Psychiatry vs Clinical Psychology

[deleted388502]

Hi All,

I'm sure that this is a really common question and I've searched all the threads and read as much as possible, but I'd like as much insight into my personal situation as I can get as I'm really struggling right now.

I'm a sophomore Neuroscience major at a top 50 university with a 3.6 GPA, I made A's and B+'s in gen chem, I'm looking at the B+ to A range for ochem depending on how my final goes, but I'm finding myself unmotivated for finding a reason to go to medical school. It has been what I've wanted my whole life but I'm finding lately I really am only interested in it because I want to go into psychiatry. I want to be able to do therapy though, and from what I've read psychiatrists have the options to do therapy but the $$ comes from drug appointments, etc. I don't particularly care about the $$ as long as I'm making a decent living but I'm starting to wonder whether it's really worth putting myself through medical school when I could go just get a Ph.D in clinical?

My interests are primarily in eating disorders. I've worked in a research lab for all of undergrad thus far, and I run neuropsych consultations. I want to work with patients with eating disorders by doing therapy and my research interests are finding the neurological basis behind eating disorders. I was slightly interested in neurosurgery/emergency medicine early on, but all of it seems equally interesting to me I guess. I guess the lifestyle of clinical psychology where eventually you can set your own hours appeals to me. I know getting a Ph.D isn't easier but the work sounds more interesting and up my alley. I know I could get through medical school, I just don't know if I'd be happy with my decision to go by the end.

I'm really at a standstill as to whether I should continue on pre-med, because according to my advisor I should seriously start packing some psych courses in there if I'm considering clinical psych because currently I have none, and I can't fit them in and graduate in four and study abroad if I'm pre-med. So basically I have to figure it out. Plus, I don't want to risk a GPA drop from second semester ochem. I'm also curious as to how easy it is to get a job after getting a doctorate, preferably in a private practice, and how job stability is. My parents are extremely opposed to me dropping pre-med and essentially would no longer support me so this is a really big decision for me. Do I need to double major in psych or minor in clinical psych if I'm interested in this route or would the Neuro major be enough?

Any advice is appreciated!

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[Doctor Eliza]

This has been rehashed so very many times on here, I think we are running out of energy to discuss it. The best advice I can give you is that at this early stage in the game I wouldn't start closing doors. Absolutely take organic chem next semester because if you change your mind back to premed, it will be harder to make it up later. Also take a psych class before making this decision! A lot of people think they want to be a psych major until they start taking classes. Also, my sense is that for premed, you need to take the prerequisites, but you don't necessarily need to be a neuroscience or bio or chem major. It is likely possible to major in psych and still fulfill the requirements to apply to med school.

Re: studying abroad and psych, I think this might be tricky to do if you want to graduate in 4 years and go right to grad school after undergrad. To apply to grad school you need research lab experience and this can be harder to do if you are away from your university. That was probably the number 1 reason I didn't go abroad. Of course, I absolutely regret it and would encourage you to think about how you can make that work (such as going abroad for only a semester/summer, taking a longer time to graduate, etc.)

I think the best advice about career path will come from practicing psychologists and psychiatrists. They can best give you the benefits and challenges of each field. This board has some ideas and it is worth searching previous threads, but only a small handful of us are actually practicing in the profession.

Good luck,
Dr. E

 

[Therapist4Chnge]

This is what happens when I'm trying to avoid doing my work....

1. -iatry v. -ology has been covered ad nauseum, so a search will cover the basics.

2. Good research experience and volunteering are needed for both paths, so you can work on them. Classes honestly don't matter much outside of the "required" ones for each path. A 3.5+ GPA and a solid GRE/MCAT should get you some interview, but you still need to close. Research fit and choice are much more of an issue for -ology, as med school an be a bit more shotgun (within reason), but there are variances between programs.

3. Definitely talk with -ologists & -iatrists about day to day work because it is VERY different for 95% of things. -iatry is often done as a part-time consultant, as the work is generally about med checks, and the therapy is split amongst other providers. I have worked with a couple of very good ED-focused psychiatrists, and they would often say that it was as much about Art as Science. Polypharm is often PolyFAIL....IMHO. I wish they had a pill or four that actually could address "the eating disorder", but often it is about getting other comorbidities under control so therapy can BEGIN to start in on the ED. -ology for the residential and in-patient setting seems to be shifting to administrative/management bc there are cheaper therapy options. Private practice -iatry/-ology can do what they want, but the grind limits billable hours.

