Advice required

[TangoDown]

Hey folks,

I apologize for the long-windedness. I've spent a while in periods of self reflection whilst trying to figure out what I wanted to do with my life. I seriously considered medical school for the past year or so (with the intent of becoming a psychiatrist), to the point where I started some of the prerequisites, but realized as of late that I simply don't have the desire to spend years brute-memorizing genetic and biochemical minutia (and that's not to say I don't have the willpower to commit to a hard pursuit).

I do know that I want to work in the clinical setting (as I've been volunteering in one for a while now) and I do know that I want a career that revolves around psych, since I fell in love with the subject after taking General Psychology about a year ago (currently in a biopsych course and love that too).

I've talked extensively with a friend who is applying to PhD programs/Baylor/Rutgers and the thought of doing testing/assessments sounds like something I'd love to do as I love reading about intelligence/memory but would like to apply that to the clinical setting with the mentally ill/neurologically ill. Now I don't know how much I'd love research because I haven't had the opportunity to do any (I go to a large community college with the intent to transfer to a UC relatively soon), but I would definitely start looking for opportunities if I settled on the clinical psych route.

On the other hand, through tireless searching of the net, I've become aware of the pitfalls in clinical psychology. I'm not so much worried about the length of training or acceptance rates but the uncontrollable bottlenecks within training that many grad students and psychologists alike seem to fixate on (read: internship crisis, dissertation troubles, job market, dipping salaries) during discussion as to if getting the doctorate is "worth it."

The second option I've been considering is psych nursing with the intent of, after a few years of practicing as a psych nurse, seeing if I wouldn't mind going the route of PMHNP. I know it's a completely different profession than clinical psychology (and I wouldn't be able to do in depth assessments), but I'd still be able to work with those with mental illness, obviously in a different role (though maybe transition to a 50-50% med management/psychotherapy practice down the line - of course receiving some post-grad/post-doc training in CBT or maybe a masters in counseling).

I guess what I'm trying to say is, though I'd prefer the job of a Clinical Psychologist more because it better fits my interests, PMHNP seems like a happy medium when the aforementioned clinical psych bottlenecks are factored into the equation. I can practice a career in psych without worry about factors outside of my control will determine if I graduate from schooling or if I can pay the bills. But then again, it isn't the in-depth study of psychology, and I might feel like I'm selling myself short by "compromising."

Now the caveat is, I've got less than 2 weeks to decide my major because I'm registering for classes for the Spring. In my mind, after that point, deciding to switch majors again would present a waste of time (most of my General Ed courses are done and I started on med school prereqs. If I start on nursing school prereqs and then decided it wasn't for me, I'd have to go back and take other major prereqs). Furthermore, my community college (one of the largest in the country) is under threat of losing its accreditation, so I may be racing the clock here.

Thanks for anyone kind enough to read this mountain of text. Any more information needed on my situation and I'll be happy to provide.

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[Lisa44201]

I would stay with psych, for a few reasons: for starters, it's what you want to do, and to that end your career goals match the degree; you've also done the research necessary to differentiate a PhD from any of the other psych options, so you're approaching the situation realistically.

I just read through the links on Inside Higher Ed; this would by my other reason for not switching. Looks like CCSF has 350+ tasks to complete by June in order to not get completely shut down; that's a hell of a lot. I would personally be putting more effort into your contingency plans for if/when they are shut down; navigating a new major and transferring to a different school are stressful tasks in and of themselves; doing both at the same time is even less fun.

 

[TangoDown]

Thank you for the input.

I am currently declared as a Biopsych major, but I feel the harder premed requirements (O-Chem) might hurt my GPA either way, and since I'm not pursuing med school anymore, I'll be switching to either a Psych BA or a BSN (nursing). So I'd be switching degrees either way.

Now UCSB's psych degree has only 3 psych courses before upper division (weirdly enough), so with both General Psych and Biopsych complete, all I would need to take next semester would be a research methods course, calculus, stats, and some blow-off art course. Thus I think I could be finished before CCSF would theoretically close. Alternatively, another school's psych BA would require a few more lower division psych courses, which would probably look better, but I'm sure As in a bunch of upper division psych courses would outshine a lack of psych courses during my time at CC.

Nursing, I'd at least have to stay at CCSF (or another CC) through Fall '14.

 

[AnnoyedByFreud]

If I remember correctly, CCSF has officially lost its accreditation. You could do your BSN at SF State... I recommend pursuing PMHNP unless you are absolutely certain you must be a clinical psychologist and nothing else will do. If you are at all ambivalent, then I don't think it's worth the sacrifice and potentially dimmer prospects.

 

[TangoDown]

The accreditation committee recommended that we lose accreditation. There's a very high-profile appeal process going on at the moment, so everything is up in the air. Many people believe it's still too big to fail (serves 90,000 students), but anything is possible. I don't know when we find out if the appeal has failed or not, but we'll be officially losing accreditation in mid-July 2014. That means that the school will be closing at that point.

I see you're in PMHNP school. Removing myself from the vitriol spewed about NPs all over this forum, how well do you think your program is preparing you to become a psychiatric provider?

 

[TangoDown]

Anybody else want to lend an opinion?

