Clinical Neuropsychology career vs Psychiatry

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OrthoRehab33

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Okay, so Im quite torn between these two fields. There appears to be a lot of overlap between them (maybe I'm wrong). However, judging by the paths to get to each career I'd say Im leaning towards an MD. My reasons being: 1) its actually easier to get into med school then a PhD Clinical Psych 2) each take roughly the same amount of time (Med school 4 yrs then another 3 to specialize vs 5-6 yrs PhD in Clinical +1-2 yrs in Neuropsych) 3) the pay is almost twice as much
Things I really dislike about MD is that theres not much psychological testing like Neuropsych to test cognitive impairment. With a PhD your career is more flexible to move towards clinical/research/teaching. Also I dislike the fact that I cant specialize right away (totally understandable but I know I want to get into psychiatry/neurology). So breaking it down simply: easier admission (not much but theres many more factors when applying towards med school which can help soften the blow to a lower GPA or something), same amount of time to obtain degrees, higher earnings. Im definitely not trying to downplay PhD and Id absolutely appreciate anyones feedback because honestly as I said Im torn between the fields.
 
I'm not convinced that it's any easier to get into medical school than a clinical PhD program.

Take my state, for example.
  • The acceptance rate for the PhD in Clinical Psychology program at the University of Oregon was 4.6% (10 out of 217) for the 2009 entering class
  • The acceptance rate for the MD program at Oregon Health & Science University was 2.7% (120 out of 4521) for the 2009 entering class (the most recent data I can find)

Based on the only clinical-psychology PhD program in this state and the only MD program in the state, the MD program is more difficult. Yes, you will find statistics to support the opposite conclusion (I think the statistics are opposite at U. of Washington), but either way they are both highly competitive programs and I think it's naive to think that MD programs are "easier" on any substantial level. (Also: you have to remember that both programs are somewhat self-selecting. It might be easier for Person A to get into a clinical PhD program if he's really strong with statistics. But Person B might have a better chance at an MD program if she's really strong in organic chemistry.)

You're right that psychiatry and neurology will not give you all the same tools for cognitive testing as a neuropsychology program. If that's really important to you then that's cool.

I think you're incorrect, however, in saying that "With a PhD your career is more flexible to move towards clinical/research/teaching." Who do you think is doing all the clinical work in psychiatry units? And what about outpatient psychiatrists? Who do you think is doing all of the research in those psychiatry journals? Who do you think teaches psychiatry to medical students and psychiatry residents?

If a psychiatrist wanted to work in a non-medical psychology department, that would be possible, as well. I think this would be a lot more common if it didn't mean a $50,000-$100,000 cut to their salary! They wouldn't necessarily be more hirable than someone with a clinical PhD, because they couldn't supervise them in the clinic, but I think it would be possible for them to get hired... especially for programs that might want to start offering post-doctoral psychopharmacology programs!

There are good and bad reasons to go into either program. I don't think the perceived ease of admissions should be the factor you use to decide.
 
Your day-to-day duties and your role in patient consultation/care are in no way similar really. I would say the only similarity would be that you see patients with mental illness and both learn about neuroanatomy during the course of their training.

Psychiatrist generally have little interest, themselves, in testing/assessment, cognitive neuroscience, cognitive rehabilitation approaches, psychometrics, etc. Although they do utilize npsychs as consultants and for treatment planning and differential diagnosis. Neurology and Primary Care docs are probably our biggest refferal base though.
 
I agree with erg--on a day-to-day basis, I honestly don't see much similarity between the job responsibilities of the average neuropsychologist vs. the average psychiatrist. Although also keep in mind that most members of this forum (myself included) aren't yet practicing psychologists, so take our perspectives with a grain of salt.

Perhaps you could elaborate on what it is between the two professions that you see as being so similar, or what it is about each field that interests you? We might then be able to provide some insight so you can make a more-informed career decision.
 
What are your interests? Based on your interests, look at the day-to-day life of those in the fields which might fit, and then decide which one would sustain you based on the "happiness factor", not money or time spent in the degree. As erg alluded to, you should look into neurology, and I'd add PM&R as an option if you are interested in neuropsych-related stuff.

I think the $$ reward is more consistent in any medical field than in neuropsych. I know a few neuropsychologists who make more than the average neurologist, but this is uncommon, and differences in reimbursement vary a lot on a state-by-state basis, more so than in medicine. Despite this I'd never do anything other than neuropsych, but thats just me.

Anyway, do you have a population of interest? Like TBI, dementia, autism, dev. delay, epilepsy, movement disorders, etc? Do you see yourself working with a pediatrics vs adult/gero population? These are good things to be thinking about, which you probably are.
 
Okay, so Im quite torn between these two fields. There appears to be a lot of overlap between them (maybe I'm wrong). However, judging by the paths to get to each career I'd say Im leaning towards an MD. My reasons being: 1) its actually easier to get into med school then a PhD Clinical Psych 2) each take roughly the same amount of time (Med school 4 yrs then another 3 to specialize vs 5-6 yrs PhD in Clinical +1-2 yrs in Neuropsych) 3) the pay is almost twice as much
Things I really dislike about MD is that theres not much psychological testing like Neuropsych to test cognitive impairment. With a PhD your career is more flexible to move towards clinical/research/teaching. Also I dislike the fact that I cant specialize right away (totally understandable but I know I want to get into psychiatry/neurology). So breaking it down simply: easier admission (not much but theres many more factors when applying towards med school which can help soften the blow to a lower GPA or something), same amount of time to obtain degrees, higher earnings. Im definitely not trying to downplay PhD and Id absolutely appreciate anyones feedback because honestly as I said Im torn between the fields.

