did you guys like neuroanatomy or any other psych related basic science courses?

[abcxyz0123]

I was just wondering...were you all a fan of neuroanatomy and "brain and behavior" or similar psychiatry related basic science courses during the first two years of med school? I've had a lot of fun shadowing psychiatrists, and it seems like a dream job......but I don't really find the basic science coursework related to psychiatry that interesting. Not horribly uninteresting though...just kind of like...blah. Does this mean that psychiatry is probably not for me? I hope not.

However, I want to go into forensic child psych...which I think would be more interesting...and I found one of our courses called "human development" (which covers mainly child psych topics and is taught by a lot of child psych faculty) to be fascinating and extremely interesting. I also majored in history and loved that...to relate to the forensic part.

So....to clarify my question...im just wondering if anyone had similar experiences of not really enjoying neuroanatomy or brain & behavior type courses but loved clinical psychiatry?

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[BobA]

I was just wondering...were you all a fan of neuroanatomy and "brain and behavior" or similar psychiatry related basic science courses during the first two years of med school? I've had a lot of fun shadowing psychiatrists, and it seems like a dream job......but I don't really find the basic science coursework related to psychiatry that interesting. Not horribly uninteresting though...just kind of like...blah. Does this mean that psychiatry is probably not for me? I hope not.

However, I want to go into forensic child psych...which I think would be more interesting...and I found one of our courses called "human development" (which covers mainly child psych topics and is taught by a lot of child psych faculty) to be fascinating and extremely interesting. I also majored in history and loved that...to relate to the forensic part.

So....to clarify my question...im just wondering if anyone had similar experiences of not really enjoying neuroanatomy or brain & behavior type courses but loved clinical psychiatry?

I did not like neuroanatomy (or any anatomy) because memorizing things is kind of boring, and when something bores me I usually don't study it that well and consequently I get a "bad" grade in it. Being bad at a subject makes me like it less and it's a downward cycle.

I loved physiology because it's less memorization and more conceptual.

I think clinical psychiatry is more on the conceptual end. It's pretty un-related to anatomy.

HOWEVER, my future residency program has a strong neuro-anatomy component and I'm looking forward to really mastering that material. Since I see myself as more of a more biologically-oriented psychiatrist who plans to work in either Sleep or with chronic mental illness, I think knowing the neuroanatomy will be important to me even if I don't take to it naturally. I can learn this stuff it just takes a little more effort.

 

[Faebinder]

The problem is once you figured out the anatomical source of the problem, there is little to fix it and it is thought as "non-psychiatric" despite the behavioral symptoms. This robs you of the chance for the info to stick in your brain. This may be remedied in the future as we see more focused treatments.

Take as many neuroanatomy courses.. including development. It will help a lot however don't be in distress if you don't enjoy them. The truth is, many don't enjoy them either.... again that will change slowly once things are better defined and better treatments evolve.

 

[sunlioness]

Neuroanatomy hurts my brain.

I like it when I am learning it from the angle of trying to figure out why something I am interested in is happening. But just memorizing pieces of brain and what they do is so not my cup of tea.

 

[beezley]

You really won't know until you do your rotations. I LOVED all the coursework related to psych and neuro and was able to ace it without much difficulty unlike say, immunology or hematology...ugh. But I was gung ho on being a radiologist of all things. I was blindsided by how much I loved psych and then in retrospect when I looked at my first two years and what I excelled in it made sense.

I loved and did well in non psych stuff too though like cardio and ID, so who knows.

I did two months of neuro rotations, loved it but couldn't get over the faker patients and how lots of diseases really are depressing like ALS.



I think most people would be reasonably happy doing many things in medicine, you will just have to see what works for you and your life when the time comes.

 

[strangeglove]

The sad fact is that the neuroanatomy that is taught to medical students, which is dry, static and based almost entirely on memorization (much like gross anatomy), bears little resemblance to the scientific field of neuroscience, which is dynamic, exciting and thought of by many as one of the forefronts of human knowledge. This is related to the fact that, historically, neuroanatomy has been taught to medical students to prepare them to localize lesions in neurologic patients. In contrast, most research in neuroscience these days, especially research on the neural basis of memory, language, emotion, executive function (i.e. cognitive neuroscience, which involves a lot of neuroanatomy), is directly relevant to psychiatry. Unfortunately, they don't really teach you this stuff in medical school, or if they do it's often crammed into 1-2 lectures, with the rest devoted to a slice-by-slice tour of lesion-deficit syndromes. In the end, medical neuroanatomy seems like a waste of time, since knowing where the lesion is rarely helps you manage patients who have strokes etc. (it's usually good for a few laughs at rounds). That being said, you don't need to know anything about neuroanatomy to be a good psychiatrist (whether your focus is pharmacology or psychotherapy), though you will need to know a little to pass the boards. If you want to be a psychiatric researcher in basic science, however, you'd better know more than most neurologists.

