Introductory Post/Some questions

[sisterburden]

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Hi everyone! I have been lurking these forums for about six months now. I don't know how I stumbled here, but it's been a Godsend having the chance to read about the practice of healthcare from so many perspectives.

First, let me briefly introduce myself. I am a non-traditional undergraduate student in my "second coming" at college. After high school, I thought it best to take time off in order to deal with lingering personal issues. I have since returned to school(with an awesome diagnosis of ADHD-PI under my belt) and am quite proud to say that I have been very successful upon returning to school.
I ALWAYS knew that once I got it together, I would want to pursue a career in behavioral health. I currently major in Psychology at a community college and am applying to four year schools, especially schools with programs that cater to non-traditional students. My top choice is Columbia. I will begin my premed requirements upon entering a four year school since everything I read implies that med schools are not too keen on pre-reqs taken in CC's. I have no doubts that I will finish my bachelors in this field. I do, however, have questions/concerns about what comes after.

1. How much will being a "non-traditional" uGrad impact the decision process for med schools? It is much different from being a "career changer," as I have yet to accomplish anything, lol. Furthermore, will the two years I spent in CC have a negative impact even if I chose the most challenging courses I could find and performed well?

2. I am also very interested in research. Would it help boost my application as an eventual psychiatrist to complete a thesis-based master's in psychology before applying to med school, especially due to my circumstance? Would an MPH in socio-medical sciences be better?

3. For those of you in residency/attending, what is the training like in psychotherapy? Do you have exposure to special forms, particularly DBT/CBT? Is psychotherapy really a focus of practice for psychiatrists today? In addition to my interest in science and my fascination with its application in medicine, one of the main reasons I chose premed was to have a greater understanding of the body's systems as a whole so that I can provide the most well-rounded treatment possible. I am concerned about the idea of spending so much time in school with the interests that I have only to do medication management.

4. For those of you that work with midlevels, how EXACTLY does the work differ? I have scoured this forum and cannot seem to get through five posts before it becomes a 20 page thread on why midlevels suck/want to take over the world. That's not what I'm looking for, and part of why I was slightly worried about joining the forum to ask questions. I understand the difference in curriculum already: I am interested in the difference when in PRACTICE specifically. I am aware of the tension regarding this subject matter and really don't want this thread to go there. I have read a few "turf war" threads here and they are so remarkably uninformative. Even though it appears that the most friction occurs in FP, I don't want this thread to be like that. I just want honest answers on how the professions differ in reality, not on paper since psych is so unique to other forms of medicine.

I would ask more but this is already quite long and I want people to actually read this post! Haha. Any form of help would be greatly appreciated. See you all around!🙂

 

[NeuSci]

Welcome, Sister.

Hi everyone! I have been lurking these forums for about six months now. I don't know how I stumbled here, but it's been a Godsend having the chance to read about the practice of healthcare from so many perspectives.

First, let me briefly introduce myself. I am a non-traditional undergraduate student in my "second coming" at college. After high school, I thought it best to take time off in order to deal with lingering personal issues. I have since returned to school(with an awesome diagnosis of ADHD-PI under my belt) and am quite proud to say that I have been very successful upon returning to school.
I ALWAYS knew that once I got it together, I would want to pursue a career in behavioral health. I currently major in Psychology at a community college and am applying to four year schools, especially schools with programs that cater to non-traditional students. My top choice is Columbia. I will begin my premed requirements upon entering a four year school since everything I read implies that med schools are not too keen on pre-reqs taken in CC's. I have no doubts that I will finish my bachelors in this field. I do, however, have questions/concerns about what comes after.

1. How much will being a "non-traditional" uGrad impact the decision process for med schools? It is much different from being a "career changer," as I have yet to accomplish anything, lol. Furthermore, will the two years I spent in CC have a negative impact even if I chose the most challenging courses I could find and performed well?

I personally know many people in their 30s, 4 people in their 40s and one in their 50s who decided to go to medical school at those ages, some after career changes, from farmer to Physio PhD. I've heard of many, many others, even a freakin' screenwriter in L.A. My path was kind of non-traditional, too, including three years at a CC, as well as other non-traditional, call them extracurricular, things. I did end up in med school, and one where I'm happy, but it's not a top one. I did interview and was wait-listed at some top schools, including Columbia, but my extracurriculars, which you are not likely to have had, brought me down. I bring this up to point out that even non-traditional students have a shot at the top schools. So, don't worry, just work hard and kill the MCAT.

