Psychiatry: Is it worth it?

[Maeloryne]

Hey guys,
I am currently an undergraduate student and I am a Psychology major. I have a pre-med concentration, so don't worry I am getting my science classes in! I want to become a Psychiatrist, but I have a few questions that I hope you guys can clarify:
1) Should a Psychiatrist become a DO or MD? What are the benefits to each?
2) Is the salary of a Psychiatrist worth it with all of the schooling debt?
3) Is it possible to have a family while being a Psychiatrist? Family is very important to me, but I will be in my early 30's when I finally become licensed and don't want to miss out on having my own family.

Any responses are appreciated - Thank you

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[freemontie]

Google searches:
1) "psychiatrists"+"DO vs. MD" site:forums.studentdoctor.net
2) "psychiatrists"+"salary"
3) "psychiatry"+"work life" site:forums.studentdoctor.net

Would give you a wealth of information. 15+ years of SDN conversations. Obviously these topics come up organically and regularly. If you know basic research skills you probably wouldn't bother making this thread.

 

[milesed]

1. does not matter
2. yes- same as any doctor
3. yes, depending on how you decide to work

 

[Maeloryne]

I actually just wanted input from people going through these things, not some web search. Jerk.

 

[MacDonaldTriad]

MD tend to match better than DOs given similar scores. DO schools tend to cost more so I would try the MD route first and DO second. Although some DO students state that DO was their intended preference, most people play it MD first then DO. MD schools are a bit harder to get into, but this by itself is an argument for trying.

 

[Mad Jack]

I actually just wanted input from people going through these things, not some web search. Jerk.

His advice is actually legit though. It'll dig up a bunch of prior threads on this same topic that can yield you thousands of useful responses instantly.

 

[sunlioness]

Hey guys,
I am currently an undergraduate student and I am a Psychology major. I have a pre-med concentration, so don't worry I am getting my science classes in! I want to become a Psychiatrist, but I have a few questions that I hope you guys can clarify:
1) Should a Psychiatrist become a DO or MD? What are the benefits to each?
2) Is the salary of a Psychiatrist worth it with all of the schooling debt?
3) Is it possible to have a family while being a Psychiatrist? Family is very important to me, but I will be in my early 30's when I finally become licensed and don't want to miss out on having my own family.

Any responses are appreciated - Thank you

1. In terms of actually being prepared to do the work, it doesn't matter. However, unless you have a passion for the osteopathic philosophy, I'd try the MD route first. Not because it's better, but because a lot of people still think it is.

2. Sure. You'll pay off your loans working as a psychiatrist. What the loans do do though is make it hard to leave the field of medicine if you ultimately decide you'd rather do something different.

3. Yep, it sure is. Probably one of the more friendly specialties to having a family and a life outside of work.

Best wishes!

 

[wolfvgang22]

Hey guys,
I am currently an undergraduate student and I am a Psychology major. I have a pre-med concentration, so don't worry I am getting my science classes in! I want to become a Psychiatrist, but I have a few questions that I hope you guys can clarify:
1) Should a Psychiatrist become a DO or MD? What are the benefits to each?
2) Is the salary of a Psychiatrist worth it with all of the schooling debt?
3) Is it possible to have a family while being a Psychiatrist? Family is very important to me, but I will be in my early 30's when I finally become licensed and don't want to miss out on having my own family.

Any responses are appreciated - Thank you

1. Doesn't really matter in most U.S. states
2. Yes, more than worth it as long as you don't take on abnormally high debt for a med student (at least keep your total educational debt under $300K for goodness sake - the less the better obviously)
3. Yes, very possible. This is one of the many major positives of being a psychiatrist.

 

[liquidshadow22]

can people comment on whether or not seeing acutely psychotic patients ever gets boring? I think these patients are absolutely fascinating, but I was wondering if that wears off after the 400th patient? Or is it really that every psych patient is different as an individual and that this always keeps things exciting?

 

[Baller MD]

can people comment on whether or not seeing acutely psychotic patients ever gets boring? I think these patients are absolutely fascinating, but I was wondering if that wears off after the 400th patient? Or is it really that every psych patient is different as an individual and that this always keeps things exciting?

Everything becomes routine if you do it enough times.

 

[OldPsychDoc]

Know what guys? I discharged a lady today after her second admission in a month for a rough post-partum psychosis.
Her husband brought in their baby, and if you could have seen the look on her face when she got to hold that little one again--finally...

Yeah. It's really worth it.

 

[Leo Aquarius]

It you want to be a physician, and you are drawn to mental illness, then it's definitely worth it. I'm a resident and so far I'm very happy with my decision. I have time for family every day, make 100K, will triple that later in my career, and still have time for family.

Thinking about fellowships, I'm considering addictions or pain training since many of my patients have concomitant pain and addictions issues that make treating their mental disorders that much more challenging.

 

[Bartelby]

can people comment on whether or not seeing acutely psychotic patients ever gets boring? I think these patients are absolutely fascinating, but I was wondering if that wears off after the 400th patient? Or is it really that every psych patient is different as an individual and that this always keeps things exciting?

