Attending switch to psych

[joschmo]

Hi all, new attending here in something else. I had multiple points in residency where I felt that psych is more where I belonged but for various reasons including wanting the security of being fully trained in something to fall back on, I completed residency and have now been practicing for about 2 years. Now that I'm out it's become pretty clear that I should have switched to psychiatry years ago. Obviously I'm going to talk to my former med school, etc but I wanted to post to see if anyone has been in this same situation of trying to basically repeat a residency after having completed one in another specialty. I DID search this forum extensively but all I could find was advice about transferring to psych while partway through another residency. Thanks in advance.

---

Members don't see this ad.

 

[Shikima]

Reach out to programs and let them know where you are and what your goals are. Contacts will be important. A bonus will be that you can moonlight while doing residency.

 

[MacDonaldTriad]

Get a PGY-II spot if you can find one. PGY-I's are not allowed to moonlight no matter how much training they have.

 

[Aramis4u]

joschmo, you are not alone.
I had done another residency and fellowship(albeit in another country) before coming here and deciding to do Psychiatry.
Specifically, I know an ER doc who is now in the same program that I matched into this year.
Also, I know a couple who were sub specialty fellowship trained in a surgical specialty who are now in the NE region doing Psychiatry residencies.
If it matters, everyone I mentioned here, except myself, are American medical school graduates.
Oh and in case you did peds and are interested in child psychiatry there are some lateral entry programs that make you board eligible in child and adolescent psychiatry.

If you ask me, as long as you know what you want and some help from above, its totally do-able!

 

[nitemagi]

My old program had a range of people switching into psych from other specialties. I've met peds, surgeons, and anesthesiologists who all switched. Some had been in practice as long as 10 years.

 

[weirdtube]

Long time lurker of these boards, finally managed to make an account- why? Because the original post is basically me. Currently an IM attending (hospitalist). Hate it. OP, what field are you in?

 

[Shikima]

Long time lurker of these boards, finally managed to make an account- why? Because the original post is basically me. Currently an IM attending (hospitalist). Hate it. OP, what field are you in?

Welcome to the underbelly.

 

[milesed]

We had a former neurosurgeon who'd switched.

 

[sunlioness]

I knew an ophthalmologist.


Sent from my iPad using Tapatalk

 

[Psychotic]

There is a derm doc in my residency program. It happens...

 

[SomeDoc]

Anecdotally, I have encountered or know individuals at different stages in training (residents to attendings) who switched into psychiatry from: orthopedics, gen surg, ob-gyn, radiology, anesthesiology, neurosurgery. I think it comes down to the realization that psychiatry can be a personally and professionally fulfilling specialty, with good lifestyle and compensation in the objective sense, with the option to work more for added income.

 

[northernpsy]

Just to add even more anecdotal data points, I personally know a pediatrician and an Internal Medicine doc who completed psychiatry residencies after being in practice for a number of years. I am not sure about the IM guy, but I know the pediatrician was able to start as a PGY-2. Both of them were good residents.
I think coming in as an attending who successfully completed a previous residency would help you stand out as an applicant. Life experience and maturity definitely help in psych too.

If any of you switchers would care to share, I would be interested to hear more about what is leading you to want to switch.

 

[vistaril]

the people I've known who switched into psychiatry viewed it more as a switch out of medicine into mental health. They got sick of whatever they were doing, and so they wanted to go into a different field. It's a more global level of frustration than a switch from say anesthesiology to pmr because they didn't like the OR anymore for example.

 

[MiddleRoad]

Get a PGY-II spot if you can find one. PGY-I's are not allowed to moonlight no matter how much training they have.

Both Columbia and Cornell tend to keep spots open for PGY2 transfers. If you remain interested you should contact the program directors at these two programs (though they may be more competitive than some places as they are both top 10 residency programs in NYC).

 

[lamaupin]

Hello there,
Sorry for the late reply but I have been remodeling my house and haven't checked sdn out in a while.
I was in your exact same situation, I was (relatively new) staff in another specialty and realized I just loved psych. I have made the big jump and am now in training and absolutely loving it, despite giving up all my "perks" (title, office, parking spot, etc etc etc). It's even weirder as I am doing it at the same hospital, but I have NO regrets.
No knowledge is ever wasted so you have not wasted any time in your past specialty, and no matter how old you are, in three years you are going to be that same age anyway, so why not do what you love?
I had a lot of people discouraging me to do a second residency, and it was actually the folks here on SDN who gave me lots of encouragement.
In any case, in case you are wondering, I came in as a PGY-2 even though I did a transitional year internship.
If you have any questions or want to vent/discuss, please feel free to PM me!

