Accepted to medical school! But...

[Doctorwhoafficionado]

I am very excited to announce that I was accepted to medical school after I was waitlisted and convinced I wouldn't get in. However, as one does when they are unsure of their future, I had to find alternative plans and just started a job in the mental health field. I am conflicted between accepting the offer and going to school to become a psychiatrist or continuing with my job then possibly going the PsyD route. My interests obviously include psychology/psychiatry and working with kids as well. I majored in psych and bio and am just looking for advice and if anyone else was in a similar boat. This could be the biggest decision of my life.

Thank you!

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[njtrimed]

I am very excited to announce that I was accepted to medical school after I was waitlisted and convinced I wouldn't get in. However, as one does when they are unsure of their future, I had to find alternative plans and just started a job in the mental health field. I am conflicted between accepting the offer and going to school to become a psychiatrist or continuing with my job then possibly going the PsyD route. My interests obviously include psychology/psychiatry and working with kids as well. I majored in psych and bio and am just looking for advice and if anyone else was in a similar boat. This could be the biggest decision of my life.

Thank you!

What is the PsyD route?

 

[Doctorwhoafficionado]

What is the PsyD route?

It's for a degree in clinical psychology. Basically likea PhD but more emphasis on practice and less on research

 

[Tchotchke]

First of all, congratulations on the job and getting in to med school! At the end of the day, do you want to be a physician? Will helping others with their mental health in the capacity as a PsyD satisfy you? Reflect on if you are still in "defeated mode" and perhaps that is why you would strongly consider this job. Think of how far you have come to have earned this med school acceptance. Think of the reasons you applied to med in the first place. Re-read your personal statement. If it still rings true, I would stay on the med path! But if it doesn't ring true, maybe you're just not into it anymore. That being said also think of the opportunity cost for preparing to apply for PsyD--that's another exam (GRE) and other extracurriculars and applications you have to deal with.

 

[Doctorwhoafficionado]

First of all, congratulations on the job and getting in to med school! At the end of the day, do you want to be a physician? Will helping others with their mental health in the capacity as a PsyD satisfy you? Reflect on if you are still in "defeated mode" and perhaps that is why you would strongly consider this job. Think of how far you have come to have earned this med school acceptance. Think of the reasons you applied to med in the first place. Re-read your personal statement. If it still rings true, I would stay on the med path! But if it doesn't ring true, maybe you're just not into it anymore. That being said also think of the opportunity cost for preparing to apply for PsyD--that's another exam (GRE) and other extracurriculars and applications you have to deal with.

Thank you, that was great and honest advice!

 

[Levo]

I've heard from multiple people that there is a psychiatrist shortage going on right now, with patients in many areas of the country having little access to psychiatric care. This mean that if you choose to go into psychiatry, you'll be filling a very real acute need. It also means you'll have your pick of well-paid jobs in desirable urban areas if you want them, which I would hope isn't the reason you're interested in mental health, but is a great benefit. Psychiatry is a great career choice for those who have the interest and patience for it.

 

[EM2Be2017]

It's not uncommon to have second thoughts once you actually get in. There really is only one question you need to ask yourself, do you want to be a physician? Reflect on why you pursued medicine in the first place and see if those are still true. The practice of psychiatry vs a PsyD are very different, so take a look at those careers and try to imagine which one would make you happier.

Not to make your decision more stressful, but if you give up this opportunity to go to med school now, it is unlikely that you will be accepted to med school again if you change your mind in the future.

 

[PsycheDrJ]

Congratulations, firstly - on the job and the acceptance.
Here is my advice, I hope you find it practical as it comes from a clinical psychologist:
1) Do you have an interest in medication? providing medical/psychological assistance with medication?
(I personally want to be a psychiatrist to oversee prescribed medication as I believe it to severely overused/overly depended upon/overly prescribed).
As told to me by a clinical psychologist, it is the same amount of work, but one route has a better payoff. Consider this.
2) A medical degree, as mentioned above gives you much more flexibility financially, an incentive.