What did you decide? I am contemplating clinical neuropsychology versus medical school.
 
In addition to the higher salary, the MD is also much more in demand and you won't have trouble landing a residency position and then a high paying job. There is a huge shortage of psychiatrists out there. Every psychiatrist I know has a 4-6 month wait list if they are in private practice. With neuropsychology, it is very tough to land an APA internship these days and I believe even tougher to land a 2-year neuropsychology fellowship. So even after committing to 6 years of graduate school, you may not be able to gain entry into the field and technically become a neuropsychologist.

I'm not commenting on which field is more of a fit since they are both pretty different as mentioned above.
 
Psych residency is not 3 years. It's 4.
 
Psych residency is not 3 years. It's 4.

For the purposes of comparison, the # of years in training is the same for both--8 years post-college (this includes the 2 year neuropsychology post-doc requirement). Although with a PhD, you never know how long its going to take you to defend your dissertation. 7 years in school is not uncommon for some programs. Med school is a guaranteed 4 years.
 
For the purposes of comparison, the # of years in training is the same for both--8 years post-college (this includes the 2 year neuropsychology post-doc requirement). Although with a PhD, you never know how long its going to take you to defend your dissertation. 7 years in school is not uncommon for some programs. Med school is a guaranteed 4 years.

There are certainly no guarantees with respect to getting through medical school in 4 years. Then one has to apply for residency, which is also surely no guarantee. Psych is currently on the lower-range of residency competitiveness, although that is also not guaranteed to remain the same. And any subspecialization in psychiatry will tack on additional year(s) of training.
 
There are certainly no guarantees with respect to getting through medical school in 4 years. Then one has to apply for residency, which is also surely no guarantee. Psych is currently on the lower-range of residency competitiveness, although that is also not guaranteed to remain the same. And any subspecialization in psychiatry will tack on additional year(s) of training.

I know many people who got into psychiatry residency and many went to foreign medical schools. My understanding from talking to psychiatrists, is that if you go to a US Medical School, you will match for a psychiatry residency since as you mention its on the lower-range of competitiveness. However, for clinical psychology, the match rate for apa accredited internships nationwide is only 50%, and that does not include students who drop out of the match because they didn't get interviews. Basically, this means that the majority of students in our field these days do not match to an APA accredited internship (these are very important to secure fellowships, jobs, and for licensure in some states). Nothing is guaranteed, but the odds are very different among these two fields. I'd like to see a statistic that shows that 50% of people do not match to an accredited residency program in psychiatry.
 
I know many people who got into psychiatry residency and many went to foreign medical schools. My understanding from talking to psychiatrists, is that if you go to a US Medical School, you will match for a psychiatry residency since as you mention its on the lower-range of competitiveness. However, for clinical psychology, the match rate for apa accredited internships nationwide is only 50%, and that does not include students who drop out of the match because they didn't get interviews. Basically, this means that the majority of students in our field these days do not match to an APA accredited internship (these are very important to secure fellowships, jobs, and for licensure in some states). Nothing is guaranteed, but the odds are very different among these two fields. I'd like to see a statistic that shows that 50% of people do not match to an accredited residency program in psychiatry.

True today, but the face of Graduate Medical Education is dramatically changing in the coming years.
 
True today, but the face of Graduate Medical Education is dramatically changing in the coming years.

People always predict doom and gloom in their respective fields. Let's talk once salaries fall to a median of 60K for MD's and free standing institutions are accredited by the AMA. The AMA is a strong organization with a powerful lobby. We unfortunately do not have a strong organization that promotes our interest.
 
People always predict doom and gloom in their respective fields. Let's talk once salaries fall to a median of 60K for MD's and free standing institutions are accredited by the AMA. The AMA is a strong organization with a powerful lobby. We unfortunately do not have a strong organization that promotes our interest.

I've certainly seen physicians bemoan the AMA on SDN, particularly with respect to protection from mid-level encroachment and declining reimbursement rates.

That being said, what I'll say to our physician colleagues is this--if you think the AMA is bad, then the AP(ology)A can at times bring entirely new meaning to the word "ineffectual."
 
I know many people who got into psychiatry residency and many went to foreign medical schools. My understanding from talking to psychiatrists, is that if you go to a US Medical School, you will match for a psychiatry residency since as you mention its on the lower-range of competitiveness. However, for clinical psychology, the match rate for apa accredited internships nationwide is only 50%, and that does not include students who drop out of the match because they didn't get interviews. Basically, this means that the majority of students in our field these days do not match to an APA accredited internship (these are very important to secure fellowships, jobs, and for licensure in some states). Nothing is guaranteed, but the odds are very different among these two fields. I'd like to see a statistic that shows that 50% of people do not match to an accredited residency program in psychiatry.

These %'s, like many stats trying to compare apples and oranges, don't reflect the true nature of the field. If there were for-profit medical schools pumping out medical students across the US, the %'s would be different, but currently the total #'s are kept quite in check at the medical student and graduate medical education (residency) level. #'s apply to school in themselves are not reflective of interest, since pre-meds often get selected out before they even reach the point of applying through doing poorly in their science pre-requisites. A closer approximation would be looking at ratio of pre-meds to those accepted, but obviously that is a flawed comparison as well.

As with all of these discussions, everyone has a dog in the fight and wants to imagine their competitiveness as greater to feel that their investment of time/money/life is worthwhile, so pay selective attention to those figures which hype the importance of their program. But in truth they're not equivalent in competitiveness. It's like saying one person is "smarter" than another. There are many domains of cognitive fxning, and just because one person excels in a single domain doesn't make them superior in all domains. To generalize like that is ridiculous.
 
