another psychology or psychiatry thread... w/ twist

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I would love some advice on a dilemma I have been chewing over from various angles for a year. I am officially stuck.

I am trying to decide, while working full time, how best to leverage the time between now and the next admissions cycle by taking classes.

The choices are psychology (the PhD) and going straight for the MD in psychiatry. Other programs I have looked at involve speech language pathology and occupational therapy. I have a 3.8 in a non-psych subject from an Ivy, 170 on the GRE, and two non-psych pubs. Not exactly tailored to anything right now.

Applied to 4 Phd programs in my city last cycle- 3 rejected, 1 waitlist then rejected.

What I want: to work with both adults and kids (I have more experience and confidence with kids). Particularly communication and speech difficulties. I am extremely passionate about the idea of doing psychotherapy but will not know where this will take me 10, 15 years down the road. People say it is wise to branch out, and I know I am good with kids, having volunteered/taught kids with learning disabilities.

HOWEVER! I want a kid of my own. My boyfriend is currently encouraging me to try child psychiatry.
I am worried that being a psychiatrist will a) not leave time for a family and b) require a late start for my family. I am 26= 1 post bac year +4 med + 4 residency +1 child fellowship.

Psych residencies in this area purportedly have some VERY family friendly programs but the idea of definitely poppin' one out M4 or 2nd year of residency is scarily definite for me right now. I know I want a family.

I am also not primarily a believer in meds. I love the idea of doing therapy with childen.

The money is not important. Being somewhat in control, autonomous, and secure enough to have a family + middle class existence is.

So- overall, any recommendations? :idea: ! :luck:

P.S. What is the job market like for Phds with a speciality in childhood social skills/language difficulty and communication? What kind of a salary can I aspire to there?

Sorry I know this is a tall order!!!! Any feedback would be much appreciated, as the questions are just whirling around in my head, and I know it's time to jump in.

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I'm not intending to further confuse you, but your clinical interests seem to indicate you'd enjoy behavioral neurology more than psychiatry.

Just a thought.
 
I'm a psychiatrist that usually doesn't come to this side of the forums. Mind you that I have a bachelor's in psychology and almost went into the field. I too struggled to decide on which one.

Ultimately, and it was not as informed a decision as I have now with many more years of experience I chose psychiatry because I figured if I couldn't decide which one I would've liked better so I choose the one with better money and more job security. (Of course I know now that's not always true with psychiatry vs. psychology).

The biggest drawback with going into psychiatry if you love the behavioral sciences is so much of medical school is not based on mental health but the pure physical. While some people may say this is simply an obstacle, it's an obstacle to the degree where it's not like jumping over a hurdle but climbing over a mountain. By the time you get to the other side you're likely going to be a very different person. It's easy to deal with delayed-gratification on the order of hours, weeks or even months. When it comes to years, now that's a different thing.

Personally I hated medical school and found memorizing things like the little doo-hickeys (I don't remember what they're called now) that anchor a hair follicle into the skin irrelevant since I knew I wanted psychiatry from the start. I also had to tolerate years of several medical doctors telling me not to go into psychiatry based on their own narcissistic and closed-minded viewpoints that their field was the best.

My advice is weigh the following factors: what would you like more? Being a physician, trained in the medical science (including cutting up flesh, sticking fingers up anuses, drawing blood), specialized in treating mental illness or a seeker of the human mind in general with more of a mathematical/experimental training foundation? Think about the quality of life while as a student in either field. The work hours in medical training are horrendous and to the degree where it's going to be like being drafted into the military but highly structured, while psychology graduate school can be stressful in a very different way because you're likely going to have to come up with new material. I know several that can do one but not the other.

Also factor in what profession is more to your liking once you finish your training including the day-to-day activities, lifestyle, and the pay.

I am worried that being a psychiatrist will a) not leave time for a family and b) require a late start for my family. I am 26= 1 post bac year +4 med + 4 residency +1 child fellowship.

Your worries are valid. It's not easy being in a relationship if youi're in medschool or residency unless your partner is willing to support you. I've known several women who quit medschool because they didn't believe they could have a family while being a medstudent. I've mentioned before in the psychiatry forum-in a sense it's actually quite sexist. Most women entering medschool are in the mid-20s, and by the time they graduate from a residency in their mid-30s. Most medschools and residencies have little tolerance for allowing women to take time off to have and raise kids. I recall being on call during my internal medicine rotation and a colleague of mine in internal medicine was working a 24 hour shift while her 4 year old daughter was in the call room while coloring some pictures. She was on the medical floors about 20 hours while on call and had to ask the other residents while in the call room to keep tabs on the kid. During the little free time I had, I sat with the kid. Another woman I knew was pregnant, was incontinent but made to come back to work by the program director because she used up her maximum maternity leave time and had to wear a Depends diaper because she was not going to be excused.
 
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There are several people in my clinical psych Ph.D. who've had children while in the program or on internship. It can be stressful to juggle it all but it sounds like a proper vacation compared to what whopper described. I think Ph.D. programs are more varied as far as culture goes compared to the medical education track. Definitely feel out the programs and ask to talk to grad students who have families.

If you want to do behavioral work and you don't care about salary then in my opinion medical school should be thrown out the window. Your interests actually seem more lined up with Speech/Language Pathology--and you could be practicing after a 2 year masters (3 if you have no undergrad coursework in this area). I believe in all 3 fields you do end up having to choose between adult/children.