Agree with the posters above, psychiatry is an excellent field with plenty of time for family life as well.

For psychotic patients there will not be the "novelty" factor of having never, for instance, seen a well-formed paranoid delusional system after you have seen many of them but I think it remains interesting. It puts your psychopathological skills into play to differentiate schizophrenia v bipolar v a number of other things that can look psychotic, and it is pretty fun to make the diagnosis and come up with a treatment plan. It's an opportunity to use a skill set that most other providers don't have (it's rare to see a family medicine doctor or internist who would be comfortable managing a new-onset psychotic disorder alone).

 

[fzwarrior]

It you want to be a physician, and you are drawn to mental illness, then it's definitely worth it. I'm a resident and so far I'm very happy with my decision. I have time for family every day, make 100K, will triple that later in my career, and still have time for family.

Thinking about fellowships, I'm considering addictions or pain training since many of my patients have concomitant pain and addictions issues that make treating their mental disorders that much more challenging.

You're making 100K in residency?

 

[Baller MD]

You're making 100K in residency?

Moonlighting.

 

[Leo Aquarius]

You're making 100K in residency?

Yes, moonlighting. One of my colleagues is making more in fact.

 

[chicagochildpsych]

I'm closing in on 500k, if you are passionate and enjoy your work don't worry about the specialty you choose.

 

[Baller MD]

I'm closing in on 500k, if you are passionate and enjoy your work don't worry about the specialty you choose.

PP right? Can't be an employed position.

 

[chicagochildpsych]

Yes, pp

 

[BritTrooper]

If you are ambitious and talented, I would recommend you go into a more high powered field. Opportunities and respect and really outstanding in the top tier specialties. Otherwise psychiatry is fine if you want a comfortable lifestyle and easily manageable cerebral workload.

 

[Nasrudin]

If you are ambitious and talented, I would recommend you go into a more high powered field. Opportunities and respect and really outstanding in the top tier specialties. Otherwise psychiatry is fine if you want a comfortable lifestyle and easily manageable cerebral workload.

What? I can't even.... Please elaborate.

 

[EMDO2018]

Is it possible to be a good psychiatrist if you have no faith in the medications? Some of the antidepressants I have taken seem to be no more than sugar pills.

 

[touchpause13]

Is it possible to be a good psychiatrist if you have no faith in the medications? Some of the antidepressants I have taken seem to be no more than sugar pills.

Are you serious?

Just because a particular med didn't work for you doesn't mean it doesn't work for anyone.

 

[erg923]

Is it possible to be a good psychiatrist if you have no faith in the medications? Some of the antidepressants I have taken seem to be no more than sugar pills.

Your personal experience is not an empirical study of the subject.

Its called evidence based medicine/practice, not personal bias medicine/practice for a reason, right?

 

[W19]

I'm closing in on 500k, if you are passionate and enjoy your work don't worry about the specialty you choose.

Oh boy!

 

[W19]

If you are ambitious and talented, I would recommend you go into a more high powered field. Opportunities and respect and really outstanding in the top tier specialties. Otherwise psychiatry is fine if you want a comfortable lifestyle and easily manageable cerebral workload.

Seriously! I can't believe a resident writes this nonsense...

 

[jettavr6]

If you are ambitious and talented, I would recommend you go into a more high powered field. Opportunities and respect and really outstanding in the top tier specialties. Otherwise psychiatry is fine if you want a comfortable lifestyle and easily manageable cerebral workload.

Some of the greatest opportunities right now are in neuro-science. Are you sure you aren't Vistaril?

 

[vistaril]

I'm closing in on 500k, if you are passionate and enjoy your work don't worry about the specialty you choose.

nice....Im going to do over 400 but Im having to hustle to do it. No true pp positions either.

 

[vistaril]

Your personal experience is not an empirical study of the subject.

Its called evidence based medicine/practice, not personal bias medicine/practice for a reason, right?

well to be fair, depending on how you look at the evidence based side of it, his statement wouldn't be completely off base(at least for patients with dysthymia and antidepressants)

 

[EMDO2018]

Moonlighting.

How many extra shifts is that? And what city?

 

[W19]

nice....Im going to do over 400 but Im having to hustle to do it. No true pp positions either.

Wait! I remember reading some of your posts where you said it's quasi impossible to make that kind of salary in psych... Do you work over 65 hrs/week?

 

[Mad Jack]

Wait! I remember reading some of your posts where you said it's quasi impossible to make that kind of salary in psych... Do you work over 65 hrs/week?

I also remember him saying he took a pay cut so he could take the appropriate amount of time with patients and that his group wasn't thrilled about it, if I recall correctly.

 

[Mad Jack]

Is it possible to be a good psychiatrist if you have no faith in the medications? Some of the antidepressants I have taken seem to be no more than sugar pills.

Your issues seem to be more related to lifestyle than a chemical imbalance of some sort, from what I've gathered. I wouldn't put that one on the antidepressants- you probably shouldn't have been prescribed them in the first place.

 

[touchpause13]

Your issues seem to be more related to lifestyle than a chemical imbalance of some sort, from what I've gathered. I wouldn't put that one on the antidepressants- you probably shouldn't have been prescribed them in the first place.