 

[Sendtrees]

Pursuing NP route will likely put you in front of patients, earning a salary, long before a PhD. It sounds like you'll get most of what that way. Good luck!

 

[AnnoyedByFreud]

The accreditation committee recommended that we lose accreditation. There's a very high-profile appeal process going on at the moment, so everything is up in the air. Many people believe it's still too big to fail (serves 90,000 students), but anything is possible. I don't know when we find out if the appeal has failed or not, but we'll be officially losing accreditation in mid-July 2014. That means that the school will be closing at that point.

I see you're in PMHNP school. Removing myself from the vitriol spewed about NPs all over this forum, how well do you think your program is preparing you to become a psychiatric provider?

I think it's adequate preparation. Much of what you learn is refined on the job. You will not be as well trained in therapy as a psychologist, and you won't get the pure medicine training of a psychiatrist, but it's a happy in between for me. I'm also quite interested in physical health, so the NP training was more appropriate for me than psychology training. Make sure you're interested in physical health as well, I really can't emphasize that enough. It's a big part of the training.

 

[eowyne]

I would recommend getting psychology research experience to see how you like it. If you don't like it, a PhD program would not be fun. In any case, doing research improves your application prospects, which means getting in a better program, which means an easier time getting internships... etc. I do think that if you have geographical l limitations, the nursing market gives you a lot more choices. Or a LCSW degree, if you don't like the physical/biological aspects of nursing.

 

[priorities2]

I'm a BSN student planning to go for PMHNP afterward and I'm not that interested in physical health. I've become more so as I've moved through the prereqs to the nursing courses and clinicals but I'm still not too interested. I would say the physical health portion is definitely bearable for someone who just wants to focus on mental health after graduation - for the BSN portion, anyway. I can't speak to the physical health aspect of a master's program.

 

[AnnoyedByFreud]

I'm a BSN student planning to go for PMHNP afterward and I'm not that interested in physical health. I've become more so as I've moved through the prereqs to the nursing courses and clinicals but I'm still not too interested. I would say the physical health portion is definitely bearable for someone who just wants to focus on mental health after graduation - for the BSN portion, anyway. I can't speak to the physical health aspect of a master's program.

I should say that I'm enjoying the physical health aspects of the NP program much more than the RN portion of my training. During the RN portion I felt like the assessments were too simplistic and half the floor nurses did them wrong anyway and/or just copied the charting from the previous shift. Plus I hated L&D with a passion. Now that I'm learning how to take a history, do a true, detailed physical, and come up with a real differential and plan, I'm much happier. Plus they tailor all our training, even the physical stuff, toward psych. So it's interesting to me and still relevant.

 

[TangoDown]

I should say that I'm enjoying the physical health aspects of the NP program much more than the RN portion of my training. During the RN portion I felt like the assessments were too simplistic and half the floor nurses did them wrong anyway and/or just copied the charting from the previous shift. Plus I hated L&D with a passion. Now that I'm learning how to take a history, do a true, detailed physical, and come up with a real differential and plan, I'm much happier. Plus they tailor of all our training, even the physical stuff, toward psych, so it's interesting to me and still relevant.

In what setting are you hoping to practice in after you graduate/are credentialed?

 

[AnnoyedByFreud]

In what setting are you hoping to practice in after you graduate/are credentialed?

I am uncertain at this point. I am doing NHSC, so my first two years after graduating will probably be in an outpatient mental health clinic for underserved populations. I see PMHNPs working in-patient psych, psych emergency, C&L, outpatient mental health clinic, outpatient private practice, specialty practice (like an ED clinic), jails, etc.

 

[TangoDown]

Just to clarify, I enoy neuro/neuropsych and can tolerate most of the other sections in physio. I think if I were to go to the Psych PhD route, I'd lean toward neuropsychology because I'm fairly reductionist.

I am uncertain at this point. I am doing NHSC, so my first two years after graduating will probably be in an outpatient mental health clinic for underserved populations. I see PMHNPs working in-patient psych, psych emergency, C&L, outpatient mental health clinic, outpatient private practice, specialty practice (like an ED clinic), jails, etc.

Nice. I've looked into the USPHS Commissioned Corps as an option down the line.

I am shadowing an MD and an NP soon at the free clinic I volunteer at. Hopefully I can fit them both in before I have to register for classes.

Too bad there aren't anymore duel NP/PA programs out there anymore like Duke used to have. PA programs seem like they teach the right about of "why" in terms of clinical science whilst the nursing lobby is extremely powerful. Would seem, theoretically at least, like a great combination.

May have some more questions for you down the line. Appreciate the guidance.

 

[AnnoyedByFreud]

Too bad there aren't anymore duel NP/PA programs out there anymore like Duke used to have. PA programs seem like they teach the right about of "why" in terms of clinical science whilst the nursing lobby is extremely powerful. Would seem, theoretically at least, like a great combination.

May have some more questions for you down the line. Appreciate the guidance.

Yeah, feel free to PM me if you have any questions. Here comes a rant: I will say that the oft-repeated SDN meme that NPs don't know the 'why' behind what they're doing is pretty much BS. Especially in psych, where PMHNPs get far more comprehensive training compared to PAs.

 

[TangoDown]

Sent you a PM a few days ago. Hope you get a chance to respond.