Btw, I don't recall Sidney Friedman prescribing any meds. Did he? :

edit: Tho its not really a fair question I guess cause it was set in the late 50s :)
 
I'm not intending to further confuse you, but your clinical interests seem to indicate you'd enjoy behavioral neurology more than psychiatry.

Just a thought.

How interesting- I had to go look up this thread to understand what you meant: http://forums.studentdoctor.net/showthread.php?t=275775. Thanks for that suggestion!!!

...While some people may say this is simply an obstacle, it's an obstacle to the degree where it's not like jumping over a hurdle but climbing over a mountain. By the time you get to the other side you're likely going to be a very different person.....

I've mentioned before in the psychiatry forum-in a sense it's actually quite sexist. Most women entering medschool are in the mid-20s, and by the time they graduate from a residency in their mid-30s.

Yes, it's like the army! Or volunteering to go into space. Imagine being 100K+ in debt and discovering one can not have children anymore, or must have them NOW, or else.

Memorizing facts comes really easily to me. I daydreamed in my last job, which required a lot of stressful, not that open ended "finding the 'right' answer" style research, about having nothing to do but memorize. It's more the lack of a support system in medical training that strikes me as difficult, as I can imagine the stress that would add to making personal decisions (like starting a family). I mean other than informal support like residents babysitting ;)

I am devoted to my job right now but I can not imagine having to consider my coworkers' reactions to choosing to breed and factor them into the decision.

Anyhow thanks for this great answer. Now I'm curious to know if the culture varies from residency to residency, as roubs pointed out is true for PhD programs below.

I think Ph.D. programs are more varied as far as culture goes compared to the medical education track.

From the perspective of starting a family or the culture in general?

Your interests actually seem more lined up with Speech/Language Pathology--and you could be practicing after a 2 year masters (3 if you have no undergrad coursework in this area).

Absolutely-- yet my ultimate goal is being my own boss and I'm not sure Speech Language Pathology is a secure enough path to that for me. I will have no financial support during or after school. And, well, at 1/2 the cost of med school....:)

FYI according to the spreadsheet I made for two arbitrary Phd/ MD tracks, the MD only starts outstripping the Phd 6 years after the completion of training. That's the straight Phd, no neuropsych training or other specializing. For those who know in advance they will finish and have a clear preference for medical study, psychiatry is probably better financially. (No surprise there).
 
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If you like working with neurobehavioral problems of children (e.g. autism spectrum, learning disabilities, tourette and tics, dyslexia, some focal epilepsies, ADHD etc.) you could enjoy a

1) "pediatric neuropsychology" 2-year fellowship after completing a 4/5-year doctorate (PsyD, or PhD) in general clinical psychology. This usually involves psychometric evalutation and rehabilitation of cognitive functions (attention, perception, memory, thinking, mentalizing, language, writing, arithmetic, emotions etc.) in children with neurodevelopmental disorders (as stated before, autism, dyslexia and learning disabilities, Down syndrome, TBI etc,.).

http://en.wikipedia.org/wiki/Pediatric_neuropsychology

2) "neurodevelopmental disabilities/pediatric neurology" (6-year combined) residency after an MD which involves 2-years of general pediatrics and 4-year combined program in pediatric neurology and neurodevelopmental disabilities (e.g. diagnosing and treating pediatric patients with learning disabilities, developmental motor, speech, language problems, autism spectrum, epilepsy etc.)

http://www.abpn.com/cert_ndd.html


For more typical "mental-health" problems like severe emotional and behavioral problems (like some cases labeled as "ADHD", Conduct disorder/oppositional defiant disorder, childhood depression and anxiety, child and adolescent psychosis, drug-abuse etc.) you would rather enjoy child and adolescent psychiatry (2-year fellowship after a general psychiatry residency) or clinical psychology focused on children and adolescents (also 2-year fellowship after a general clinical psychology PhD or PsyD).

Another pathway from the MD-route which is similar to child and adolescent psychiatry (and neurodevelopmental disabilities as well) is "developmental/behavioral pediatrics" which is a 3-year training in general pediatrics followed by 3-year fellowship in developmental/behavioral pediatrics.


I have done this research myself ( i was also interested in similar stuff) so hope i helped. It seems that there are many (unfortunately a bit long!) pathways leading to these patient-groups so choose one that suits you and enjoy!
 
A lot of your interest are also a big part applied behavior analysis. You could achieve certification at the masters level (and, depending on where you are, not have too much trouble finding a job that meets your personal needs), with an increasing number of options to go on and get the Ph.D.. The main journal in the field- Journal of Applied Behavior Analysis- is online, with a search engine on its website and all issues available via pubmed central. I'd suggest taking a look at some of the research done in this field. If it fits into what you're interested in, in might be a great option.
 
I'm going to say something that is egocentric, and possibly ignorant and I invite my psychological colleagues to correct me.

Medschool, in short, is 4 years of taking in inhuman amounts of data (about 25 credits per term and all of them are hard credits. College is about 15 credits per term but about 1/3 the credits are hard, 1/3 are medium, 1/3 easy-medschool they're all hard), and then having to spit out the data in the form of answering multiple choice tests. You're expected to swallow in huge volumes of data, then over a very mind-crushing 1-2 weeks just be in exams all day long and take tests.

I remember during exam week having to pull an all-nighter before an exam, after the exam having 48 hours till the next exam and requiring sleeping pills to make me fall asleep because I couldn't fall asleep thanks to all the caffeine that kept me up the night before, then waking up and drinking in about 20 cups of coffee till the next exam, then taking sleeping pills again.....

