Is Psychiatry becoming more competitive a good or bad thing?

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twospadz

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Not to confirm or refute any claims above, I don't see how having more qualified candidates on paper would be a bad thing. Obviously it would not be a good thing for the average applicant.
 
Not to confirm or refute any claims above, I don't see how having more qualified candidates on paper would be a bad thing. Obviously it would not be a good thing for the average applicant.

Short-term, a good thing, as more patients can access services.

Long term, a bad thing, as the demand for psychiatry training will create increasing numbers of positions to meet this demand, eventually saturating the market and precipitating decreasing compensation and employment issues. Look to pathology and radiology for examples.
 
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Short-term, a good thing, as more patients can access services.

Long term, a bad thing, as the demand for psychiatry training will create increasing numbers of positions to meet this demand, eventually saturating the market and precipitating decreasing compensation and employment issues. Look to pathology and radiology for examples.

Most of us will be established on the downswing of middle age or retired y the time psych is capable of saturating.

And, child psych is currently in a tailspin.
 
I question if the number of training slots for psychiatry will increase with any increase in interest in Psych. As it is, seems like programs expand and contract at will despite a very week interest in psych by US MD graduates. I also question how much more competitive psych has become. I do agree that if we doubled our psych slots, pay would go down.
 
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It's only good if the quality of applicants are good. More academically oriented (MDPhDs, others interested in research) are going into psych, as are more people from top 10 US med schools (just observationally, I don't have data on this one), so that is good. However, there are also a lot of very mediocre and low quality people going into it as well, which is not a good thing (but then where else do they go? you need damn smart people in primary care as well).

Truthfully I would take a smart DO or FMG with high scores and work ethic with an intellectual passion for psychiatry over a mid/bottom tier US MD any day
 
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I think it's transient competitiveness due to increased paranoia of other fields. Once ppl start getting paranoid about prescribing psychologists and mental health nurses they'll go back to wanting Gas and other fields.
 
I think the stigma on mental illness will probably keep psychiatry from becoming super-competitive (at least during our generation), but I don't see any real downside to having more of the most intelligent doctors flocking to the field if it did somehow become known as one of the big lifestyle specialties. Even non-competitive specialties still benefit from having very intelligent and qualified docs. For example, I think even though primary care has a low barrier to entry, it takes a tremendous amount of intelligence, knowledge, and skill to truly master primary care. Likewise, with psychiatry - even if we do have some people in our specialty because they couldn't get into the specialty they really wanted, to be a truly great psychiatrist isn't easy.

How is it that Derm has been able to protect their profession so much better than other specialties such as Path and Rads? There would be plenty of justification for increasing derm residency slots with the number of people wanting to go into derm - but you don't see that happening, and you also don't hear much about NPs taking over Derm. Man, the dermatologists really are smarter than the rest of us are. :)
 
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How is it that Derm has been able to protect their profession so much better than other specialties such as Path and Rads? There would be plenty of justification for increasing derm residency slots with the number of people wanting to go into derm - but you don't see that happening, and you also don't hear much about NPs taking over Derm. Man, the dermatologists really are smarter than the rest of us are. :)
It's true you don't hear much about NPs taking over derm. I wonder if it's just a matter of time though.

http://archderm.jamanetwork.com/article.aspx?articleid=1895673

"Nurse practitioners and physician assistants billed independently for more than 4 million procedures at our cutoff of 5000 paid claims per procedure. Most (54.8%) of these procedures were performed in the specialty area of dermatology."
 
What do you mean?

Could you please expound upon this?

Hmm, I may be chicken-littling here. After reviewing match data, it appears static. We're getting about 290 a year, and US Allo percentage has been static (not a perfect metric I know). However, perception amongst the child psychiatrists I know is that it's getting harder to recruit the really talented ones into child. Three programs I'm familiar with that traditionally filled with their choice of candidates, have had to scramble over the last two years. The two programs I've most recently been affiliated with have struggled to get their best and brightest to go into child, whereas historically there was no such issue.

*Shrug* Maybe we all need CBT.
 
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It's true you don't hear much about NPs taking over derm. I wonder if it's just a matter of time though.

http://archderm.jamanetwork.com/article.aspx?articleid=1895673

"Nurse practitioners and physician assistants billed independently for more than 4 million procedures at our cutoff of 5000 paid claims per procedure. Most (54.8%) of these procedures were performed in the specialty area of dermatology."

