Did the expected salary for psychiatry make you hesitate about choosing psychiatry? If yes, how did you get over your hesitation?

[whopper]

I'd rather not say, but here's a hint.

Surgeon Salary (April 2024) - Zippia

The average salary for a Surgeon is $155,553 per year, or $75 per hour in United States. Find out the average a salary by state, years of experience, and field.

www.zippia.com

The average surgeon's salary? I make more.
The 90th percentile? I make more.

The cool thing isn't so much the money but that I actually really love what I do, it's about 50 hours a week and I'm in the right work-life balance. I got time to spend with my wife, kids, and actually do stuff I like to do on the side. Forgot to add that I do work a little on the weekends. Mostly an NP at the addiction clinic calling me "Dr. Whopper we got a guy who's got this problem ___." "What do we do next?" I spend about 2 hours a weekend on this type of thing and the calls are not stressful cause we got good staff and none of them, at least at this time, are idiots.

Another major factor is my dad is probably going to be dead in a year and my niece may seriously (and this is no joke) have prodromal schizophrenia and her mother (my sister) who's a saint and one of the nicest people I know is devastated. So the work-life balance thing is very important and I don't know if I want to do the Lex-Luthor-we-make-a-huge-thingee-thing (that's no so much about the money but it'll make money, but more about making a huge positive difference-but I may be working way too hard on it). We'll see how this pans out.

---

Members don't see this ad.

 

[robellis]

Lol…no…you don’t make more..those salaries online are all bs go talk to actual surgeons they’re all clearing easily 500k and much more usually

 

[whopper]

Agree. Most surgeons I know make about $500K a year. They're working till they drop, are on their 3rd wife, and paying the first two alimony, and the ex-wife's boyfriend is driving the surgeon's old sportscar but yeah more like $500K.

 

[capsychiatrist]

The prison system in california pays well due to lawsuits, with the locums paying better. CDCR pays about $336k for a staff psychiatrist (up to $382k for a chief of psychiatry), with internal moonlighting being a low $157/hr, and the typical locums positions pay $250/hr but there are some correctional inpatient units than can pay up to $335/hr. How good that is depends on your frame of reference. there’s a reason they always hace vacancies

In most of the country, working for the prison system is not necessarily lucrative. In fact many places pay very poorly. Prisons are not required to provide "adequate psychiatric services", merely the services must not be "deliberately indifferent." The kinds of lawsuits that have come about in correctional systems are things like acutely manic and psychotic patients being beaten to death by correctional officers rather than receiving psychiatric treatment.

The federal bureau of prisons pays about $282k for psychiatrists, which is about the median salary for psych nowadays.

I guarantee you most "red states" do not pay well for correctional psychiatry, and even if they did, it would absolutely not be worth working in those hellholes of prisons.

For a staff psychiatrist position at CDCR, do you know how common it is to start someone at the high end of the listed pay range? Or do new hires automatically start at the low end? And in general, would inpatient be expected to pay more than outpatient?

 

[PikminOC]

Agree. Most surgeons I know make about $500K a year. They're working till they drop, are on their 3rd wife, and paying the first two alimony, and the ex-wife's boyfriend is driving the surgeon's old sportscar but yeah more like $500K.

ballpark how much you make? inquiring minds...

 

[bGMx]

Agree. Most surgeons I know make about $500K a year. They're working till they drop, are on their 3rd wife, and paying the first two alimony, and the ex-wife's boyfriend is driving the surgeon's old sportscar but yeah more like $500K.

I'm curious, how much do you use your knowledge from medical school?
How much do you use your knowledge from the preclinical part of medical school?
I'm curious because I'm in the depths of M2 right now and want to hear what this is all about.

 

[PikminOC]

I'm curious, how much do you use your knowledge from medical school?
How much do you use your knowledge from the preclinical part of medical school?
I'm curious because I'm in the depths of M2 right now and want to hear what this is all about.

It's layered knowledge. It's all important.

 

[splik]

For a staff psychiatrist position at CDCR, do you know how common it is to start someone at the high end of the listed pay range? Or do new hires automatically start at the low end? And in general, would inpatient be expected to pay more than outpatient?