Now as bad as that is, psychology grad school is a different type of stress because you likely will have to come up with something new. Think of John Nash from A Beautiful Mind. The hours might not be as tough (though they are still tough), but your actually going to really have to use your brain in a creative manner vs. being reduced to human encyclopedia.

Personally I find the latter more appealing if you're actually passionate about what you're doing. It could be hell if you don't like it. And as I said before, as difficult as medschool is, I know people in it who could not do psychology grad school because they were pretty much data-robots. They could take in obscene amounts of data and spit it out but could not think of how to push the existing bounds of knowledge.

I had a conversation with one of my mentors, ranked one of the top 100 medical doctors in the country and we discussed how we both truly hated medical school. I think I hated it because I really was an artist by training who after years of being determined to go into art just absolutely fell in love with the behavioral sciences. My mind was not wired to be a living computer. I think he hated it because he really is a scientist and a critical thinker and wanted to push the field forward. That type of thinking is not what medical school is about.

Now when you get passed all the schooling and residency, yes you could push the field forward, but by then your mind has been hammered and reshaped into a data-taker-in-then-spitter-outter.

Occasionally this discussion goes on in the psychiatry thread, and I've made comments that I feel psychologists can have more of a life even in grad school despite how difficult it is. Some interpreted that as a criticism. No way. The fact that (at least IMHO) the training is more balanced on the human mind and not based on simply giving out multiple choice tests on inhuman amounts of material, while allowing students to incorporate more creative reasoning IMHO is something that makes psychology graduate training better than medical training.

The biggest thing that ticked me off with medical school is that it wasn't so difficult because it was good education or difficult in a manner by design to make us better. It usually was so difficult because classes were often taught by A-hole professors that didn't give a damn about teaching and were bringing in mad money to the institution through research and it was difficult because the a-hole didn't spend the proper time teaching and making sure the exams were well designed. There were times the mean exam scores were on the order of 35% (with multiple choice question choices A-D), highly suggesting the exam didn't even validly gauge our real knowledge of the material.
 
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whopper, what you've said mirrors pretty much every comparison I've heard made between med school and psych graduate school, so if your post isn't entirely accurate, it seems to be pretty darn close, and is in good company. The one main caveat might be that (and this is said from my standpoint of never having attended med school) there's significantly more variability in the intensity and quality of psych grad school training when compared to med school.

We definitely have instructors who care much more about teaching than others, but as a whole, most professors view course work as almost a formality. This doesn't mean that no faculty take classes seriously, but there's a reason the saying "B = Ph.D." is so ubiquitous; there's a definite importance hierarchy with respect to grad school responsibilities, and when it comes down to it, classes are at or near the bottom. The vast majority of your learning is expected to occur outside of class, and even more than that (because we could argue that the majority of learning in any type of program occurs outside class), to occur in pursuing activities entirely unrelated to class.

All in all, as you've said, the grad school process seems to place a stronger emphasis on critically creative/creatively critical thinking and responding rather than massive information consumption. Grad school training, as a whole, also seems to be significantly less-structured than med school. You've done a great job of listing the upsides of this setup. The downsides are that there's really no one looking over your shoulder to be SURE you're learning what you're supposed to learn and doing what you're supposed to do. I'd imagine the "bare minimum" in med school is still a helluvalot of work resulting in attaining a helluvalot of knowledge; conversely, skating by with the bare minimum in grad school could result in someone graduating a program (or at least entering internship) being woefully unprepared for either/both independent clinical practice or/and independent scholarly activity, with a significant amount of variability across programs and advisors as well.

On a more "quasi-philosophical" level, I can't speak to med school and its general atmosphere, but clinical psych grad school training almost universally seems to have an "it depends" mentality with respect to answering questions. You essentially continually hear that there are few clear, black-and-white answers to much of anything, and if there are, you're expected to go out and hunt them down for yourself. Thus, if you're not ok existing in a perpetual state of ambiguity and uncertainty, grad school could be a highly unpleasant experience.
 
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Realistically, with either the PhD or MD route, it will be hard to start a family until your early to mid 30's. It can be done earlier with either route, but it will be a struggle Both my psychologist and physician friends are finally able to start getting pregnant and we are all early to mid 30s.

I suspect that there is real variability among PhD programs. My program was interested in training hard core researchers and they treated us terribly. There was no understanding for personal or family issues, even when very reasonable. Also, in our program there were clear favorites and "whipping-boys.". If you had the right advisor and they liked you, your experience was much better. I suspect that there is less of this with medical school, where your progression through school depends more on objective measures of success.

Also, it is worth thinking about the financial piece a little. I know you said that the money isnt important, but in the same sentence you said that you want a comfortable middle class existence. I wouldn't take for granted that you'll be able to have a comfortable middle class existence with a PhD. I am very displeased with my earning power as a psychologist, and I didn't think I would be. I feel that I am not going to be able to provide for my kids as well as I would have had I been a psychiatrist. It really bothers me that insurance companies reimburse psychiatrists at a rate triple the rate that they reimburse me. Of course a lot depends on how much income your husband brings to the table. If he makes enough, your salary might be less important.

Also, do you want to work full or part time? As a psychologist this is pretty easy to do this. I don't know about psychiatrists. I know that in some medical specialties, part time is 40 hrs per week!