I would imagine it is only a matter of time as the numbers of NP grads increase exponentially. As I've lamented before the kicker is very few schools require RN experience now and in fact most are encouraging undergraduate students to remain in school without working in an effort to retain their tuition. The original intent of the brief, superficial NP education as compared to medical school was justified as building on the years of solid nursing experience and as such the flimsy nursing research articles touting similar outcomes MD vs NP are no longer of any value if they ever really were. The assertion that the shortage of providers is a justification to push through any one with a checkbook who can fog up a mirror held close under their nose is disgusting. That physicians groups aren't grabbing this bull by the horns continues to surprise me. I wonder if most physicians or even the general public is aware of this new trend, that the fresh faced 22yo diagnosing and writing a prescription for your kid probably only had one or two pharmacology courses. Not that this would address all the woes but mandating a set number of years of RN experience in the NP specialty they are pursuing or mandatory fellowships would be a reasonable and relatively easy accommodation which would keep the University bean counters happy because no negative effect on their bottom line.

http://www.amednews.com/article/20120702/business/307029951/6/
 
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Psychiatry is becoming more competitive, but so is everything, psych still has one of the lowest average step 1 scores on the charting outcomes. The average for psych may have went up from 218-222, but the average for FM did the same thing, and the average for EM went from 23o-235.
 
Psychiatry is becoming more competitive, but so is everything, psych still has one of the lowest average step 1 scores on the charting outcomes. The average for psych may have went up from 218-222, but the average for FM did the same thing, and the average for EM went from 23o-235.


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This was posted on the anesthesia forum.

Its all relative, yes everything is going up. So the question is, which specialties are going up at a faster rate.


For Step 1, after a quick eyeball, it seems like the most raw increases are:

1) Rad Onc/ PMR (+6)
2) Neurosurg/Plastics (+5)
3) Psych/Peds (+4)

But of course, Psych's baseline, 2014 step 1 score is much lower than the other 4 specialities, so that needs to be taken into consideration.

The specialties which seem to have performed the "worst" for step 1 are:

1) Rads (-1)
2) ENT (0)

So the question is, will psych continue to increase 2 points each year for the next 5 years vs. others that are increasing 0-1 point per year? I personally think so, because in 2011, Psych Step 1 average was 214. So in the past 6 years, (2011-2016), psych has gone up 10 points (214-224) or 1.67 pts/year (compared to IM, 226-233, 7 points for example or anesthesia, 226-232, 6 points or Rads stuck at 240 over the same 6 year period). And therefore, psych gradually narrowing the difference.


For discussion sake (2011-2016), PMR has an impressive 12 point increase (214-226). Everyone is raving about how EM has joined "ROAD", but they also increased the same 10 points just like psych (223-233) over the 6 period.

http://www.nrmp.org/wp-content/uploads/2013/08/chartingoutcomes2011.pdf


Only time will tell, but I suspect by 2020 Psych will have closed the gap on mid-tier specialties (GSurg/OBGYN/Gas/IM/Rads), only 2-3 pts behind. I don't see why Psych can't maintain current rate of competitiveness for the next few years.
 
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Why not just assume that Family Medicine is going to be at a 230 by 2020 as well with that logic. Hell, why not assume that Rads onc will be 270 by then too.
 
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Isn't there a score compression trend happening over time with the bottom half and median rising, but the upper half not necessarily going up?
 
Here's my question though. Do you guys legitimately think that it's due to people having more of an interest in psychiatry or whether it's the same people who want a lifestyle specialty that is driving PM&R to be more competitive?
Do you think that in the end more competitive applicants simply drowns out the people who legitimately want to be psychiatrists with people who are half hearted about it but want to work a 8 to 5 job?
 
Here's my question though. Do you guys legitimately think that it's due to people having more of an interest in psychiatry or whether it's the same people who want a lifestyle specialty that is driving PM&R to be more competitive?
Do you think that in the end more competitive applicants simply drowns out the people who legitimately want to be psychiatrists with people who are half hearted about it but want to work a 8 to 5 job?

