Last minute cold feet...

[warpaint]

Hi all,
I am posting because I'm in a bit of a predicament regarding residency applications. I have been planning on applying to psychiatry for a while now, I have done my core clerkship and a few electives and enjoyed them all. However, I just finished another elective and feel as if something has changed:
1) I find myself missing medicine - hard findings, physical examination, etc. I used to not mind the subjective side of psych at all, now I feel like I am reaching for diagnoses and throwing meds around randomly.
2) I don't feel as empathetic/patient as I used to with some of my patients - mainly the really low-functioning patients that are difficult to interview. Sometimes I just don't know if I can handle dealing with that for the rest of my life.
I don't know what's happened, but it's pretty distressing given that applications are due so soon. Could it be that I just have cold feet because I'm finally having to make a decision?
I was recently advised to apply for a prelim year instead of psychiatry--if I decide I miss psych and want to do it after all, I was told it would be easier switching from medicine than having to go the other way. However, I have everything ready for psychiatry and it's extremely hard for me to let go of the plans I've been formulating for years now. Switching to medicine last minute seems a bit rash... but I am afraid that if I end up in psych unhappy, I will be seen as damaged goods to other specialties if I try to switch out. Not really sure why this would be, as I have excellent grades/scores/credentials, I just am afraid it will be that way.
Has anyone else been through this? Am I over-fatalizing things a bit? Would really appreciate any advice and support anyone has to offer.

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[diagonal]

Look at physician satisfaction surveys by specialty. It appears that the thrill of mashing on someone's abdomen and scouring EMRs for PTTs loses it's thrill.

If you were a goobery IM type, then my observation would be kind of meaningless. However, you were drawn to psych, so at least at some level you "get it". And with that, I trust 20yrs down the line, you'll be happy to be practicing medicine in a specialty that has the potential to genuinely improve someone's life - while allowing you to enjoy your own.

 

[OldPsychDoc]

Hi all,
I am posting because I'm in a bit of a predicament regarding residency applications. I have been planning on applying to psychiatry for a while now, I have done my core clerkship and a few electives and enjoyed them all. However, I just finished another elective and feel as if something has changed:
1) I find myself missing medicine - hard findings, physical examination, etc. I used to not mind the subjective side of psych at all, now I feel like I am reaching for diagnoses and throwing meds around randomly. ....

As a good friend said to me at this stage: "You'll get enough body fluid taps and orifice exams in internship to last you a lifetime."

(She wasn't wrong...)

 

[vistaril]

Hi all,
I am posting because I'm in a bit of a predicament regarding residency applications. I have been planning on applying to psychiatry for a while now, I have done my core clerkship and a few electives and enjoyed them all. However, I just finished another elective and feel as if something has changed:
1) I find myself missing medicine - hard findings, physical examination, etc. I used to not mind the subjective side of psych at all, now I feel like I am reaching for diagnoses and throwing meds around randomly.
.

If you have this concern now, it's only likely to increase as you continue in your psych training.

No, I don't mean palpating someones abdomen or other parts of the physical exam(that medicine really doesnt usually do in most cases anyways).....I'm referring more to the evidence base in medicine, the understanding of pathology, etc....

so no.....there isn't nearly as much evidence for much of the stuff we do in psychiatry compared to medicine. There isn't well understood mechanisms for our illnesses. If that is going to be a big problem for you(as i suspect), then you probably shouldnt do psych.....

 

[vistaril]

Look at physician satisfaction surveys by specialty. It appears that the thrill of mashing on someone's abdomen and scouring EMRs for PTTs loses it's thrill.
QUOTE]

people always use this example....usually pitting one extreme of interesting vs another extreme of tedious and unpleasant.

why not change the comparison around and use some really cool procedure in medicine vs an example in psych of seeing a malingering opiate detox pt in the ER......

I do psych and like it just fine, but let's not act like a lot of our work isn't uninteresting and routine...and let's not act like a lot of other fields don't have really cool and interesting stuff.

 

[vistaril]

As a good friend said to me at this stage: "You'll get enough body fluid taps and orifice exams in internship to last you a lifetime."

(She wasn't wrong...)

psych interns do AT MOST 4 months of inpatient medicine or peds usually......some programs do 1-2 only and the other couple months consist of outpt medicine or peds...

Generally, being a psych intern on a medicine ward for a few months doesn't get you "enough fluid taps to last a lifetime"

not that there is anything particularly useful or neccessary about doing LPs or thoras or paras or whatever for a psych intern, but it's not something most psych interns get a lot of exposure to. And some psych interns will never do any of that(not neccessarily a bad thing). Keep in mind early in the intern year prelims and medicine people are going to want to get their procedure cards signed off on asap, and so in most cases they are going to get those procedures if they want them(and it's in the interest of the program to get them for them)......

 

[diagonal]

people always use this example....usually pitting one extreme of interesting vs another extreme of tedious and unpleasant.

why not change the comparison around and use some really cool procedure in medicine vs an example in psych of seeing a malingering opiate detox pt in the ER......

