Is Psych going to become much more competitive in the next few years?

[Tyrone Slothrop]

What other conclusion did you think you will achieve by posting the question in a forum filled with psychiatrists?

Well, check out the path boards or even worse nuclear med.. very bleak. The psychiatry forum is pretty consistently upbeat and positive. I think partly because of the people who pursue psychiatry, but people's job satisfaction must certainly play a role.

Personally one of the bigger factors in my decision to pursue psychiatry was when I realized it was one of the few departments I'd been where most people seemed happy and content with their jobs.

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[@JackShephard]

Well, check out the path boards or even worse nuclear med.. very bleak. The psychiatry forum is pretty consistently upbeat and positive. I think partly because of the people who pursue psychiatry, but people's job satisfaction must certainly play a role.

Personally one of the bigger factors in my decision to pursue psychiatry was when I realized it was one of the few departments I'd been where most people seemed happy and content with their jobs.

Good point.

 

[Blitz2006]

Well, you have to compare it to other fields in medicine - then those don't seem as bad.

Exactly.

Also, my point was that it is nice to see that hardworking psychiatrists are financially rewarded appropriately. Even derm is tough to pull 500k right?

 

[Tyrone Slothrop]

Exactly.

Also, my point was that it is nice to see that hardworking psychiatrists are financially rewarded appropriately. Even derm is tough to pull 500k right?

There is a window where more money doesn't seem to add that much to your life. Does the guy making 250k live much differently from the guy making 350k? They both still have to go to work in the morning, they'll both retire roughly the same way. Material possessions might be "nicer" but not by much.

I think more money only really starts to matter when it means you can have more free time and retire earlier. If you enjoy your work even that isn't such a huge draw.

That's why I think comparisons between salaries in different fields aren't so meaningful. Past a certain point job satisfaction and free time contribute far more to quality of life than income. Who cares what derm earns? If you wouldn't be happy doing the work, it doesn't matter.

 

[Blitz2006]

There is a window where more money doesn't seem to add that much to your life. Does the guy making 250k live much differently from the guy making 350k? They both still have to go to work in the morning, they'll both retire roughly the same way. Material possessions might be "nicer" but not by much.

I think more money only really starts to matter when it means you can have more free time and retire earlier. If you enjoy your work even that isn't such a huge draw.

That's why I think comparisons between salaries in different fields aren't so meaningful. Past a certain point job satisfaction and free time contribute far more to quality of life than income. Who cares what derm earns? If you wouldn't be happy doing the work, it doesn't matter.

I agree with you 100%. But im discussing between making 200k (avg.) Versus a ceiling salary (500k). To me that is a big difference (300k extra per year).

But again this is just my personal view. Extra 300k per year may be negligible to you. Fair enough

 

[Psychotic]

I agree with you 100%. But im discussing between making 200k (avg.) Versus a ceiling salary (500k). To me that is a big difference (300k extra per year).

But again this is just my personal view. Extra 300k per year may be negligible to you. Fair enough

Yours is a straw man argument; not every med student has the drive, interest, and frankly the scores necessary to land a highly competitive, high paying specialty, so your "extra $300k" argument is not very representative of the realistic choices most applicants face.

I don't care what high paying medical field you pick, if you are making $500k, you are working hard and almost certainly working 50 to 60 hard hours a week, plus you are responsible for running a business, having staff, etc. I don't think any gig is worth that "extra" $$$ unless it is exactly what you want to be doing every bloody day. In psychiatry, people have a good chance of working a lighter work week (30 or so hours a week) and still making a very decent living, or they can turn it up a notch and grow a cash pay practice and make even more money if they are so motivated.

 

[@JackShephard]

I agree with you 100%. But im discussing between making 200k (avg.) Versus a ceiling salary (500k). To me that is a big difference (300k extra per year).

But again this is just my personal view. Extra 300k per year may be negligible to you. Fair enough

500k isn't likely.

Don't go into medicine trying to get rich, you'll be miserable.

 

[Shikima]

Hey Shikima.

Impressive. Do you mind giving a brief overview of your typical week?

Do you do pure private practice? Do you mix in any inpatient work? How about ect or telepsych?

I wouldn't mind have variety. ..not sure if I can handle 100% outpatient/private practice. .