Take this with a grain of salt, I am a psychologist who really wishes she had gone to med school instead! You might also be interested in the recent "would you do it again" thread.

Best,
Dr. E
 
Whopper-- again, what an amazingly invaluable answer! Thank you so much!

Acronym Allergy-- The ambiguity you stressed here is a really valuable point taken-- maybe that anxiety is inherent in any kind of creative work-- say, a novel project, or a painting. Grad students on here definitely talk about how their advising plays a big part in how that anxiety plays out-- aka how much pressure to produce and publish.

Dr. Eliza- Thank you for that candid assessment. I'm so so sorry you've had such a bad experience, what a nightmare! Whipping boys-- that sounds just terrible! But is a middle class existence out the window?--(Are we really talking figures like 35K for raising kids on?)

To sum up both paths then, in a sort of negative light: medical school is more facts and figures, perceived as merit based, more hardcore, and more cruel-- grad school more nebulously creative, intellectual, and nepotistic and also cruel. :) These are the stereotypes-- does this mean they pretty much hold up? Any happy stories about the education involved in becoming a psychologist/psychiatrist?
 
I've certainly enjoyed my time in grad school and internship, and am looking forward to fellowship, but as you mentioned in your post, this can greatly depend on advisor. Mine was awesome (as have been my supervisors thus far on internship), and so my grad school experience was equally-awesome.

In terms of pay, I'm of course not a practicing psychologist, so I can only quote figures--I believe the median income for psychologists is $65k, with a good bit of variability (e.g., some people will start close to $100k after licensure, and others will start in the $40k range). The advantage vs. a physician's salary, as you mentioned, is the potential to make it through grad school with little or no debt, which is difficult to do with med school (unless you're in a physician-scientist track, go military, etc.). Thus, as you mentioned earlier, it takes a few years for the true earnings differences to equalize and for psychologists to then be surpassed.
 
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Dr. Eliza- Thank you for that candid assessment. I'm so so sorry you've had such a bad experience, what a nightmare! Whipping boys-- that sounds just terrible! But is a middle class existence out the window?--(Are we really talking figures like 35K for raising kids on?)

Wait . . . $35k isn't considered middle class? I apparently need to readjust my thinking. :laugh:


Any happy stories about the education involved in becoming a psychologist/psychiatrist?
Er, the happiest students I know have been the ones who left. :smuggrin: Admittedly, I do know students who were not particularly pleased while here but felt much better about the whole grad school experience once they left for internship.
 
Oh, I'm so sorry! I didn't mean that-- now I feel horribly vulgar. I guess I meant 35K is not the most comfortable salary to support 2, or 3 people on in NYC. It can certainly be done, but earning more would certainly make it easier. Sorry- absolutely didn't mean to offend.
 
Oh, I'm so sorry! I didn't mean that-- now I feel horribly vulgar. I guess I meant 35K is not the most comfortable salary to support 2, or 3 people on in NYC. It can certainly be done, but earning more would certainly make it easier. Sorry- absolutely didn't mean to offend.

No worries! You did not offend. I simply find the whole money talk amusing (granted, I was raised in a family of 6 with a yearly income of < $12k). I can understand people who need to consider large metro areas, trying to raise kids (those suckers are expensive!), other extenuating situations, etc., but the individuals I hear who say they couldn't possibly "survive" on < $75-100k (to support themselves alone; or with some, if they are in a relationship with a shared, comparable income, no kids in the equation) just tickles my funnybone. :smuggrin: Priorities, folks.
 
No worries! You did not offend. I simply find the whole money talk amusing (granted, I was raised in a family of 6 with a yearly income of < $12k). I can understand people who need to consider large metro areas, trying to raise kids (those suckers are expensive!), other extenuating situations, etc., but the individuals I hear who say they couldn't possibly "survive" on < $75-100k (to support themselves alone; or with some, if they are in a relationship with a shared, comparable income, no kids in the equation) just tickles my funnybone. :smuggrin: Priorities, folks.

Very true, and agreed. Although to be fair, I don't know that most of the individuals on here with gripes about psychologists' earnings are claiming to expect having difficulty surviving (although some are, and seemingly legitimately so given their individual circumstances) as they are saying something along the lines of, "we're worth more and should be paid accordingly." Basically, the idea of, "we go to grad school for the better part of a decade and end up making a median salary of $65k? That stinks."

And there's also the sentiment of, "we've done a cruddy job of protecting our scopes of practice and demonstrating/advocating for our worth." That's all subjective, of course, and ruled by market forces, but that's the gist of the income-related complaints as far as I've been able to tell.
 
Very true, and agreed. Although to be fair, I don't know that most of the individuals on here with gripes about psychologists' earnings are claiming to expect having difficulty surviving (although some are, and seemingly legitimately so given their individual circumstances) as they are saying something along the lines of, "we're worth more and should be paid accordingly." Basically, the idea of, "we go to grad school for the better part of a decade and end up making a median salary of $65k? That stinks."

And there's also the sentiment of, "we've done a cruddy job of protecting our scopes of practice and demonstrating/advocating for our worth." That's all subjective, of course, and ruled by market forces, but that's the gist of the income-related complaints as far as I've been able to tell.