And to get back to the OP of this resurrected thread, psychiatry definitely opens up more options, but as my psychologist mentor from undergrad used to tell me "the training changes you." Meaning your priorities may be different once you've finished training than it is right now. You may value research now, but the experience and rigor of medical training may change that, as might being older, being in debt, being around certain people, etc.

Psychiatrists CAN get training in whatever they want, and legally could learn to do psychological testing, but I know of very few that do. Few also get research training, though I know some that do and are outstanding at it. The benefit of doing research as a psychiatrist is that you have a rich and intensive clinical background from which to draw, which may or may not be the case from psychological training (more intensive theoretical, less varied clinical settings, less severe psychopathology in general).
 
T

As with all of these discussions, everyone has a dog in the fight and wants to imagine their competitiveness as greater to feel that their investment of time/money/life is worthwhile, so pay selective attention to those figures which hype the importance of their program. But in truth they're not equivalent in competitiveness. It's like saying one person is "smarter" than another. There are many domains of cognitive fxning, and just because one person excels in a single domain doesn't make them superior in all domains. To generalize like that is ridiculous.

You clearly misread my point. I'm not saying that clinical psychology is a more competitive field or that psychologists are more competent/brighter. The weeding out is just done at the end of training rather than during college/medical school applications process (pre-med courses clearly weed out many people, but at least they weed them out before they complete 4 years of medical school). Applicants need to consider this before entering our field. There is more risk in this regard. This is not an attractive aspect of our field, and does not make the field more worthwhile--quite the opposite. From my perspective, its important for every applicant to know about the current internship crisis so that they can make informed decisions.
 
You clearly misread my point. I'm not saying that clinical psychology is a more competitive field or that psychologists are more competent/brighter. The weeding out is just done at the end of training rather than during college/medical school applications process (pre-med courses clearly weed out many people, but at least they weed them out before they complete 4 years of medical school). Applicants need to consider this before entering our field. There is more risk in this regard. This is not an attractive aspect of our field, and does not make the field more worthwhile--quite the opposite. From my perspective, its important for every applicant to know about the current internship crisis so that they can make informed decisions.

I appreciate that as a point, but I don't feel that point of filtering at different phases of training was mentioned in your original post. Thanks for making it now, and in general I'd agree. Though still they're filtering based on markedly different skillsets and domains of intelligence/functioning.
 
I've certainly seen physicians bemoan the AMA on SDN, particularly with respect to protection from mid-level encroachment and declining reimbursement rates.

That being said, what I'll say to our physician colleagues is this--if you think the AMA is bad, then the AP(ology)A can at times bring entirely new meaning to the word "ineffectual."

Medicare actually gave psychiatrists a 1 percent raise for med management this year while psychologists got a huge cut
 
Medicare actually gave psychiatrists a 1 percent raise for med management this year while psychologists got a huge cut

I believe our cut was in the neighborhood of 45%. That makes the reimbursement rate unmanageably low. I will no longer be accepting Medicare patients. Fortunately, the elderly comprise very little of my caseload.

Dr. E
 
Psychiatrists CAN get training in whatever they want, and legally could learn to do psychological testing, but I know of very few that do. Few also get research training, though I know some that do and are outstanding at it. The benefit of doing research as a psychiatrist is that you have a rich and intensive clinical background from which to draw, which may or may not be the case from psychological training (more intensive theoretical, less varied clinical settings, less severe psychopathology in general).

I'd love to see actual data on whether psychologists see those with less severe psychopathology than psychiatrists. I think this has far more to do with what your interests are and where you work. I've been routinely shot down when trying to get a psychiatry referral for those with SMI due to psychiatrists filling their books up with depression, ADHD, and anxiety issues. That being said this is just my rather short experience; I'd love to see actual numbers.

Another tangent but I'm also curious as to someone's claim that psychiatrists could get a job in a psychology department. Has anyone seen this happen frequently where an MD has a lab in a clinical program? other than those loosely affiliated or those with an MD/PhD? I don't know if it would work but it could definitely be interesting. Also, PhD psychologists most certainly can teach in medical schools so I don't think this opportunity would differentiate opportunities for MDs vs. PhDs

Re. the OP - I don't see the jobs of a neuropsychologist and psychiatrist as overlapping all that much. They both study the brain? I'd recommend talking to, and possibly shadowing, people in both areas and see what they actually do. Once you have insight into that then you'll be better prepared to pursue one line or the other. Each profession has its pluses and minuses. And let's face it - neither profession is at the top of the well respected health care food chain.
 
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I'd love to see actual data on whether psychologists see those with less severe psychopathology than psychiatrists. I think this has far more to do with what your interests are and where you work. I've been routinely shot down when trying to get a psychiatry referral for those with SMI due to psychiatrists filling their books up with depression, ADHD, and anxiety issues. That being said this is just my rather short experience; I'd love to see actual numbers.

I was referring to the training requirements. Psychiatrists generally do a large amount of training in psychiatric ER's, inpatient hospitals, as well as having specialty rotations (child/adolescent, addiction, neurology, consult/liaison), in addition to a minimum of a year of outpatient treatment (most residencies have clinics that go for multiple years, just not FT). On average this means psychiatrists have more exposure to sicker people during training. Most psychologists I know get their clinical hours in 1, maybe 2 clinical settings. But others can speak to their own training experience.
 
I was referring to the training requirements. Psychiatrists generally do a large amount of training in psychiatric ER's, inpatient hospitals, as well as having specialty rotations (child/adolescent, addiction, neurology, consult/liaison), in addition to a minimum of a year of outpatient treatment (most residencies have clinics that go for multiple years, just not FT). On average this means psychiatrists have more exposure to sicker people during training. Most psychologists I know get their clinical hours in 1, maybe 2 clinical settings. But others can speak to their own training experience.

