Switching from psychology to psychiatry

[modelingrace]

There was a similar post on this issue but its very old and had few responses. I am hoping that I can get some good insight. I am 26 and in my 1st year of a PsyD program. I am considering switching to psychiatry instead. I am not comfortable with the limitations of a psychologist and the several patient needs for which I would have to refer out to neurologists or psychiatrists. As a psychiatrist, I would still be able to conduct psychotherapy but with the option of psychopharmological treatment methods as well. I'm also worried about the demand for psychologists in a healthcare-driven economy considering they cannot administer meds and LPCs and the like can do counseling. Aside from my age and already being in a PsyD program, here are the other problems: I have a BA in psychology and only took one science course (chemistry). Any suggestions for making such a transition (post-bacc. science courses, med school acceptance, course/time of progression) and how it is viewed in the medical community (switching from social science to natural science, leaving PsyD program)? I really appreciate any constructive feedback or guidance.

---

Members don't see this ad.

 

[heyjack70]

I don't think a switch would be viewed negatively. From a practical standpoint, you are going to be short at least 2 years of science prerequisites. Gen chem, Organic chem, physics, and biology. I'm not sure what the shortest time to finish these req's would but it is not a simple summer course load.

As far as your bachelor's, it doesn't matter at all, in fact some would say a bachelor's outside of the sciences is actually preferred.

Another route to psych"IATRY" would be nursing school with plans to become an ARNP. They will teach you to prescribe meds, I guess, but you won't be a physician. I think that any therapy instruction would be non-existent which sounds like it would be a non-starter for you.

 

[235750]

Remember that all psychiatrists are trained as scientists and physicians first. You have about 7 years ahead of you with about 2 months spent in psychiatry.

Do you have any interest in general medicine or the sciences? If not, nursing school may be a good compromise. You will have more patient contact in your initial training as a nurse vs that of a premed during the prereqs which will be about 3 years. You should check out the non-trad part of SDN for more information if you choose medical school

 

[nitemagi]

I don't think a switch would be viewed negatively. From a practical standpoint, you are going to be short at least 2 years of science prerequisites. Gen chem, Organic chem, physics, and biology. I'm not sure what the shortest time to finish these req's would but it is not a simple summer course load.

As far as your bachelor's, it doesn't matter at all, in fact some would say a bachelor's outside of the sciences is actually preferred.

Another route to psych"IATRY" would be nursing school with plans to become an ARNP. They will teach you to prescribe meds, I guess, but you won't be a physician. I think that any therapy instruction would be non-existent which sounds like it would be a non-starter for you.

People are exaggerating on the pre-requisites. You typically need 2 semesters gen chem, 2 semesters organic chem, 2 semesters physics, 2 semesters biology. I did it in a post-bacc pre-med program in a year and a summer.

Schools just want to know that you can handle the science. Therefore others commonly take additional courses to prove they can handle the more advanced stuff. But if you smack down the MCAT they probably won't care. You'd be a "non-traditional" student so no one is expecting you to do 3 years of sciences.

 

[IT514]

There was a similar post on this issue but its very old and had few responses. I am hoping that I can get some good insight. I am 26 and in my 1st year of a PsyD program. I am considering switching to psychiatry instead. I am not comfortable with the limitations of a psychologist and the several patient needs for which I would have to refer out to neurologists or psychiatrists. As a psychiatrist, I would still be able to conduct psychotherapy but with the option of psychopharmological treatment methods as well. I'm also worried about the demand for psychologists in a healthcare-driven economy considering they cannot administer meds and LPCs and the like can do counseling. Aside from my age and already being in a PsyD program, here are the other problems: I have a BA in psychology and only took one science course (chemistry). Any suggestions for making such a transition (post-bacc. science courses, med school acceptance, course/time of progression) and how it is viewed in the medical community (switching from social science to natural science, leaving PsyD program)? I really appreciate any constructive feedback or guidance.

As someone who had similar thoughts in the first year (now a 3rd year clinical), I can tell you that these stopped when I began working in clinics with psychiatry and neurology. They have their limitations as well and refer to us for plenty of things, esp in terms of assessment, young kids with behavior problems not responsive to meds, and patient competency issues.

However, my particular program is heavy in neuropsych training and research, which has played a large role in my satisfaction with what I am able to do. I've also learned that I do in fact play an important role in medication management. I dont know what your program is like in that regard.

This is not to say dont drop out and go to med school. Go for it if that is what you want. There are many places in desperate need for good psychiatrists, thats for sure. I would advise against dropping out of a PsyD program for nursing.

 

[whopper]

Are you willing to spend years in an extremely difficult curriculum where there will be very very very little taught in the mental health sciences? If you get into medical school you pretty much have to finish it because the price of the education is extraordinarily high.

I wasn't getting a Psy.D., but like you, most of my training was in psychology. I chose to go to medical school because I wanted to be a psychiatrist. I hated it. I hated memorizing thousands of slides of various cancers when I knew I would not be doing it in clinical practice, I couldn't stand the narcissistic surgeons screaming at the operating staff for being late by one minute when they were often late by 40. I couldn't stand the idiot internal medicine doctors telling the medstudents to stay away from psychiatry when they hardly knew anything about it.

