Counselor to Psychiatrist?

[rearae86]

Hello,

I'm a Clinical Mental Health Counselor considering continuing my education and applying to medical school to become a Psychiatrist.

Are there any Psychiatrist's here that have taken a similar path? Any advice/warnings?

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[wolfvgang22]

I started out as a case manager/social worker, and took some post grad psychology courses before deciding on medical school instead. I was not a math and science guy in school. Before that I had earned a graduate degree in education and worked in public high schools.

One thing you should be aware of if you decide on med school is that you would be trained as a physician first and foremost, and will always be a physician, who is specializing in Psychiatry. It will change who you are. I am a Physician, all the time now, it is how I see the world now to a large degree. This is good and bad. No longer a layman, many things are medicalized, including mental illness. I'm less laid back. I became much more disciplined, and much more of a perfectionist. This is also good and bad. Medical training tries to turn you into an ascetic workaholic, and it will succeed to some degree if you are to survive training and become a competent physician. Medical school, and then residency, is in my opinion, far more grueling than anything else I've ever done. It is financially more rewarding. I'm not sure if it is emotionally more rewarding. On the one hand I like having more responsibility and say in treatment planning, on the other hand it is also more frought with concerns that I could be sued for malpractice, etc. I'd still do it all again. Why? Why do people climb Mt. Everest?

 

[rearae86]

I started out as a case manager/social worker, and took some post grad psychology courses before deciding on medical school instead. I was not a math and science guy in school. Before that I had earned a graduate degree in education and worked in public high schools.

One thing you should be aware of if you decide on med school is that you would be trained as a physician first and foremost, and will always be a physician, who is specializing in Psychiatry. It will change who you are. I am a Physician, all the time now, it is how I see the world now to a large degree. This is good and bad. No longer a layman, many things are medicalized, including mental illness. I'm less laid back. I became much more disciplined, and much more of a perfectionist. This is also good and bad. Medical training tries to turn you into an ascetic workaholic, and it will succeed to some degree if you are to survive training and become a competent physician. Medical school, and then residency, is in my opinion, far more grueling than anything else I've ever done. It is financially more rewarding. I'm not sure if it is emotionally more rewarding. On the one hand I like having more responsibility and say in treatment planning, on the other hand it is also more frought with concerns that I could be sued for malpractice, etc. I'd still do it all again. Why? Why do people climb Mt. Everest?

Great information! Thank you.

 

[NickNaylor]

I don't have any first-hand experience, but I would echo the importance of recognizing that medical school is NOT "psychiatry school." In fact "psychiatry school" is essentially the last thing that it is because psychiatry - at least at my medical school and at the school affiliated with my training program - is taught pretty superficially compared to other topics in medicine. Thus, you must have at least enough interest in medicine as a whole to hack it through what is essentially four years that may not appear to be at all related to what you ultimately want to do.

 

[wolfvgang22]

I will say that I learned to love topics like anatomy, surgery, infectious disease, cardiology, nephrology, and a host of other medical topics I had little interest in before med school. I started with one goal only - to become a psychiatrist. I knew I'd have to tough out these subjects in med school, but I was pleasantly surprised how interesting and relevant these things have turned out to be to the practice of psychiatry. There is so much to learn, and I'll never run out of things to discover in medicine! I'm never, ever bored (except when I have to do paperwork.) The enthusiasm and pride my fellow students had for medicine was contagious, and still is. It really is cool to belong to this profession and associate with colleagues who have high levels of ambition, intelligence, and compassion in equal measure.

 

[rearae86]

I will say that I learned to love topics like anatomy, surgery, infectious disease, cardiology, nephrology, and a host of other medical topics I had little interest in before med school. I started with one goal only - to become a psychiatrist. I knew I'd have to tough out these subjects in med school, but I was pleasantly surprised how interesting and relevant these things have turned out to be to the practice of psychiatry. There is so much to learn, and I'll never run out of things to discover in medicine! I'm never, ever bored (except when I have to do paperwork.) The enthusiasm and pride my fellow students had for medicine was contagious, and still is. It really is cool to belong to this profession and associate with colleagues who have high levels of ambition, intelligence, and compassion in equal measure.

Did your experience as a case manager provide you with any strengths in medical school?

 

[rearae86]

I don't have any first-hand experience, but I would echo the importance of recognizing that medical school is NOT "psychiatry school." In fact "psychiatry school" is essentially the last thing that it is because psychiatry - at least at my medical school and at the school affiliated with my training program - is taught pretty superficially compared to other topics in medicine. Thus, you must have at least enough interest in medicine as a whole to hack it through what is essentially four years that may not appear to be at all related to what you ultimately want to do.

Thank you. Right now my end goal is Psychiatry since that is closest to my experience and knowledge, however I do expect to develop a stronger foundation in medicine to get there. It's possible that my specialty may change if I find something that suits me better.