 

[northernpsy]

Hello there,
Sorry for the late reply but I have been remodeling my house and haven't checked sdn out in a while.
I was in your exact same situation, I was (relatively new) staff in another specialty and realized I just loved psych. I have made the big jump and am now in training and absolutely loving it, despite giving up all my "perks" (title, office, parking spot, etc etc etc). It's even weirder as I am doing it at the same hospital, but I have NO regrets.
No knowledge is ever wasted so you have not wasted any time in your past specialty, and no matter how old you are, in three years you are going to be that same age anyway, so why not do what you love?
I had a lot of people discouraging me to do a second residency, and it was actually the folks here on SDN who gave me lots of encouragement.
In any case, in case you are wondering, I came in as a PGY-2 even though I did a transitional year internship.
If you have any questions or want to vent/discuss, please feel free to PM me!

Glad to see that things worked out for you. Did you have to go through the whole rigmarole of formally applying through ERAS or was it more like just meeting with your friends in the psych dept to tell them you'd be interested if they had an open spot?

Personally I think it is unrealistic to expect that over the course of a career you will never change your mind about what you find interesting as you grow, change, and learn over a lifetime. Not to mention that over your career there may be shifts in the job market, reimbursement, malpractice premiums, etc. that can make a field you used to like less attractive 10-20 years down the road. I am trying to pay down my debt as fast as possible because I want to know that I could walk away from this if I ever decide I want to.

 

[lamaupin]

Glad to see that things worked out for you. Did you have to go through the whole rigmarole of formally applying through ERAS or was it more like just meeting with your friends in the psych dept to tell them you'd be interested if they had an open spot?

Personally I think it is unrealistic to expect that over the course of a career you will never change your mind about what you find interesting as you grow, change, and learn over a lifetime. Not to mention that over your career there may be shifts in the job market, reimbursement, malpractice premiums, etc. that can make a field you used to like less attractive 10-20 years down the road. I am trying to pay down my debt as fast as possible because I want to know that I could walk away from this if I ever decide I want to.

Hello Northernpsy,
I agree about what you are saying about how we change our minds as we grow over our lifespan. I think for me personally there was a lack of self-awareness, as I was attracted to my initial specialty (PM&R) BECAUSE, not in spite of, the psych overlay of many of the patients, which meant that I was always getting the referrals of the patients that the rest of the department (i.e., psych patients) that no one else wanted to see.
In any case, I was in contact with the psych department, as well as PD of the residency at my hospital, and they were very supportive, but I still had to apply. I'm military so it wasn't through ERAS but the department didn't really have control over my acceptance, although I believe they put in a good word for me. I am very very blessed as the Navy usually doesn't allow doctors to train in a second residency, so I am very grateful to the Navy and to the psychiatry department for the opportunity to do something I love. I say that because if it can happen for me, it can happen for anyone!

 

[Therapist4Chnge]

We had a former neurosurgeon who'd switched.

Wow, that seems like a very drastic change from the typical personality. Was it to a clinical focused or more research focused residency?

 

[Salpingo]

the people I've known who switched into psychiatry viewed it more as a switch out of medicine into mental health. They got sick of whatever they were doing, and so they wanted to go into a different field. It's a more global level of frustration than a switch from say anesthesiology to pmr because they didn't like the OR anymore for example.

That's probably less global and more of a reflection on your specific practice area/residency program. I think there are cases of people who burnout and switch, but they generally don't match or practice in the high competition areas. The people I've known who switched either as residents or attendings had always been drawn to psych but ultimately felt obligated to chose a specialty that was "medicine" and not a different field. After working and missing the deeper human interactions that real "medicine" doesn't always allow for, they realized life is too short to compromise. Some also go the opposite route into anesthesiology or consulting (which often has a worse lifestyle).

To the OP, I'll join the chorus of people and mention I've worked with several attendings turned residents and it was great. Keep in mind the PGY-2 spots can fluctuate depending on the people who left the program early for whatever reason. It also seems like more of a rolling admission compared to PGY-1 match.

 

[milesed]

Wow, that seems like a very drastic change from the typical personality. Was it to a clinical focused or more research focused residency?

She'd been injured and was not able to operate as well.

