int med or psych

I think IM is better for all three actually. I think IM makes slightly less than psych on average. But you are done with residency in 3 years instead of 4. Then if you want you can do fellowship in GI or Cards, which are well paying because of the procedures, though fellowship is another 3 years. There are post psych fellowships, but my lowly understanding is that they do not add much to a salary when you consider the extra year or two fellowship, and really come into play only when competing for jobs in metropolitan areas. IM can work in clinic, as a hospitalist, in urgent care, emergency medicine, so there are lots of options for shift work/lifestyle work. Though the shift work jobs are probably higher stress; in psych you will always have suicidal patients which can be stressful. And if you want to pursue another specialty later on, the broad training of IM poises you to do that. If you want to go into radiology for example. It's unlikely a psychiatrist has returned to pursue an anesthesia residency; I would think the general medical knowledge lost in the years of psych practice would be prohibitive.

Of course these are all debatable factors in choosing a specialty. The bottom line is do what you love to do. If you love IM, do it, if you love psych, do it. I would hate to be an internist because the job looked good on paper.

heman466s said:

hey guys!
I am really confused about choosing between psych and int med..
I like both but cant decide..in a job i am looking for:

1.money
2.lifestyle.
2.dont wnt too much stress..

And of course img frendly!....a little overview on the fellowships after residency that are available will also be helpful!!!

I am inclined towards psych but am scared of choosing it thinkg that i will not make much money after giving all the hard work for all these years!

Plz help.. I am sure many will find this useful!

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pm&r?

Child adds $30k to salary (or a lot more if private practice), as does forensics potentially.

Your factors don't seem to discriminate realistically between the specialties.

Am I reading between the lines that you (like most) want a specialty with good pay, low stress, low hours, high lifestyle, and accessible to IMG's?

I forgot to use my sarcasm font.

Of course you want that. Everyone wants to work as little as possible for the most money. That shouldn't be the way you pick a specialty imo.

If you want a well paying low stress job, and you are smart, you should do an IM residency at a hospital with a radiology residency at the same site. Once you get through IM you will know the place, you will have built a reputation (hopefully a good one), and you will have networked well with the powers that be in radiology. Then apply for the radiology residency. Radiologists make great money, and they seem to work 8-5 hours, with nighthawk covering PM shifts. And guess what happens if there is an emergency imaging study...and there is no radiologist...do they call you?...no, the ED attending reads it. This is a circuitous route, but as an IMG you may be stuck going this way. I would also recommend applying to rads from the get go and praying.

heman466s said:

and i think

exactly!
ok.. are GI and cardio very competitive fellowships?and do they have combine programs in this that are IMG FRENDLY!!!
wat bout geriatrics after IM?HIGH PAYING?
can psych residents do pain fellowship after psych residency?
?
Thanx in advance!

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GI and cardio are VERY competitive fellowships.
There are no "combined programs", unless you're looking at an ABIM research pathway, which trades the middle two clinical years with research. You'd have to qualify, based on your track record in research. Probably not IMG friendly.

Geriatrics after IM doesn't add much to your pay, if anything. I think most geriatricians do general IM as well.

Psych residents can do a pain fellowship.

heman466s said:

PM&R??????????!!!!!!!!!!
i heard it is one of the lowest paying.

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Absolutely not. PM&R = Plenty of Money & Relaxation. They can also do a pain fellowship.

heman466s said:

hey guys!
i am really confused about choosing between psych and int med..
i like both but cant decide..in a job i am looking for:

1.money
2.lifestyle.
2.dont wnt too much stress..

and of course IMG frendly!....a little overview on the fellowships after residency that are available will also be helpful!!!

i am inclined towards psych but am scared of choosing it thinkg that i will not make much money after giving all the hard work for all these years!

plz help.. i am sure many will find this useful!

Click to expand...

Psych has a more relaxed lifestyle, and much better pay. Factor in the relaxed lifestyle (shorter hours), and it becomes MUCH better pay.

Seems like you haven't done your research.

heman466s said:

hey guys!
i am really confused about choosing between psych and int med..
i like both but cant decide..in a job i am looking for:

1.money
2.lifestyle.
2.dont wnt too much stress..

and of course IMG frendly!....a little overview on the fellowships after residency that are available will also be helpful!!!

i am inclined towards psych but am scared of choosing it thinkg that i will not make much money after giving all the hard work for all these years!

plz help.. i am sure many will find this useful!

Click to expand...

Do what you enjoy, because no one knows what is going to happen to the medical payment system in the US. Medicare doesn't have the money to keep funding things like they are, so people like the Ortho guys are in for a big surprise.