 

[wolfvgang22]

Did your experience as a case manager provide you with any strengths in medical school?

Not academically in med school, moreso practically. It helped when working to discharge patients, refer patients, write progress notes, do a basic mental status exam, do treatment plans, etc since I was used to doing these things before med school. Working with persons with mental illness was not some new scary experience for me as it is for many medical students. It made the learning curve for Psychiatry in particular less steep for me.

 

[deleted407021]

I will say that I learned to love topics like anatomy, surgery, infectious disease, cardiology, nephrology, and a host of other medical topics I had little interest in before med school. I started with one goal only - to become a psychiatrist. I knew I'd have to tough out these subjects in med school, but I was pleasantly surprised how interesting and relevant these things have turned out to be to the practice of psychiatry. There is so much to learn, and I'll never run out of things to discover in medicine! I'm never, ever bored (except when I have to do paperwork.) The enthusiasm and pride my fellow students had for medicine was contagious, and still is. It really is cool to belong to this profession and associate with colleagues who have high levels of ambition, intelligence, and compassion in equal measure.

I've heard many people call psychiatry the "least medical" of all medical specialties. What're your thoughts/feelings on this sentiment? Does your 2nd year basic medical knowledge come into play a lot?

I'm going into 2nd year and I've always had an interest in psychiatry (have a psych degree from UG, as well) but I also find myself really getting a lot of satisfaction out of my primary care skills. I'm excited to learn basic psych evaluation skills but I also think I like the practice of being a hands on physician. Do you still apply a lot of the basics in practice?

Thanks!

 

[wolfvgang22]

Basic medical knowledge is essential. And used every day.
Here's an extreme example:
Yesterday I completed a complicated consult to the ICU placed by Internal Medicine on a patient of mine they felt was having catatonia after being admitted for seizure. They are at a loss and neurology failed to find evidence of seizures on an EEG. The differential diagnosis in that particular case included seizure, pseudoseizure, catatonia, and delirium. I ended up recommending an LP and serologic tests because I suspect West Nile encephalitis. We will see what we find!

Most of the time it's more I notice someone's arthritis pain is not well controlled, leading to poor mood. Or there is a deficiency in B12 or Vitamin D. Every day I'm monitoring LFTs and CBCs for patients taking medication like Clozapine or Lamictal.

Only do psychiatry if that is what you wish to spend most of your time doing. If you want to spend most of your time doing IM or infectious disease or neurology or cardiology or whatever, do that instead. But being a psychiatrist does NOT mean giving up your MD (or DO). I don't touch patients a lot, it's mostly a cognitive specialty. So if you really enjoy giving knee injections or scraping seborrheic lessons off people, don't be a psychiatrist, do primary care.

 

[deleted407021]

Basic medical knowledge is essential. And used every day.
Here's an extreme example:
Yesterday I completed a complicated consult to the ICU placed by Internal Medicine on a patient of mine they felt was having catatonia after being admitted for seizure. They are at a loss and neurology failed to find evidence of seizures on an EEG. The differential diagnosis in that particular case included seizure, pseudoseizure, catatonia, and delirium. I ended up recommending an LP and serologic tests because I suspect West Nile encephalitis. We will see what we find!

Most of the time it's more I notice someone's arthritis pain is not well controlled, leading to poor mood. Or there is a deficiency in B12 or Vitamin D. Every day I'm monitoring LFTs and CBCs for patients taking medication like Clozapine or Lamictal.

Only do psychiatry if that is what you wish to spend most of your time doing. If you want to spend most of your time doing IM or infectious disease or neurology or cardiology or whatever, do that instead. But being a psychiatrist does NOT mean giving up your MD (or DO). I don't touch patients a lot, it's mostly a cognitive specialty. So if you really enjoy giving knee injections or scraping seborrheic lessons off people, don't be a psychiatrist, do primary care.

Thanks for the thorough answer!

 

[Wilf]

Here's an extreme example:
Yesterday I completed a complicated consult to the ICU placed by Internal Medicine on a patient of mine they felt was having catatonia after being admitted for seizure. They are at a loss and neurology failed to find evidence of seizures on an EEG. The differential diagnosis in that particular case included seizure, pseudoseizure, catatonia, and delirium. I ended up recommending an LP and serologic tests because I suspect West Nile encephalitis. We will see what we find!

Most of the time it's more I notice someone's arthritis pain is not well controlled, leading to poor mood. Or there is a deficiency in B12 or Vitamin D. Every day I'm monitoring LFTs and CBCs for patients taking medication like Clozapine or Lamictal.

Nice, what made you lean toward West Nile?

Do you routinely get CBCs on patients taking lamictal? I never have and none of my attendings have ever suggested it.