I pretty much work outpatient only. I feel inpt is far too soul sucking for me and psych ER work is not too satisfying for me professionally. The majority of time is typically spent working with PTSD and mood dysregulation. As a side note, I used to have fun working with personality disorders but not so much any longer - typically the therapists in my community aren't engaging heavily with CBT/DBT.

 

[EMDO2018]

How common is it to moonlight in psych 1 12-15 hr shift a week during years 2-4?

 

[notdeadyet]

How common is it to moonlight in psych 1 12-15 hr shift a week during years 2-4?

The limiting factor is usually your location, so if this is important to you, it's a question you have to feel out. DO NOT rely on what everyone posts here, because your answers will vary from "no problem" to "no way," depending on where you train.

You can theoretically moonlight once you pass your Step 3 and get your unrestricted medical license. This can happen as soon as after your intern year (how long depends on your state, as licensing varies). Many spots only have internal moonlighting in PGY-2 year and if you're in a location that is limited to this, it might be hard to find 12-15 hours per week as competition can be stiff. PGY-3 opens you up to most external moonlighting but some places require PGY-4.

Long and short of it, moonlighting is awesome for extra cash but can be a challenge if you absolutely have to have it to live. I went from working about 60 hours/month during much of PGY-2 year to scrambling to link together 20 hours/month within a few months because the next class that got their license apparently had a lot of credit card debt because competition was more keen for moonlighting gigs. I now have a few different gigs I string together.

 

[TexasPhysician]

The limiting factor is usually your location, so if this is important to you, it's a question you have to feel out. DO NOT rely on what everyone posts here, because your answers will vary from "no problem" to "no way," depending on where you train.

You can theoretically moonlight once you pass your Step 3 and get your unrestricted medical license. This can happen as soon as after your intern year (how long depends on your state, as licensing varies). Many spots only have internal moonlighting in PGY-2 year and if you're in a location that is limited to this, it might be hard to find 12-15 hours per week as competition can be stiff. PGY-3 opens you up to most external moonlighting but some places require PGY-4.

Long and short of it, moonlighting is awesome for extra cash but can be a challenge if you absolutely have to have it to live. I went from working about 60 hours/month during much of PGY-2 year to scrambling to link together 20 hours/month within a few months because the next class that got their license apparently had a lot of credit card debt because competition was more keen for moonlighting gigs. I now have a few different gigs I string together.

All good points. I began extensive moonlighting PGY-2, but other nearby programs keep residents too busy until almost PGY-4. Other places I interviewed completely prohibited it.

 

[EMDO2018]

The limiting factor is usually your location, so if this is important to you, it's a question you have to feel out. DO NOT rely on what everyone posts here, because your answers will vary from "no problem" to "no way," depending on where you train.

You can theoretically moonlight once you pass your Step 3 and get your unrestricted medical license. This can happen as soon as after your intern year (how long depends on your state, as licensing varies). Many spots only have internal moonlighting in PGY-2 year and if you're in a location that is limited to this, it might be hard to find 12-15 hours per week as competition can be stiff. PGY-3 opens you up to most external moonlighting but some places require PGY-4.

Long and short of it, moonlighting is awesome for extra cash but can be a challenge if you absolutely have to have it to live. I went from working about 60 hours/month during much of PGY-2 year to scrambling to link together 20 hours/month within a few months because the next class that got their license apparently had a lot of credit card debt because competition was more keen for moonlighting gigs. I now have a few different gigs I string together.

Okay, so I guess it would help to do you residency in a major city where there would be lot of opportunities. Or maybe a city that surrounded by a lot of small towns.

 

[whopper]

I got a theory that the Myers Briggs personality type of someone that would love psychiatry is likely very far from the type of person interested in medical school, and thus most interested in mental health would enter psychology and not psychiatry. It's just a theory but I've noticed that with most medstudents being engineers, biologists, chemists, or something along those lines while in pre-med and so far having been in the humanities, psychology or sociology.

So while I'd love to hear more people are going into psych, the flip-side is more job opportunities and healthy security for me though I really wish more people would apply.

Agree with the above concerning money and ethics. Play it smart and you can make more money by being the better doctor that gives better care.

And being a psychiatrist you could have the free time to make money in ventures outside of practice. Not something I'd recommend for the medical fields where you push yourself and work 60+ hours/week.