Now that it's all over and done, I do think psychiatrists need a medical education. I've seen too many cases where the mental health issues were caused by a medical problem that were missed by the primary care doctor (only thinking of the physical problems) and even other psychiatrists (who only think of the mental health phenomenon in a vacuum).

But it was a very hard and difficult bridge to pass to get where I am. I'm happy I did it was not like you have to endure 6 months of hell, more like 6 years of it.

 

[235750]

People are exaggerating on the pre-requisites.

Our experiences are different than yours Nitemagi, but that doesn't mean that we're embellishing.

The requirement for most schools is 2 years of chem, 1 yr physics and biology; plus genetics, calculus, biochem if you want to be competitive, and of course the MCAT. Then you have to apply a year ahead of time. If you were able to compress all of that to a year, and you did well in everything without a science background, then hats off to you. But for many, that's just not realistic.

When I took my pre-reqs for med school I hadn't been in college for years, and my last science/math classes were in high school. The OP sounds like he/she is in a similar situation. Going straight into the premed 'weeding courses' like general chemistry would've been a mistake, so I took intro to chem, and a few other courses.

Requirements aside, I strongly believe that the question the OP should be asking him/herself is, "should I switch to medicine?" Any premed who has a specific interest in one specialty should ask that question first. Once that's answered through experience in the classroom and non-therapy related hospital exposure, then sure, I say go for it! Best of luck in whatever you choose

 

[Chimed]

But it was a very hard and difficult bridge to pass to get where I am. I'm happy I did it was not like you have to endure 6 months of hell, more like 6 years of it.

I also went through the whole "psychology vs. psychiatry" dialoge before going to med school. In the end, I decided that there was a possibility I may end up liking one of the other speciality such as neurology or even family medicine, even though in the back of my mind I knew I'd end up going into psych. But that curiosity into the other specialities was what pushed me down the medical route. I also wanted as many options as possible and, for myself, was concerned psychology would limit me to either doing research and/or just therapy. I wanted to play with drugs. I also knew that although I would not get as much psychotherapy training in psychiatry, that I could always find ways to fill in any gaps and learn enough therapy to be proficient. The discussion of being able to prescribe meds as a psychologist was brought up and many told me just to go into psychology because eventually they will get prescription rights. But that never sat very well with me and I knew I wouldn't be comfortable prescribing medications without a medical background.

Unlike Whooper, I actually enjoyed medical school. I was even fascinated by surgery. I loved learning physiology. Sure there were times when I felt like I was going to puke from the constant shoving of route memorization down my throat. But, overall, it wasn't so bad. If I didn't have that interest in general medicine, however, I don't know how I would have gotten through it. So, if you're not at least somewhat interested in other areas of medicine from at least an intellectual standpoint, you might want to seriously reconsider psychiatry. As Whooper said, medicine is a long road to get into the mental health field. Personally, I'm extremely glad I didn't go the psychology route. That is no disrespect toward psychology (I think very highly of psychologists). I just like having more options for treatment that psychiatry affords.

 

[whopper]

Actually I did like some of medical school, but overall I disliked it more than I liked it.

A lot of that medical data does become important later on, but it's one of those things where I had to be practicing psychiatry a few years before I saw it.

IMHO psychiatric training needs to be more mental health related and less physical. A psychiatry resident could have done 30 surgeries by the time he/she graduates but no in depth history that takes into account from birth to present once, but I digress....

 

[digitlnoize]

I didn't get interested in psych until 3rd year of med school, but that being said, think long and hard about whether or not you want to spend another 9-10 years and 200-300k on schooling. It was worth it for me, but make sure it's worth it to you. You will need to enjoy medicine, so I would see about shadowing an IM doc or something. Good luck.

 

[medium rare]

Finish your Psy.D., get licensed and then do a psych NP. This is what I did and it has been well worth it. Total time will be shorter than med school + residency.

 

[PSYCHNP]

Finish your Psy.D., get licensed and then do a psych NP. This is what I did and it has been well worth it. Total time will be shorter than med school + residency.

If being able to to prescribe meds was the OP's goal. Perhaps even getting a PA license after finishing the PsyD program may be an option.

Although, I believe the psychnp program involves more psych related classes than a traditional PA program.

 

[st2205]

I'd like to add on as well as give my opinion regarding a few of the things that have been mentioned in this thread.

Obviously you'll want a plan of attack before you leave enrollment in a professional school to embark on the potential of entering another professional school. Getting into the PsyD was a feat in itself. Though a lot can be said for professional satisfaction and doing what you love, other aspects that often don't get as much consideration are job stability and security. Often those with both security and being able to do what they love will tell you to, above all else, do what you love, which is true but they may often neglect security since it's something they already have. What I'm getting at is that on one hand you don't want to walk away from your PsyD and for whatever reason not get into medical school and on the other hand you wouldn't want to get through the PsyD and end up struggling in clinical practice wishing you had a bit more stability in your career (I'm not implying people aren't able to have a stable clinical practice) but based on this phrase...