I do psych and like it just fine, but let's not act like a lot of our work isn't uninteresting and routine...and let's not act like a lot of other fields don't have really cool and interesting stuff.

"really cool" is a great term for a 17yr old that is naive to the fact that everything gets old after a while. I didn't see heart surgeons running around with constant erections at how awesome their work is. Those ever-so fascinating endovascular procedures were being performed by guys yelling at people in the OR and audibly pining about when they get to go home.

Unless you're an eccentric, and to some extent you need to be in some of those "cool" fields if you're ever going to be happy, then everything is bound to grow old after a while. I'm nearly certain that happiness is more strongly correlated to control over one's life than it is 80 hrs weeks and stent coils.

 

[dl2dp2]

Hi all,
I am posting because I'm in a bit of a predicament regarding residency applications. I have been planning on applying to psychiatry for a while now, I have done my core clerkship and a few electives and enjoyed them all. However, I just finished another elective and feel as if something has changed:
1) I find myself missing medicine - hard findings, physical examination, etc. I used to not mind the subjective side of psych at all, now I feel like I am reaching for diagnoses and throwing meds around randomly.
2) I don't feel as empathetic/patient as I used to with some of my patients - mainly the really low-functioning patients that are difficult to interview. Sometimes I just don't know if I can handle dealing with that for the rest of my life.
I don't know what's happened, but it's pretty distressing given that applications are due so soon. Could it be that I just have cold feet because I'm finally having to make a decision?
I was recently advised to apply for a prelim year instead of psychiatry--if I decide I miss psych and want to do it after all, I was told it would be easier switching from medicine than having to go the other way. However, I have everything ready for psychiatry and it's extremely hard for me to let go of the plans I've been formulating for years now. Switching to medicine last minute seems a bit rash... but I am afraid that if I end up in psych unhappy, I will be seen as damaged goods to other specialties if I try to switch out. Not really sure why this would be, as I have excellent grades/scores/credentials, I just am afraid it will be that way.
Has anyone else been through this? Am I over-fatalizing things a bit? Would really appreciate any advice and support anyone has to offer.

As I'm fresh out of my CBT class, I see very clearly that a lot of things that you are saying are cognitive distortions.

(1) you know that RATIONALLY even in psych, meds are not actually thrown around randomly, and there is a systematic way to approach differentials.

(2) you also know that RATIONALLY that not all of your patients will be low functioning--in fact, most of your patients in your PP will be whatever you want them to be, high or low functioning.

(3) "If I end up in psych and unhappy, I will be seen as damaged goods. Not sure why..." Clearly RATIONALLY you know this is not gonna be the case, but you FEEL like that, because you are ANXIOUS.

So, restructure your thoughts a bit with rationalism and evidence: Fact, psychiatry has a body of evidence--not as much as medicine perhaps, but it still does. Fact, psychiatry deals with high and low functioning patients, and help many of them get better. Fact, if you have decent scores and perform well clinically, even if you end up not liking psych you should have no problem switching out and doing another specialty. Of course, you know all that already--now you just need to believe it.

If you feel really anxious about it, one exercise that might help is imagine what would happen if you made a mistake 5 years down the road--it's not the end of the world! Decatastrophize. Expose yourself to risks with careful planning. I'm not saying that psych is really the right specialty for you, but the first part of figuring out what's the right thing is to disambiguate what your feel and what you rationally considered for months. Another thing that might be helpful is to get some short term, goal focused therapy--I remember when I made this decision I needed some guidance from an unbiased person and it helped quite a bit.

 

[Leo Aquarius]

To the OP, I went through something like this. Firm diagnoses. Objective data. Sound decisions. It's how we're trained in medical school. By golly, it's what makes the most sense right? These are not the stuff psychiatry is made of. You have to ask yourself again what brings you the greatest satisfaction - dealing with firm diagnoses, objective data, and sound decisions? or face-to-face counseling? So far in residency I find psychiatry really is about the face-to-face element of patient care. The interview is your scalpel. You have to really enjoy getting to know people to thrive in the field. Being afraid of some people is only natural. For me, the strongest therapy is interpersonal relationships. A great therapist makes all the difference for, say, an addict. It's really what you find most satisfying. I sometimes miss objective data and clear diagnoses, and am bothered by psych diagnoses that are clearly incorrect. I will always miss these things. But at the end of the day I make a real impact in a few lives without having to use drugs or instruments or imaging, and I really appreciate that purity that I can use anywhere, anytime.

 

[SmallBird]

psych interns do AT MOST 4 months of inpatient medicine or peds usually......some programs do 1-2 only and the other couple months consist of outpt medicine or peds...

Well, to be fair, at my program we do 6 months inpatient medicine...

 

[F0nzie]

When I've had last minute cold feet its because internally I was not happy with my decision. I've had similar ambivalence in other scenarios where happiness was shrouded by guilt and flawed logic. Imagine a scenario where you are happy and do that. Your hard work deserves it.

