FM vs Psych

[ENS]

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Currently, I'm an intern in FM with the Navy. I'm stuck...FM or Psych. I can't help but project how my lifestyle is going to be like as FM doc. I'm beginning to realize that lifestyle is huge on my list, and I would love to continue doing the things that I enjoy. I have never been hard core in the sciences, and my background is in the social sciences. Don't get me wrong, I do enjoy all the aspects of FM. It's just overwhelming at times, and I would hate to be just average. I do enjoy psych, and it definitely meets a lot of the criteria. Once civillian, I can make decent money, a doable lifestyle, and a less stressful one. However, I know I'll miss medicine. It's like a no win situation. I know I'm early in my training, but the Navy forces you into deciding what you're going to do in the next 2-3 yrs. Any advice or input would be appreciated.

 

[jjbmsiv]

I can make decent money, a doable lifestyle, and a less stressful one.

True as this may be, I don't find these to be sufficient reasons to become a psychiatrist.

 

[PsychMD2100]

I have to agree that these don't sound like positive reasons to become a psychiatrist.

However, it sounds like you want to talk about lifestyle and I'll try to address that. Psychiatry is one of the few specialties where you still have a lot of control over your schedule. In the managed care systems in my area, FP is always pushed to produce in terms of the number of patients they're expected to see. In some places, FP is given 15 minutes to see a patient, even though patients will often bring up multiple complaints.

Psychiatry certainly has its managed care positions but there's a relatively large number of solo private practitioners. You can work as much or as little as you would like. You'll also be a specialist in mental health.

Do psychiatry, but be prepared for the stigma surrounding mental health.

 

[OldPsychDoc]

If "missing medicine" is the issue, keep this in mind: a recent study indicated that SPMI patients (severe persistent mentally ill--e.g schizophrenia, bipolar) die on average TWENTY-FIVE YEARS earlier than non-affected individuals. We are often the only doctors these people see on any regular basis. There's plenty of medicine to pay attention to in these folks.

(Also want to add--the best child psychiatrist I ever worked with came out of a Navy residency. Good luck!)

 

[motheroftwo]

I switched from FM to psych, and now I have a colleague who is switching from psych to FM. We both are very happy with our decisions. Consider the following: all medical specialities require a level of commitment other professions do not; the lifestyle you have right now is not the lifestyle you'll have after residency if you stay in FM; while there is much exposure to psych issues in FM, overall the patients in psych are much more decompensated. In FM last year, I could I could have normal conversations with over 90% of my patients. That's not true in psych. At least not in the first encounter. With time, I've seen my friends in FM get better at medicine, and more comfortable handing all that information that seemed so overwhelming during internship. By the end of my intership, I was getting pretty good at the fifteen minute urgent care visit. I don't miss medicine at all. I love the time I spend with my patients. My colleague missed medicine too much, and she didn't really like spending an hour with an alcoholic, depressed child molestor. I won't say I LOVE someone like that, but it is intriguing. Psychiatry has a lot of information also, which can also be overwhelming. And while it's true we should not forget about medical issues, the patients have many non-medical issues that only the psychiatrist will help them with. Good luck with your decision.

 

[ENS]

I know my initial thread about making the switch was incomplete. The thing is that I enjoy the psychosocial issues involved in every patient. I have a background in Anthropology, which I absolutely love. I enjoy why people do the things they do, their environment, and their future outcomes. I enjoy medicine, but I don't feel complete. I was never heavily into the sciences, but I love the social sciences. I really want to get to know my patients, and, yeah, I know the conversations won't be "normal." Anyways, I think I'll be happier in Psychiatry.

 

[phd2b]

There are some options to combine FP/Psych, IM/Psych, and Triple Board. I'd give them a look before making your decision. Check out FREIDA and do some homework to see if any of these resonate with you.