I'm also worried about the demand for psychologists in a healthcare-driven economy considering they cannot administer meds and LPCs and the like can do counseling.

Anyway, now that that's out of the way I'd like to hit on a couple other points. There was a PsyD on these forums a couple years ago who ended up going to a DO school (Nova, I believe). You could run a search to try to find out who that was since what I remembered is that he had some of the same reasoning you did.

With regards to how long it would take to do prerequisites is largely variable from individual to individual, but since you already graduated I would echo what was said about just taking the standard prerequisites. I wouldn't worry about piling on any of the tangentially-related courses like calculus and genetics. Some schools are requiring biochem but they are in the minority, by far. In any case, if you need to take a biochem course you could do so after being accepted, as it would just need to be done by matriculation. Obviously doing well in a biochem course can look great on an application, so don't get the wrong idea. Anyhow, since you're 26 you're likely not that far removed from undergrad (if at all). Taking any intro courses would be unnecessary. To give perspective, I graduated high school with a 2.4, did a light semester at the CC and got a 2.7 then didn't return to school for two years. I was able to complete two semesters of physics over the summer (since they do two summer sessions), then did my year of general chemistry and biology over the next year then finished off with organic chemistry the next summer. Obviously different things change by circumstance, but what I'm trying to highlight is that you don't need to pick up full-time enrollment in undergrad and take cell bio, physiology, microbiology, etc. in order to get into medical school. If you hang around the pre-med forums you may get this impression.

I had originally looked into medical school because of an interest in psychiatry. I chose the medical school path for psychiatry over the psychology route for many reasons. It's difficult to get an appreciation for the differences between the fields when first looking at them. Despite my naive decision, it took quite a while to begin to understand all the ways in which the fields differ. I'm glad I did choose the medical school route for many reasons which I will explain later, but it's imperative to understand that psychiatry isn't clinical psychology with Rx.

When I originally started the premed classes I didn't really enjoy them. I was just doing it to knock out the requirements (but then again it's not like people are taking organic chemistry for fun). What I really enjoyed were my psychology courses. When I registered for a neuroscience course from the neuro department (I was a psych major and figured I'd just take it for fun since it wasn't required) it was actually pretty fascinating to me to see how what I had studied previously became relevant within a psychological setting. I've found this to be equally true with the medical school curriculum (anatomy sucks). You may like medicine and you may not. You may end up loving psychiatry and you very well may end up loving radiology, or surgery, or pediatrics. Of all the military medical psychologists who ended up going to medical school (~4-5) I think all of them ended up in different fields than psychiatry (I'm only assuming they went to school with the assumption they'd do psychiatry).

I'm pretty naive on some of the intricaces of the PsyD so maybe none of what I say will be relevant. I know they're shorter than their PhD counterparts, but what kind of time-frame are you looking at -- 4-5 years? Again, I know a lot of the PhDs are funded with a stipend, but I'm not sure this is true for the PsyD -- perhaps you could clarify. If you're paying for the PsyD yourself, obviously there may be more motivation to quit and changes if called for, but if its funded then perhaps it makes it a more difficult situation.

Is leaving the PsyD and starting premed what your plan would be or are you thinking you could pursue both? I don't know if your PsyD allows you to do anything outside of the program, but ideally I'd try to take a premed course concurrently (like general bio). If you've got summers off (I have no idea) then that can give you a much better idea of whether or not you want to pursue medical school without having to make the permanent decision of leaving the PsyD. Others have mentioned doing the PsyD followed by NP/PA. I'd take a hard look at what your goals are and what you think you may enjoy and why before deciding mid-level vs. psychiatry. I'd strongly suggest you contact your school's psychiatry department if they have one. Tell them your thoughts and see if they can get you some exposure to a broad range of psychiatric practice (inpatient, outpatient, ER, consult, child, etc.)

I'm sure there were things I could have written better but hopefully I was able to accurately covey some of my thoughts.

 

[IT514]

My concern for the OP is the kind of thinking that might go with being in your first year, which goes away once you realize what you can do. If you dont start your clinical externships in 1st year, its hard to see what you can actually do.

If you really believe that all you can do with your PsyD is therapy...you need to talk to someone in your program. Therapy is great but theres much more to clinical psych. And if you think assessment is boring, its just because you havent learned how to do it well yet...which no one would expect of a first year.

You also referred to the field as a "social science." Like I mentioned in my first response, my program is heavy in neuro, and what I do in terms of research and in the clinic is FAR from social science. I'm thinking that the problem might be your choice of program? Just a thought...

I'd encourage you to talk to your advisor. Even as a student working alongside attending psychiatrists and neurologists, I've never felt "limited" in any way in terms of patient care, as I bring something different to the table. If you get the sense from your faculty that all they will be able to teach you is therapy, then maybe go elsewhere...and go to med school if thats what you want to do.