Justifying Psychiatry vs Psychology

[x_prometheus_x]

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I'm not sure if there have been posts on this or not so don't chastise me. I am not yet in med school, but was imagining a question from an adcom interviewer, "So why psychiatry over psychology?" Can anyone answer this question? I can reason that medicine is necessary, but I'm not sure what specific illnesses require medicine...maybe substance abuse and scjizophrenia? Are there other reasons to choose psychiatry vs pyschology? The validation of becoming a doctor vs phd?

 

[PsychEval]

The more likely question from the adcom interviewer might be: Why psychiatry over Dermatology, Radiology, Internal Medicine, etc.

 

[x_prometheus_x]

The more likely question from the adcom interviewer might be: Why psychiatry over Dermatology, Radiology, Internal Medicine, etc.

Hopefully you are correct 🙂 My personality , the long-term contact with patients, and a bunch of personal reasons that prove my earnest interest, but after 4 years I suppose alot of people change their area of interest.

 

[Psyclops]

For one thing, it's easier to get into med school than it is to get into a PhD program in psych.

 

[Anasazi23]

I'm not sure what the above comment has to do with the OP's question. 😕 Besides, the groups are difficult to compare since the applicant pools are vastly different and required prerequisite coursework in psychology is much easier in general. And no, it's not personal differences. Calculus based physics is harder than Introduction to developmental psychology. 😉

I believe that poster is a psychology grad student. Anyhow, there are lots of reasons one may pursue psychiatry over psychology. Primarily, one who pursues psychiatry instead of psychology adheres to the medical model of disease and health, rather than an academic approach. This includes an approach to the patient that centers on the assessment, diagnosis, and treatment of a psychiatric condition through a variety of treatment options.

This is not to say that psychiatrists cannot conduct, for example, primarly psychotherapy with little use of psychiatric medications. By and large, however, Psychiatric disease is approached from a standpoint not unlike other medical diseases. A psychiatrist sees a patient, gathers a chief complaint, conducts their assessment while tabulating a differential diagnosis, assigns a diagnosis, and provides treatment. Psychology, on the other hand, concerns themselves more with the assessment process, and often approaches the patient as a "work in progress" focusing more on talk-therapy interventions, while their schooling focuses more on theory and research methods (at least for PhD).

I've copied and pasted some of the more 'practical' reasons for pursuing psychiatry over psychology.

This way, I'm ensured that I can write for whatever I want, conduct TMS therapy (on the way soon...lot of cool new data), perform ECT without legal battles, never worry about inferior training lawsuit threats, receive substantially higher pay, be much more marketable, have full access to established physician-only continuing education programs, have equal and full respect amongst my physician colleagues, write for non-psychiatric drugs as I saw fit to further help my patients, not worry about insurance coverage providing payment to non-physicians, have a comprehensive medical background so that I am fully versed with my patients' many, varied and often complex medical questions, work in psych C/L settings if I so chose without impunity, have full access to drug company samples to help patients who cannot immediately pay or have access to medications, have the peace of mind knowing that I can relocate to anywhere in the country knowing that great jobs are available, teach psychiatry at a university at physician level pay if I so chose, have full gamut of psychiatry APA approved fellowships should I want to pursue them (I do), and simply know that I went through the most extensive training available to 'do what I do.'

 

[LM02]

I believe that poster is a psychology grad student. Anyhow, there are lots of reasons one may pursue psychiatry over psychology. Primarily, one who pursues psychiatry instead of psychology adheres to the medical model of disease and health, rather than an academic approach. This includes an approach to the patient that centers on the assessment, diagnosis, and treatment of a psychiatric condition through a variety of treatment options.

As a psychologist, I agree with Anasazi's post - I think it does a nice job of summing up the differences.

However, the quoted part above can apply equally to psychologists and psychiatrists - although I wouldn't say that we practice in "the medical model," the dominant approach is the biopsychosocial model of mental illness. And most of our clinical work is, indeed, in the assessment, diagnosis and treatment of the psychiatric condition.

However, the difference lies in where we place our emphasis - we acknowledge the "bio," and in fact do receive training in biological bases of behavior. But our training and practice is much more focused on the "psychosocial."

It's a subtle clarification, but one worth bringing up. As much as there is overlap in the fields, they are also vastly different. For example, the MD is primarily a professional degree whereas the PhD is primarily a research degree.

Given the differences, it's not hard to make a case for psychiatry if that is what you want to pursue...

 

[ratched]

When I interviewed for med school, I also had a pretty good idea that I was headed into psychiatry. This was fairly obvious based on my application, and I was asked at numerous interviews "why not psychology?". So definitely have an answer ready for this question if you are marketing yourself as a future psychiatrist.

What I learned through 2 interview processes (med school and recently residency) is that you can (and probably should) view interview questions as an opportunity to talk about aspects of yourself - I know that sounds self-centered, but hey, it's an interview. You don't need to concoct the most sound, intellectually-satisfying argument in a case like this. Though, Anasazi's post can provide you with excellent material for this.

If you did well in your pre-med sciences (bio, chem, etc...), then talk about how you have a particular talent in viewing the world abstractly and microscopically, and that this approach is taught and honed in medical school. Talk about the unique talents a psychiatrist must show during his/her training and professional life, and how knowledge of neurochemistry and neurophysiology leads to pioneering achievements in the field. Then, as an example, weave in some of your other science interests/awards/etc... Maybe an interesting humanities class that got you thinking about the mind-body problem.

Be careful not to stray TOO far from the question, but don't feel constrained by it. Remember, at the end of the interview, you want the interviewer to think highly of YOU and your accomplishments - your particular views on psychology or health care or stem cell research will not be what gets you in to med school.

I'm only speaking anecdotally here. It's possible that some/most of my interviewers didn't appreciate my antics. But hey, I got into med school, and found out that I successfully matched, so something's working.