The average salaries for general IM and adult psych are almost exactly the same, hovering ~180-200k give or take. You can make much more or less than this in either field.

Seriously, do what you enjoy. That's what will be the lowest stress and the best paying (you'll want to work more).

heman466s said:

1.money
2.lifestyle.
2.dont wnt too much stress..
l!

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Psychiatry tends to be better than general IM in these areas

You can't compare the lifestyle of a cardiologist to a psychiatrist, even one who owns a cash only practice and makes the same amount of money.

GI/Cardio/Pain are very different from psychiatry. Procedure based vs. thinking based. I notice you aren't really considering infectious disease or rheumatology.

If its all about the money...you are in the wrong business.

You should cross post on Internal Med forum, the contrasting responses might be interesting/enlightening.

Maybe you would find interesting the Psych Consult/Liason subspecialty

heyjack70 said:

You should cross post on Internal Med forum, the contrasting responses might be interesting/enlightening.

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Except you might have wanted to look 3 posts down to see that there was another IM v. psych post there before you posted your question. So far you haven't been flamed, though, which is surprising.

But the thread was closed.

I'm a medical student in the US who's also struggling between IM and Psych. The IM department at my school has been much more proactive about recruiting me then the Psych department. I was fairly convinced that I was going to do Psych, but the continued outreach from IM has reminded me why I was originally considering medicine.

I enjoyed both rotations immensely. I find myself always wanting to spend a little more time with the patients who have psychiatric problems when I'm doing medicine, but I'm afraid I'll miss treating all of the non-psych medical problems of my patients if I become a psychiatrist.

For me the tipping point may be that I think Psychiatry will afford more flexibility in my schedule and practice.

LEdaddy said:

I'm a medical student in the US who's also struggling between IM and Psych. The IM department at my school has been much more proactive about recruiting me then the Psych department. I was fairly convinced that I was going to do Psych, but the continued outreach from IM has reminded me why I was originally considering medicine.

I enjoyed both rotations immensely. I find myself always wanting to spend a little more time with the patients who have psychiatric problems when I'm doing medicine, but I'm afraid I'll miss treating all of the non-psych medical problems of my patients if I become a psychiatrist.

For me the tipping point may be that I think Psychiatry will afford more flexibility in my schedule and practice.

Click to expand...

You do get to deal with non-psych medical problems if you do inpatient psych or C/L. For your patients in the hospital, you're their physician, so if they get hypertensive, it's your deal. Of course, you could always consult the hospitalist, but you can take on more of that stuff if you feel comfortable.

Lifestyle is huge, too. I personally would hate being a hospitalist, which seems like the dream lifestyle job for IM residents. I guess in both fields, though, you can have a pretty stable outpatient practice with minimal call. My understanding in primary care is that you take a paycut, though, with those types of jobs, whereas in psych, outpatient providers don't make substantially less money.

About the IM department recruiting you, it's hard to tune that out, but I'd recommend trying. In psych, I think we assume none of the students we work with want to do it, so we're a little less aggressive about recruiting, which is unfortunate.

heman466s said:

OK HOWS THE MONEY?i hope its not all paper work!

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If money and low stress are your chief criteria, then CL is not for you. Money is middle of the road, stress is high. You really have to do it for the love of the game.

Doc Samson said:

If money and low stress are your chief criteria, then CL is not for you. Money is middle of the road, stress is high. You really have to do it for the love of the game.

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The zebras are pretty cool.

Fermata said:

The zebras are pretty cool.

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They are - I think my job is the coolest thing you can legally be paid money to do. If you're looking for a high paying low stress job however, this isn't it.

Philosophically, you have to be comfortable with gray areas in psychiatry, and knowing you don't know exactly what you're doing. IM is more like mathematics - closed system, numbers in, numbers out. Psych can be attempted like that, and it may work, but my experience is that you need an ever-expanding system to accommodate all the possible factors, ways of understanding what's happening, and all the different ways to treat what's happening.

Doc Samson said:

They are - I think my job is the coolest thing you can legally be paid money to do. If you're looking for a high paying low stress job however, this isn't it.

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Boutique dermatology is your answer my friend.

Manicsleep said:

Boutique dermatology is your answer my friend.

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Just get a time machine, go back and become a US MD, publish an article or two in JAMA and have your father be a dermatologist, too. Then match into derm no problem.

heyjack70 said:

Just get a time machine, go back and become a US MD, publish an article or two in JAMA and have your father be a dermatologist, too. Then match into derm no problem.

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It also helps to have strong knees.

Fermata said:

It also helps to have strong knees.

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Oh my goodness!!! I'm shocked this sort of thing still goes on!!