Definitely lifestyle. Why do you think Derm/Ophtho are top dogs? LIFESTYLE. Only difference is, not everyone can get 250s. So next bet is PMR/Psych. I mean, I obviously have no data to back this up, and this is my opinion only, but do you really think if Derm had Primary Care Pay and were expected to work 50-60 hour weeks/weekends, it would be super competitive? I doubt it.

So yes, unfortunately, competitiveness may have a downside in that it may drown out people of sincere interest in psych. But then again, you can say that about any speciality right? I'm sure there are lots of people with 210s who sincerely love Derm or ENT or Plastics...but c'est la vie.
 
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Definitely lifestyle. Why do you think Derm/Ophtho are top dogs? LIFESTYLE. Only difference is, not everyone can get 250s. So next bet is PMR/Psych. I mean, I obviously have no data to back this up, and this is my opinion only, but do you really think if Derm had Primary Care Pay and were expected to work 50-60 hour weeks/weekends, it would be super competitive? I doubt it.

So yes, unfortunately, competitiveness may have a downside in that it may drown out people of sincere interest in psych. But then again, you can say that about any speciality right? I'm sure there are lots of people with 210s who sincerely love Derm or ENT or Plastics...but c'est la vie.


Well that's the thing, Psych is only a lifestlye specialty on the surface. It has an extremely high rate of people quiting every year.
I'll humor the notion that FM is also a quazi-life style specialty too tbh. Sure it's not a strict 40 hour job, but ppl can easily find a pretty good balance and lifestyle for sure.


Also I think psych especially recruits on a whole person case.
 
Why not just assume that Family Medicine is going to be at a 230 by 2020 as well with that logic. Hell, why not assume that Rads onc will be 270 by then too.

You missed my point. Everything is indeed going up. I was trying to show that competitiveness can be measured by the rate of change.

Look at 2009:

http://www.nrmp.org/wp-content/uploads/2013/08/chartingoutcomes2009v3.pdf

The big guns, Derm/ENT were around 240ish (241/242). Now they are around 250ish. So roughly 8-9 point jump in 8 years. Now Radiology, which was once part of the "holy grail", was 238 in 2009, and now only 240 8 years later. So even Rads went "up", but the rate is obviously much slower and clearly it is no longer a "ROAD" specialty.

Interesting enough, psych went DOWN 2 points from 2009 to 2011 (216 to 214). So +4 gain these past 2 years isn't anything to sneeze at.
 
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You missed my point. Everything is indeed going up. I was trying to show that competitiveness can be measured by the rate of change.

Look at 2009:

http://www.nrmp.org/wp-content/uploads/2013/08/chartingoutcomes2009v3.pdf

The big guns, Derm/ENT were around 240ish (241/242). Now they are around 250ish. So roughly 8-9 point jump in 8 years. Now Radiology, which was once part of the "holy grail", was 238 in 2009, and now only 240 8 years later. So even Rads went "up", but the rate is obviously much slower and clearly it is no longer a "ROAD" specialty.

Interesting enough, psych went down from 2 points from 2009 to 2011 (216 to 214). So +4 gain these past 2 years isn't anything to sneeze at.

Rads & Gas are suffering paranoia in short term market. Once it chills out it'll balance out.

Also if we're talking baseline, i.e FM = 100% match rate almost for everyone, that any specialty close to that number probably has a very low competitiveness.
 
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Rads & Gas are suffering paranoia in short term market. Once it chills out it'll balance out.

Maybe, lets see this year with the DR and IR going separate paths, will be interesting to see how DR holds up.
 
Well that's the thing, Psych is only a lifestlye specialty on the surface. It has an extremely high rate of people quiting every year.
I'll humor the notion that FM is also a quazi-life style specialty too tbh. Sure it's not a strict 40 hour job, but ppl can easily find a pretty good balance and lifestyle for sure.

Is this actually true? I normally think of the high-burnout specialities as those that are either high pressure (EM) or high workload (some surgical fields).
 
Can somebody tell me why people say psych is fun to read about but its horrible to practice? I haven't had my psych rotation yet, but academically I find it really interesting, it was my favorite block during the first 2 years favorite subject to study for step 1, I don't mind talking to patients, but if I don't want to do therapy, I can just do med checks right?
 
Can somebody tell me why people say psych is fun to read about but its horrible to practice? I haven't had my psych rotation yet, but academically I find it really interesting, it was my favorite block during the first 2 years favorite subject to study for step 1, I don't mind talking to patients, but if I don't want to do therapy, I can just do med checks right?