It’s pretty standard to start at the high end of the range

 

[Monocles]

I'm curious, how much do you use your knowledge from medical school?
How much do you use your knowledge from the preclinical part of medical school?
I'm curious because I'm in the depths of M2 right now and want to hear what this is all about.

I can't speak about forensics in particular, but in general very little of the pre-clinical learning from medical school is utilised in psychiatry. For instance, I use zero histology, anatomy, organ pathophysiology, very little genetics and biochem, some neuroscience, and a lot of pharmacology. In general I would say <10% of the "hard science" from the first two years of medical school is directly applicable to general psychiatry or any of the sub-specialties. Psychiatry is like a very narrow but "deep" slice of the overall medical pie.

The one exception might be consult/liaison psychiatry where there is more overlap with internal medicine.

 

[dl2dp2]

Well, yes. If you have the unfortunate timing of a recession or a -56% drawdown occurring at the beginning or your retirement, there's no option but to go back. The question is for how long though? Assuming a physician put off retirement from 2008 until the market recovering to the original position in 2011, that's only three extra years of working. During that time if they had been contributing per usual, they would have enjoyed that MASSIVE 56% discount on stocks and I would argue be way ahead in numbers than if the recession had never happened at all.

What would you do in retirement tho. I feel like I'd rather continue working, gradually increase overhead, and push it to fatFIRE, instead of this weird up-down thing where your consumption level is really uneven.

Plus, this job isn't all that demanding and often as close to a hobby as you can get as far as jobs go, depending on how you practice. I really prefer my job over most of the so-called leisure activities. The leisure activities that I can imagine that I'd truly enjoy (i.e. futzy around luxury real estate, that sort of thing) require fatFIRE level capital. I'd get REALLY bored if I carry out the middle-class retirement. Just look at my parents. OH DEAR GOD NO.

 

[whopper]

I'm curious, how much do you use your knowledge from medical school?
How much do you use your knowledge from the preclinical part of medical school?
I'm curious because I'm in the depths of M2 right now and want to hear what this is all about.

I use it quite a bit. I often times have to play PCP or catch a PCP's mistake. E.g. patient comes in with BP 200/130, doesn't meet criteria for HTN crisis and doesn't want to go to the ER. I tell the patient to see their PCP ASAP and call them right after our meeting. Her PCP tells her to start Lisinopril 10 and follow up in a year. WTF? Seriously.

Patient tells me what happens and I tell them to get a new PCP and I start treating their BP.

This type of thing isn't daily but it is at least biweekly.

About every 2-3 months I see a patient where their physical health is directly tied to their emotional well-being. E.g. someone with Ehlers Danlos and the chronic pain causes anxiety. I've had cases where I had to send a patient to the ER because I correctly diagnosed a case that their PCP and other physicians missed such as Temporal Arteritis, Autoimmune Encephalitis, a tumor on the brachial plexus causing neuro problems on the left arm, etc.

 

[Monocles]

What would you do in retirement tho. I feel like I'd rather continue working, gradually increase overhead, and push it to fatFIRE, instead of this weird up-down thing where your consumption level is really uneven.

Plus, this job isn't all that demanding and often as close to a hobby as you can get as far as jobs go, depending on how you practice. I really prefer my job over most of the so-called leisure activities. The leisure activities that I can imagine that I'd truly enjoy (i.e. futzy around luxury real estate, that sort of thing) require fatFIRE level capital. I'd get REALLY bored if I carry out the middle-class retirement. Just look at my parents. OH DEAR GOD NO.

During M4 year I worked hard in my handful of psychiatry and peds sub-Is and then filled the remainder of my schedule with the lightest, credit-granting rotations my med school had to offer. From October to June academic requirements were anywhere from 3-10 hours monthly. I was essentially a full time student on paper only.

I filled my time by reading, drawing, hiking, working out, catching up with old friends, learning to cook, gardening, hosting dinner parties (lived alone in my parents' very large house at the time). In some ways I felt like an old-world aristocrat whose entire existence was based on spur-of-the-whim leisure moments and self-actualisation through learning about whatever was interesting. Funny enough my food and lifestyle expenses (living in a lower cost of living rural state at the time) was under $500 a month (thanks to my parents owning the house and living in another state).

It was the happiest 8 months of my entire life and I felt like I didn't come close to doing all the things I had wanted to do. I felt so incredibly greedy for time that I could have easily done this for another decade before ever getting bored. I remember nearly crying when I had to face the harsh realities of intern year and going from working <2 hours a week to 60+.