It's really so variable though that it's hard to make definitive statements. For example, I'm in a very research heavy program and yet I've had 3.5 years of clinical practica the majority of which have been with severe psychopathology. My research is also along the same lines so I have many hours of contact that don't count as clinical hours but they involve a great deal of exposure. I will hopefully be going on internship for a full time clinical placement for those with SMI so that will be another year of training focused specially on those with severe psychopathology.

Given that I come from a program that does not push for clinical hours, I wonder how much additional time/exposure people have who come from more balanced programs.
 
Behavioral neurology in particular will give you what you want. Basically you see cooler cases and get the first crack at the presentation picture before referring off to neuropsych.
 
I was referring to the training requirements. Psychiatrists generally do a large amount of training in psychiatric ER's, inpatient hospitals, as well as having specialty rotations (child/adolescent, addiction, neurology, consult/liaison), in addition to a minimum of a year of outpatient treatment (most residencies have clinics that go for multiple years, just not FT). On average this means psychiatrists have more exposure to sicker people during training. Most psychologists I know get their clinical hours in 1, maybe 2 clinical settings. But others can speak to their own training experience.

Its actually not uncommon for people to train in 4-5 different clinical settings these days in graduate school, particularly if you are not interested in an academic career. Many psychologists I know had 5-6 years of clinical training in different settings just by the time they graduated (even before fellowship). I live in a competitive part of the country so psychologists need tons of clinical hours to match at a site. For example, in graduate school, I trained at an addiction treatment center, medical school, inpatient psychiatry, community clinic (seeing adolescents, children, and adults), and a counseling center. On my internship, I was able to complete rotations in inpatient psychiatry (consult/liason as well), psychiatric ER, behavioral medicine, and a general outpatient clinic. The 4 years that you spend in medical school studying, we are actually spending out in the field completing hospital and clinic placements. I'll have 8 years of clinical training by the time I get licensed. There is no psychiatrist out there who gets 8 years of supervised clinical training by the time they finish residency.
 
On average this means psychiatrists have more exposure to sicker people during training. Most psychologists I know get their clinical hours in 1, maybe 2 clinical settings. But others can speak to their own training experience.

For example, in graduate school, I trained at an addiction treatment center, medical school, inpatient psychiatry, community clinic (seeing adolescents, children, and adults), and a counseling center. On my internship, I was able to complete rotations in inpatient psychiatry (consult/liason as well), psychiatric ER, behavioral medicine, and a general outpatient clinic.

It's an interesting distinction. I think it's possible that, generally speaking, psychiatrists do have more exposure to sicker people, but that's medical training. What about healthy people? I think it's important to see the entire gamut because otherwise you have a model where you see everyone as sick or potentially sick. Excuse me while I get all positive psychology on you all. :meanie:
 
I was referring to the training requirements. Psychiatrists generally do a large amount of training in psychiatric ER's, inpatient hospitals, as well as having specialty rotations (child/adolescent, addiction, neurology, consult/liaison), in addition to a minimum of a year of outpatient treatment (most residencies have clinics that go for multiple years, just not FT). On average this means psychiatrists have more exposure to sicker people during training. Most psychologists I know get their clinical hours in 1, maybe 2 clinical settings. But others can speak to their own training experience.

I haven't seen any data to support this assertion.

I consistently hear the above said and also implied on the Psychiatry forum that psychiatrists deal with "sicker" or "more severe" cases than psychologists. It sounds like the SDN version of, "when I was in school we were forced to walk uphill both ways, in snow...and we liked it!!" The vast majority of my work these days is with a non-psychiatric population, so it is no skin off my nose, but the scientist in me still raises an eyebrow whenever I hear about "sicker" people. I've had my fill of dealing with severe pathology, but if people want to compare the average chart size of their patients...so be it.
 
It sounds like the SDN version of, "when I was in school we were forced to walk uphill both ways, in snow...and we liked it!!"

:laugh:

I wonder if that's how clinical psychologists sound to counseling or school psychologists.
 
The 4 years that you spend in medical school studying, we are actually spending out in the field completing hospital and clinic placements. I'll have 8 years of clinical training by the time I get licensed. There is no psychiatrist out there who gets 8 years of supervised clinical training by the time they finish residency.

I'm not trying to turn this into a pissing contest. To clarify though, medical school involves at least 2 years of primarily clinical work, with most curricula also incorporating longitudinal outpatient care starting earlier (I started in the 2nd month of medical school). So I beg to differ.
 
I haven't seen any data to support this assertion.

I consistently hear the above said and also implied on the Psychiatry forum that psychiatrists deal with "sicker" or "more severe" cases than psychologists. It sounds like the SDN version of, "when I was in school we were forced to walk uphill both ways, in snow...and we liked it!!" The vast majority of my work these days is with a non-psychiatric population, so it is no skin off my nose, but the scientist in me still raises an eyebrow whenever I hear about "sicker" people. I've had my fill of dealing with severe pathology, but if people want to compare the average chart size of their patients...so be it.

It would be interesting to put together a table comparing required hours/standard training between the two. Overall there is some heterogeneity amongst training for psychiatrists, but I would there is a lot more heterogeneity in psychology training, so on average psychiatrists have more exposure in broader clinical contexts. The other side is that psychiatrists are often brought in during the worst of decompensation cases in hospitals and ER's, and I bet see on average more patients, but often lack the same depth that psychologists get with a patient in seeing fewer patients for more hours/patient. All this has been hashed out before in other thread (this kinda thing really needs a sticky).
 