2. I am also very interested in research. Would it help boost my application as an eventual psychiatrist to complete a thesis-based master's in psychology before applying to med school, especially due to my circumstance? Would an MPH in socio-medical sciences be better?

Research nowadays is always a plus, some would say a must. However, taking extra years to do it, while maybe improving your application, may not be worth the time spent. I'm 32, and just about to graduate med school. I still have a long road ahead of me in residency. If your grades and scores are good, or great if you're shooting for the moon, then volunteer research through your University should suffice. Hopefully, you'll end up at a place where you can get on-board some good psychiatric research. Although, my research was in CT Surgery, it did nothing but help for my med school interviews, and even my psych interviews.
I also heard, though I didn't look into much because I was already doing it, that medical research, either clinical or BS (hur, hur; I will always find that funny) is the best for your med school app.

3. For those of you in residency/attending, what is the training like in psychotherapy? Do you have exposure to special forms, particularly DBT/CBT? Is psychotherapy really a focus of practice for psychiatrists today? In addition to my interest in science and my fascination with its application in medicine, one of the main reasons I chose premed was to have a greater understanding of the body's systems as a whole so that I can provide the most well-rounded treatment possible. I am concerned about the idea of spending so much time in school with the interests that I have only to do medication management.

While I'm not a resident yet, my experience on the interview trail and researching programs is that programs vary on how much focus they put on biological vs therapeutic approaches. Some have little therapy while doing lots of bio research, while others are the reverse. Most are somewhere in the middle. You can do what you want. I hear from some that money's in med management, which I haven't found to be the case from having spoken to my faculty, but academic psych is different. I think you can still have a thriving, lucrative practice that is a good mix of therapy and med management. The traditionally bio part is really fascinating to me, but so is therapy, which I really consider a facet of the bio part.

4. For those of you that work with midlevels, how EXACTLY does the work differ? I have scoured this forum and cannot seem to get through five posts before it becomes a 20 page thread on why midlevels suck/want to take over the world. That's not what I'm looking for, and part of why I was slightly worried about joining the forum to ask questions. I understand the difference in curriculum already: I am interested in the difference when in PRACTICE specifically. I am aware of the tension regarding this subject matter and really don't want this thread to go there. I have read a few "turf war" threads here and they are so remarkably uninformative. Even though it appears that the most friction occurs in FP, I don't want this thread to be like that. I just want honest answers on how the professions differ in reality, not on paper since psych is so unique to other forms of medicine.

I've worked with a number of midlevels in psych. Some of them aren't the nicest people to med students, which can also be said for attendings and residents, but they seem to be appreciated and valued by the attendings with whom I worked. I can't say much more than that.

I would ask more but this is already quite long and I want people to actually read this post! Haha. Any form of help would be greatly appreciated. See you all around!🙂

In the end my road, and I'm sure everyone else's, was never easy. The worst part has always been the waiting, for test scores, acceptances, attendings to start rounds, etc. However, it's always been fun and challenging. Hopefully, it will be for you, as well. You still have time to decide what will work best for you. If you have little direct experience with psychiatry or even medicine, it may be beneficial for you to spend some time with MDs, or for matter PsyDs/Psych PhDs, or NPs. You may find medicine isn't the best fit. I hope you do, but then a part of me can't imagine why anyone would be other than a MD. Best of luck to you. PM me if you have any other questions, regardless of length.

 

[digitlnoize]

1. How much will being a "non-traditional" uGrad impact the decision process for med schools? It is much different from being a "career changer," as I have yet to accomplish anything, lol. Furthermore, will the two years I spent in CC have a negative impact even if I chose the most challenging courses I could find and performed well?

It doesn't make a huge difference. Your MCAT score and GPA's are a much more important factor than anything else. That being said, non-trads are typically at somewhat of a disadvantage in these areas (often GPA's because we weren't trying to be doctors during our first year or two of college and probably got some B's or worse.)

I went through much the same thing you're going through now. I kinda consider myself a career changer (had a full-time job running a music store and teaching guitar lessons + playing in bands and recording people for money), but not really. I hadn't really accomplished very much besides some good music...

Community College doesn't matter at most schools. If you go to a 4 year school, then take Orgo at CC because it's easier, then that can look bad, but otherwise it's not a big deal. I did my first 2 years at CC as well.