 

[vistaril]

I have no doubt that psychiatrists in private practice who want to work same hours and are not concerned with providing the best care can earn more than orthopedic/neuro surgeons. Of course this is not a reason to do psych. Does anyone think otherwise?

this is delusional. Neurosurgeons who want to go to certain community hospital systems(and I don't mean in the middle of nowhere type places) get payola left and right to come aboard about their salaries. You're talking a completely completely different level of reimbursement alltogether. which is fine- I certainly couldn't have been a neurosurgeon, and I'm sure what they do is worth it.

 

[Nasrudin]

this is delusional. Neurosurgeons who want to go to certain community hospital systems(and I don't mean in the middle of nowhere type places) get payola left and right to come aboard about their salaries. You're talking a completely completely different level of reimbursement alltogether. which is fine- I certainly couldn't have been a neurosurgeon, and I'm sure what they do is worth it.

I don't disagree with you. Nevertheless. For your phallic fascination on the prowess of other specialties, I'm Rx'ing you 3 sets of squats and deadlifts daily. And a quart of man juice every morning. Just for starters.

 

[moonshined]

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[AthensBeth]

We took the Meyers Briggs in class when I was an MS1, and I remember being astounded with the results. They had us all go to different corners based on our results. Before medical school, I'd never even met someone who was an S and not an N. In fact, two of my closest friends are INFPs like me (I'm like Jerry in that Seinfeld episode when he wants to date himself). It was amazing how many people where in S and J corners. But I think psychiatry is a good career for INFPs, if you can make it through medical school without too much trauma!

 

[TexasPhysician]

I got a theory that the Myers Briggs personality type of someone that would love psychiatry is likely very far from the type of person interested in medical school, and thus most interested in mental health would enter psychology and not psychiatry. It's just a theory but I've noticed that with most medstudents being engineers, biologists, chemists, or something along those lines while in pre-med and so far having been in the humanities, psychology or sociology.

So while I'd love to hear more people are going into psych, the flip-side is more job opportunities and healthy security for me though I really wish more people would apply.

Agree with the above concerning money and ethics. Play it smart and you can make more money by being the better doctor that gives better care.

And being a psychiatrist you could have the free time to make money in ventures outside of practice. Not something I'd recommend for the medical fields where you push yourself and work 60+ hours/week.

While I agree with the rest of your post, Myers Briggs is useless. All research I have seen outside those directly benefiting from its sales have shown it is not significant by any measure. Pure hokum.

 

[jno]

While I agree with the rest of your post, Myers Briggs is useless. All research I have seen outside those directly benefiting from its sales have shown it is not significant by any measure. Pure hokum.

What proposed uses of MBTI had been studied? I wonder how they designed such studies as most of the proposed uses are like understanding interpersonal relationships better, etc. - stuff that have outcomes that are hard to define. Can you post any links to those independent studies?

 

[AthensBeth]

Well, it has always seemed more accurate than my astrological sign and my Chinese year animal (my whole class were rams!). So, that speaks wonders to its scientific accuracy and applicability.

 

[whopper]

Forgot his name and last I knew he was at Jefferson. He specializes in trying to make medical education more meaningful and effective and has done research on the MBTI and medical education. He's not an MD but works extensively with MDs.

We took the Meyers Briggs in class when I was an MS1, and I remember being astounded with the results. They had us all go to different corners based on our results. Before medical school, I'd never even met someone who was an S and not an N. In fact, two of my closest friends are INFPs like me (I'm like Jerry in that Seinfeld episode when he wants to date himself). It was amazing how many people where in S and J corners. But I think psychiatry is a good career for INFPs, if you can make it through medical school without too much trauma!

The guy that does the research at Jefferson does presentations where he puts students into categories and sounds like you were in one of them. I was at one too. Nuts, forgot his name.

About the MBTI, I wouldn't go as far as to say it's pure hokum, but I'm not dismissing Texasphysician's post. Any test has errors and problems with it.

 

[TexasPhysician]

Forgot his name and last I knew he was at Jefferson. He specializes in trying to make medical education more meaningful and effective and has done research on the MBTI and medical education. He's not an MD but works extensively with MDs.



The guy that does the research at Jefferson does presentations where he puts students into categories and sounds like you were in one of them. I was at one too. Nuts, forgot his name.