It would be interesting to put together a table comparing required hours/standard training between the two. Overall there is some heterogeneity amongst training for psychiatrists, but I would there is a lot more heterogeneity in psychology training, so on average psychiatrists have more exposure in broader clinical contexts. The other side is that psychiatrists are often brought in during the worst of decompensation cases in hospitals and ER's, and I bet see on average more patients, but often lack the same depth that psychologists get with a patient in seeing fewer patients for more hours/patient. All this has been hashed out before in other thread (this kinda thing really needs a sticky).

I remember reading somewhere about this a couple of years back? the numbers came out to somewhere between 9,000-12,000 hours of supervised clinical training in both psychiatry and psychology (this includes extra hours that people do on internship and fellowship, which is why its so high). Neither field was able to claim an advantage.

Also, in your earlier post, how many years did you spend in medical school actually seeing and treating psychiatric patients under the supervision of a psychiatrist? I'm not referring to research or hospital experience in general. I don't know anyone in medical school that had this experience throughout the entire 4 years.
 
I remember reading somewhere about this a couple of years back? the numbers came out to somewhere between 9,000-12,000 hours of supervised clinical training in both psychiatry and psychology (this includes extra hours that people do on internship and fellowship, which is why its so high). Neither field was able to claim an advantage.

Also, in your earlier post, how many years did you spend in medical school actually seeing and treating psychiatric patients under the supervision of a psychiatrist? I'm not referring to research or hospital experience in general. I don't know anyone in medical school that had this experience throughout the entire 4 years.

Psychiatric training is informed by medical training. A point missed by many that attempt to generalize that more psychological training somehow equates to having some medical training.

As for the 12,000 hours, I believe psychologists were less but others attempted to add in fellowships to bump it. Again, it would be useful to do a detailed breakdown to actually look at the data.

These were some productive prior threads on this topic (psych vs. psych), and I always appreciate the discussions with T4C and Jon Snow. I did not see any breakdown showing clinical hours for psychologists, and I believe most states require something in the range of 1500-2000.

http://forums.studentdoctor.net/showpost.php?p=10437291&postcount=21
http://forums.studentdoctor.net/showpost.php?p=10504272&postcount=61
http://forums.studentdoctor.net/showthread.php?t=708329
http://forums.studentdoctor.net/showthread.php?t=790232
 
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Sounds like you include the time you spent rotating through surgery and gynecology into the number of hours of clinical training in psychiatry. I'm not sure that number of hours mean anything after a certain point, but psychologists who complete 2 -year fellowships will have a similar amount of hours. Fellowships/post-docs are required for us in the majority of states to be licensed, and we are getting extensive supervision at this stage typically. However, the number of years of clinical training will be longer for psychologists from start to finish vs. the number of years you were supervised in psychiatry specifically (8 years vs. 3-4).

If you are adding the amount of time you spent on a surgery rotation then a psychologist can add the amount of time he spent lecturing in courses in psychology, grading papers, doing research and writing. I'm sure this would amount to 40,000 hours for each field. You would have to set meaningful parameters for each field on how to define hours and what counts.

The 1500-2000 hours required for licensure do not include any predoctoral hours you completed over the previous 6 years or so.
 
Sounds like you include the time you spent rotating through surgery and gynecology into the number of hours of clinical training in psychiatry. I'm not sure that number of hours mean anything after a certain point, but psychologists who complete 2 -year fellowships will have a similar amount of hours. Fellowships/post-docs are required for us in the majority of states to be licensed, and we are getting extensive supervision at this stage typically. However, the number of years of clinical training will be longer for psychologists from start to finish vs. the number of years you were supervised in psychiatry specifically (8 years vs. 3-4).

If you are adding the amount of time you spent on a surgery rotation then a psychologist can add the amount of time he spent lecturing in courses in psychology, grading papers, doing research and writing. I'm sure this would amount to 40,000 hours for each field. You would have to set meaningful parameters for each field on how to define hours and what counts.

The 1500-2000 hours required for licensure do not include any predoctoral hours you completed over the previous 6 years or so.

If you read through some of the old threads, it's 7800-12000 hours in residency alone in psychiatry. That's not counting medical school rotations. And you can't mix in lectures, as then you're muddying CLINICAL training with ALL training. You can add plenty of fellowships and eventually get the equivalent, but can you tell me that fellowships are REQUIRED for psychologists? These are the hours REQUIRED for psychiatrists.
 
It is hard to compare precisely because there is more variability in psychology practica experiences. I know some people that did all of their training in community mental health. I personally trained across 4 sites and in just about every level of care. Psychiatrists have more "standardized" standards.

But if you just want to compare aggregate clinical hours, I am sure they are close on average. I did less than many of my peers, but when I added it up through graduate school, internship, and postdoc, it was over 9000 hours of supervised clinical work under licensed clinical psychologists.

It really is apples and oranges though. Not really sure why it matters? I suppose it is important to note that the training is qualitatively different. If the decision is based on finances only, psychiatry hands down is a better option.
 
If you read through some of the old threads, it's 7800-12000 hours in residency alone in psychiatry. That's not counting medical school rotations. And you can't mix in lectures, as then you're muddying CLINICAL training with ALL training. You can add plenty of fellowships and eventually get the equivalent, but can you tell me that fellowships are REQUIRED for psychologists? These are the hours REQUIRED for psychiatrists.

12000 hours in 4 years?

No, fellowships aren't required for psychologists, but in most states, postdoctoral hours are required in some form. 4000 hours are definitely required after graduation for neuropsychology.
 
If you read through some of the old threads, it's 7800-12000 hours in residency alone in psychiatry. That's not counting medical school rotations. And you can't mix in lectures, as then you're muddying CLINICAL training with ALL training. You can add plenty of fellowships and eventually get the equivalent, but can you tell me that fellowships are REQUIRED for psychologists? These are the hours REQUIRED for psychiatrists.

