So, what is the general consensus on the utility of completing a triple boards program(Pediatrics/Psychiatry/Child Psychiatry)? Can you pretty much chalk it up as being similar to IM/Psych or FM/Psych where most residents usually end up just practicing psychiatry(or child psychiatry in the case of the triple boards)? Speaking of which, why is it so hard to see and bill patients for both medical and psychiatric issues? Or for that matter why is it so unlikely that in a given day you could have a varying schedule of patients where the chief complaint is either psychiatric or medical? Is having 4 days of Psychiatry plus 1 day of IM/FM/Peds(depending on which combined residency you completed) really that unfeasible/not worth it?
Triple Board
- Thread starter Darkskies
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Useless. Child psych pays better than adult psych and peds. Almost everyone ends up just treating child psych.
Side note. The academic center where I trained forced all peds trained faculty to take inpatient call. No extra pay was provided. Due to this, double boarded faculty all dropped their peds boards.
Side note. The academic center where I trained forced all peds trained faculty to take inpatient call. No extra pay was provided. Due to this, double boarded faculty all dropped their peds boards.
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Triple board is triple board. You will get less exposure to all 3 disciplines but 3 board certifications looks great on paper and it will open more doors.
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I swear TexasP... You have the inside scoop on how not to get screwed. You never fail to impress.
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For about 1% of the jobs out there. Every triple boarder I know, as someone mentioned above, ends up practicing in child psych. For the vast majority of them, I'd questioned how much the pets icu rotations really helped and especially at the expense of all the adult psych and child psych training they lost.
Combined boards are awesome for a small percentage of the people who do them.
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This
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Good luck with MOC on three boards!
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Triple Boards are ok, but quadruple boards are better
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How are triple boards in terms of competitiveness compared to just straight up psych residency? For example, If we really want to be a child psychiatrist and train at institute X for residency, is it more difficulty to get in their general psych programme or the triple board programme?
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I doubt it is much different.
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I've noticed that among many triple-boarders they don't know child psych, or general psych, or pediatrics as well as someone that just did one thing.
E.g. they couldn't run a psych ER as well, an inpatient unit as well, or do pediatrics as well.
Now this wasn't all of them, just most of them. Further they had a majorly frustrating position of having to take 3 board exams! Three!
I'm triple-boarded but one of those boards is one where I didn't have to do anything. It was just that I had to show I did some journal articles and pay some money. One is in forensic psychiatry and the other is in general psychiatry. IMHO those two actually work together cause inpatient and forensic work quite well especially when you're identifying and kicking out malingerers or involuntarily committing them.
Another frustration is the way the field is, it's easy to get a job where you're using one of those specialties but not all three. Trying to do a job that does all three is kind of like jamming a square peg into a round hole.
It's kind of like setting up a restaurant at a place where you change your oil and eat a meal while your oil's being changed If it's not finished by then you could watch a movie. "We're looking for mechanics that went to culinary school but can also run a movie projector."
A strength, however, of the triple-board is sometimes these fields do have a grey area in between all of them such as, for example, child custody cases where there is physical abuse, physical problems in a child with also psychiatric issues, etc, and when this happens a triple-boarder (at least from what I've seen) is invaluable.
If you are very interested in all three fields, and see yourself somehow using all of them go for it but don't just do it to one-up everyone else.
E.g. they couldn't run a psych ER as well, an inpatient unit as well, or do pediatrics as well.
Now this wasn't all of them, just most of them. Further they had a majorly frustrating position of having to take 3 board exams! Three!
I'm triple-boarded but one of those boards is one where I didn't have to do anything. It was just that I had to show I did some journal articles and pay some money. One is in forensic psychiatry and the other is in general psychiatry. IMHO those two actually work together cause inpatient and forensic work quite well especially when you're identifying and kicking out malingerers or involuntarily committing them.
Another frustration is the way the field is, it's easy to get a job where you're using one of those specialties but not all three. Trying to do a job that does all three is kind of like jamming a square peg into a round hole.
I can't think of any. The problem is there's so few of them and a niche where all three specialties are needed in one place aren't exactly compatible with the way hospitals and outpatient offices arrange themselves.
