How competitive is Army psych?

[DD214_DOC]

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Title says it all. It seems it may be competitive since there are only two spots to match. How likely are deferrments for psych?

 

[IgD]

Trust me you don't want to do an outservice psychiatry residency. Psychiatry in the military is very different than on the outside and there will be a very steep learning curve if you try to do so.

 

[DD214_DOC]

Trust me you don't want to do an outservice psychiatry residency. Psychiatry in the military is very different than on the outside and there will be a very steep learning curve if you try to do so.

So how difficult is it to match inside the military?

 

[notdeadyet]

Psychiatry in the military is very different than on the outside and there will be a very steep learning curve if you try to do so.

Could you expand on that, IgD? I'm heading towards National Guard commissioning and am interested in Psych. Curious what the learning curve will be if I'm deployed.

 

[chemist157]

Title says it all. It seems it may be competitive since there are only two spots to match. How likely are deferrments for psych?

It's not competitive. For at least the last couple of years it hasn't even filled.

 

[99WtoDoc]

Regarding which branch?

 

[ieatpizza]

Refer to this powerpoint, slide 12: https://apps.mods.army.mil/MedEd/HPSP/Powerpoint/GMEslideshow_08_files/frame.htm

14 spots: 7 at Tripler, 7 at Walter Reed. Half of the time it doesn't fill up. Applicant-to-spot ratio: 0.64 in 2008, 1.07 in 2007, 0.83 in 2006, 1.5 in 2005, 1 in 2004, 0.57 in 2003. There's also a combined IM-Psych program at Walter Reed, 2 spots.

 

[DD214_DOC]

Refer to this powerpoint, slide 12: https://apps.mods.army.mil/MedEd/HPSP/Powerpoint/GMEslideshow_08_files/frame.htm

14 spots: 7 at Tripler, 7 at Walter Reed. Half of the time it doesn't fill up. Applicant-to-spot ratio: 0.64 in 2008, 1.07 in 2007, 0.83 in 2006, 1.5 in 2005, 1 in 2004, 0.57 in 2003. There's also a combined IM-Psych program at Walter Reed, 2 spots.

Wow, neurology looks really easy to get into. Maybe they intentionally let spots go unfilled instead of taking a crappy applicant?

 

[ieatpizza]

Wow, neurology looks really easy to get into. Maybe they intentionally let spots go unfilled instead of taking a crappy applicant?

I don't think so. Maybe you don't know this, but neurology is just that unpopular, as it is in the civilian realm as well.

 

[DD214_DOC]

I don't think so. Maybe you don't know this, but neurology is just that unpopular, as it is in the civilian realm as well.

Why? I knew it wasn't a hot specialty but I did not realize it was despised as much as it is. I don't think it's really that bad.

Also, is the Army even allowed to intentionally let spots go unfilled? I thought they had some sort of need to fill as many as they can so they won't get their funding cut or something. (I really don't know much about how it works)

 

[IgD]

Could you expand on that, IgD? I'm heading towards National Guard commissioning and am interested in Psych. Curious what the learning curve will be if I'm deployed.

In civilian psych, there is a lot of emphasis on psychotic and bipolar disorders. In military psych the emphasis is on mood and anxiety disorders. Civilian psychiatrists are more liberal with psychotropic meds. In military medicine there are all kinds of strict rules as to what psychotropic meds you can prescribe and under what circumstances. Military psych is a form of occupational medicine and the confidentiality rules are different. In military psychiatry there is a different standard of documentation and you have to write all sorts of disability paperwork like limited duty and medical boards.

Hope that helps!

 

[notdeadyet]

In civilian psych, there is a lot of emphasis on psychotic and bipolar disorders. In military psych the emphasis is on mood and anxiety disorders.

Interesting. Is it fair to say that military psych is more outpatient focused?

Civilian psychiatrists are more liberal with psychotropic meds. In military medicine there are all kinds of strict rules as to what psychotropic meds you can prescribe and under what circumstances.

Are these restrictions ever too confining when trying to practice?

Military psych is a form of occupational medicine and the confidentiality rules are different. In military psychiatry there is a different standard of documentation and you have to write all sorts of disability paperwork like limited duty and medical boards.

Makes sense. The learning curve being administrative makes a lot of sense. I was worried that the learning curve was clinical. That sounds to be less the case.

 

[orbitsurgMD]

Why? I knew it wasn't a hot specialty but I did not realize it was despised as much as it is. I don't think it's really that bad.

Also, is the Army even allowed to intentionally let spots go unfilled? I thought they had some sort of need to fill as many as they can so they won't get their funding cut or something. (I really don't know much about how it works)

Chronic patient problems: migraine, back pain, psychic pain. It can be a dumping ground for depressed and unhappy people. They can be hard to fix, and many have substance dependency issues, which are also hard to fix. And there is a substantial component of secondary gainers who have wormed their way through orthopedists, neurosurgeons, anesthesia pain management specialists and finally get to neurologists, wanting to be given disability and other rewards for illness. You become their form-completion clerk.

There is high liability. Stroke patients. Chronic pain patients, etc.

That isn't to say there aren't opportunities for satisfying practice. I have colleagues who specialize in epilepsy that are happy. Others specialize in demyelinating disease and other inflammatory or infectious neuropathies.

 

[orbitsurgMD]

Interesting. Is it fair to say that military psych is more outpatient focused?

Are these restrictions ever too confining when trying to practice?

Makes sense. The learning curve being administrative makes a lot of sense. I was worried that the learning curve was clinical. That sounds to be less the case.

It always seemed to me that military psych had a limited role in treating chronic disease of any kind. Once a patient became unfit for general duty, the best case was temporary limited duty. Most of the time, the member was discharged administratively (mostly for Axis II disorders and behavioral sequelae, and almost always in cases of Axis I diagnoses which were disqualifying.)