Postdoctoral hours are required for psychologists in the vast majority of states in order to get hours for licensure! Some fellowships are two years some are one year. Neuropsychology requires a two year fellowship. You cannot get licensed without a fellowship/post-doc in most states. In my state, you need 4 hours of supervision after you graduate. There are only a handful of states that don't require this.

Overall, the number of hours are going to be in the same ballpark (for me its going to be 12,000 since i'm doing a 2 year fellowship). However, clinical psychologists spend more years getting supervised clinical training in psychology (7-8 years on average vs. 3 years of supervised experience in psychiatry).

Also, research on developing expertise shows that 10,000 hours of practice is required in order to be an expert in an area. After 10,000 hours there may be no added benefit?
 
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12000 hours in 4 years?

.

Nitemagi is counting a 60-hour work week. Plus, he is counting all the time he spent rotating through the hospital doing work unrelated to psychiatry. I think the same can be said of clinical psychology internships and post-docs. They are meant to be "40 hours" but people work 50+ hours weeks all the time.
 
I don't understand the frequent psychiatry vs. psychology debates here.
While psychiatry and psychology both involve mental illness there is a great deal of difference in what each field actually does. I'm glad there are people who want to be psychiatrists because they serve an important function. I'm also glad there are psychologists as they serve important functions too.

Psychology has always been best for me as I want to do research and didn't want to spend years learning things I have no interest in (OB/GYN, primary care, etc rotations? No thanks!). Yes, it's not the top field in terms of finances or respect (although psychiatry isn't either) but it's what I decided was right for me. My choice has no bearing on what's best for other people or what's the most difficult/awesome/OMGimportant.
 
Sure does look like a pissing contest is going on in here to me.

On another note, I've certainly found this to be true:

I wonder if that's how clinical psychologists sound to counseling or school psychologists.

...when it comes to bragging about the severity of the clients they see. Conversely, the counseling psychologists brag about how they see "healthy" and "more diverse" clients and how they "see the whole person" and don't just diagnose according to an icky "medical model." :meanie:
 
Nitemagi is counting a 60-hour work week. Plus, he is counting all the time he spent rotating through the hospital doing work unrelated to psychiatry. I think the same can be said of clinical psychology internships and post-docs. They are meant to be "40 hours" but people work 50+ hours weeks all the time.

I guess it never occurred to me to count my 60 hour weeks (which were about average on postdoc). But I'm not hating on Nitemagi.
 
As a medical student, let me give you my perspective - not on psychiatry, because I am not a psychiatrist, let alone being a psychologist (I have one family member who is a psychologist, but that's it), but as a person who is trying to decide what to do with my life.

For the record, I have the utmost respect for psychologists. The family member I spoke of is without a doubt the smartest person I ever met, and the little interactions I've had with psychologists (either attending a lecture, or seeing them practicing) has been nothing but exemplary. From what I know of their training - it is excellent and comprehensive and everyone I have encountered has been very smart and dedicated. I know there is a lot of animus - especially where there is overlap - but I think that's human nature to a degree. I would trust a psychologist completely with my mental health, and would seek their care without any hesitation, if I had a problem that required it. And clearly there is huge overlap with psychiatry, but I think the fields are extremely different. But overall, I have zero negative things to say about psychologists.

As a medical student, I am currently deciding between psychiatry, emergency medicine, and general surgery. That should tell you the difference. You are a physician first, and everything you do is approached from that angle. Tonight, I am staying up all night trying to learn lung pathology for an exam in couple weeks - the current page I was reading (before this break 😛) was looking at pathophysiology of nonmucinous bronchioalveolar carcinoma vs. mucinous branchioalveolar carcinoma, and trying to differentiate them by cell morphology in a pathology slide - these are the types of things that will be tested. When you go to medical school, that's what you're going to be learning for 99% of the time. If you're not OK with being a physician first - learning the workup of a patient with urinary incontinence, or about how the nematode ascaris lumbricoides infects humans, or memorize the origin, distribution of the gastroduodenal artery and the exact point which it branches into the superior pancreaticoduodenal artery, you don't want to be a psychiatrist because medical school is not for you. It can be a slog at times for even the most interested students - if you come in not really 'caring' at all - I would be astonished to see you finish. It's really hard memorizing the mechanism of action, side effects and contraindications of the many many chemotherapy drugs if you have no interest in ever actually seeing a patient with a non mental health issue. I am sure there are similar criteria for being a psychologist, and I will leave it to the people who've been through that training to tell you about that. I am sure it's just as rigorous and tough, but in its own way. You need to know the difference.

If you want to be a psychiatrist, you choose to be a physician first, and then you choose a specialty. From what several psychiatrists have told me, the lens you bring to a situation is that of a physician first. Yes, a lot of the biological knowledge may go away and you may not remember the chemical reason for the existence of Auer rods in Acute promyelocytic leukemia, but the approach and the basics are still going to stick with you. If you don't find that at least a little interesting, you will not get through medical school. There is some, but not a lot, of psychiatry in the first two years - a four-six week rotation in your third year and then your residency is where you really learn the most about mental illness. In third year, my second rotation is likely going to be OB/Gyn - where I'll be helping to deliver babies, and then on the next rotation I'll be scrubbing in on spinal surgeries and making sure I don't touch anything.