People say that because unfortunately medical students only get a snapshot of Psychiatry. Most only spend 4 weeks on inpatient unit, see some patients stabilized, and most of the time see patients waiting for social worker to find placement. 4 weeks inside a locked unit.

While inpatient psych is obviously an integral and crucial part of our field, it certainly is not representative of Psychiatry as a whole.

There is outpatient clinic, forensic jails, partial programs, methadone clinics, suboxone clinics, consult service, ER.... Just to name a few. But I doubt most med students experience these settings in their core psych rotation.

Plus there are tons of subspecialties, from addiction to child to sleep to geriatric to neuropsychiatry. So while reading about how methadone and suboxone work is fascinating to read about, if you only spend time in an inpatient unit you are unlikely to witness the clinical efficacy of these drugs in the real world.

Someone can correct me if I'm wrong, but I'm fairly certain around the country only 10%" do therapy, and they are concentrated in a few cities (NY, SF, Chicago).
 
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Is this actually true? I normally think of the high-burnout specialities as those that are either high pressure (EM) or high workload (some surgical fields).

I think someone on this forum showed that it was nearly 2% higher than the next leading ( ex. 5% v.s 7%).
I imagine in the end working with difficult populations or having to double guess yourself on whether your patient is legitimate and or dispensing medicine that can be abused is something that wears someone down over time. Hell, talking to some people about their problems can leave you exhausted in your general day.
 
Here's my question though. Do you guys legitimately think that it's due to people having more of an interest in psychiatry or whether it's the same people who want a lifestyle specialty that is driving PM&R to be more competitive?
Do you think that in the end more competitive applicants simply drowns out the people who legitimately want to be psychiatrists with people who are half hearted about it but want to work a 8 to 5 job?

The difference with psychiatry, though, is that a lot of people just can't stand the patients or the field. The other lifestyle specialties are, for the most part, still "traditional" medicine specialties. I think most people don't mind them as a result, and it's simply a question of what field is the most interesting to them and/or what they can realistically match into.

I've found that very few students seem to actually have much interest in psych - sometimes because they don't find the actual medicine interesting, sometimes because they don't like that it is quite different from what you spend 95% of your time doing in medical school, and sometimes because they can't stand the patients. I think the pre-requisite of being able to "deal with" psychiatric patients will always be there. There will be other options for those that aren't interested in psychiatry but value lifestyle. It's not as if psychiatry is the only lifestyle field around. And there are fields that run the gamut from non-competitive (e.g., PM&R, pathology) to competitive (e.g., derm) that also offer lifestyle benefits. There's no reason to for someone to go into psychiatry just for the lifestyle. Even the most uncompetitive applicant has other options that will fit that single criterion if psych isn't their "passion."
 
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Here's my question though. Do you guys legitimately think that it's due to people having more of an interest in psychiatry or whether it's the same people who want a lifestyle specialty that is driving PM&R to be more competitive?
Do you think that in the end more competitive applicants simply drowns out the people who legitimately want to be psychiatrists with people who are half hearted about it but want to work a 8 to 5 job?

Lifestyle. Eventually, most of us grow up and realize that our personal lives are actually pretty important, and that the quality of our own lives is more important than some notion of self-sacrificial altruism, a notion that most med students are lying about anyways. It would be nice if, as a profession, we can get over this anathema towards self-interest. It's all a façade anyways.

The high levels of stress, low job satisfaction, and burnout are partially self-imposed. We do have the power to stop such nonsense. The first step is putting the responsibility of health back where it belongs -- the patient.
 
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Lifestyle. Eventually, most of us grow up and realize that our personal lives are actually pretty important, and that the quality of our own lives is more important than some notion of self-sacrificial altruism, a notion that most med students are lying about anyways. It would be nice if, as a profession, we can get over this anathema towards self-interest. It's all a façade anyways.

The high levels of stress, low job satisfaction, and burnout are partially self-imposed. We do have the power to stop such nonsense. The first step is putting the responsibility of health back where it belongs -- the patient.


So where do you think the averages will be for psych in 2020?
 
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So where do you think the averages will be for psych in 2020?

