raspberry swirl

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i am a 4th year who should be working on my ERAS stuff right now, only im not sure what i want to do. i either want to do pediatrics or psychiatry. i cannot decide. i love both. it has been suggested to me that if im not sure, i should just do an internship and apply for residency next year... but i still think that in a year im not going to be able to decide. i think i will always love both pediatrics and psych (i'd do a child fellowship). i feel like if i do an internship and wait a year, im just delaying the inevitable and causing myself more stress during an already stressful internship. however, i know that as of now, im not comfortable making a decision ... im feeling really stuck. its so frustrating because all of my friends know exactly what they want. is anyone, or has anyone, been in this position? is it worth it to delay the decision, or should i just make a decision and go with it in blind faith, since im pretty sure thats what i'd be doing in a year anyway? any thoughts or opinions would be appreciated ... i feel like im giving myself some serious ulcers over this :(

(oh and i already know about the combined peds/psych programs- there's only one on the east coast, and its mt sinai, and i'd never get it, plus its research based which im not all that into ... although i may apply there anyway just for giggles.)
 

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raspberry swirl said:
i am a 4th year who should be working on my ERAS stuff right now, only im not sure what i want to do. i either want to do pediatrics or psychiatry. i cannot decide. i love both. it has been suggested to me that if im not sure, i should just do an internship and apply for residency next year... but i still think that in a year im not going to be able to decide. i think i will always love both pediatrics and psych (i'd do a child fellowship). i feel like if i do an internship and wait a year, im just delaying the inevitable and causing myself more stress during an already stressful internship. however, i know that as of now, im not comfortable making a decision ... im feeling really stuck. its so frustrating because all of my friends know exactly what they want. is anyone, or has anyone, been in this position? is it worth it to delay the decision, or should i just make a decision and go with it in blind faith, since im pretty sure thats what i'd be doing in a year anyway? any thoughts or opinions would be appreciated ... i feel like im giving myself some serious ulcers over this :(

(oh and i already know about the combined peds/psych programs- there's only one on the east coast, and its mt sinai, and i'd never get it, plus its research based which im not all that into ... although i may apply there anyway just for giggles.)
Dear RS:

Believe it or not, I had somewhat similar thoughts a long-time ago. I liked my 2 months on child psych and it would have been my alternative if I hadn't gone pedi. There's a lot of adolescent psych work in neonatology actually (14 y/o moms :rolleyes: ).

In any case, what made the decision for me was that I could never see myself doing an adult psych residency which is needed as part of the path to pedi psych. Also, I felt the field was poorly defined and the role of medicines vs talking unlikely to be resolved for kids. Obviously nothing has changed in 2 and a half decades. :laugh:

My own personal recommendation would be to consider matching into a pedi categorical residency. You can always change to psych after a year if you hate pedi. But, if you stick it out in pedi you have the option of either then doing psych, making you a very well-trained pedi psych, or doing developmental or adolescent medicine. Of course, you could always do general pedi too. Regardless, you'll have lots of options.

Obviously, I'm biased in this. I do think pedi psych is a good field but lots of what you might like can be done within a pedi career and that's where I'd recommend starting.

You can PM me if you'd like to discuss it further.

Regards

OBP
 

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peds: work a lot, get paid nothing
psych: easy hours, decent pay.
everything else being equal, i'd go for psych.
 
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raspberry swirl

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thanks old bear, i've seen your posts in the peds forum, and they're always helpful ... i will definitely pm you later. however, my intention was not for this to be a peds vs psych thread- i would still like to hear from some people (any specialty) who did an internship first, and then applied to residency ... im wondering if it really made your decision easier after another year, or if it just made things harder, or if it really changed anything at all .... i just dont want to have any regrets, but i have a feeling i'll have regrets either way ...
 