So yeah, while I don't hate my job by any means (as I mentioned in another thread I ADORE my coworkers and my patient population), I've tasted retirement and know the true potential of how happy I could become. Perhaps I am just anti-work on principle, but the idea of waking up for your job, coming home and sleep, then repeat ad infinitum until you die feels like a travesty of a waste in terms of human potential. And if you have the financial means (either through high earning, low expenses, or both), you might as well seize the potential.

My dream is to some day be a stay at home dad and spend time with my kids, have more time for my hobbies. Maybe I'll completely stop working for a couple of years, and then once my kids are pre-school aged, I can either go take art classes or get an MBA for funsies during the daytime, and be the domestic partner supporting my family at night. Unlike me, my wife actually enjoys working and she is the type to get bored so she will probably have an upward trajectory career-wise.

 

[bGMx]

It's layered knowledge. It's all important.

I can't speak about forensics in particular, but in general very little of the pre-clinical learning from medical school is utilised in psychiatry. For instance, I use zero histology, anatomy, organ pathophysiology, very little genetics and biochem, some neuroscience, and a lot of pharmacology. In general I would say <10% of the "hard science" from the first two years of medical school is directly applicable to general psychiatry or any of the sub-specialties. Psychiatry is like a very narrow but "deep" slice of the overall medical pie.

The one exception might be consult/liaison psychiatry where there is more overlap with internal medicine.

I use it quite a bit. I often times have to play PCP or catch a PCP's mistake. E.g. patient comes in with BP 200/130, doesn't meet criteria for HTN crisis and doesn't want to go to the ER. I tell the patient to see their PCP ASAP and call them right after our meeting. Her PCP tells her to start Lisinopril 10 and follow up in a year. WTF? Seriously.

Patient tells me what happens and I tell them to get a new PCP and I start treating their BP.

This type of thing isn't daily but it is at least biweekly.

About every 2-3 months I see a patient where their physical health is directly tied to their emotional well-being. E.g. someone with Ehlers Danlos and the chronic pain causes anxiety. I've had cases where I had to send a patient to the ER because I correctly diagnosed a case that their PCP and other physicians missed such as Temporal Arteritis, Autoimmune Encephalitis, a tumor on the brachial plexus causing neuro problems on the left arm, etc.

Thank you all-- I hesitate to start a new thread about this which is why I ask here; I came to medical school wanting a career as a psychiatrist, and am rolling down that field effectively, but I find studying the minutia of the forearm to such a high degree... not the most inspirational thing.

 

[Monocles]

Thank you all-- I hesitate to start a new thread about this which is why I ask here; I came to medical school wanting a career as a psychiatrist, and am rolling down that field effectively, but I find studying the minutia of the forearm to such a high degree... not the most inspirational thing.

I think based on the variety of responses you got, there can be a huge range of applied medicine knowledge. Those of us who like medicine more tend to continue doing more "stethoscope-y" things, whereas those who do not can work in settings that have a much higher mental health focus. (Ex: I like kids and teens because they are generally medically healthy!) This continues to be true when you consider the degree of medical integration into clinical practices - in some places you ARE the PCP (like Whopper) whereas others you are not allowed to even order a CBC without a medical consult (my old fellowship)

 

[PikminOC]

I use it quite a bit. I often times have to play PCP or catch a PCP's mistake. E.g. patient comes in with BP 200/130, doesn't meet criteria for HTN crisis and doesn't want to go to the ER. I tell the patient to see their PCP ASAP and call them right after our meeting. Her PCP tells her to start Lisinopril 10 and follow up in a year. WTF? Seriously.

Patient tells me what happens and I tell them to get a new PCP and I start treating their BP.

This type of thing isn't daily but it is at least biweekly.

About every 2-3 months I see a patient where their physical health is directly tied to their emotional well-being. E.g. someone with Ehlers Danlos and the chronic pain causes anxiety. I've had cases where I had to send a patient to the ER because I correctly diagnosed a case that their PCP and other physicians missed such as Temporal Arteritis, Autoimmune Encephalitis, a tumor on the brachial plexus causing neuro problems on the left arm, etc.