And I can go with these arguments with minimal to no issues (I also don't recall seeing many make the "survival" argument around here (SDN), although there may have been one or two in the past over the years). I think I was primarily expanding my observation to include folks regardless of profession who complain about their salaries and their inability to make it in the world. I need to stop running into these folks! :p
 
Haha duly noted, and again, agreed. It's just particularly troubling for us and our profession when we see new-hire psychologist positions offering yearly salaries of $35k. Not that these positions traditionally have many takers (unless they're formal post-docs), but given the current economic climate and high number of potentially poorly-trained psychologists entering the market, there's a very real possibility that more of these jobs will be taken out of perceived/real necessity, which of course damages the profession as a whole.
 
Any happy stories about the education involved in becoming a psychologist/psychiatrist?

Yes, I'm happy with my experience in a balanced clinical PhD program. The "Would You Do it Again?" thread is populated heavily by people who answer this question with "no." Posters on that thread make good points about the state of the field, and I can see why they answer that way. Posters on this thread have also accurately portrayed the type of stress you are likely to experience in grad school. (Although no one has touched on the stress of applying to internships/residency, which is its own unique brand of anxiety :).) All that being said, I am happy with the way most things have turned out. My faculty and classmates have been very supportive, and the amount I've learned throughout training makes it worth it to me. I hope that feeling continues as I finish everything up and move on to a career. I don't think I'm being naive, as I am pretty well educated about the state of the job hunt. I suppose we'll see.
 
Yes, I'm happy with my experience in a balanced clinical PhD program. The "Would You Do it Again?" thread is populated heavily by people who answer this question with "no." Posters on that thread make good points about the state of the field, and I can see why they answer that way. Posters on this thread have also accurately portrayed the type of stress you are likely to experience in grad school. (Although no one has touched on the stress of applying to internships/residency, which is its own unique brand of anxiety :).) All that being said, I am happy with the way most things have turned out. My faculty and classmates have been very supportive, and the amount I've learned throughout training makes it worth it to me. I hope that feeling continues as I finish everything up and move on to a career. I don't think I'm being naive, as I am pretty well educated about the state of the job hunt. I suppose we'll see.

I agree that it was a unique form of stress, particularly with the imbalance. However, I have to say, after-the-fact it was pretty anticlimactic.

I think it is a good warm-up for later applications. Personally I found the postdoc and later job searches to be much more stressful, as these decisions have much more significant weight for your career trajectory than internship. To be honest, I don't think your internship is all that important when you get to the "real-world" outside of networking, because people want to know what you have done lately or have specialty in. It really is only important for the purposes of graduation, IMO. No one asks me about my internship on job interviews.
 
I agree that it was a unique form of stress, particularly with the imbalance. However, I have to say, after-the-fact it was pretty anticlimactic.

I think it is a good warm-up for later applications. Personally I found the postdoc and later job searches to be much more stressful, as these decisions have much more significant weight for your career trajectory than internship. To be honest, I don't think your internship is all that important when you get to the "real-world" outside of networking, because people want to know what you have done lately or have specialty in. It really is only important for the purposes of graduation, IMO. No one asks me about my internship on job interviews.

Looking back, I'd say I probably experienced an equal amount of stress during the internship and postdoc application cycles, just with respect to different facets of each process. For internship, it was more a matter of mildly freaking out about whether or not I'd match, and the significantly rocky place I'd be in with my program if I didn't end up somewhere. I also received my interview invites almost all at once fairly early on, and then had a slow-and-steady trail of rejections for the remainder of the process, which definitely eroded my confidence a bit.

For postdoc, I did much better ratio-wise re: interviews to applications, so that didn't worry me as much. I also wasn't exceedingly worried that I wouldn't match. Rather, I was more anxious about choosing the programs to which I applied, and then deciding how I wanted to rank programs during the match. As Pragma points out, the career ramifications of postdoc seem to reach much further than those of internship. Thus, my stress related to whether I would make the "wrong" choice and dead-end my career before it really began.
 
I see. Not to take the thread too far off in this direction, but I suppose I was thinking that the post-doc process would be less stressful because, outside of neuropsych, grads don't have to restrict themselves to formal post-docs, but can apply for starting jobs as well. Did this ease the pressure at all, or did it make it worse? Would you highly recommend the formal post-doc route?

For me, matching for internship is requiring a cross-country move and a huge lifestyle change (living apart from my spouse), so that definitely adds to my feelings about the process.
 
I see. Not to take the thread too far off in this direction, but I suppose I was thinking that the post-doc process would be less stressful because, outside of neuropsych, grads don't have to restrict themselves to formal post-docs, but can apply for starting jobs as well. Did this ease the pressure at all, or did it make it worse? Would you highly recommend the formal post-doc route?

For me, matching for internship is requiring a cross-country move and a huge lifestyle change (living apart from my spouse), so that definitely adds to my feelings about the process.

I can't really speak to the non-match situation, as I only applied to I believe two non-match sites. It seemed, at least based on posts here, to be somewhat stressful despite the UND, as no one really knew when they'd be contacted exactly or how the entire process would actually work. Not sure how it stacked up against internship, though.

Not having to abide by a strict formal postdoc could make things less-stressful, I'd imagine, as there aren't any hard and fast deadlines. It would seem to add stress with the contract negotiation aspect, though.

As for location, I know that everyone I spoke with said that it factored much, much more heavily into their decisions for postdoc than internship (this was the case for me as well). I didn't apply anywhere that I couldn't see myself potentially living for at least 5-10 years.
 
I see. Not to take the thread too far off in this direction, but I suppose I was thinking that the post-doc process would be less stressful because, outside of neuropsych, grads don't have to restrict themselves to formal post-docs, but can apply for starting jobs as well. Did this ease the pressure at all, or did it make it worse? Would you highly recommend the formal post-doc route?