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raspberry swirl said:
thanks old bear, i've seen your posts in the peds forum, and they're always helpful ... i will definitely pm you later. i would still like to hear from some people (any specialty) who did an internship first, and then applied to residency ... im wondering if it really made the decision easier after another year, or if it made their life easy or harder, or really changed anything at all .... i just dont want to have any regrets, but i have a feeling i'll have regrets either way ...
There are other Triple Board programs to choose from. The ones out west are Hawaii and Utah. I was considering going into this specialty, because like you, I liked both my peds an psych rotations.

Another specialty you should consider is Developmenta/Behavioral Pediatrics, it's a very integrative, holistic approach to behavioral problems and definitely covers a lot of psych during your training. You first go through a pediatric residency first then apply for this 3 yr fellowship. Feel free to PM me if you have any questions.
 

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Bernardo_11 said:
There are other Triple Board programs to choose from. The ones out west are Hawaii and Utah. I was considering going into this specialty, because like you, I liked both my peds an psych rotations.

Another specialty you should consider is Developmenta/Behavioral Pediatrics, it's a very integrative, holistic approach to behavioral problems and definitely covers a lot of psych during your training. You first go through a pediatric residency first then apply for this 3 yr fellowship. Feel free to PM me if you have any questions.
Bernardo is definitely the expert, but I concur that developmental pedi is a strong up and coming field in academics as well as more generally. Increasingly, ALL interventions we do in babies are being looked at via the lens of long-term outcome. Thus, developmental has a strong academic component potential in the future. For example, in this weeks NEJM are a series of reports about using inhaled nitric oxide for premature infants. The accompanying editorial demands long-term developmental data to assess true benefits. This never would have been suggested 20 years ago, but after the disaster related to post-natal steroids and long-term disability, this has come to the forefront.
 

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You could also just apply for psychiatry. The first year has 6 months of inpatient psych, 2 months of neuro, and 4 months of either med or peds. You'd get to try lots of more peds and psych. If you like psych, then you're on your way. If you prefer peds, then you can switch and maybe finish 32 months later.
 

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I was in the same shoes as you last fall and I only applied for transitional programs. Best decision of my medical school career! I had the benefit of a 4th year of medical school electives plus more clinical experience in these first few months. Just working in the ER this month has helped me to rule out many specialties e.g. psych and er. I am so happy that I did this transitional year.
ETA: Oh, you could do child psychiatry.
 

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Hi,
I don't know about your specific question, (sounds like the above poster does though), but I just wanted to address the assumption you made that all of your friends know exactly what they want. They probably don't. It's likely a big show. Seriously, talk to some people in your class and you'll see that just about everyone is as confused and scared/unable to make a decision as you are. Doesn't solve your problem, but may make you feel less alone. Why don't you talk to someone at your school, an advisor-type person. Maybe they can help you tease out what you really want but can't see yet. Best of luck. It will all work out!
 
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LHCF said:
I was in the same shoes as you last fall and I only applied for transitional programs. Best decision of my medical school career! I had the benefit of a 4th year of medical school electives plus more clinical experience in these first few months. Just working in the ER this month has helped me to rule out many specialties e.g. psych and er. I am so happy that I did this transitional year.
LHCF, so you are in a transitional program now? are you currently in the process of applying for residency next year? do you feel more confident in your decision? (have you made a decision??) do you think it's an extra stress/hassle to apply and interview during your intern year? i've heard that its a huge pain in the a$$. one girl i talked to, she said her program gave her a really hard time about taking days off to interview.
 

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raspberry swirl said:
LHCF, so you are in a transitional program now? are you currently in the process of applying for residency next year? do you feel more confident in your decision? (have you made a decision??) do you think it's an extra stress/hassle to apply and interview during your intern year? i've heard that its a huge pain in the a$$. one girl i talked to, she said her program gave her a really hard time about taking days off to interview.
i'm undecided between pediatrics and internal medicine. is it possible to do a one year internship in peds and then if i really don't love it as much as i thought, i can switch over to a IM residency? do people do that? won't it look bad if you are switching residencies? also when would you have to apply for IM if you've just started peds internship, I mean programs start on july 1st and ERAS opens sep 1st so does that mean you only have 2 months to decide if you want to make the switch?
thanks
 