 

[Stagg737]

I've heard from multiple people that there is a psychiatrist shortage going on right now, with patients in many areas of the country having little access to psychiatric care. This mean that if you choose to go into psychiatry, you'll be filling a very real acute need. It also means you'll have your pick of well-paid jobs in desirable urban areas if you want them, which I would hope isn't the reason you're interested in mental health, but is a great benefit. Psychiatry is a great career choice for those who have the interest and patience for it.

This is very true, but matching psychiatry was also more competitive than ever this year. So much so that there were only 4 unfilled positions for people to SOAP into as well as many attendings in the psych forum saying they didn't even interview people this year that they would have previously ranked. Idk if this year was an anomaly or if it's going to start trending towards becoming more competitive like EM has, but it's something to be aware of. Also not trying to discourage OP from taking the med school route, as I'm still very, very happy with my choices thus far and am planning to enter psych, just trying to give as full of a picture as possible.

 

[sinombre]

This is very true, but matching psychiatry was also more competitive than ever this year. So much so that there were only 4 unfilled positions for people to SOAP into as well as many attendings in the psych forum saying they didn't even interview people this year that they would have previously ranked. Idk if this year was an anomaly or if it's going to start trending towards becoming more competitive like EM has, but it's something to be aware of. Also not trying to discourage OP from taking the med school route, as I'm still very, very happy with my choices thus far and am planning to enter psych, just trying to give as full of a picture as possible.

But how many US med students matched? I know of multiple people who literally failed step 1 and still matched at 'top' programs coming from a US MD school. Obviously this is anecdotal, and they are really awesome people which I'm sure helped. But after going through the match this past year and watching all of my friends/classmates go through it as well, it seems like psychiatry is a viable option for just about any US med student.

Also the starting salary for psychiatry is insane given the number of hours worked. And the residency seems pretty damn chill. If I were interested in psych I would have done it in a second.

 

[libertyyne]

Scope of practice is really what this comes down to. Do you want to be able to have medications, ECT management, and ability to admit to an inpatient unit? Do you want to have the choice to see sicker patients? If so, MD or DO is the way to go.

 

[libertyyne]

But how many US med students matched? I know of multiple people who literally failed step 1 and still matched at 'top' programs coming from a US MD school. Obviously this is anecdotal, and they are really awesome people which I'm sure helped. But after going through the match this past year and watching all of my friends/classmates go through it as well, it seems like psychiatry is a viable option for just about any US med student.

A step score above 210 equates to a 90% match in psych.

 

[DO2015CA]

We all had the second thoughts once we got in. Its normal because it all feels so real right now. Go to medical school, you will thank me in the long run.

 

[DO2015CA]

I have also heard that there are too many PsyD students are graduating leading to dilution of the salaries. No clue if thats true, I just wanted to mention it

 

[Moose A Moose]

If you can imagine yourself being happy not being a physician, don't go to medical school. /story

 

[Levo]

If you can imagine yourself being happy not being a physician, don't go to medical school. /story

Mehh, you get what you pay for. Sure the training process to become a doctor sucks, but once you're through, you are pretty much guaranteed to be able to find a job with a 6-figure starting income in most cities in the US. Other top professionals like lawyers and basic science (bio, chem, physics) PhDs can work insane hours too, but often face lower incomes and tighter job markets. I don't know how for a fact how many PsyD jobs there are, but if it's a tighter market than for MD psychiatrists, it could objectively make sense to swallow the bitter med school/residency pill to be able to get the work conditions you want for the income you want in the city you want.

Again, not saying that one should choose a career based solely on practical considerations (I chose medicine because I love it!). But if one does look solely at the practical considerations, there are many medical specialties that look really good!

 

[kb1900]

You literally have more job security, more autonomy, more freedom, and more foundational knowledge as a psychiatrist over a psyD.

There is not a single benefit of going the psyD route except that it is just easier. And the psyD degree isn’t funded and the number of degree holders will only increase in the future.