About the MBTI, I wouldn't go as far as to say it's pure hokum, but I'm not dismissing Texasphysician's post. Any test has errors and problems with it.

Someone at my school did this too in MS1 - he had income from the test. I looked up the independent research at the time which showed no correlation between a classification and study skills. Those with skin in the game published so much on it with positive results that it just keeps going - my opinion. Some of my classmates bought into the classification and adjusted their studying based on our professor's recommendations. The failure rate in the group was quite high. Was it self-selecting? Maybe

Thinking maybe it was better suited for career aptitude, I discussed it with a PhD psychologist who basically laughed at the idea. She explained that it was too superficial to be accurate. Much better tests supposedly exist.

Now if you argue that an outgoing individual who wants to hit the scene daily will not get along as well with someone who prefers reading, I agree. They will have different MB classifications and likely not click as well. Maybe it could find a niche in helping pick friends or dates?

Just my thoughts....

 

[AthensBeth]

The guy that does the research at Jefferson does presentations where he puts students into categories and sounds like you were in one of them. I was at one too. Nuts, forgot his name.
.

Weird! It was during my first-year at Jefferson. I forget his name too. I thought it was fun. He wasn't suggesting we use the information to study. I just remember being in corner with very few people, and one of them ended up being my closest friend. I don't think the swath of people on the other side of the room would have enjoyed sitting around, drinking a glass of wine, and listening to episodes of This American Life together. So it was very useful in finding a comrade.

 

[moonshined]

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[StECT]

So, what was the conclusion? Is Psych going to become much more competitive in the next few years?

 

[TexasPhysician]

So, what was the conclusion? Is Psych going to become much more competitive in the next few years?

Doubtful in my opinion.

 

[shan564]

Doubtful in my opinion.

I agrizzle.

 

[MacDonaldTriad]

I would say very doubtful, but not for bad reasons. The hypercompetitive nature of the premed process doesn’t select very well for the qualities we want. Nor does the culture of medical school attract much psych interest. None of these make psychiatry less attractive, but its lack of competitiveness does make it a conduit for less impressive trainees if that is the reason they choose psychiatry. That doesn’t make the field less impressive in the academic sense. Only a small percentage of doctors are publishing and doing research. Cream still rises to the top and good doctors still do good work if equipped with the proper training and if they possess the right qualities to want to do psychiatry. If the pay were doubled tomorrow, we might get a few more gifted people interested, but they probably would not be in it for the right reasons. Some of these would be surprised they had a knack for the job, but many would not.

 

[OldPsychDoc]

So, what was the conclusion? Is Psych going to become much more competitive in the next few years?

Maybe it will, maybe it won't.
Probably we'll all be bartering Prozac for chickens to feed our families...

 

[conchatumare]

Long time reader, read this article the other day and think you guys will find it interesting: http://www.nimh.nih.gov/about/director/2012/the-future-of-psychiatry-clinical-neuroscience.shtml

 

[moonshined]

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[jjmack]

Long time reader, read this article the other day and think you guys will find it interesting: http://www.nimh.nih.gov/about/director/2012/the-future-of-psychiatry-clinical-neuroscience.shtml

While an interesting read, that article is almost two years old.

 

[conchatumare]

While an interesting read, that article is almost two years old.

Does that matter? The article commented on a trend over the past decade. I doubt that less MD-PhDs are applying now than they were 2 years ago. If anything, the interest has grown even more since then.

Anyways, I think its very easy to predict that Psych will become more competitive and "prestigious" in the future. At least at my school (US MD), there is a clear trend of more students applying to Psych residencies over the last decade (from looking at previous match lists).

 

[IamPsychiatrist]

I think it will be more competitive, but what does that mean?

It's on the lower end now - it will never move to the top (Derm, Ortho, Plastics) - at best it could be more competitive than FM/Peds, but still less than things like EM.

 

[punkedoutriffs]

- at best it could be more competitive than FM/Peds, but still less than things like EM.

It is just crazy to me how much of a bubble med students operate in. Like you ask anyone "outside the loop" whether they'd want a job with rotating shifts/high stress/in the weeds/etc. vs one with low stress, flexible hours, etc. and it's a no brainer. The latter is better, despite the extra $100k, which at that point, is just not worth the tradeoff. It's like, by being around the medical community, we somehow get indoctrinated with a different set of values that we think will persist throughout our life, but they won't. It's scary to me that most students are making decisions with lifelong consequences in this myopic state.