4. Eating disorder work is the epitome of 'a burn out waiting to happen'. EDs represent the highest mortality rate for any psych diagnosis, relapse rates can be upwards of 90%+, and you need to have significant clinical chops to hold your own on a team and with the patients. Comorbidities are plentiful within the population, and the work is a grind because of the amalgamation of presenting problems. It is some of the most frustrating and complex work I did as a therapist.

5. At the end of the day it is you sitting in a room...across from someone who has some very serious and often deadly struggles ahead of them. They often won't want to listen to you, and they often aren't in a position to actually hear what you are saying. You will get the kitchen sink thrown at you in regard to resistance, though sometimes you learn to be a plumber...and other times you learn to duck.

6. As a clinician you can only really control a very small piece (your interventions, usually) of the entire puzzle. Even with the help of a team, hopefully their friends/family, and the ED recovery community (when they go back into the world)...it is a battle measures in hours and days. Treatment response is often fleeting. Lastly, and probably most importantly....few other Dx groups will push a clinician's buttons like the ED population. Boundaries, counter-transference, and clinical knowledge will all be pushed each and every day.

7. I put in 5+ yrs working in and around the field as a student, trainee, and a researcher. The above isn't exactly a ringing endorsement for the work, but it is what I learned during my time. I left the field awhile back, so I can't be much help w. current info, but maybe others would be open to talking about their impressions of the field as it stands today.

 

[AnnoyedByFreud]

meh. as far as I can tell if you wanna make money you need an rx pad. MD/DO, PA, NP, whatever. However, you have to be interested in that line of work and learning a lot of physical health stuff, along w/the mental health stuff...

 

[MBellows]

This is what happens when I'm trying to avoid doing my work....

1. -iatry v. -ology has been covered ad nauseum, so a search will cover the basics.

2. Good research experience and volunteering are needed for both paths, so you can work on them. Classes honestly don't matter much outside of the "required" ones for each path. A 3.5+ GPA and a solid GRE/MCAT should get you some interview, but you still need to close. Research fit and choice are much more of an issue for -ology, as med school an be a bit more shotgun (within reason), but there are variances between programs.

3. Definitely talk with -ologists & -iatrists about day to day work because it is VERY different for 95% of things. -iatry is often done as a part-time consultant, as the work is generally about med checks, and the therapy is split amongst other providers. I have worked with a couple of very good ED-focused psychiatrists, and they would often say that it was as much about Art as Science. Polypharm is often PolyFAIL....IMHO. I wish they had a pill or four that actually could address "the eating disorder", but often it is about getting other comorbidities under control so therapy can BEGIN to start in on the ED. -ology for the residential and in-patient setting seems to be shifting to administrative/management bc there are cheaper therapy options. Private practice -iatry/-ology can do what they want, but the grind limits billable hours.

4. Eating disorder work is the epitome of 'a burn out waiting to happen'. EDs represent the highest mortality rate for any psych diagnosis, relapse rates can be upwards of 90%+, and you need to have significant clinical chops to hold your own on a team and with the patients. Comorbidities are plentiful within the population, and the work is a grind because of the amalgamation of presenting problems. It is some of the most frustrating and complex work I did as a therapist.

5. At the end of the day it is you sitting in a room...across from someone who has some very serious and often deadly struggles ahead of them. They often won't want to listen to you, and they often aren't in a position to actually hear what you are saying. You will get the kitchen sink thrown at you in regard to resistance, though sometimes you learn to be a plumber...and other times you learn to duck.

6. As a clinician you can only really control a very small piece (your interventions, usually) of the entire puzzle. Even with the help of a team, hopefully their friends/family, and the ED recovery community (when they go back into the world)...it is a battle measures in hours and days. Treatment response is often fleeting. Lastly, and probably most importantly....few other Dx groups will push a clinician's buttons like the ED population. Boundaries, counter-transference, and clinical knowledge will all be pushed each and every day.

7. I put in 5+ yrs working in and around the field as a student, trainee, and a researcher. The above isn't exactly a ringing endorsement for the work, but it is what I learned during my time. I left the field awhile back, so I can't be much help w. current info, but maybe others would be open to talking about their impressions of the field as it stands today.

A kitchen sink reference in a discussion about ED...