Averages of what? Step I? I have no idea. I don't imagine it will change much in 4 years. Probably still under 230? As others have mentioned, psych is somewhat protected from an abundance of applicants due to the nature of the work and field itself, and the general sense that it's the least, "mediciney" of all the specialties. Even then, child is probably the more lucrative area of psych, and even most psychiatrists don't want to do child psych. I get offers all the time for $280k-$320k. The demand is absurd, and the supply is incredibly low. Sometimes, however, there is a reason why supply is low...
 
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Averages of what? Step I? I have no idea. I don't imagine it will change much in 4 years. Probably still under 230? As others have mentioned, psych is somewhat protected from an abundance of applicants due to the nature of the work and field itself, and the general sense that it's the least, "mediciney" of all the specialties. Even then, child is probably the more lucrative area of psych, and even most psychiatrists don't want to do child psych. I get offers all the time for $280k-$320k. The demand is absurd, and the supply is incredibly low. Sometimes, however, there is a reason why supply is low...

Based on some of the patients I've inherited, I wish the supply was lower sometimes.
 
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Averages of what? Step I? I have no idea. I don't imagine it will change much in 4 years. Probably still under 230? As others have mentioned, psych is somewhat protected from an abundance of applicants due to the nature of the work and field itself, and the general sense that it's the least, "mediciney" of all the specialties. Even then, child is probably the more lucrative area of psych, and even most psychiatrists don't want to do child psych. I get offers all the time for $280k-$320k. The demand is absurd, and the supply is incredibly low. Sometimes, however, there is a reason why supply is low...

I disagree somewhat with your first part. You are right, psych is obviously less "mediciney". But I noticed on this forum (not just your post), people tend to portray psych as some vague, hippy specialty that is far removed from the 'medical world'. I understand that psych is unique, but I dunno, I feel like a 'good' psychiatrist integrates medical knowledge into their practice. For instance few months, in clinic I got a patient that was on effexor 375 mg, and he told me that he recently was also started on HTN meds. His MDD wasn't treated adequately which is why PMD referred to Psych (yes, I was shocked that PMD on his own accord titrated effexor up to 375 before consulting psych). After tailoring patient off effexor and switching to remeron, MDD has been treated, and patient's BP actually went down so much that PMD took patient off norvasc. So most likely effexor was causing HTN? But anyways, my point is, I feel like psychiatrists if they want to, can make their field 'mediciney' even when treating MDD/Bipolar/GAD, etc. (ie, checking vitals, monitoring labs). Even for management, while we are not regimented like internists treating HTN or Endocrinologists treating DM, we still do have some guidelines/symptom scales for treating MDD, GAD, Schizophrenia, its just a bit more flexible.

And yes, we don't physically examine patients, but we still take histories from patients, prescribe medications, review some neuroimaging, review routine labs, which is more than what a lot of other 'doctors' do (ie. pathologists, radiologists, etc). So while we don't fit the textbook definition of a doctor (steth around neck, white coat, etc), we are not the only speciality that doesn't either. So I dunno, I'm not sure we can keep using that we are not "real doctors" as a cop out excuse of why psych isn't as competitive as it can be.

I personally think it all comes down to reimbursing/lifestyle with regards to competitiveness. I'm certain if psych had starting salaries of 400k like certain surgical specialties, we wouldn't be having this conversation.

Just my 2 cents.
 
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I disagree somewhat with your first part. You are right, psych is obviously less "mediciney". But I noticed on this forum (not just your post), people tend to portray psych as some vague, hippy specialty that is far removed from the 'medical world'. I understand that psych is unique, but I dunno, I feel like a 'good' psychiatrist integrates medical knowledge into their practice. For instance few months, in clinic I got a patient that was on effexor 375 mg, and he told me that he recently was also started on HTN meds. His MDD wasn't treated adequately which is why PMD referred to Psych (yes, I was shocked that PMD on his own accord titrated effexor up to 375 before consulting psych). After tailoring patient off effexor and switching to remeron, MDD has been treated, and patient's BP actually went down so much that PMD took patient off norvasc. So most likely effexor was causing HTN? But anyways, my point is, I feel like psychiatrists if they want to, can make their field 'mediciney' even when treating MDD/Bipolar/GAD, etc. (ie, checking vitals, monitoring labs). Even for management, while we are not regimented like internists treating HTN or Endocrinologists treating DM, we still do have some guidelines/symptom scales for treating MDD, GAD, Schizophrenia, its just a bit more flexible.