Yes PCP doesnt always have time to look into everything. I do

 

[adiradirim]

E.g. patient comes in with BP 200/130,
Her PCP tells her to start Lisinopril 10 and follow up in a year. WTF? Seriously.

Gotta give the Lisinopril time to bring that pressure down

 

[Psychresy]

During M4 year I worked hard in my handful of psychiatry and peds sub-Is and then filled the remainder of my schedule with the lightest, credit-granting rotations my med school had to offer. From October to June academic requirements were anywhere from 3-10 hours monthly. I was essentially a full time student on paper only.

I filled my time by reading, drawing, hiking, working out, catching up with old friends, learning to cook, gardening, hosting dinner parties (lived alone in my parents' very large house at the time). In some ways I felt like an old-world aristocrat whose entire existence was based on spur-of-the-whim leisure moments and self-actualisation through learning about whatever was interesting. Funny enough my food and lifestyle expenses (living in a lower cost of living rural state at the time) was under $500 a month (thanks to my parents owning the house and living in another state).

It was the happiest 8 months of my entire life and I felt like I didn't come close to doing all the things I had wanted to do. I felt so incredibly greedy for time that I could have easily done this for another decade before ever getting bored. I remember nearly crying when I had to face the harsh realities of intern year and going from working <2 hours a week to 60+.

So yeah, while I don't hate my job by any means (as I mentioned in another thread I ADORE my coworkers and my patient population), I've tasted retirement and know the true potential of how happy I could become. Perhaps I am just anti-work on principle, but the idea of waking up for your job, coming home and sleep, then repeat ad infinitum until you die feels like a travesty of a waste in terms of human potential. And if you have the financial means (either through high earning, low expenses, or both), you might as well seize the potential.

My dream is to some day be a stay at home dad and spend time with my kids, have more time for my hobbies. Maybe I'll completely stop working for a couple of years, and then once my kids are pre-school aged, I can either go take art classes or get an MBA for funsies during the daytime, and be the domestic partner supporting my family at night. Unlike me, my wife actually enjoys working and she is the type to get bored so she will probably have an upward trajectory career-wise.

I, like you, am very much on the work to live side of things. In our field we could conceivably work 4 days a month and live on that and essentially be retired from day 1. Have you ever considered something like this?

I do have a kid so this kind of life makes me feel guilty. I admit I think about banging out those 50 hour weeks so I can give her all the stuff I didn't have, take her on amazing trips, leave her a really nice inheritance, etc. But damn it's tempting to think about just doing a bit more work than the absolute minimum and still getting to live better than the average American family.

 

[psyguru]

Just looking to get some different opinions, as I am a current medical student who is leaning towards psych but is hesitating because of the average salary.

Are you only considering the salary of clinical work or non-clinical work such as expert-witness work?

 

[Zyprexa100]

Psych salary should not make you hesitant. It keeps getting better!

 

[Monocles]

I, like you, am very much on the work to live side of things. In our field we could conceivably work 4 days a month and live on that and essentially be retired from day 1. Have you ever considered something like this?

I have a friend from residency who is now a super high end private practice doc and she does exactly this. She works "concierge" and basically charges enough to work 1 day a week to cover all her expenses. They have a rotating system of a handful of "celebrity" psychiatrists that all cover each other on a specific day in case emergencies come up. It's a pretty good system but I never schmoozed enough to get in on it lol, also I dislike outpatient. But it's certainly a very viable model!

Personally I'm too "commitment phobic" for long-term relationships with patients. In fellowship I had many patients and families who got REALLY attached and said if I ever started a private practice to please call them. I thought about this time-wise, and I could certainly carry a cohort of teens to adulthood (which would certainly match my retirement schedule for ~6 ish years) but would feel really bad leaving them. I decided it's better to have a clean break and I would want nothing to hold me back when it's time to retire and move on from medicine. It's easier to have shorter term therapeutic relationships w/ inpt where you try to do a good job and send them along their way and never think about them again.

 

[Stagg737]

I'm curious, how much do you use your knowledge from medical school?
How much do you use your knowledge from the preclinical part of medical school?
I'm curious because I'm in the depths of M2 right now and want to hear what this is all about.

