on those required rotations. A strong medicine recommendation also helps, since psychiatry residencies have medicine or pediatrics requirements in intern year. Not sure if the sub-I in December is a good idea, since you'll be interviewing pretty heavily then. You can always sign up and then change your mind depending on how many interviews you get... Good luck!
So happy you're interested in psychiatry! It's a wonderful field. I was thinking about another field before psychiatry (surgery), but decided the end of third year. I'd had some research in psychiatry before then, but overall, I don't think it's necessary. I think if you get a good rec from your attending on your third year rotation and interview well I think you'll be okay. As long as your other rotation evaluations speak to your ability to listen to patients in a sensitive manner/be appropriately empathetic. I'm assuming you can't do a sub-I earlier because of requirements? If not, just make sure you do well on those required rotations. A strong medicine recommendation also helps, since psychiatry residencies have medicine or pediatrics requirements in intern year. Not sure if the sub-I in December is a good idea, since you'll be interviewing pretty heavily then. You can always sign up and then change your mind depending on how many interviews you get... Good luck!
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One good psych eval and several good LORs from other specialties would be no problem. It might be nice to have a second psych elective for another letter, but hey, if you can't, you can't. It'll be more important to tell your story of switching from OB to psych, and it will probably be an interesting story.
Purposefully, my last two m3 clerkships were OB and psych, because I was pretty much 40/60 deciding between the two going into 3rd year. My joke was always that I couldn't stand dealing with crazy people all day, so I chose psychiatry. It was probably the decision to be a child psychiatrist that sealed psychiatry vs OB vs FM.
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I like to tell myself that really you're dealing with crazy people all day no matter what you do or where you are. Being a psychiatrist just means you have the tools to be able to deal with them.
...but i don't use the word "crazy."
Consider Psych-OB as a specialty. We have specialty training here and the need is huge!
SUB-I's are that critical, but would be nice. Do what you can do get one b/c it'll prepare you for intern year at the very least.
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...but i don't use the word "crazy."
Crazy can be a great word, and that's why I like that joke, because it draws a distinction between folks with mental illness and folks who self-loathingly spend a million hours in the hospital learning to be second rate surgeons (GYN residents). The former deserves respect and recognition of dignity. The latter is just crazy.
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hey, can you explain a little bit more about the psych-ob? never heard of that before. thanks.
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we call it perinatal psychiatry in europe - it is basically dealing with high risk women during pregnancy and is very interesting from both the complex social issues as well as the pharmacological issues. Perinatal psychiatrists (in europe anyway) deal with changing medication regimens for women with chronic mental illness planning pregnancy, treating mental illnesses during pregnancy (depression, schizophrenia, bipolar, anorexia are the common ones), consulting on issues related to risk and child protection once the child is born, and treating post-partum depression and puerperal psychosis, often in mother-baby units to encourage bonding between mother and child during those crucial aspects. Some of the most interesting challenges relate to anorexia in pregnancy (there is an interesting literature on this, but it really is heartbreaking), domestic violence usually starts during pregnancy, prescribing in pregnancy and breast feeding, working with mothers who have had abusive childhoods and are likely to inflict misery on their children (one of the few areas for which there is a role for intensive psychoanalytic therapy in people who could really benefit and not simply the mildly neurotic and rich), and ECT during pregnancy. As I understand it, it is not currently a recognized sub-specialty in the US but there are definitely people working in this field.
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http://www.womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/
http://www.womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/
http://www.northshorelij.com/NSLIJ/Perinatal+Psychiatry
http://www.med.unc.edu/psych/wmd/patient_care/perinatal-inpatient
http://www.rcpsych.ac.uk/members/sections/perinatal/training.aspx
http://www.iop.kcl.ac.uk/departments/?locator=976
http://www.marcesociety.com/
http://www.womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/
http://www.northshorelij.com/NSLIJ/Perinatal+Psychiatry
http://www.med.unc.edu/psych/wmd/patient_care/perinatal-inpatient
http://www.rcpsych.ac.uk/members/sections/perinatal/training.aspx
http://www.iop.kcl.ac.uk/departments/?locator=976
http://www.marcesociety.com/
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Welcome to psychiatry!
It's the hidden treasure of specialties during med school. I say this because students don't get adequate exposure to the larger world of psychiatry beyond hospital inpatient work. A great amount happens in clinics and practice settings of all kinds, treating very exciting and compelling patient populations that is very rewarding. Psych-Ob is just one solid example. (Of course inpatient psychiatry can be very rewarding too.)
It's the hidden treasure of specialties during med school. I say this because students don't get adequate exposure to the larger world of psychiatry beyond hospital inpatient work. A great amount happens in clinics and practice settings of all kinds, treating very exciting and compelling patient populations that is very rewarding. Psych-Ob is just one solid example. (Of course inpatient psychiatry can be very rewarding too.)
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with the exception of the classics (i.e. Freud, Janet, Kraepelin, Jaspers, Fish, Bleuler, Schneider and many of the marxist psychoanalysts) psychiatric texts are largely to be avoided. articles are the way forward such that the field in changing so much. there are of course a few recent texts worth reading, but in general you are better of reading some articles and this is certainly true for perinatal psychiatry. i will see if i can dig up some articles on anorexia in pregnancy as i had a patient with this a while ago and found it so fascinating (i don't normally have any interest in eating disorders).
This is a good summary of Psych OB, as are the other posts so far.
Here in the psych-OB clinic we'll also see a range of mental health conditions in women who haven't gotten pregnant yet or are post-partum as well.
For instance, we'll see someone with high functioning bipolar type 1 who wants to know what to do about their lamictal/abilify regimen before conceiving. You might also see post-partum depression, consult on inpatient post-partum psychosis (relatively rare), and do f/u 's for this as well. You also follow pregnant women who are on suboxone.
Also, we'll sometimes see mood disorders related to menopause or PMDD.
Here the psych-OBs are embeded in the OB/GYN clinic and the OB/GYN's LOVE having us around. It's a nice atmosphere.