And yes, we don't physically examine patients, but we still take histories from patients, prescribe medications, review some neuroimaging, review routine labs, which is more than what a lot of other 'doctors' do (ie. pathologists, radiologists, etc). So while we don't fit the textbook definition of a doctor (steth around neck, white coat, etc), we are not the only speciality that doesn't either. So I dunno, I'm not sure we can keep using that we are not "real doctors" as a cop out excuse of why psych isn't as competitive as it can be.

I personally think it all comes down to reimbursing/lifestyle with regards to competitiveness. I'm certain if psych had starting salaries of 400k like certain surgical specialties, we wouldn't be having this conversation.

Just my 2 cents.

I think it is more the nature of the work. Medicine as a field attracts a lot of folks who get uncomfortable interacting with a given patients for more than 5-10 minutes. The surgical friends I have dread clinic as though apocalypse is coming each time they go. At 400k starting, sure a lot more people would be interested, but there would still be folks who just want no part of really getting to know a patient. I think many folks in FP and peds would love to jump over to psych if it paid 2x what they make however.
 
I think it is more the nature of the work. Medicine as a field attracts a lot of folks who get uncomfortable interacting with a given patients for more than 5-10 minutes. The surgical friends I have dread clinic as though apocalypse is coming each time they go. At 400k starting, sure a lot more people would be interested, but there would still be folks who just want no part of really getting to know a patient. I think many folks in FP and peds would love to jump over to psych if it paid 2x what they make however.

There are people in my class that fall into this description too.
While Derm and Psych are compared commonly, I think another major reason that Derm is so competitive is due to the fact that it is also far more lucrative in general. I think the average psych makes 200k, the average derm is closer to 300.


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There are people in my class that fall into this description too.
While Derm and Psych are compared commonly, I think another major reason that Derm is so competitive is due to the fact that it is also far more lucrative in general. I think the average psych makes 200k, the average derm is closer to 300.

Derm's salary is nearly 100% of the reason it is so competitive . Independently, we need a $$ emoji!
 
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I personally think it all comes down to reimbursing/lifestyle with regards to competitiveness. I'm certain if psych had starting salaries of 400k like certain surgical specialties, we wouldn't be having this conversation.

Just my 2 cents.

Whats the difference between 280k and 400k? A lot of people don't want to do psych because of the stigma associated with mental illness, and the lack of diagnostic test and objectivity makes students and attendings in other specialties say psuchiatrist aren't " real" doctors.
 
Whats the difference between 280k and 400k? A lot of people don't want to do psych because of the stigma associated with mental illness, and the lack of diagnostic test and objectivity makes students and attendings in other specialties say psuchiatrist aren't " real" doctors.

The difference between 280 and 400k is nearly 100k extra in disposable and/or investable income a year. It cuts the time to get to "#$^&# you money" in half.
Video reference.

At the pay rate I'm about to accept (academic), I have basically no chance of getting there while I'm young enough to enjoy it. Still going to make the same choice, still glad I did, but yeah, it matters.
 
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Derm's salary is nearly 100% of the reason it is so competitive . Independently, we need a $$ emoji!

I don't understand why reimbursements are so high in Derm tho. Not to mention I don't understand why Derm does so much of what it does. I think adding a 1 year derm fellowship for FM doctors would reduce a lot of wait time for random crap like cyst expression.
 
I don't understand why reimbursements are so high in Derm tho. Not to mention I don't understand why Derm does so much of what it does. I think adding a 1 year derm fellowship for FM doctors would reduce a lot of wait time for random crap like cyst expression.


FM should do what the NPs do, and just add a one year fellowship for whatever lucrative thing they want to do, GI fellowship= scopes, Derm fellowship= derm stuff, etc
 
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The difference between 280 and 400k is nearly 100k extra in disposable and/or investable income a year. It cuts the time to get to "#$^&# you money" in half.
Video reference.

At the pay rate I'm about to accept (academic), I have basically no chance of getting there while I'm young enough to enjoy it. Still going to make the same choice, still glad I did, but yeah, it matters.



Yeah I agree with this. 120k/year is a big difference.