Still in residency, but I use it frequently. Pharm will obviously be extremely important and C&L does require one to utilize minutiae at times but also lends to a more well-rounded foundational knowledge. Even in pure psych settings I still use what I'd consider fair amounts of M2 info when considering various pathologies and how meds may effect them (liver, kidneys, thyroid, GU, etc).

Yes, there will be a large amount of info you can dump, but there's also tidbits that can be very useful and I've found myself going back to reference my physiology and pathophys texts more than I had expected.

I do have a kid so this kind of life makes me feel guilty. I admit I think about banging out those 50 hour weeks so I can give her all the stuff I didn't have, take her on amazing trips, leave her a really nice inheritance, etc. But damn it's tempting to think about just doing a bit more work than the absolute minimum and still getting to live better than the average American family.

I can relate to this and I'd love to work to pay off my debts, then switch to PT work where I can make 6 figures. But I don't want to do this because I want to set an example that you have to work to get what you want. I don't want them to grow up seeing their dad work 20 hours a week, have a comfortable living with minimal work, and think they can have that without working hard themselves.

 

[comp1]

It's kind of sad that people can't find enough meaning and joy in their work to not want to retire early...

 

[starbuck2]

I can relate to this and I'd love to work to pay off my debts, then switch to PT work where I can make 6 figures. But I don't want to do this because I want to set an example that you have to work to get what you want. I don't want them to grow up seeing their dad work 20 hours a week, have a comfortable living with minimal work, and think they can have that without working hard themselves.

Just play golf the other 20 hours a week and pretend you’re at work 😂

 

[Stagg737]

It's kind of sad that people can't find enough meaning and joy in their work to not want to retire early...

I don't think that's the issue for a lot of people. I think for many it's the burnout of having to work within our health system and the amount of non-psych and non-medical work that we end up doing. I completely understand those who enjoy a part of it but are completely exasperated with admins, certain patient populations, etc who want to pursue things they really love outside of healthcare. I think in most careers people would just shift gears, but our salaries make it possible to have a lot of financial stability quickly so that if we really wanted or needed to retire we'd be secure.

I'll probably always do PT work or occasional locums, but it's hard to deny that it would be nice to only have to work 10-20 hours a week and still make 6 figures now.

 

[Mad Jack]

For anyone not in the know, FIREcalc is a great tool to project spending models versus historical market returns to determine your odds of a successful retirement

 

[calvnandhobbs68]

It's kind of sad that people can't find enough meaning and joy in their work to not want to retire early...

I mean I like my work and I totally recognize I get paid pretty well for what I do compared to many other fields but I still often feel like I don't get to spend as much time with my family as I'd like, along with staying current in the field and whatnot. I try to get up to workout most mornings at 5:45-6AM, get back home around 7:15ish, take a shower, eat, then get into work 30-45min early to prep for the day, start seeing patients at 9AM, then work till 5PM, wrap things with notes and stuff, get home about 6PM, have around 1.5 hours to spend with my kid until bedtime for her and then maybe another 2-2.5 hours to do anything else I want to do for fun/need to catch up on reading before I try to get to bed so I can shoot for 7 hours of sleep.

I can't say my day is particularly tough compared to other fields but there is this sense that the 40 hour workweek is a purely artificial thing we've imposed on ourselves and this idea that it's "sad" that people don't want to do that is a very American thing.

 

[Psychresy]

It's kind of sad that people can't find enough meaning and joy in their work to not want to retire early...

Perhaps they find more meaning in other areas of life?

 

[AD04]

It's kind of sad that people can't find enough meaning and joy in their work to not want to retire early...

I've been thinking about why some people enjoy working so much and other people don't. The best answer I can come up with is this varies based on people's degree of conscientiousness. Some people work out and eat right even when they already snagged a spouse. Some people work even though they don't need the money.

I do wonder if there's any adaptive traits regarding low conscientiousness.

 

[thepoopologist]

If I had 10 million dollars I wouldn't see the point of work.

However as far as having to work goes, its been fine.

 

[LimpSpatula]

I've been thinking about why some people enjoy working so much and other people don't. The best answer I can come up with is this varies based on people's degree of conscientiousness. Some people work out and eat right even when they already snagged a spouse. Some people work even though they don't need the money.

I do wonder if there's any adaptive traits regarding low conscientiousness.