I keep giving you these completely random medical examples (even though I know I'll forget a lot of it regardless of the specialty I choose) over and over again to drive home the point that medical education is just that - a comprehensive medical education. You have to deal with all the body parts, fluids, conditions, complaints and everything that goes along with that. Are you OK with doing that? I am - I love interacting with patients and figuring out those problems (of course, I prefer some over the others) - but if you are just so focused on psychiatry that you are just ignoring everything else, I think you're making a bad decision. Basically if I couldn't be a psychiatrist, I know I could be happy in several other medical fields. Even in psychiatry residency, much of first year, you take care of medical problems - managing electrolytes patients in renal failure, workup of someone with acute chest pain, etc. This is just my opinion, but I truly think you probably need to love medicine first, and then fall in love with the mental health aspect of medicine. Rather than thinking of it as loving mental health first and then 'oh, I'll deal with the rest as something I just have to get through'.

People on this forum can tell you more about the training to be a psychologist. And I am sure psychiatrists can tell you about why they chose it. For what its worth - I know several people in my class who want to be psychiatrists, and none of them came into medical school thinking they would - but they were all interested in, and still are interested in, being physicians.

My advice for anyone: shadow both psychiatrists and psychologists, but also don't forget the path and the differences in focus you need for both fields.
 
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Okay, so Im quite torn between these two fields. There appears to be a lot of overlap between them (maybe I'm wrong). However, judging by the paths to get to each career I'd say Im leaning towards an MD. My reasons being: 1) its actually easier to get into med school then a PhD Clinical Psych 2) each take roughly the same amount of time (Med school 4 yrs then another 3 to specialize vs 5-6 yrs PhD in Clinical +1-2 yrs in Neuropsych) 3) the pay is almost twice as much
Things I really dislike about MD is that theres not much psychological testing like Neuropsych to test cognitive impairment. With a PhD your career is more flexible to move towards clinical/research/teaching. Also I dislike the fact that I cant specialize right away (totally understandable but I know I want to get into psychiatry/neurology). So breaking it down simply: easier admission (not much but theres many more factors when applying towards med school which can help soften the blow to a lower GPA or something), same amount of time to obtain degrees, higher earnings. Im definitely not trying to downplay PhD and Id absolutely appreciate anyones feedback because honestly as I said Im torn between the fields.

As a medical student, let me give you my perspective - not on psychiatry, because I am not one, let alone being psychologist (I have one family member who is a psychologist, but that's it), but as a person who is trying to decide what to do with my life.

For the record, I have the utmost respect for psychologist. The family member I spoke of is without a doubt the smartest person I ever met, and the little interactions I've had with psychologists (either attending a lecture, or seeing them practicing) has been nothing but exemplary. From what I know of their training - it is excellent and comprehensive and everyone I have encountered has been very smart and dedicated. I know there is a lot of animus - especially where there is overlap - but I think that's human nature to a degree. I would trust a psychologist completely with my mental health, and would seek their care without any hesitation, if I had a problem that required it. And clearly there is huge overlap with psychiatry, but I think the fields are extremely different. But overall, I have zero negative things to say about psychologists.

As a medical student, I am currently deciding between psychiatry, emergency medicine, and general surgery. That should tell you the difference. You are a physician first, and everything you do is approached from that angle. Tonight, I am staying up all night trying to learn lung pathology for an exam in couple weeks - the current page I was reading (before this break 😛) was looking at pathophysiology of nonmucinous bronchioalveolar carcinoma vs. mucinous branchioalveolar carcinoma, and trying to differentiate them by cell morphology in a pathology slide - these are the types of things that will be tested. When you go to medical school, that's what you're going to be learning for 99% of the time. If you're not OK with being a physician first - learning the workup of a patient with urinary incontinence, or about how the nematode ascaris lumbricoides infects humans, or memorize the origin, distribution of the gastroduodenal artery and the exact point which it branches into the superior pancreaticoduodenal artery, you don't want to be a psychiatrist because medical school is not for you. It can be a slog at times for even the most interested students - if you come in not really 'caring' at all - I would be astonished to see you finish. It's really hard memorizing the mechanism of action, side effects and contraindications of the many many chemotherapy drugs if you have no interest in ever actually seeing a patient with a non mental health issue. I am sure there are similar criteria for being a psychologist, and I will leave it to the people who've been through that training to tell you about that. I am sure it's just as rigorous and tough, but in its own way. You need to know the difference.

If you want to be a psychiatrist, you choose to be a physician first, and then you choose a specialty. From what several psychiatrists have told me, the lens you bring to a situation is that of a physician first. Yes, a lot of the biological knowledge may go away and you may not remember the chemical reason for the existence of Auer rods in Acute promyelocytic leukemia, but the approach and the basics are still going to stick with you. If you don't find that at least a little interesting, you will not get through medical school. There is some, but not a lot, of psychiatry in the first two years - a four-six week rotation in your third year and then your residency is where you really learn the most about mental illness. Even in residency, much of first year, you take care of medical problems - managing electrolytes patients in renal failure, workup of someone with acute chest pain, etc.

People on this forum can tell you more about the training to be a psychologist.

My advice for anyone: shadow both psychiatrists and psychologists, but also don't forget the path and the differences in focus you need for both fields.

This is a great post. I don't know if this thread is still alive, but it's a great post.

Lokhtar, not that you asked, but you are posting on a psychology forum. From someone who has been surrounded by intelligent physicians (my dad being a cardiothoracic surgeon), ask yourself: Do you have what it takes to deal with the high-stress demands of emergency medicine, or do you ascribe with the interesting yet controversial field of psychiatry (the "step-child" of medicine) or do you want a challenging and consistent job, aka general surgery? By the thoughtfulness and thoroughness of your post, I admire your determination and have no doubt that you will do the best at whatever path choose.

Thanks for sharing your perspective. Good luck to you & on your exam.:luck:

To the OP, as those clinical neuropsychologists-in-training have stated, psychiatry boasts a different training altogether. If you want to focus on non-pharmaceutical treatment, then psychology is your route. If you want to focus on the biological processes and mechanisms that can be treated, focus on medicine. The patient/client/individual is best served by a multidisciplinary team approach regardless, so just figure out what your strengths & limitations are and it will guide your career decisions.