For me, matching for internship is requiring a cross-country move and a huge lifestyle change (living apart from my spouse), so that definitely adds to my feelings about the process.

Yeah I neglected that part. I moved to a new city with my wife for graduate school and refused to leave that city for internship or postdoc. Not everyone made that decision the same way I did, and it would be very stressful. I wasn't willing to do that. I think I viewed internship as just another hoop to jump through, and the year went fast for me.

What I found more stressful about post-graduation employment was that it is hard to weigh options that are so different. I did go with a Div 40 fellowship which narrowed it down for me, but how competitive those are/having to deal with any loans you have/still being paid peanuts/burning out because you have been working tons of hours for so many years all led to it being stressful.

The other stressful part of it is that you are "on your own" kind of and also judged based on what you choose. There is a sense of security when you are still in school and still have time to make decisions or look for other experiences. What happens after graduating, for better or worse, is you get pigeon-holed into what your primary position is. In my case, I've been doing nearly 100% clinical work, because that is what my fellowship requires. But there are other things that I want to do academically, and I have had to work extra hard to keep my CV relevant and competitive. 1-2 years away from something is a long time! I am warned to keep myself from the "clinical rut" because some academic places might not want to hire you if you are perceived as a primarily a clinician and not commited to being a productive scholar. I find myself having to explain to people that neuropsychology is not the only thing that I do, and that it is just a part of my professional skillset.

So, I guess I am saying that I found postdoc applications difficult because I am not the type of person that identifies entirely with a subspecialty. But the "real world" wants to define and label you. Because you have to go nearly "all-in" with these postdocs for very little compensation, and they have such a significant bearing on your employment prospects for the forseeable future, I consider this stress to be worse than internship.

Fortunately, I landed at a place where I could still pursue outside interests if I was willing to put in the extra time.

To get back to the point of the thread, I'd say that you'll run into this problem in med school too. Everyone thinks their specialty is the best. You have to work harder if you want to cross-train.
 
What happens after graduating, for better or worse, is you get pigeon-holed into what your primary position is. In my case, I've been doing nearly 100% clinical work, because that is what my fellowship requires. But there are other things that I want to do academically, and I have had to work extra hard to keep my CV relevant and competitive. 1-2 years away from something is a long time! I am warned to keep myself from the "clinical rut" because some academic places might not want to hire you if you are perceived as a primarily a clinician and not commited to being a productive scholar. I find myself having to explain to people that neuropsychology is not the only thing that I do, and that it is just a part of my professional skillset.

So, I guess I am saying that I found postdoc applications difficult because I am not the type of person that identifies entirely with a subspecialty. But the "real world" wants to define and label you. Because you have to go nearly "all-in" with these postdocs for very little compensation, and they have such a significant bearing on your employment prospects for the forseeable future, I consider this stress to be worse than internship.

Oh gosh. Wow, really good insight. I can totally relate, although I'm just now moving from masters program to PhD program, as my academic and professional experience thus far is quite varied. It really does stink that there is this pigeon-holing that happens based on positions being 100% clinical or research, so that those who want the variety must work extra hard to maintain their forward momentum. I guess if we are the kind of people who like variety, we are destined for a life of constantly juggling many hats so one of them does not fall off? A small price to pay? I dunno.

I'm glad to see some opinions about internship not mattering so much--the competition of it makes up for how much it matters in the long run, I guess.
 
I don't know about psychiatrists. I know that in some medical specialties, part time is 40 hrs per week!

Psychiatrists on average make about 150-180K a year. I know some that make a million, some that make 130K.

While psychiatry may make more money you're also likely going to be have a huge debt burden and be forced to work crazy hours (80+) for a few years.

By the time you graduate residency, working 40 hours a week is pretty much nothing--at least it is for me and most medical doctors I know.

There are ways to make very very good money in the field. Several areas of the country are extremely underserved and if you set up practice in one of those areas you could make very good money, among several other options, but I've noticed that the majority of psychiatrists just take a job and don't think of creative ways to make a lot of money. I think it's a combination of being in a 6 figure salary comfort zone so why take risks?, the other factor being that medschool in general kills off creativity in the brain, and that some of those ways to make money aren't exactly ethical. E.g. running a Methadone clinic where you know more than half the patients are just selling their Methadone to someone else.
 
and that some of those ways to make money aren't exactly ethical. E.g. running a Methadone clinic where you know more than half the patients are just selling their Methadone to someone else.

Oh come on, now. That doesn't mean it's unethical. Methadone clinics can be MUCH more regulated and tight than your average MD in an office writing scripts for benzos and opiates to addicts. Spread your love equally, please :D.
 
It's really interesting that while few people on this site seem to LOVE med school (and the rates of depression in med school are high by so many accounts), there are also not that many who are like fully convinced grad school is worth it!

Granted, so far, all of my interactions/ volunteer experiences with clinical profs have been so unnerving and awkward so I'm probably speaking out of that to some extent.

Speaking just from an overall quality of life perspective, where do you find the good programs? Is it just the luck of the draw?
 
Ask to talk to some current students and see what they think of work/life balance. Also chances are w/a program at a R1 university you will be pushed harder in the research realm.

If you don't want to be competitive for a job in academia you could just move past those programs. (you said you want to do clinical work w/kids but not research?)
 