So forget wanting to be healthy, it’s all about snagging a spouse? With how easy it is to snag some side tail nowadays I’d argue its almost necessary to maintain the looks part of it to keep your partner interested.

As far as work goes, unless you have meaningful contribution to society, there’s little incentive other than money to keep doing it. We should know this, it’s basic psychology. People are always wondering why CEOs and politicians are working in their 80s....

 

[nexus73]

It's kind of sad that people can't find enough meaning and joy in their work to not want to retire early...

I think this is most people, but I'd assume most doctors enjoy their jobs more than the average human, and maybe it's because the pay is good. But there are a lot of frustrations.

Others have hit the major issues: annoying systems, administrative bloat, non-doctors making decisions that affect clinical care, insurance rules, and the ever present risk of lawsuits or board complaints that will take time and cause stress. And you worry about your patients off hours. I doubt a lot of computer programmers are worrying about their code over the weekend. Being a doctor is a job that can be hard to leave at work. There is a lot you do not have control over but still have to deal with every day.

“Oh, you hate your job? Why didn't you say so? There's a support group for that. It's called EVERYBODY, and they meet at the bar.” ― Drew Carey

 

[Anotherwin]

Are you only considering the salary of clinical work or non-clinical work such as expert-witness work?

Both. I assume most folks just stick with clinical work, and so was wondering how that would be. Ideally I want to be able to engage in private practice as well as expert-witness work.

 

[psyguru]

Both. I assume most folks just stick with clinical work, and so was wondering how that would be. Ideally I want to be able to engage in private practice as well as expert-witness work.

I do both clinical work as well as expert work. I am aware of other forms of non-clinical work as well.

 

[Ludwig2000]

Kind of a peripheral question -
For neuropsychiatry IMEs, do you need to have completed a neuropsych / behavioral neurology fellowship?
Or if you’ve otherwise demonstrated expertise, ie through publications, treatment experience, can you pick up some of that kind of work?

 

[psyguru]

Kind of a peripheral question -
For neuropsychiatry IMEs, do you need to have completed a neuropsych / behavioral neurology fellowship?
Or if you’ve otherwise demonstrated expertise, ie through publications, treatment experience, can you pick up some of that kind of work?

My neuropsychiatric expertise is focused on TBI, SCI, stroke, and the co-occurring NCD. I am board-certified in BIM and work in a PMR TBI/SCI center. Many of the IMEs I perform are TBI personal injury cases. I also feel comfortable doing other cases that involve NCD that is not caused by TBI or stroke such as Testamentary Capacity (often done by non-forensic geriatric psychiatrists...also these do not actually require an IME as the individual is deceased) or Adjudicative Competency IME with someone with Alzheimer's Disease. Of course, neuropsychiatry can involve other topics outside of stroke, TBI, and the resulting NCD.

 

[splik]

Kind of a peripheral question -
For neuropsychiatry IMEs, do you need to have completed a neuropsych / behavioral neurology fellowship?
Or if you’ve otherwise demonstrated expertise, ie through publications, treatment experience, can you pick up some of that kind of work?

Most people who do neuropsych IME are neuropsychiatrists or cognitive neurologists, without the forensic training. Also a lot of neuropsychologists (and there are quite a few forensic neuropsychologists). There are very few forensic neuropsychiatrists. Most forensic psychiatrists are not skilled in neuropsychiatry, but inevitably come across cases involving TBI (a lot of personal injury cases involve TBI) or dementia (comes up in civil competencies and criminal competency evals). I am certified in both behavioral neurology/neuropsychiatry and forensics, very few people are. As psyguru said, there are also very few people boarded in both BIM (brain injury medicine) and forensics, as BIM is a relatively new field and its mainly PMR, I only know a few psychiatrists with that. You don't need any specific certifications or fellowships - but it certainly can help establish your expertise early on in your career. Working clinically with neuropsych patients, and publishing in the field, teaching and holding leadership positions in the field are other ways of establishing your credibility.