It's kind of like setting up a restaurant at a place where you change your oil and eat a meal while your oil's being changed If it's not finished by then you could watch a movie. "We're looking for mechanics that went to culinary school but can also run a movie projector."
A strength, however, of the triple-board is sometimes these fields do have a grey area in between all of them such as, for example, child custody cases where there is physical abuse, physical problems in a child with also psychiatric issues, etc, and when this happens a triple-boarder (at least from what I've seen) is invaluable.
If you are very interested in all three fields, and see yourself somehow using all of them go for it but don't just do it to one-up everyone else.
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Not really sure what it would add to a child psych practice, honestly. Whenever I encounter some unfamiliar medical thing in peds patients, I simply look it up. I imagine in order to make time for the non-psych training, you end up likely sacrificing training and exposure to therapy.
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Several times I see problems in patients that are outside my field. Of course it would be better if I knew EVERYTHING, but hey, not like I'm going to do surgery, IM, radiology, Ob-Gyn, well for that matter every single residency out there.
I can just simply call the doc in the other field. Now the problem there is half the time the doctor on the other end is being difficult and won't talk to me or take the case seriously enough. Private practice attendings play a game that I call "No one's allowed to talk to the attending, even if you are an attending and it's an emergency."
I can just simply call the doc in the other field. Now the problem there is half the time the doctor on the other end is being difficult and won't talk to me or take the case seriously enough. Private practice attendings play a game that I call "No one's allowed to talk to the attending, even if you are an attending and it's an emergency."
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Triple boarded doctors end up practicing psychiatry 99% of the time because they like practicing psychiatry. The few times we have to fill an opening in our program, the best talent comes from residents trying to get out of their multi board training program. These transfers almost always do fellowships, they just want out of the family medicine or Peds. I may have a bias because I work in psychiatry so all of the triple boarded doctors I know practice psychiatry. It might be interesting to go over to the Peds board and ask if anyone there is psychiatry boarded. You may even find one or two.
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Why stop at a triple board? That office wall isn't going to fill itself. I got curious and tried to see how many quadruple boarded psychiatrists I could find through google. I got two in the first two pages.
Anybody found/know a quintuple boarder? Those must be as cool/rare as five-leaf clovers
Anybody found/know a quintuple boarder? Those must be as cool/rare as five-leaf clovers
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A few old timers around who are - during the days where you just needed to take an exam. Or changed careers later on in life.
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Just finished working with a great psychiatrist who at one time held: Family Medicine, Anesthesia, Adult psych, Addictions, C&L. He only keeps up the last 3 now, and I believe and the certifications were split between Canada and USA.
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I am quad: IM and sleep by the ABIM; Psychiatry and Psychosomatics by the ABPN. The docs who are quintuple or more tend to be older (mid 50's +) when grandfathering was easier.
One of my colleagues, Dr. Joseph Kwentus, is boarded in Neurology, Psychiatry, Sleep, Psychosomatics, Pain, addiction, plus a few other neuro and psych subspecialties.
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With Today's MOCs, it's pointless to explore that route any longer. And with Ins company mandating it now - rather than a measure for 'coming into your own'; le sigh.
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Dealing with the ABPN is a pain, but the ABIM is pretty flexible (especially now that Practice Improvement is suspended) and will take MOC activities from other boards- however the IM recert exam is a pretty difficult- I am surprised I passed several yrs ago
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Most people do not end up practicing all 3 when they do Peds/Child/Psych, however I do know many who are "triple boarded" in Psych/ChildPsych and another psych fellowship like addictions or forensic and they do use that and it has been beneficial financially as forensic consulting in child psych in particular is quite lucrative.
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It is also very hard to make any additional money in. Forensic work that pays well requires good marketing of yourself to attorneys. I know 3 child psych forensic docs in my area. All are similar in age/experience. 2 don't ever get cases. 1 gets them all as she has marketed herself well to attorneys at the expense of salary initially. The one getting the cases made the least money for the first 3-4 years while she spent time networking with the right people in the right positions.