Like I said earlier, I think this whole "stigma" thing is blown out of proportion. If Psych was crushing an easy 400k, I don't think that many people will care about "stigma". Outside of the medical world, I'm pretty sure society regards derm and psych on similar levels of "prestige". I'm fairly certain most non-medical people are not aware that Derm is the pinnacle of medicine (like we do inside the medical world). They usually think things like plastics and neurosurgery are the cream of the crop. Yet Plastics and Neurosx aren't part of the elite "ROAD" specialties. Because we know that Derm makes 500k crunching 9-5 hours, while Neuosurg hits maybe 700k-800k, but with crazy hours and ridiculous malpractice, things people don't consider.

The bright side is psych is going up on reimbursements (while most others are coming down), and hopefully simple economics of supply and demand continue to drive our stock up.
 
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I'm fairly certain most non-medical people are not aware that Derm is the pinnacle of medicine (like we do inside the medical world). They usually think things like plastics and neurosurgery are the cream of the crop.

Some people probably don't even think of Derms as "real doctors" (in the sense that surgeons, primary care docs, and EM docs are "real"). I suspect that Derms probably don't lose a lot of sleep over that though.
 
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Short-term, a good thing, as more patients can access services.

Long term, a bad thing, as the demand for psychiatry training will create increasing numbers of positions to meet this demand, eventually saturating the market and precipitating decreasing compensation and employment issues. Look to pathology and radiology for examples.
We're short enough psychiatrists that I doubt any of us will be out of a job in our working lifetimes. Another big difference with psych is that if you're good, there's a market for cash therapy, something that I doubt will change in the future, because a good psychiatrist is tough to find.
 
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Hmm, I may be chicken-littling here. After reviewing match data, it appears static. We're getting about 290 a year, and US Allo percentage has been static (not a perfect metric I know). However, perception amongst the child psychiatrists I know is that it's getting harder to recruit the really talented ones into child. Three programs I'm familiar with that traditionally filled with their choice of candidates, have had to scramble over the last two years. The two programs I've most recently been affiliated with have struggled to get their best and brightest to go into child, whereas historically there was no such issue.

*Shrug* Maybe we all need CBT.
Child psych is just a rough field- I love psych, but C&A is brutal and not for me. I have a feeling a lot of others feel the same way.
 
Child psych is just a rough field- I love psych, but C&A is brutal and not for me. I have a feeling a lot of others feel the same way.

I think I could do adolescent. But child psych no. I don't understand kids, but I understand when a kid is hurt and suffering. I wouldn't be able to separate my life from job.
 
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At the pay rate I'm about to accept (academic), I have basically no chance of getting there while I'm young enough to enjoy it. Still going to make the same choice, still glad I did, but yeah, it matters.

Say it ain't so! Why is it ok for academia to expect so much while offering insultingly low rates and in the end rob a skilled physician like yourself of your FU stash?
 
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Child psych is just a rough field- I love psych, but C&A is brutal and not for me. I have a feeling a lot of others feel the same way.
SO I guess you've done your psych rotation, how is child brutal? My guess would be the parents helicoptering and what not. The only rotations I have done are OB/gyn ( :dead:ptsd from that one) and a couple of electives.
 
Yeah I agree with this. 120k/year is a big difference.

Like I said earlier, I think this whole "stigma" thing is blown out of proportion. If Psych was crushing an easy 400k, I don't think that many people will care about "stigma". Outside of the medical world, I'm pretty sure society regards derm and psych on similar levels of "prestige". I'm fairly certain most non-medical people are not aware that Derm is the pinnacle of medicine (like we do inside the medical world). They usually think things like plastics and neurosurgery are the cream of the crop. Yet Plastics and Neurosx aren't part of the elite "ROAD" specialties. Because we know that Derm makes 500k crunching 9-5 hours, while Neuosurg hits maybe 700k-800k, but with crazy hours and ridiculous malpractice, things people don't consider.

The bright side is psych is going up on reimbursements (while most others are coming down), and hopefully simple economics of supply and demand continue to drive our stock up.

Yep, back in the day rads and anesthesia were low prestige and pretty much full of IMGs. Then they became super competitive and well-respected although both are now having their issues (nurse anesthetists with gas, over-saturation with rads). We might go the same way -- super cool for a bit and then over-saturated with falling wages due to NPs and maybe even too many actual psychiatrists if they open all these proposed residency programs.

I'd like to make $400k/year. Hell, I'd like to make $300k without being required to work every other weekend to pull it off.
 
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