How important to learn TMS in residency?

[jbomba]

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About to start my fourth year and considering electives. I'm curious how important you all think learning TMS will be. As in, for a new doc who will likely be practicing into the 2050s, is this something you foresee becoming so mainstream I'd be doing myself a disservice by not learning it now?

 

[wolfvgang22]

Low to moderate? I would choose to learn anything new I can in residency, while the training is free. Buff that CV and have another tool in the pocket should a TMS practice opportunity present itself

 

[comp1]

Pretty darn low.

 

[Sushirolls]

In my area, seems to be almost all ARNPs doing it...

If you have the opportunity to get exposure with an elective, do it.

 

[Psychresy]

What kind of reimbursement are people seeing for TMS?

 

[Sushirolls]

What kind of reimbursement are people seeing for TMS?

Good enough, that the only psychiatrist (*numerous ARNPs too) in my area doing it, essentially abandoned their medication management side of things and ramping up the TMS services and expanding offices.

 

[Stagg737]

Definitely do it as an elective if you can. You never know where you'll end up and plenty of job applications mention what I think of as internal side hustles to people interested/qualified. I think I've actually seen TMS mentioned more than ECT in the job postings I've gotten. It's also straightforward enough that you could double up on another procedure or interest in that elective if you wanted to and the program allowed it.

 

[Geraltofrivia]

How does one "buff up" on TMS (and even ECT)? My program was somewhat lackadaisical about both, sad but true to say

Edit: And I suppose I have to say I guess now post-residency

 

[TexasPhysician]

What kind of reimbursement are people seeing for TMS?

Reimbursement can be good. The problem is the high cost to us and getting enough patients to do it. Patients are relatively uninterested in my experience. Few practices move forward with TMS. I’ve seen people lose $100k by getting 1 and can’t get patients.

 

[FlowRate]

What kind of reimbursement are people seeing for TMS?

If there's demand in your area, seems pretty significant. One of our docs went part time while he started his TMS practice and decided to full quit our org despite not being anywhere near full with his TMS practice yet.

Regarding the OP, probably more important to get ECT training if you think you may ever want to consider doing that in the future.

 

[mistafab]

I spoke with several recent grads who all gave the same advice.

”get as much training and supervision you can while it is free.”

I wouldnt pass on an opportunity to train in this while you can. Unless you are dead set in outpatient PP or something. We had a grad offered a position to start a tms program due to their training. Why say no? If you never use it, at least you understand it. ECT same thing. Ketamine even.

My 2 cents anyway. You’ll be older and less interested in learning stuff every year.

 

[TexasPhysician]

I spoke with several recent grads who all gave the same advice.

”get as much training and supervision you can while it is free.”

I wouldnt pass on an opportunity to train in this while you can. Unless you are dead set in outpatient PP or something. We had a grad offered a position to start a tms program due to their training. Why say no? If you never use it, at least you understand it. ECT same thing. Ketamine even.

My 2 cents anyway. You’ll be older and less interested in learning stuff every year.

While I agree with the idea, I’ve also had plenty of offers to train in TMS for free to get me to do TMS. I just don’t see the value yet. If you have the chance, go for it in training. If your top choice doesn’t offer it, I wouldn’t worry in the least.

 

[Ironspy]

I learned TMS as an attending and it’s not hard to learn and the manufacturers will train you for free. Would have been nice to get more exposure in training but not a huge deal. Odds are the equipment in residency would have been different anyhow. . Lots of demand for TMS where I am

 

[hallowmann]

You can learn it with training sessions outside of residency, and its going to be heavily dependent on the TMS machines you use in your job. You could have a ton of training on one in residency, and then be using a completely different one, and while the basics from a general knowledge standpoint will be the same, the practical knowledge of using the device will just not be there.

I agree that if you have access to it, you should at least get some exposure to it, but its not the end of the world if you don't. It really is straightforward so a little bit of operating knowledge and reading will be enough to get comfortable enough with it.