 

[DoctorSpoc]

I am currently looking for a PGY-II spot in Psychiatry if anyone knows of one; I'm a mature and seasoned Anesthesiologist/ER doctor, MD and trained in the US. Any advice as to openings/contacts would be greatly appreciated!

 

[twospadz]

I am currently looking for a PGY-II spot in Psychiatry if anyone knows of one; I'm a mature and seasoned Anesthesiologist/ER doctor, MD and trained in the US. Any advice as to openings/contacts would be greatly appreciated!

Just curious. Why do you want to switch out of EM/Anesthesiologist into psych?

 

[Crayola227]

lol triple board certified, and there must be some way to use all 3 effectively

for some reason I can see these 3 working together somehow

I mean, psych patients are having emergencies all the time, and I can totally see the need to straight knock them out

there is no type of crazy this doc will not be overly equipped to handle

 

[Extralong]

I would also throw this out there. If you are an attending way out in practice, and want to still have a decent living, especially if you have a family, I would recommend starting pgy2 year and doing psychiatry part time while you moonlight in your initial specialty. There are programs, that would let you be part time for sure.

 

[michaelrack]

lol triple board certified, and there must be some way to use all 3 effectively

for some reason I can see these 3 working together somehow

I mean, psych patients are having emergencies all the time, and I can totally see the need to straight knock them out

there is no type of crazy this doc will not be overly equipped to handle

Anesthesia/psych would be a good combo for ECT

 

[DoctorSpoc]

I am currently looking for a PGY-II spot in Psychiatry if anyone knows of one; I'm a mature and seasoned Anesthesiologist/ER doctor, MD and trained in the US. Any advice as to openings/contacts would be greatly appreciated!

Just to clarify my previous request for assistance: I never took my Anesthesiology Boards because the ER attending work was enough and then got burnt out working 12 h solo shifts in busy ERs...

 

[medicool]

Nymc Valhalla seems to have a Pgy 2 open . Check on Freida residency vacancies

 

[MDNext]

Hi- I was about to start a new post, when I found this string- I too am looking to switch to Psych, however I have a bit of a twist in my background- Maybe you can all be of help?

US MD IM&Rheum BC, (MOC IM)- finished fellowship 10yrs ago (!) went into research w episodic volunteer patient care (last ~4yrs ago)
Would like to do Psychiatry - looked at ERAS and really wonder what are my chances? How can I be a better candidate (or even considered to be a candidate)? And Do I need to do PGY1(again)?

If you are wondering- I had considered Psych in residency- but continues day IM-->specialty. It was my care/study of chronic pain patients (who need counseling along w meds) & years in corporate America (which is a unique atmosphere that most docs don't understand) - that makes feel my experiences and interests match to benefit pts with mental health issues.
Thanks for your help!!

 

[northernpsy]

If you really like working with chronic pain patients, well, all I can say is that I could give you plenty of referrals if you were my colleague.

I think there is a good chance that you could start as a PGY-2 since an IM internship satisfies the ABPN requirements for a PGY-1 year in psychiatry (I just can't say for sure that it would be enough due to how much time has passed and the possibility that programs might wonder if you had retained enough clinical skills after not working clinically for 4 years).
If there is a way that you can get back into clinical work then I think that would likely improve your chances. However I'd probably start with contacting Psych programs you are interested in to see what they have to say.

 

[MDNext]

If you really like working with chronic pain patients, well, all I can say is that I could give you plenty of referrals if you were my colleague.

I think there is a good chance that you could start as a PGY-2 since an IM internship satisfies the ABPN requirements for a PGY-1 year in psychiatry (I just can't say for sure that it would be enough due to how much time has passed and the possibility that programs might wonder if you had retained enough clinical skills after not working clinically for 4 years).
If there is a way that you can get back into clinical work then I think that would likely improve your chances. However I'd probably start with contacting Psych programs you are interested in to see what they have to say.

Thanks NorthernPsy for the guidance, optimism and the possibility of a future patient referral
I'll reach out to local programs and see what they think about my re-entrance
If needed- I can definitely shadow an internist to demonstrate my commitment/current knowledge- plus hoping it would help bypass re-doing PGY1
Thanks again

 

[MDNext]

you absolutely do not to do need to do PGY1 or shadow an internal medicine physician - you are board certified in that field already!!! If anything you might consider shadowing a psychiatrist. I would not be worried about your time away from medicine if you had w compelling reason to return this is different to someone who never practiced after residency or only had a year under their belt - you have completed a fellowship albeit a while ago!