I actually love research but the process of squabbling over authorship and trying to suck up to "mentors" really gives me the heebie jeebies. I can not see myself in academia in the long term, and switching fields to psychology was to some extent motivated by that career epiphany, since psych does offer so many different paths.
 
Then I'd get the "Insider's Guide" and look at programs that are below a 6 on the clinical<->research scale.
 
I actually love research but the process of squabbling over authorship and trying to suck up to "mentors" really gives me the heebie jeebies. I can not see myself in academia in the long term, and switching fields to psychology was to some extent motivated by that career epiphany, since psych does offer so many different paths.

I agree with roubs's responses above, particularly with respect to picking up a copy of the Insider's Guide. Also, keep in mind that this is going to differ quite significantly from program to program, and even advisor to advisor. Thus, sometimes an interview is the best/only way to help sort out which program(s) will be the best fit for you.

I attend an R1, for example, yet have never been overtly pushed by my advisor to conduct research if it's not what I wanted (beyond thesis and dissertation, of course). I've also been fortunate in that I've never squabbled with anyone re: authorship, or had to suck up to any of my supervisors, whether it be for research or clinical work.

Now I realize that my experiences may not generalize to most other situations, but I also believe that their general positivity is due at least in part to my outlook and approach to grad school as a whole. It will be, in large part, what you make of it.
 
Oh really? Well, maybe my experiences have scared me off the field a bit. Surely there are good programs out there; unfortunately, perhaps the only way to figure out the quality of a program is to already be in it!

And roubs and Acronym Allergy, does this mean that the programs with a clinical focus also tend to have a less "driven" atmosphere?
 
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Oh really? Well, maybe my experiences have scared me off the field a bit. Surely there are good programs out there; unfortunately, perhaps the only way to figure out the quality of a program is to already be in it!

Speaking with students in each of the programs, as roubs suggested, is also a good way to get a feel for how things go. Many grad students are honest about how happy they are with the program; if they love or hate it, they'll usually tell you as much.
 
Speaking with students in each of the programs, as roubs suggested, is also a good way to get a feel for how things go. Many grad students are honest about how happy they are with the program; if they love or hate it, they'll usually tell you as much.

This is definitely true--during my PhD interviews this past cycle, it became very obvious that the students at some programs (most of them, thankfully) were very happy and that the students at some programs were, uh, not. Students will also frequently give you hints or inform you outright as to whether or not their mentors are easy to work with.
 
It's really interesting that while few people on this site seem to LOVE med school (and the rates of depression in med school are high by so many accounts), there are also not that many who are like fully convinced grad school is worth it!

I'm of the attitude of being like a Jewish Rabbi when people ask me if they should become a medical doctor. I remember hating medical school and needing to take a year off to feel human again. Becoming a nurse-practitioner or a physicians assistant will still give the person good pay, a satisfying career if healing is what the person wants to do while the person could still have a life during their training. I'm not looking to convert anyone to go into medicine.

If any of you have any kids, the best phenomonlogical experience that was closest to being in medschool was my life after my daughter was born where I had very poor sleep for the next few months. Now imagine that with the same level of fear as if you were speeding to get to work because you were late knowing your boss is going to be real ticked off with you and feeling that level of anxiety and stress for about 4 years straight.

Like I said above, the fact that I think for the majority that grad school would lead to a more balanced lifestyle vs. medical school is a good thing. When I or other people stated this in the psychiatry thread some people interpreted it as a psychiatrist saying that the education was somehow superior or we were better than you psychologists. I don't think that at all. If anything 70% of the hell of medical school or residency is simply hazing/poor teaching/continuing practices in medicine that are simply idiotic and stressful to students and residents. I have tremendous respect for psychologists as a whole. The fact that medical training is so difficult in so many ineffective ways is idiotic and IMHO has actually caused a great deal of psychological harm and limitations in the way doctors think.

We are in a field that just a few years ago program directors thought it was a good thing to work residents 100+ hours a week and if the resident ran over someone on the way home while they fell asleep behind the wheel driving, or if the resident fell into the surgery field due to falling asleep while assisting a surgeon (an open wound where the surgeon is working) well that's not the hospital's fault at all, blame the resident. Several residency programs are still doing that despite that it's now illegal and the ones that stopped doing this only did so because new laws and regulations were made to stop this, not because the people running the program believed in improving the work conditions.
 
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Maybe the financial situation of med students is a pretty good analogy for those that tremendous emotional investment. That amount of stress sounds terrible and insane-- like going 200K into debt emotionally. But I'm pretty sure many people who get through it end up thanking themselves for the next 50 years.
 
I haven't seen any posts by current medical students, so I'll leave my two cents here:

While I respect whoppers opinions, medical schools not all that bad. It's a transforming experience, and even if you go in determined that you want to end up in psychiatry, there's a lot to be gained from learning medicine. I guess that has a lot to do with how it's being taught though.

That being said, I'll tell you what I was told once and what I tell everyone that tells me that they're considering medicine: only go into it if you can't see yourself doing anything else.

Considering 4 years of med school, 4 years of residency and 1-2 years of fellowship, being an M3, I'm still early in the path. There have been lots of challenges so far, and there's only going to be more to come. You have to be 100% certain that you're going into the field for the right reasons (not because a significant other or anyone else is pushing you in) because it's a long road.
 