One of the physicians please correct me if I'm wrong but I always believed that antidepressants don't really do anything if you don't actually have depression.

 

[StilgarMD]

One of the physicians please correct me if I'm wrong but I always believed that antidepressants don't really do anything if you don't actually have depression.

I'm sure you're also aware that there are plenty of people with depression for whom it does nothing. I don't think you can really retroactively diagnose someone based on whether a medication worked (at least not in this case)

 

[touchpause13]

I'm sure you're also aware that there are plenty of people with depression for whom it does nothing. I don't think you can really retroactively diagnose someone based on whether a medication worked (at least not in this case)

Yup I'm aware of that as well and agree.

 

[smalltownpsych]

Also, there are many people who have problems with addictive substances who don't feel that psychotropics do much of anything because compared to meth or hydro's or even alcohol - they just aren't going to feel the more subtle and delayed effects of a SSRI, for example.

 

[touchpause13]

Interesting, I didn't know that

 

[OldPsychDoc]

Also, there are many people who have problems with addictive substances who don't feel that psychotropics do much of anything because compared to meth or hydro's or even alcohol - they just aren't going to feel the more subtle and delayed effects of a SSRI, for example.

I call it "trying to taste the savory mushroom in the Thai curry".

 

[erg923]

A cornerstone (if you will) of psychotherapy, cognitive models/orientation in particular is the notion of self agency, and to a lesser degree, increasing internal locus of control. If we buy this premise, then psychotropics for mild or even moderate depression seems quite counter therapeutic. At least to me...

 

[vistaril]

Wait! I remember reading some of your posts where you said it's quasi impossible to make that kind of salary in psych... Do you work over 65 hrs/week?

I probably average 57-60 total hours per week. I'm also very efficient. I don't think my base pay or contracts are better or worse than most. I get to that salary by working more than most and being more efficient(with the stuff that isn't hourly) than most.

 

[W19]

I probably average 57-60 total hours per week. I'm also very efficient. I don't think my base pay or contracts are better or worse than most. I get to that salary by working more than most and being more efficient(with the stuff that isn't hourly) than most.

I guess you are smiling all the way to the bank... Good to know there is also money in psych if one is efficient and willing to work the hours.

 

[Frazier]

I guess you are smiling all the way to the bank... Good to know there is also money in psych if one is efficient and willing to work the hours.

Vistaril doesn't always smile, but when he does, it's when he's on the way to the bank.

 

[Baller MD]

I probably average 57-60 total hours per week. I'm also very efficient. I don't think my base pay or contracts are better or worse than most. I get to that salary by working more than most and being more efficient(with the stuff that isn't hourly) than most.

How do you become more efficient in psych?

 

[Shikima]

How do you become more efficient in psych?

How do you get to Carnegie Hall?

 

[Baller MD]

How do you get to Carnegie Hall?

I mean do you write a brief H and P and progress note, etc.? Thanks for the sarcasm.

 

[vistaril]

I mean do you write a brief H and P and progress note, etc.? Thanks for the sarcasm.

Relevant(ie non copied and pasted) part of Progress note(say an inpatient on day 4 with schizoaffective dx admitted for being agitated/psychotic/whatever): denies avh. Still some paranoia related to neighbors possibly following him. Denies ior. No si. Mood is 'fine'. Denies side effects from meds. Sleep, energy, appetite all 'ok'. Staff reports he hasn't appeared agitated last 24 hrs and no major incidents.
Mse: copied and pasted(may alter a word or two)
Assessment: copied and pasted(may alter a word or two)
Plan: increase Risperdal to 4mg qhs
(Some other stuff in the daily plan copied and pasted)

That shouldn't take more than a minute. Notes should be a VERY SMALL allotment of your total clinical time.

 

[vistaril]

I guess you are smiling all the way to the bank... Good to know there is also money in psych if one is efficient and willing to work the hours.

There is more money in general medicine for people who want to work hard and be efficient though. Bringing the same number of hours and efficiency to inpatient medicine, for example, and I really believe I'd make 40 percent more. You would have to juggle the right sort of hospitalist contracts that allowed for flexibility of course.

 

[nitemagi]

A cornerstone (if you will) of psychotherapy, cognitive models/orientation in particular is the notion of self agency, and to a lesser degree, increasing internal locus of control. If we buy this premise, then psychotropics for mild or even moderate depression seems quite counter therapeutic. At least to me...

Not necessarily. Patients choose to pursue treatment. They choose to take their medications. Self agency (IMO) is inherent in the choices we make. How we act, and how we choose to respond to a situation. Taking medication is a choice, and therefore can be a daily reminder of choosing to pursue health.

How would it be "counter" therapeutic?

 

[Mad Jack]

There is more money in general medicine for people who want to work hard and be efficient though. Bringing the same number of hours and efficiency to inpatient medicine, for example, and I really believe I'd make 40 percent more. You would have to juggle the right sort of hospitalist contracts that allowed for flexibility of course.

Yeah, but you'd be juggling a whole lot more patients.