Another Peds vs. Psych/Child Psych

[MahoganySmoothC]

Incoming 4th year DO student going through specialty crisis and need advice. I'll try to keep this short. I have only had an outpatient peds rotation (classic DO school issue) but I spent a year doing research at a tertiary children's hospital and got a ton of exposure to sick kids then. I love working with kids but I hate primary care and would need to do a fellowship, how likely is it to change my mind once I start? I am terrified of the income issues with peds as well. As for psych, I dont enjoy it as much but I dont hate it. I love the lifestyle aspect and CAP has the option of still working with kids making good money and having a life outside of the hospital. What do I do!?

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[psyspy]

Rising m4 interested in psych. I like kids a lot but what may ultimately keep me away from outpatient cap in particular is dealing with the parents. Many of those parents will have personality disorders or other serious mental illness themselves.

 

[Taddy Mason]

I would put interest/intrinsic enjoyment in a field above potential salary, as the former will contribute more to long term satisfaction and decreased risk/degree of burnout compared to the latter. If for some reason you had to go without fellowship would you be happier long term in peds or psych? The length of training for peds+fellowship and CAP is basically a wash (5-6 years with peds depending on the fellowship/specialty v. 5 with CAP). What if you go into psych and find out CAP isn’t what you expected while in residency or even fellowship (which is not uncommon)? Also, keep in mind that with psych you still have to do 6mo of adult medicine/neuro (some programs may allow 1-2 months of peds or peds neuro but these are more often the exception than the rule). And before anyone else mentions it, yes there are the post peds portal programs but I believe there are only 4 of these and the overall training will ultimately be longer; but nonetheless is an option if you go peds and then change your mind. Triple board is also an option though I would never encourage someone to go this route, however that’s just my 2 cents.

 

[Mad Jack]

Rising m4 interested in psych. I like kids a lot but what may ultimately keep me away from outpatient cap in particular is dealing with the parents. Many of those parents will have personality disorders or other serious mental illness themselves.

CAP is 60% parents, 40% kids. It's a family job, really. And the thing is when it goes right it's very rewarding, but when it doesn't it can be *rough.* Being able to provide comfort and reassurance to a family that is struggling is great, being yelled at for a situation that is not in your power to control or change is a challenge. I think the hardest thing about CAP is that often the dissatisfied parents make things feel very personal toward the psychiatrist, despite most outcomes being more a result of the systems present than anything

 

[calvinhobbes]

You have to ask yourself if you want to be a specialist or a primary care physician. A pediatrician is a PCP. A psychiatrist is a specialist. Peds gets paid significantly less. (Even FM pays much more bc they see adults). CAP gets paid significantly more. In Peds you’re seeing a billion patients a day. In Psych you’re maybe seeing 8-12 a day? In Peds if you specialize you most likely will work at an academic institution where the pay will be less than gen peds, and they will have say over your schedule, etc. In private practice psych, you do what you want where you want when you want. You can see adults too. Sky is the limit. In peds you have overhead costs, psych almost none. Peds is very restrictive, psych is not. That’s why I would recommend psych to anyone who doesn’t care about not having procedural skills but still enjoys psychopharm and the joys of a true patient-doc relationship.