Also, FYI, psyDs are not necessarily “more clinical”. I know of a few psychiatrist-psyD-social worker teams that pretty much evenly distribute their time doing the behavioral interventional stuff for their pts.

 

[Stagg737]

But how many US med students matched? I know of multiple people who literally failed step 1 and still matched at 'top' programs coming from a US MD school. Obviously this is anecdotal, and they are really awesome people which I'm sure helped. But after going through the match this past year and watching all of my friends/classmates go through it as well, it seems like psychiatry is a viable option for just about any US med student.

Also the starting salary for psychiatry is insane given the number of hours worked. And the residency seems pretty damn chill. If I were interested in psych I would have done it in a second.

1,067 U.S. seniors applied psych, 923 matched, so 86.5% match rate for U.S. seniors this year. On top of that, only 4 positions went unfilled in spite of 111 positions being added since the 2016 match when 7 positions went unfilled, and that gap was filled with mostly US seniors. I'm not saying psych is going to be competing with derm or ortho, but it used to be one of the fields where you just needed a pulse to match, and according to the psych residency forums and the PDs/attendings there, that was far from the truth this year.

The second paragraph I agree with. I think a lot of people think it's either not profitable or that psychiatrists are scraping by. I think most of the guys that don't make much choose that path to have an easier lifestyle, and I know a few guys that make absolute bank working surgeon hours (much more than surgeons do).

 

[Doctorwhoafficionado]

Thanks everyone, your advice has been super helpful! I'm always open to more, and really appreciate all the honesty.

 

[grapefruit17]

I just matched into residency for psychiatry.

The best advice I'll give you is follow your gut. You know yourself better than anyone. How far do you want to go in your education, and what level of training do you want? It depends on what your desire is in the field. Feel free to ask me any questions you have. Ill do my best to answer them.


And yeah def was more competive this year in my opinion.

 

[Okazaki Frag Grenade]

Thanks everyone, your advice has been super helpful! I'm always open to more, and really appreciate all the honesty.

I think the answer of PsyD vs MD partially depends on how you would practice with the PsyD. Do you see yourself wanting to teach (at a university) and/or do psychological testing? If the answer is no to both of those, then the PsyD isn't worth it if your main goal down the road is just counseling. At least in my state, master's level counselors are reimbursed by insurance at an hourly rate that is comparable to psychologists. It's less, but both are still paid quite well. How much of that you see depends on your practice structure (e.g. your own private practice, working for a clinic, group practice). The difference is that scope of practice if you wanted to do testing or teach at a college/grad level because you can't do those unless your a PhD/PsyD.

Another thing to keep in mind - insurance panels can be "closed" to new providers in mental health, meaning you couldn't bill insurance when you graduated. My state is not accepting new counselors or social workers right now. But I'm not sure if it applies to PsyD, so perhaps do some research on that for where you hoped to end up. I have not heard of this problem for psychiatrists, as there is generally a huge need in most areas.

Psych was my career prior to starting medical school, so PM me if you have more specific questions.

 

[futuremdforme]

MD has a lot more options. Keep in mind you're already accepted for MD, you would have to reapply for PsyD, write the GRE, etc. You would probably get in somewhere but it's not like it's a guarantee to get your top choice. MD salaries are definitely better.

 

[@n0nym0us]

Happened to see this post (I am a PhD clinical psychologist) and thought I would clear up misconceptions. A PhD in clinical psychology is not a research only degree. In fact, average PhD students have MORE clinical hours than PsyD students when applying to our internships (final clinical year long training). Most PhD psychologists also end up in clinical practice and not in academia. It seems a pretty common misconception so I wanted you to have more factual information. One thing to consider too, good, solid PhD programs are also funded (most with full funding). I came out of training with no debt.

Think about the ROI for a non-funded degree (whether PhD or PsyD) when thinking about this as a career option. I am employed as a FTE with the federal government with about 80% clinical duties and 20% research/program evaluation duties. Most of my PhD peers are 100% clinical. Psychologists have such a different scope of practice compared to an MD/DO so it would be very beneficial for you to talk more with those in the field.