Thank you for everyone who added to the discussion, having found this place, I can't imagine a more invaluable place to have found this info- everyone is so honest about a process (apps, grad/med school, internships/residency and beyond) that seems pretty much like climbing Everest. :xf:I feel lucky.

I decided to go for psych but will take the prereqs for med school. I'm not an ideal candidate for psych and would be doing it just because I think it's a good fit, and the topic is interesting, and... I like research.... :sleep: and for a bunch of other reasons like a billion other people out there who have already known for eons that they want to do psych. I know, I'm not unique, but it feels like it might work out. This is such a special topic.

In any case, my final decision was applying for this round in psych (Fall 2013) and getting started on the prereqs Fall of 2012 so as to transition, if I don't get in, into a health field like medicine or OT.
 
In my doctoral psychology program we could miss two classes (that is your maternity leave). Thankfully, I had my daughter the first week of the summer break (which lasted a total of three weeks). Love working at the VA as I now have protected maternity leave for my next child.
 
In my doctoral psychology program we could miss two classes (that is your maternity leave). Thankfully, I had my daughter the first week of the summer break (which lasted a total of three weeks). Love working at the VA as I now have protected maternity leave for my next child.

Two days a year or for the entire duration of the program?

I spend more days than that a year trying to aim my vomit into a porcelain pot.
 
Two days a year or for the entire duration of the program?

I spend more days than that a year trying to aim my vomit into a porcelain pot.

Two classes per term.So if your class was on a Tuesday and you go into labor that Tuesday morning (have a c-section) you probably would be back home on a Friday/Saturday. Could probably miss the next Tuesday but you better be right back in class that third Tuesday or you fail the class. Seemed harsh.
 
I'm so glad I saw this thread! I've been confused as to what I really want and torn between psychiatry and clinical psychology. I've been leaning towards clinical psych and planning on applying this cycle and this just confirmed it for me even more. I had planned on taking the prerecs for med school if I didn't get in, but I've pretty much changed my mind now. I had already felt that I just wouldn't be happy in med school and right now I can't see myself doing anything other than grad school for clinical psych. If I don't get in on my first try my mom (who's been trying to talk me into med school) will just have to keep her mouth shut. :p
 
Two classes per term.So if your class was on a Tuesday and you go into labor that Tuesday morning (have a c-section) you probably would be back home on a Friday/Saturday. Could probably miss the next Tuesday but you better be right back in class that third Tuesday or you fail the class. Seemed harsh.

This is a common issue and one that women's rights advocates have been talking about for some time. Check this out: http://thefeministbreeder.com/did-you-know-pregnant-students-have-rights-neither-did-i/
 
Two classes per term.So if your class was on a Tuesday and you go into labor that Tuesday morning (have a c-section) you probably would be back home on a Friday/Saturday. Could probably miss the next Tuesday but you better be right back in class that third Tuesday or you fail the class. Seemed harsh.

I mean that's kinda ridiculous. Someone had a baby a month before end of the semester in our program and nothing like this happened, she was allowed to finish the work over the summer.
 
Same with someone in my program who had to go on months of bedrest during her pregnancy. She was given incompletes and allowed to make up the work later.
 
Same with someone in my program who had to go on months of bedrest during her pregnancy. She was given incompletes and allowed to make up the work later.

Yeah seems only fair. If the student refused and thought she somehow was entitled to turn in less work for the class and didn't want to make up work later, then it would be a different story.

Having a baby doesn't mean you should be treated any different than other students with regard to how you are evaluated academically.

Side note: at my postdoc there was a female that had a baby. After she returned from maternity leave, we were treated completely differently from then on. She received tons of extra administrative support, dedicated time from our tech to do the grunt work for her, and a flexible part-time work schedule. It meant more work and less resources for me (no tech support at all), and I typically worked over 20 hours more per week than her in the same job.

Now is that fair? I am all for women's rights, but pregnancy/motherhood shouldn't mean that you are held to a different standard such that it creates more work for other employees. My quality of life did suffer, I told my female supervisor about my concern, and I was told to "toughen up." Hmmmmmmm.

I found that comment to be quite hypocritical, given that I work with all women and we talk about women's issues and fairness in the workplace all the time. Seemed a bit ridiculous to invoke normative gender roles when it was convenient.
 
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Yeah seems only fair. If the student refused and thought she somehow was entitled to turn in less work for the class and didn't want to make up work later, then it would be a different story.

Having a baby doesn't mean you should be treated any different than other students with regard to how you are evaluated academically.

Side note: at my postdoc there was a female that had a baby. After she returned from maternity leave, we were treated completely differently from then on. She received tons of extra administrative support, dedicated time from our tech to do the grunt work for her, and a flexible part-time work schedule. It meant more work and less resources for me (no tech support at all), and I typically worked over 20 hours more per week than her in the same job.

Now is that fair? I am all for women's rights, but pregnancy/motherhood shouldn't mean that you are held to a different standard such that it creates more work for other employees. My quality of life did suffer, I told my female supervisor about my concern, and I was told to "toughen up." Hmmmmmmm.

I agree with you but only to a point. Not every school/work situation involves a zero sum game, in those instances I see no problem with giving new mothers extra allowances. Having a baby and being allowed to make up work after the current semester is over IS being treated differently, but it doesn't take away from other students or disadvantage them in any way.

Likewise if a flexible schedule can be enacted without substantially dumping on others I don't see a problem with it. Unfortunately it doesn't sound like that happened in your case and I don't think people should have to work 20 hrs extra a week to pick up slack.
 
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