All of this being said, I didn't get into MD school, and wound up at a DO school, where I'm very happy. This is mostly my own fault, as I only did OK on my MCAT (mostly due to my rusty math skills, which is common amongst non-trads) and had a poor cumulative GPA due to mistakes on my very early transcript (lots of classes I just stopped going to without withdrawing = string of F's. Oops.) Luckily I had a VERY good science GPA, which got me on a couple of MD school waiting lists, but it was a tough year and I wound up at DO school where I've been very happy. I was slightly bummed about having to leave my home state, but in retrospect, everything worked out for the best. There is very little (if any) difference between MD's and DO's in modern medicine, and there is little "DO discrimination" remaining in the real world, although it still exists at some programs, I have yet to encounter it in real life.

Anymore questions, feel free to ask away.

Also, you can find more info on the SDN Non-traditional students forum.

2. I am also very interested in research. Would it help boost my application as an eventual psychiatrist to complete a thesis-based master's in psychology before applying to med school, especially due to my circumstance? Would an MPH in socio-medical sciences be better?

I will mostly defer this one. I will say that most DO schools don't do much research, although this won't affect you much after you get into a residency...

 

[notdeadyet]

I will begin my premed requirements upon entering a four year school since everything I read implies that med schools are not too keen on pre-reqs taken in CC's.

Meh, that's more SDN than anything. Take some prereqs at a CC to find out if you like it, then take others at a four year to show you're capable. Not a biggie. I'd recommend taking Gen Chem at a CC before going whole hog to see if you even like science coursework.

1. How much will being a "non-traditional" uGrad impact the decision process for med schools? It is much different from being a "career changer," as I have yet to accomplish anything, lol.

People throw around "non-traditional" to the point it doesn't have much meaning anymore. Here's how I found them, at least when I was doing interviews for my medical school:

• Non-science majors: Something to talk about. College kids, but many of the applicants seem more human.
• Delayed college for military: Usually more mature, often disciplined. Sometimes have great stories.
• Career changers: More mature, often fairly accomplished, bring outside perspective to the table.

Furthermore, will the two years I spent in CC have a negative impact even if I chose the most challenging courses I could find and performed well?

No. Schools look at your GPA, your MCAT and where you graduated from, pretty much in that order. Two years at a JC doesn't much matter, but how you performed at the four year will. I went to a JC and ended up at a great (for me, anyway) med school in California.

2. I am also very interested in research. Would it help boost my application as an eventual psychiatrist to complete a thesis-based master's in psychology before applying to med school, especially due to my circumstance? Would an MPH in socio-medical sciences be better?

If you want to do those things, go for it. And it will be a "nice to have" bullet point on your application in residency, but I think you'll find that programs will care much more about your clinical evaluations in 3rd year, your letters of recommendation, and your Step 1 score, in that order.

Take care and good luck with your process. Hope it all turns out well.

 

[notdeadyet]

Research nowadays is always a plus, some would say a must.

Not sure what they're smoking. The vast majority of applicants to psychiatry residencies have no pre-med school research and only nominal research while in medical school. Even folks I know who ended up going into top Psychiatry programs had little to know research experience.

 

[digitlnoize]

Not sure what they're smoking. The vast majority of applicants to psychiatry residencies have no pre-med school research and only nominal research while in medical school. Even folks I know who ended up going into top Psychiatry programs had little to know research experience.

Agreed. If you look at the NRMP match stats, research doesn't really seem to affect your chance of matching in most specialties.

 

[NeuSci]

Not sure what they're smoking. The vast majority of applicants to psychiatry residencies have no pre-med school research and only nominal research while in medical school. Even folks I know who ended up going into top Psychiatry programs had little to know research experience.

Not smoking anything, but since we're going to insults, I certainly know how to use "know", though (It rhymes!).

As I said, "research is a plus, some would say a must". To elaborate, if you want to get into medical school, all things being equal, research is without a doubt a plus, i.e., if two candidates have everything else equal, except one has research and one doesn't, they'll likely take the one with research. I would not say it is a must, but judging by how often my research came up in interviews for medical school and psych, I would do it all over again and then some.

Anyway, to give you some data, instead of my anecdotal experiences, here's a link to what the NRMP has to say. Psych research stuff starts at 251.

https://services.aamc.org/publicati...rsion135.pdf&prd_id=266&prv_id=327&pdf_id=135

Couldn't find anything about research for med school applicants/admissions, but I also didn't try very hard.

As I see it, most psych folks did some kind of research (avg 1.8), and more US seniors who matched were involved in research (490) than not (153), even if that research did not end up as an abstract, poster, or publication (350 with at least one of the above vs 293 with none).

So, if you like research, as I did, or feel you need it to strengthen your application, as I did, go for it!

 

[notdeadyet]

Not smoking anything, but since we're going to insults, I certainly know how to use "know", though (It rhymes!).