 

[psyguru]

Most people who do neuropsych IME are neuropsychiatrists or cognitive neurologists, without the forensic training. Also a lot of neuropsychologists (and there are quite a few forensic neuropsychologists). There are very few forensic neuropsychiatrists. Most forensic psychiatrists are not skilled in neuropsychiatry, but inevitably come across cases involving TBI (a lot of personal injury cases involve TBI) or dementia (comes up in civil competencies and criminal competency evals). I am certified in both behavioral neurology/neuropsychiatry and forensics, very few people are. As psyguru said, there are also very few people boarded in both BIM (brain injury medicine) and forensics, as BIM is a relatively new field and its mainly PMR, I only know a few psychiatrists with that. You don't need any specific certifications or fellowships - but it certainly can help establish your expertise early on in your career. Working clinically with neuropsych patients, and publishing in the field, teaching and holding leadership positions in the field are other ways of establishing your credibility.

I think one difference is that BIM is more PMR-based so it won't have the same background in neuroscience as neuropsychiatry or neuropsychology. However, it is useful in TBI personal injury cases to help look into MMI and prognosis from a PMR perspective. Often, I will see life care plans mostly done by PMR doctors.

 

[ArdorAyurveda]

What are MMI and PMR?

So many acronyms

 

[psyguru]

What are MMI and PMR?

So many acronyms

PMR - physical medicine and rehab
MMI - maximal medical improvement - term used in disability, WC and DBA cases

 

[Dr. E psych]

you will be able to make $ close to what surgeons make if you wish to.
I second other comments that life style in psych is unbeatable.

 

[LimpSpatula]

you will be able to make $ close to what surgeons make if you wish to.
I second other comments that life style in psych is unbeatable.

I’m not so sure. Hourswise, maybe. But if you’re doing good for your patients it can be quite taxing, regardless of when you clock in/out. Off the top of my head I’d say Palliative Care has a better lifestyle.

 

[psyguru]

you will be able to make $ close to what surgeons make if you wish to.
I second other comments that life style in psych is unbeatable.

I assume you are referring to clinical income. Lifestyle (and even pay as well in some instances) is better in non-clinical settings.

 

[Atreides]

I am certified in both behavioral neurology/neuropsychiatry and forensics, very few people are.

Lol, have you seen the TV show "Chance" starring Hugh Laurie? It's about a forensic neuropsychiatrist. Based on the book of the same name by Kem Nunn.

 

[Flaw]

I've been thinking about why some people enjoy working so much and other people don't. The best answer I can come up with is this varies based on people's degree of conscientiousness. Some people work out and eat right even when they already snagged a spouse. Some people work even though they don't need the money.

I do wonder if there's any adaptive traits regarding low conscientiousness.

Personality-driven proclivities, like conscientiousness, absolutely govern to a large degree not only the type of work he finds suitable but also the amount thereof.

Though I suspect his disrelishing the work he has chosen, even in following his natural proclivities, is more a sign of either seldom variety/challenge of the work or burnout. This will always be the case if he never seeks intrinsic value in his work; others find, say, surgery to be an autotelic experience because it reinforces all of the conditions under which folk oft-enjoy: goals, challenge, instant feedback. Those who do not actively pursue transforming their craft into autotelic experiences will inevitably always hold apathy towards their job.

The same is true for all leisurely activities, too, hence why folk with an intrinsic passion, that to the myriad may seem arduous and “extra,” often have part and parcel an autotelic personality to do so (e.g., daily resistance training on top of an 80-hour workweek).

 

[DoctorMD1]

During M4 year I worked hard in my handful of psychiatry and peds sub-Is and then filled the remainder of my schedule with the lightest, credit-granting rotations my med school had to offer. From October to June academic requirements were anywhere from 3-10 hours monthly. I was essentially a full time student on paper only.

I filled my time by reading, drawing, hiking, working out, catching up with old friends, learning to cook, gardening, hosting dinner parties (lived alone in my parents' very large house at the time). In some ways I felt like an old-world aristocrat whose entire existence was based on spur-of-the-whim leisure moments and self-actualisation through learning about whatever was interesting. Funny enough my food and lifestyle expenses (living in a lower cost of living rural state at the time) was under $500 a month (thanks to my parents owning the house and living in another state).

It was the happiest 8 months of my entire life and I felt like I didn't come close to doing all the things I had wanted to do. I felt so incredibly greedy for time that I could have easily done this for another decade before ever getting bored. I remember nearly crying when I had to face the harsh realities of intern year and going from working <2 hours a week to 60+.

