IM vs Psych

[ORBITAL BEBOP]

Hello,

For those of you who have knowledge of psych and medicine, can you please tell me which is more challenging, psych or IM? I am referring to the number of hours worked, emotional drain, ability to make a difference in patient's lives, etc.

Also, in which field are future working opportunities the best in terms of work hours and flexibility in locating a job?

Thank you in advance.
Tartufe
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[orientedtoself]

Hello,

For those of you who have knowledge of psych and medicine, can you please tell me which is more challenging, psych or IM? I am referring to the number of hours worked, emotional drain, ability to make a difference in patient's lives, etc.

Also, in which field are future working opportunities the best in terms of work hours and flexibility in locating a job?

Thank you in advance.
Tartufe
__________________

Do you want to heal the mind or the body? Start there. Your lifestyle is whatever you make of it- you can work as much or as little as you want in any field. Personally, I find psych patients a drag, but I'm going into medicine.

 

[ORBITAL BEBOP]

bump

 

[rs2006]

Hi all,

First of all, I just want to make it clear that I am just a fourth yr medical student writing this. Anyway, disclaimer aside, a close friend of mine is going into psych and is doing so because of the lifestyle (relatively good pay for the number of hours worked (~180-200k/yr for approx 40hrs worked per week with minimal to no call-- basically a 9 to 5 job M to F), low stress (relative to other medical specialties), the fact that she is fascinated by mental illness (and the brain-behavior connection, etc), and also the LOW to NEGLIGIBLE malpractice (which simply means that you get to keep the money you earn without having to worry about being sued-- another plus to the lifestyle of a psychiatrist!!).

 

[ucladukes]

I think a psychologist with 6 months of pharmacology training can do about 75% of the job of a psychiatrist.

I thought prior to med school tht they were doctors, and therefore handle way more than clinical psychologists. I can't speak for all clerkships, but I can say that mine disproved that notion. I can't help but feel guilty for thinking that they wasted their time by going to med school but it creeps into my head sometimes.

Before anyone does Psych for the lifestyle - consider their suicide rates.

 

[orientedtoself]

In some ways, I found Psych very interesting, such as how personality disorders fall on a continuum with normal personality characteristics, or how mood disorders compare to normal mood. But talking to someone who is delusional is very frustrating. You can talk and reason until the end of the world and it will make no difference. It's like something is missing. And borderlines- don't you love getting jerked around by manipulative patients?

 

[KWBum]

I think a psychologist with 6 months of pharmacology training can do about 75% of the job of a psychiatrist.

I thought prior to med school tht they were doctors, and therefore handle way more than clinical psychologists. I can't speak for all clerkships, but I can say that mine disproved that notion. I can't help but feel guilty for thinking that they wasted their time by going to med school but it creeps into my head sometimes.

As an intern deep in the medicine/neurology portion of my psychiatry residency, I have to say that I found the post above to be quaintly amusing. And I have a fairly easy residency inasmuch too, as we don't have an ICU rotation.

In any event, medicine is medicine, as those who have been woken up at 3am because a patient can't breathe well know.

Maybe 15 years from now I'll have thoroughly forgotten all that...assuming I see nothing but depressed (read: bored) housewives in my practice.

But, at the typical non-academic local hospital if a shrink wants to admit someone, it's the shrink who's the primary, who does the admit H/P and physical, who writes the in-patient orders and all the rest. It's the shrink who's the C/L guy, who has to remember why agranulocytosis is a bad thing, and what drugs and medical conditions cause delerium vs dementia vs someone being genuinely nuts.

I don't know about you all, but if I decided to shoot myself (being a shrink and all), and with luck get caught at it before I can find my gun, and get the coat that buttons in the back, and get taken to Local General, I would really prefer that a shrink, and thus an M.D., take care of me, rather than a psychologist.

If I get a bit stressed, and want to "talk" to someone, or maybe have a bit of biofeedback...well, then I can see the "therapist," and be a "client."

 

[ucladukes]

As an intern deep in the medicine/neurology portion of my psychiatry residency, I have to say that I found the post above to be quaintly amusing. And I have a fairly easy residency inasmuch too, as we don't have an ICU rotation.

In any event, medicine is medicine, as those who have been woken up at 3am because a patient can't breathe well know.

Maybe 15 years from now I'll have thoroughly forgotten all that...assuming I see nothing but depressed (read: bored) housewives in my practice.

But, at the typical non-academic local hospital if a shrink wants to admit someone, it's the shrink who's the primary, who does the admit H/P and physical, who writes the in-patient orders and all the rest. It's the shrink who's the C/L guy, who has to remember why agranulocytosis is a bad thing, and what drugs and medical conditions cause delerium vs dementia vs someone being genuinely nuts.