Sorry you're insulted, but I wasn't poking fun at you. Honest.

As I said, "research is a plus, some would say a must". To elaborate, if you want to get into medical school, all things being equal, research is without a doubt a plus, i.e., if two candidates have everything else equal, except one has research and one doesn't, they'll likely take the one with research.

No one's disagreeing about research being a plus. I think we're just puzzled by the idea that it's a "must." It hasn't been the experience of me or anyone I know. There's a lot of panic bred into SDN forums about how every specialty is getting ridiculously competitive and the sky is falling, but it's often not the case.

Research is a plus for going into any specialty. How important research is on your application varies by specialty. At the important end of the spectrum are specialties like ortho, derm and rads. With the possible exception of family practice, I can't think of another specialty where research is less of a requirement for almost all programs than psychiatry.

Again, agreed that research is a plus, but the "some" who "would say a must" are... altered. Smoking something funny is one of many potential causes.

 

[notdeadyet]

Anyway, to give you some data, instead of my anecdotal experiences, here's a link to what the NRMP has to say. Psych research stuff starts at 251.

I love Charting Outcomes. It was extremely useful to get an idea of where that sweet spot is for applying to the right number of programs for a given specialty.

As I see it, most psych folks did some kind of research (avg 1.8), and more US seniors who matched were involved in research (490) than not (153), even if that research did not end up as an abstract, poster, or publication (350 with at least one of the above vs 293 with none).

I think it's important to look at the data in a way that doesn't confuse correlation and causation. You're right more people had a "research project" listed than did not. Since ERAS is self-reporting, I think you'd likely find a lot of pretty weak entries for what constitutes research in applicants attempts to check that box.

And the question isn't "do applicants get involved in research?" but "does it factor into matching?"

Rather than looking at how many applicants have a research project listing is looking at what percentage of folks matched based on their number of research experiences:

• 93.3% match rate with 0 research experience
• 94.5% match rate with 1 research experience
• 95.8% match rate with 2 research experiences
• 94.6% match rate with 3 research experiences
• 94.4% match rate with 4 research experiences
• 93.2% match rate with 5+ research experiences

So the takeaway is that the amount of research experience has very, very little impact on matching into psychiatry. In fact, more than 2 research experiences actually becomes detrimental. This is very different from most other specialties.

So, if you like research, as I did, or feel you need it to strengthen your application, as I did, go for it!

Partial agreement: If you like research, then yes by all means go for it. In fact, even if you don't like research, getting basic exposure to research is probably a very good thing for you (even if it doesn't improve your chances of matching).

But the data doesn't seem to indicate that research is a particularly strong way to strengthen your application. I think it's probably a better strategy to just find something you're passionate about and devote your little free time and energy to explore it and gain meaningful experience. PDs will see in your application that you walk the walk. If that passion is research, fine. It's also worthwhile if that passion is clinical exposure, community service, or education.

You can always put in minimal time to check the box for any category of experience in ERAS. It's hard to fake the passion part. Do what you love and love what you do and it pays back in more ways than just matching.

 

[Cinnameg]

Not sure what they're smoking. The vast majority of applicants to psychiatry residencies have no pre-med school research and only nominal research while in medical school. Even folks I know who ended up going into top Psychiatry programs had little to know research experience.

I must be smoking something because at all of my interviews I was told that I was an appealing candidate no small thanks to my research background. I was also a non-traditional student in applying to medical school so I had some time in there where I did psychiatry-related activities, like crisis counseling, and that also seemed to be an application boost (as well as just a really meaningful way to spend time . . . I really recommend working on a local crisis line, it is excellent).

A plug for OHSU: We are GREAT for non-traditional medical students. In my class of 120, less than 10 were straight-out-of-undergrad. More than a few had done pre-medical post-baccalaureate programs, either locally at Portland State or farther away (I did mine at Mills). Our average age for our entering class was 26. I'm not on the admissions committee, but year after year we consistently have a majority of MS1's who have taken at least 2 extra years in their education or other time off, or are on a second career. I worried about starting medical school at the *gasp* late age of 24 and here I felt very much on the young end.

 

[notdeadyet]

I must be smoking something because at all of my interviews I was told that I was an appealing candidate no small thanks to my research background.

Yep, it's a plus. The "smokers" in question are folks who feel that it's a must.

Nothing but love for OHSU. Great med school and I think I got a better vibe off the psych resident and faculty there than at any interview I went on. Their psych program really seems to walk-the-walk when it comes to public psychiatry.