So yeah, while I don't hate my job by any means (as I mentioned in another thread I ADORE my coworkers and my patient population), I've tasted retirement and know the true potential of how happy I could become. Perhaps I am just anti-work on principle, but the idea of waking up for your job, coming home and sleep, then repeat ad infinitum until you die feels like a travesty of a waste in terms of human potential. And if you have the financial means (either through high earning, low expenses, or both), you might as well seize the potential.

My dream is to some day be a stay at home dad and spend time with my kids, have more time for my hobbies. Maybe I'll completely stop working for a couple of years, and then once my kids are pre-school aged, I can either go take art classes or get an MBA for funsies during the daytime, and be the domestic partner supporting my family at night. Unlike me, my wife actually enjoys working and she is the type to get bored so she will probably have an upward trajectory career-wise.

OMG! I found my soul mate. I haven't met any male like that in my specialty. I am a rad

 

[Monocles]

OMG! I found my soul mate. I haven't met any male like that in my specialty. I am a rad

Lol! maybe psych has more people like me because a lot of us chose the field for the lifestyle. I think overall the pandemic has caused a lot of workers (in general, not just doctors) to do some deep soul searching and realign their life priorities. More than ever in 2021, people are asking themselves is it worth it to go toil at work 5 days a week only to have 48 hours of freedom (aka weekends).

 

[Stagg737]

I’m not so sure. Hourswise, maybe. But if you’re doing good for your patients it can be quite taxing, regardless of when you clock in/out. Off the top of my head I’d say Palliative Care has a better lifestyle.

They have issues that are just as taxing as psych though. I mean, at least most of our patients live (hopefully). I also think most of the Palliative docs I know have fairly similar or more time-demanding jobs than the psychiatrists I know who choose lifestyle. The least hours I've seen on a regular basis has been PM&R, but they also had the greatest number of hours dedicated to paperwork (largely d/t the high documentation requirements of insurance).

 

[DoctorMD1]

Lol! maybe psych has more people like me because a lot of us chose the field for the lifestyle. I think overall the pandemic has caused a lot of workers (in general, not just doctors) to do some deep soul searching and realign their life priorities. More than ever in 2021, people are asking themselves is it worth it to go toil at work 5 days a week only to have 48 hours of freedom (aka weekends).

we temporarily had volume down last year due to COVID and my practice offered several unpaid vacation days. I think I was the only one out of 70 people who was excited about that. Maybe psych has more people who have other interests in life than just making money... and more appreciative of freedom

 

[ArdorAyurveda]

During M4 year I worked hard in my handful of psychiatry and peds sub-Is and then filled the remainder of my schedule with the lightest, credit-granting rotations my med school had to offer. From October to June academic requirements were anywhere from 3-10 hours monthly. I was essentially a full time student on paper only.

I filled my time by reading, drawing, hiking, working out, catching up with old friends, learning to cook, gardening, hosting dinner parties (lived alone in my parents' very large house at the time). In some ways I felt like an old-world aristocrat whose entire existence was based on spur-of-the-whim leisure moments and self-actualisation through learning about whatever was interesting. Funny enough my food and lifestyle expenses (living in a lower cost of living rural state at the time) was under $500 a month (thanks to my parents owning the house and living in another state).

It was the happiest 8 months of my entire life and I felt like I didn't come close to doing all the things I had wanted to do. I felt so incredibly greedy for time that I could have easily done this for another decade before ever getting bored. I remember nearly crying when I had to face the harsh realities of intern year and going from working <2 hours a week to 60+.

So yeah, while I don't hate my job by any means (as I mentioned in another thread I ADORE my coworkers and my patient population), I've tasted retirement and know the true potential of how happy I could become. Perhaps I am just anti-work on principle, but the idea of waking up for your job, coming home and sleep, then repeat ad infinitum until you die feels like a travesty of a waste in terms of human potential. And if you have the financial means (either through high earning, low expenses, or both), you might as well seize the potential.

My dream is to some day be a stay at home dad and spend time with my kids, have more time for my hobbies. Maybe I'll completely stop working for a couple of years, and then once my kids are pre-school aged, I can either go take art classes or get an MBA for funsies during the daytime, and be the domestic partner supporting my family at night. Unlike me, my wife actually enjoys working and she is the type to get bored so she will probably have an upward trajectory career-wise.

Seems fitting