Thanks for the positive and encouraging response-- (&sorry for my delay in response).I didn't even think of shadowing the specialty that I want to enter! Silly me- I was so focused on compensating/demonstrating my baseline medical knowledge--but I should be looking forward and supporting my (hopeful) next career.
To your point-- I need to clearly convey my rationale for my returning to medicine & choosing psychiatry. I'm concerned that my age (40-- do I need to prove my stamina and ability to learn new things?) and my career path (winding but al can be supportive of this career move) will turn them off-- I guess only applying will tell...
Any thoughts on that?

And to your point- what is my rationale - thoughts on below are helpful -briefly
1. miss the day-to-day care and helping people get back to functioning in their daily lives
2. clinical/research in pain ) made it clear the connection of mind/body- and how it is difficult in IM/Rheum to adequately treat both. (I actually got trained in integrative medicine which helped a little - but didn't have the time to apply learnings).
3. corporate America assisted in understanding the overwhelming pressures that many working people need to address on a daily basis-
4. I believe the unique experiences would help me in understanding how to support the variety of pathologies experienced by our neighbors to get them functioning again

Thoughts ??
Got my eras token-- will write personal statement this weekend
Thanks!

 

[deleted411085]

…

 

[Attending1985]

I am an attending in Emergency Medicine but have been giving strong consideration to completing a second residency in psychiatry. I have always had an interest in underserved populations (hence my current field of Emergency Medicine) and I quite enjoy patient interactions. However, I feel the help we offer to psychiatric patients in the ED is quite limited and am interested in providing more in depth care to this population.

This late in the year I presume I would be better off waiting until the next application cycle (or does anyone disagree?). If so is it better to contact programs individually or to submit an application through ERAS? Anything in particular I should be thinking about to burnish my application? I could get a letter of rec from my current Department/chair (I work in an academic setting). I suppose I could get a letter from my former residency - but I graduated ~5 years ago and the leadership is completely different now.

I would go ahead and apply this year if you can get your application together within a couple of weeks. Except for the funding issues, the experience you have only makes you a more qualified candidate and you should get a spot. I think contacting residencies you're interested in and getting some advice would be a good idea and will get you on their radar.

 

[OldPsychDoc]

Misspoke--a program could fill an open position with you off-cycle if you are accepted before the Match opens in September (so too late this year) and you start before February 1.

 

[uname943]

I am an attending in Emergency Medicine but have been giving strong consideration to completing a second residency in psychiatry. I have always had an interest in underserved populations (hence my current field of Emergency Medicine) and I quite enjoy patient interactions. However, I feel the help we offer to psychiatric patients in the ED is quite limited and am interested in providing more in depth care to this population.

This late in the year I presume I would be better off waiting until the next application cycle (or does anyone disagree?). If so is it better to contact programs individually or to submit an application through ERAS? Anything in particular I should be thinking about to burnish my application? I could get a letter of rec from my current Department/chair (I work in an academic setting). I suppose I could get a letter from my former residency - but I graduated ~5 years ago and the leadership is completely different now.

.

Don't worry about burnishing credentials. I'd apply this year by submitting an ERAS app as well as applying directly to open pgy2 slots. Some programs have pgy2 slots just for people like you. If you don't get in, apply next year.

Also: are you interested in psychiatry mainly in the emergency setting? You could do a fellowship in emergency psych instead. Kaiser's fellowship takes emergency medicine docs.

https://residency-ncal.kaiserpermanente.org/programs/fellowships/emergency-psychiatry-fellowship/

 

[WillieTrill]

I am an attending in Emergency Medicine but have been giving strong consideration to completing a second residency in psychiatry. I have always had an interest in underserved populations (hence my current field of Emergency Medicine) and I quite enjoy patient interactions. However, I feel the help we offer to psychiatric patients in the ED is quite limited and am interested in providing more in depth care to this population.

This late in the year I presume I would be better off waiting until the next application cycle (or does anyone disagree?). If so is it better to contact programs individually or to submit an application through ERAS? Anything in particular I should be thinking about to burnish my application? I could get a letter of rec from my current Department/chair (I work in an academic setting). I suppose I could get a letter from my former residency - but I graduated ~5 years ago and the leadership is completely different now.

I would look for open positions and try to enter as a PGY-2. There's no point in you repeating an intern year.