 

[strangeglove]

I did two months of neuro rotations, loved it but couldn't get over the faker patients

And so you chose psychiatry, where they usually send the faker patients?

 

[Doctor Bagel]

I actually did like our neuro class a lot, but I'm not a huge fan of the really detailed neuroanatomy stuff (basket cells and all that other good stuff). I don't think anybody really likes that stuff except your professors.

 

[Doctor Bagel]

And so you chose psychiatry, where they usually send the faker patients?

The guy has a good point. I felt like I saw a lot of somatic or factitious stuff in neuro, and I doubt you'll see as much in psych. Somatic patients don't think they have psychiatric problems, so they're not going to seek you out, but they will see the neurologist out. At least this is what I'm hoping.

 

[strangeglove]

The guy has a good point. I felt like I saw a lot of somatic or factitious stuff in neuro, and I doubt you'll see as much in psych. Somatic patients don't think they have psychiatric problems, so they're not going to seek you out, but they will see the neurologist out. At least this is what I'm hoping.

You'll get called as a psych consult all the time on inpatients who have negative workups for neurological problems, such as conversion disorders and pseudoseizures. Also, many of the patients who present to you with depression and anxiety will have somatoform neurological complaints (i.e. it won't be their chief complaint and they won't see it as a psychiatric problem, but your job is to rule out a neurological cause and then address the psychiatric cause).

My point to beezley was that psychiatrists tend to find this stuff interesting, as opposed to annoying, since we have the time and energy to engage with the reasons why people "fake" neurological symptoms. At the same time, it is natural to feel irritated by somatoform complaints when, as a medical student or intern you are primarily concerned with the medical or neurological problems of a patient.

 

[Thorazine]

The sad fact is that the neuroanatomy that is taught to medical students, which is dry, static and based almost entirely on memorization (much like gross anatomy), bears little resemblance to the scientific field of neuroscience, which is dynamic, exciting and thought of by many as one of the forefronts of human knowledge. This is related to the fact that, historically, neuroanatomy has been taught to medical students to prepare them to localize lesions in neurologic patients. In contrast, most research in neuroscience these days, especially research on the neural basis of memory, language, emotion, executive function (i.e. cognitive neuroscience, which involves a lot of neuroanatomy), is directly relevant to psychiatry. Unfortunately, they don't really teach you this stuff in medical school, or if they do it's often crammed into 1-2 lectures, with the rest devoted to a slice-by-slice tour of lesion-deficit syndromes. In the end, medical neuroanatomy seems like a waste of time, since knowing where the lesion is rarely helps you manage patients who have strokes etc. (it's usually good for a few laughs at rounds). That being said, you don't need to know anything about neuroanatomy to be a good psychiatrist (whether your focus is pharmacology or psychotherapy), though you will need to know a little to pass the boards. If you want to be a psychiatric researcher in basic science, however, you'd better know more than most neurologists.

i love neuroanatomy and neuroscience. i did alot of reading out of my own sheer curiosity that was far outside the realm of my medical neuroanatomy course. cognitive and developmental neuroscience is a fascinating field, and neuroanatomy becomes much more relevant in this context. but they dont teach it to medical students because it doesnt necessarily correlate with patient care, and its not on the boards. in some respects, i feel neurologists are better "neuroanatomists", but psychiatrists are better "neuroscientists".

 

[beezley]

I typed a whole reply yesterday and it got lost in cyberspace.

Anyways, I hear what you are saying about the fakers in psych but in that case I do find it fascinating. For instance, when I was on neuro we got a consult for a stroke, the person had resolving (but present) facial droop and hemiplegia but symmetrical reflexes and no pronator drift and no radiologic evidence of a stroke. They also absolutely did not have the intellectual capacity to 'fake' a stroke, seemes like a conversion disorder.

We also saw this person who was having 'spells' in their sleep where they convulsed and had an orgasmic sensation. Video EEG was positive for spells but negative for seizures, it was labeled a 'sexsomnia'.

So that stuff is cool. What I didn't like about neuro was....there was just a large sense of entitlement among enough of the patients to bug me. It certainly was not all because I met a lot of nice people too.

Maybe it is that in neuro they want a medical diagnosis for what is not usually a medical problem. In psych I feel like it is all out on the table. Once they have had a good medical work-up you operate under the assumption it is not medical but psychiatric. It is all out on the table. I like that.

Anyways.
Sorry if I ramble. It has been a long day.


It is hard to quantify but something about it rubbed me the wrong way that never did with psych. I loved all my psych rotations. I