Both medical school and any doctoral program will be difficult to get into, you will be scrutinized and infantilized as they look for the best of the best. If you have the determination to be the best you can be, then go for it. Otherwise, you'll have to figure out what are your shortcomings and how to improve. There are no shortcuts, sorry to say. As my grandma said, if doctorates were so easy, they would hand them out....which they do not, you have to prove that you can earn them, and then you have to follow up on your word.
 
I think lokhtar did a great job summing up why i chose not to go the psychiatry route. If you're not even remotely interested in the non-mental illness side (general medicine), it would be virtually impossible to get through med school. I knew from the get-go i didn't want to be a physician, and when it dawned on me in undergrad that psychiatrists are physicians before anything else, i knew it wasn't for me, and this realization helped a lot.
 
I think lokhtar did a great job summing up why i chose not to go the psychiatry route. If you're not even remotely interested in the non-mental illness side (general medicine), it would be virtually impossible to get through med school. I knew from the get-go i didn't want to be a physician, and when it dawned on me in undergrad that psychiatrists are physicians before anything else, i knew it wasn't for me, and this realization helped a lot.

Yes, organic chemisty taught me a lot about myself....at that particular stage of life. :beat: If I couldn't beat it in, it wasn't going in....
 
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Lokhtar, not that you asked, but you are posting on a psychology forum. From someone who has been surrounded by intelligent physicians (my dad being a cardiothoracic surgeon), ask yourself: Do you have what it takes to deal with the high-stress demands of emergency medicine, or do you ascribe with the interesting yet controversial field of psychiatry (the "step-child" of medicine) or do you want a challenging and consistent job, aka general surgery? By the thoughtfulness and thoroughness of your post, I admire your determination and have no doubt that you will do the best at whatever path choose.

My only criteria is going to be what I would enjoy the most (sound simple right?). So just as I rotate through the hospital, figure out what type of patient population, hospital setting, diseases, procedures etc that I am most happy with. I like different aspects of each of the specialties I mentioned - I know they all have varying levels of respect, but I can't live my life worrying about if people think I'm 'doctor enough' or if some people may think my profession is worthless. If you find something where you can show up to work in the morning and you're actually happy to be there, other considerations just pale in comparison. I mean I'm going to be hopefully doing this career for 25-35+ years for 8-12 hours a day for five days a week. Each day, six hours you're at home won't make up for the 10 hours of being unhappy at work. That's a lot of hours wasted misery if you ended up doing something for the wrong reasons....

And thank you for the compliment. I wish you the best of luck as well. Time to hit the books 😛.
 
After spending a year working on a Grad Degree in Applied Psychology, as I got closer to graduation I began looking into schools for Clinical Psychology with a focus on Neuropsychology. What I found completely changed my views. Clinical psychology gives you a taste of Anatomy and Physiology however a Clinical Psychologist is still not a Medical Doctor (they may have advanced knowledge in specific physiological area's however they are not MD's or DO's).

When I began applying to clinical psychology Doctor programs I got rejected right off the bat by a few (average GPA for many of these programs is a 3.75 or higher plus excellent GMAT scores); told by others how small the program sizes were and the likelihood of acceptance was low, I was also advised to expect to complete my program in 5 - 7 years however It could take 8 - 9 (this was the average time frame for students that actually completed the program). At this point I almost fell to pieces. I came to the realization that with the nature of managed care (I consulted with other Clinical Psychologist), wages and earnings were going down. Neuropsychology is also becoming more integrated into overall clinical care as well. In the end I realized that I was trying to find a shortcut into the medical world, I cut my losses and re-enrolled in school to complete my Pre - Med requirements. I also realized that having the Dr. in front of my name had become too much of a driving factor and realized that I preferred the holistic medical approach which has led me to primarily on applying DO.

I know this is a huge debate so tossing in my two cents for anyone considering a Clinical Psychology program, please make sure to do your research first; know what your getting into and the challenges that await you; understand the earning differences and FYI my graduate program was really rough; it was no walk in the park; I had a 4.0 GPA and I earned every bit of it; I'm talking about 16 hour days just doing research and writing papers for relentless professors. There really are no shortcuts in life. I'm just glad that I learned my lesson before more time was lost going into a direction that I would ultimately regret and now I can focus on doing what will make me happy.

Feel free to share your experiences and thoughts.
 
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Agreed: Clinical psychology shouldn't be seen as a "shortcut" to anything (particularly given the average length of training, which for neuropsychology would be 7-9 years). Psychologists are great at what they do, but what they do isn't being a physician; if that's what you're looking for, then med school is the only way to go.

Also, a few other quick things:

-I'm wondering if you meant the GRE rather than the GMAT, as the former is far and away the more widely-used graduate exam by doctoral program admissions committees; although I wouldn't doubt that there are probably a handful that do instead look at the GMAT
-Wages and earnings are going down essentially across the board in healthcare; that said, a six-figure income isn't nearly as certain in psychology (i.e., it's not certain at all) as it is in medicine, and physicians do generally tend to have more employment flexibility (in terms of geographic restrictions particularly)...although this can vary considerably by physician specialty (I have a friend who's finishing up his fellowship training in electrocardiology who's complained about how he's going to be limited in terms of what types of cities/hospitals will be able to offer him employment, for example)
-Not sure why "neuropsychology is also becoming more integrated into overall clinical care as well" is a bad thing...? Unless you meant it as a positive aspect of psychology, or you were worried that constantly being surrounded by physicians would invoke feelings of, "would've, should've, could've..."
 
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