I don't know about you all, but if I decided to shoot myself (being a shrink and all), and with luck get caught at it before I can find my gun, and get the coat that buttons in the back, and get taken to Local General, I would really prefer that a shrink, and thus an M.D., take care of me, rather than a psychologist.

If I get a bit stressed, and want to "talk" to someone, or maybe have a bit of biofeedback...well, then I can see the "therapist," and be a "client."

I initially said 75%.....but perhaps that figure is an underestimate.

 

[KWBum]

I initially said 75%.....but perhaps that figure is an underestimate.

Great. An embittered med student...

Dude, pick a different career. If you think about it, you don't actually need to go to med school for half the specialties out there.

 

[ucladukes]

I am not embittered, I love what I do and would not do change anything if I could do it all over again.

I disagree with your comment about not needing medical school for most specialties out there. I will just assume that in your haste to get back at me, you resorted to irrationality. You are more wrong than I was. I win.

 

[ucladukes]

I am not embittered, I love what I do and would not do change anything if I could do it all over again.

I disagree with your comment about not needing medical school for most specialties out there. I will just assume that in your haste to get back at me, you resorted to irrationality. You are more wrong than I was. I win.

My bad, you said half the specialities out there. A bit of an exaggeration. But if I am ever on a long distance flight and get sick, I think an medical/surgical specialty out there (more than half) would have a better idea (albeit still weak) what to do than a psychiatrist.
That being said, I never said psychologists can do it all, but they can do a lot of what my psych attendings did. (more than half). Also regarding admissions, I have never seen a psych admission if they had any medical problem. A glucose of 200? Transfer back to medicine.

 

[KWBum]

My bad, you said half the specialities out there. A bit of an exaggeration. But if I am ever on a long distance flight and get sick, I think an medical/surgical specialty out there (more than half) would have a better idea (albeit still weak) what to do than a psychiatrist.

Or an intern in any specialty...

That being said, I never said psychologists can do it all, but they can do a lot of what my psych attendings did. (more than half). Also regarding admissions, I have never seen a psych admission if they had any medical problem. A glucose of 200? Transfer back to medicine.

And I specifically said in a regional, outlying hospital. That is, out in the real world.

As far as I can see, in a teaching hospital, nobody knows how to do anything other than what they do. Why should they, when they can just consult! Sugars of 200 in a cardiology patient? No no, we don't know what to do there, we just do caths! Call Medicine! Bit of numbness in a surgical patient? If I can't heal with cold steel I...call Neuro!

The trouble with med school is that any given rotation is so attending/resident dependant. Separating a specialty from a rotation (and thus the staff) is infernally difficult.

Who the h*ll knows...

Well, I'll say this...on a plane I'd rather have a decent ER doc than, say, a surgeon or a rheumatologist or, even, an internist. Heaven help me if I had an internist...! He'd think about my anion gap while I choked, seized, or what have you to death. And then he'd debate the virtues of the apnea test for proving brain death...of course, the shrink would wonder how my death will affect my 'loved ones' respective psyches...

 

[SkidRow]

Or an intern in any specialty...

Well, I'll say this...on a plane I'd rather have a decent ER doc than, say, a surgeon or a rheumatologist or, even, an internist. Heaven help me if I had an internist...! He'd think about my anion gap while I choked, seized, or what have you to death. And then he'd debate the virtues of the apnea test for proving brain death...of course, the shrink would wonder how my death will affect my 'loved ones' respective psyches...

It's funny cuz' it's true...

 

[orientedtoself]

Well, I'll say this...on a plane I'd rather have a decent ER doc than, say, a surgeon or a rheumatologist or, even, an internist. Heaven help me if I had an internist...! He'd think about my anion gap while I choked, seized, or what have you to death. And then he'd debate the virtues of the apnea test for proving brain death...of course, the shrink would wonder how my death will affect my 'loved ones' respective psyches...

Have you seen the code team in action? The cardiology team on call is the code team at our hospital. You can watch the medicine residents turn it on and save lives. SICU resident, first on the scene? Step aside, the definitive care is here.

 

[KWBum]

Have you seen the code team in action? The cardiology team on call is the code team at our hospital. You can watch the medicine residents turn it on and save lives. SICU resident, first on the scene? Step aside, the definitive care is here.

(I give up. Broad sweeping bombastic fantastic generalizations. Nit picky real-life specifics. I can't keep up. So...)

What can I say? I went into medicine because of the money. So, consequently, when I'm filthy rich (which shouldn't take very long, my being a doctor and all) I'll simply travel with an entourage comprised of ER docs, of SICU residents, of pulmonology fellows, a shrink or two, and that one attending who always yells at everyone, and makes you read articles, and present them either at 4am when you're on call, or at 4pm post-call, when you should be going home.

That way I'll have everything covered when I choke on a peanut whilst flying first class to a conference on anxious housewives in Davos.

 

[ORBITAL BEBOP]

bump