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desiree said:
i'm undecided between pediatrics and internal medicine. is it possible to do a one year internship in peds and then if i really don't love it as much as i thought, i can switch over to a IM residency? do people do that? won't it look bad if you are switching residencies? also when would you have to apply for IM if you've just started peds internship, I mean programs start on july 1st and ERAS opens sep 1st so does that mean you only have 2 months to decide if you want to make the switch?
thanks
Have you thought about combined Med/Peds residencies...my school has one that is popular with our students in your situation...I mean it's an extra year and it's a lot of work to do both but in 4 yrs you will be double boarded- Just a thought
 

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DreamLover said:
Have you thought about combined Med/Peds residencies...my school has one that is popular with our students in your situation...I mean it's an extra year and it's a lot of work to do both but in 4 yrs you will be double boarded- Just a thought
thanks, i had considered that but i'm an IMG. I know there aren't a lot of programs out there in Med/Peds and the few that are, are way too competitive for me to get my hopes up of getting accepted into, so i was just considering applying to one program(peds) and seeing how it goes. If i were to be too miserable in that field, then i would switch to IM (if that's at all possible). ARe there people out there who have switched residencies after a year and if so how easy is it to do?
 

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desiree said:
thanks, i had considered that but i'm an IMG. I know there aren't a lot of programs out there in Med/Peds and the few that are, are way too competitive for me to get my hopes up of getting accepted into, so i was just considering applying to one program(peds) and seeing how it goes. If i were to be too miserable in that field, then i would switch to IM (if that's at all possible). ARe there people out there who have switched residencies after a year and if so how easy is it to do?

Well nothing is stopping you from applying to peds residencies and those med/peds programs at the same time....even if all the med/peds programs rejected you what do you have to lose? What if you were to get interviews? You can rank those higher and if you didn't match you'd still have your ranked peds programs to match. An extra 60 bucks might be worth a try, but that's just me...I find myself clicking away on programs like I'm made of money but I know that I'll never get another chance to apply to some of these programs again, so what if they don't interview me...they certainly wouldn't interview me if I didn't apply to them in the first place...no loss...again, just a thought
 
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desiree said:
... also when would you have to apply for IM if you've just started peds internship, I mean programs start on july 1st and ERAS opens sep 1st so does that mean you only have 2 months to decide if you want to make the switch?
thanks
i am concerned about this as well ... people have been telling me to just apply for an internship or to try a year in one, and then switch, but realistically, you really only have 2 months of internship to decide anything ... besides, you'll probably be too sleep deprived and stressed to deal with it anyway ... so really, how does waiting a year even really help??
 

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raspberry swirl said:
i am concerned about this as well ... people have been telling me to just apply for an internship or to try a year in one, and then switch, but realistically, you really only have 2 months of internship to decide anything ... besides, you'll probably be too sleep deprived and stressed to deal with it anyway ... so really, how does waiting a year even really help??
Not sure if this helps, but I know it is frequently easier to switch from a more competitive residency to a less competitive residency. If push comes to shove you can decide to match into the more competitive and decide later.
 

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If you have narrowed it down to two residencies, why not flip a coin and apply to one. That gives you a 50% chance of not having to bail out after one year and switch.

Also you could apply to both residencies and make your decision only when you go make your rank list. That would give you extra time to decide.
 

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raspberry swirl said:
LHCF, so you are in a transitional program now? are you currently in the process of applying for residency next year? do you feel more confident in your decision? (have you made a decision??) do you think it's an extra stress/hassle to apply and interview during your intern year? i've heard that its a huge pain in the a$$. one girl i talked to, she said her program gave her a really hard time about taking days off to interview.
Yes, I am in a transitional program and I'm applying for ERAS right now. I feel MUCH more confident in my decision. I know people change specialties all the time but I wanted to go into it committed to one specialty because residency is really hard. I've been really lucky these first few months with easy rotations and no call, so applying has been no problem.
 
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