 

[Leo Aquarius]

The answer is Yes it will. Here's why. Psychiatry is in its technological development stage - as we continue to make strides in brain imaging and non-invasive stimulation therapies, suddenly you will see the beginnings of office procedures. And when THAT catches fire, when psychiatrists can start billing hundreds of dollars per procedure, more students will crowd the psychiatry space and competition will rise. At least that's my prediction.

 

[IamPsychiatrist]

The answer is Yes it will. Here's why. Psychiatry is in its technological development stage - as we continue to make strides in brain imaging and non-invasive stimulation therapies, suddenly you will see the beginnings of office procedures. And when THAT catches fire, when psychiatrists can start billing hundreds of dollars per procedure, more students will crowd the psychiatry space and competition will rise. At least that's my prediction.

Office procedures? Interesting. Never even thought of that.

It is just crazy to me how much of a bubble med students operate in. Like you ask anyone "outside the loop" whether they'd want a job with rotating shifts/high stress/in the weeds/etc. vs one with low stress, flexible hours, etc. and it's a no brainer. The latter is better, despite the extra $100k, which at that point, is just not worth the tradeoff. It's like, by being around the medical community, we somehow get indoctrinated with a different set of values that we think will persist throughout our life, but they won't. It's scary to me that most students are making decisions with lifelong consequences in this myopic state.

I think most decisions in youth (teens - 20s) are made in a myopic state.

Anyway, like people said above - the typical medical student probably leans away from psych. Also, many med students feel like they have something to prove - which doesn't lead to a career in psych.

 

[conchatumare]

The answer is Yes it will. Here's why. Psychiatry is in its technological development stage - as we continue to make strides in brain imaging and non-invasive stimulation therapies, suddenly you will see the beginnings of office procedures. And when THAT catches fire, when psychiatrists can start billing hundreds of dollars per procedure, more students will crowd the psychiatry space and competition will rise. At least that's my prediction.

Lets not forget prescribing Psychobiotics!

http://www.popsci.com/blog-network/...et-prozac-psychobiotics-are-future-psychiatry

 

[splik]

The answer is Yes it will. Here's why. Psychiatry is in its technological development stage - as we continue to make strides in brain imaging and non-invasive stimulation therapies, suddenly you will see the beginnings of office procedures. And when THAT catches fire, when psychiatrists can start billing hundreds of dollars per procedure, more students will crowd the psychiatry space and competition will rise. At least that's my prediction.

ha! its bad enough some psychiatrists are peddling pseudotechnologies like TMS, i think this sort of stuff actually makes psychiatry look more like a pseudoscience than increase its respectability

 

[EMDO2018]

I got a theory that the Myers Briggs personality type of someone that would love psychiatry is likely very far from the type of person interested in medical school, and thus most interested in mental health would enter psychology and not psychiatry. It's just a theory but I've noticed that with most medstudents being engineers, biologists, chemists, or something along those lines while in pre-med and so far having been in the humanities, psychology or sociology.

So while I'd love to hear more people are going into psych, the flip-side is more job opportunities and healthy security for me though I really wish more people would apply.

Agree with the above concerning money and ethics. Play it smart and you can make more money by being the better doctor that gives better care.

And being a psychiatrist you could have the free time to make money in ventures outside of practice. Not something I'd recommend for the medical fields where you push yourself and work 60+ hours/week.

INTJ?????

 

[PrideNeverDie]

ha! its bad enough some psychiatrists are peddling pseudotechnologies like TMS, i think this sort of stuff actually makes psychiatry look more like a pseudoscience than increase its respectability

it doesn't matter what it looks like. what matters is if there is clinical evidence of better outcomes and studies with significant differences. insurances reimbursing you for the procedures doesn't hurt either haha.

 

[oracle2]

As an older student psychiatry definitely appeals to me more, and the more relaxed and relatively low physical demands contribute to that. As a young person it's much easier to envision a lifetime of working long hours if you will be compensated well for it. ... once you start inching toward 30 you realize the value of time. Heck at 21 I thought my dream job was ibanking

 

[IamPsychiatrist]

As an older student psychiatry definitely appeals to me more, and the more relaxed and relatively low physical demands contribute to that. As a young person it's much easier to envision a lifetime of working long hours if you will be compensated well for it. ... once you start inching toward 30 you realize the value of time. Heck at 21 I thought my dream job was ibanking

As another non-trad, I agree. Early 20's you think you would be happy working 90 hrs/wk. Then you realize is just a big game and work isn't the point of life. Then ~40 hr weeks sound better.

 

[vistaril]

ha! its bad enough some psychiatrists are peddling pseudotechnologies like TMS, i think this sort of stuff actually makes psychiatry look more like a pseudoscience than increase its respectability

yep.....last survey on trust amongst the public I read showed the public's view of chiropractors and psychiatry exactly the same. We aren't going to make progress by moving towards mainstream in office tms. The sad thing is some chiropractor probably read the same survey and is wondering what they can do to distance themselves from chiropractors

 

[budda10000]

So basically psych is a hidden gem...

It pays according to the risk your willing to deal with. Primary care and internists also get paid out the wazoo for working in prisons. Here in CA the dept of corrections starts psychiatrists at 238k w/ full benefits for 40 hour/week and you can land a job in every corner of the state(lots of openings). Primary care/internists start at 250k/yr for the same position. Both jobs cap out at ~300k a yr base pay unless you move into management. Overtime is easily acquired and the pension is quite good(50% base pay for life @ 25 yrs I think). Prison docs can easily out-earn the lifetime salary of surgeons. I would be surprised to see the pension thing hang around, its seems unsustainable. The downside? Charles Manson is your patient

 

[notdeadyet]

Here in CA the dept of corrections starts psychiatrists at 238k w/ full benefits for 40 hour/week and you can land a job in every corner of the state(lots of openings).

As long as your define the corners of California as mostly places very few psychiatrist wants to live. With the exception of San Quentin and a couple others (which tend to be highly competitive) the vast majority of sites are in areas of the state they have trouble attracting people. California tends to build prisons in areas that few people want to live, for obvious reasons.

 

[MacDonaldTriad]

Plumbers are not known for the depth of their physics knowledge, but they all know that water seeks out its lowest point. When a job offers a third more pay than other jobs, there is a reason for that. When a job offers more money and they have lots of openings, there is a very good reason for that. You work long and hard to develop an earning potential, but not having money for so long makes it very difficult to put an accurate value on money. How much more misery is the extra money worth to you? Financial security means living below your means no matter how much you earn. Spending money on things that make you happy is nice unless you are miserable creating that disposable income.

I think it was at an APA convention in 1994 at the Fountain Blue in Miami. I was sitting at the bar and a Texan with an old fashion brick phone, cowboy boots, and a bolo tie was loudly talking to bankers moving money around trying to buy a yacht from the yacht show in the intercostal just in front of the hotel. After he hung up the phone, he must have become aware of his show of pretention because turned to me and said “Sonny, if it floats, flies, or f#%?ks RENT IT!”

 

[Blitz2006]

Well I've just started my residency in psych here in NYC. My attending this week said psych can make around 300-400k working in manhattan pp. Although he works 6 days a week as well...

Is this true or bs?

 

[jettavr6]

yep.....last survey on trust amongst the public I read showed the public's view of chiropractors and psychiatry exactly the same. We aren't going to make progress by moving towards mainstream in office tms. The sad thing is some chiropractor probably read the same survey and is wondering what they can do to distance themselves from chiropractors

So many "distrusting" patients seeking out psychiatrists that it can take more than 4 weeks to get an appointment - appointments for psychiatrists typically have the longest waiting times. Gotta love them surveys.

 

[jettavr6]

It pays according to the risk your willing to deal with. Primary care and internists also get paid out the wazoo for working in prisons. Here in CA the dept of corrections starts psychiatrists at 238k w/ full benefits for 40 hour/week and you can land a job in every corner of the state(lots of openings). Primary care/internists start at 250k/yr for the same position. Both jobs cap out at ~300k a yr base pay unless you move into management. Overtime is easily acquired and the pension is quite good(50% base pay for life @ 25 yrs I think). Prison docs can easily out-earn the lifetime salary of surgeons. I would be surprised to see the pension thing hang around, its seems unsustainable. The downside? Charles Manson is your patient

It works out higher for psychiatrists than primary care - at least that's how it was a few years ago when I worked in the system.