 

[peppy]

If you're the kind of person who likes numbers and quantifiable measures, you certainly could start evaluating your patients according to some of the rating scales that were intended to quantify psych findings such as the Ham-D and PANSS.
I'd also suggest applying to programs with a strong psychosomatic or neuropsychiatry component. You might find your interest in other aspects of medicine translates well to psychosomatic med or something like fMRI research.
Making a commitment to a specialty is tough. My experience was that no matter which road you do commit to, there are probably aspects of other specialties you'll miss.

 

[vistaril]

Well, to be fair, at my program we do 6 months inpatient medicine...

amd then 2 months of neurology for 8 months off service total?

 

[vistaril]

If you're the kind of person who likes numbers and quantifiable measures, you certainly could start evaluating your patients according to some of the rating scales that were intended to quantify psych findings such as the Ham-D and PANSS.
.

that's putting a band-aid over the real problem though......

 

[13SLC]

One thing to think about is the decision to do a prelim year. It sounds good, because it gives you a year of medicine to see if you really enjoy the day to day of actually being a medicine intern. It also gives you a salary for a year while you figure it all out. But, this time next year, when you are starting to think about medicine vs another specialty, realize that by the time you have to apply you will maybe only have 2 months of your new prelim internship under your belt. Is that really going to be helpful? You have time for two months of Sub-Is now that could suffice just as well to aid in your decision. I was in your same position, questioning psych vs medicine vs a year off....but ultimately, I did a bunch of psych sub-Is (in different specialties and different settings), medicine sub-Is, and felt that psych was going to be the better fit long term for me. I am doing inpatient medicine now, and really enjoying it, but also realizing that having already seen 5 patients with acute renal failure, I am glad I get to move on to something more stimulating soon.

 

[warpaint]

Thanks everyone for your replies (and thanks for the virtual CBT sluox 🙂 )

I do have time to complete one more elective before applications go out, so I will try to use that to my advantage... Though I have a feeling that if I haven't really figured it out yet, I probably won't by the time apps are due 🙄 For now I am working on application materials for both specialties.
I think I feel more comfortable going for psychiatry and not making a last minute switch. Even if things seem kind of hazy currently, there's a reason I've been going for psych all this time... I guess the worst case scenario is I have to switch during residency, which may not be as much of a feat as I've been making it out to be.

 

[vistaril]

here is what I think, and I might be wrong(although it's very unlikely) : you pretty much know you are going to do psych. You don't really want to do medicine. You, however, do want to put it out there that it is a "tough" decision, and very easily could have done medicine since you like it so much and all. You also came here(to a psych group) to get what you *want* to hear...that psych is everything you want it to be/wish it was. If you were truly undecided, you would have posted this same thing in the medicine forum. In that forum, however, you wouldnt have heard what you want to hear....and since your mind is already made up who wants to deal with that?

This is not uncommon amongst people who know they are doing psych. At my med school, there was one guy in the class above me who kept saying he was 50/50 between psych and anesthesiology. everyone knew he was doing psych. He ended up doing psych, but up until Sept or so of his senior year he kept telling everyone how conflicted he was. everyone just rolled their eyes and nodded, knowing he would do psych.

 

[Mezo]

I'm having a similar problem. I found this thread helpful, thanks 🙂

I don't think it is always because "you want to hear what you want!" but because it is better to ask advice from people who are more likely to have gone through the same ideas/feelings and experienced people in the field.

 

[vistaril]

I'm having a similar problem. I found this thread helpful, thanks 🙂

I don't think it is always because "you want to hear what you want!" but because it is better to ask advice from people who are more likely to have gone through the same ideas/feelings and experienced people in the field.

but if someone was truly undecided, they would post it in the medicine forum as well.....

just a quick search over the last year in this forum shows literally > dozen original posts/threads from different people supposedly "deciding" between psych and (usually) IM.

Go over to the IM forum and I can't find many/any similar posts.......the reason is obvious- people don't want to hear what the IM people would say about IM vs psych because they have already made their mind up on psych.

 

[DOC PENGUIN]

but if someone was truly undecided, they would post it in the medicine forum as well.....

just a quick search over the last year in this forum shows literally > dozen original posts/threads from different people supposedly "deciding" between psych and (usually) IM.

Go over to the IM forum and I can't find many/any similar posts.......the reason is obvious- people don't want to hear what the IM people would say about IM vs psych because they have already made their mind up on psych.

Dear Vistiral, What you have to say is actually pretty good. But what is the harm of telling us where your residency is? You say you came from a top northeastern program. Could you at least tell us where you went to Med School?

 

[vistaril]

Dear Vistiral, What you have to say is actually pretty good. But what is the harm of telling us where your residency is? You say you came from a top northeastern program. Could you at least tell us where you went to Med School?

lol....why the interest in the specifics? If I mentioned my med school that would obviously help narrow down/pinpoint where I am completing residency, so it would essentially be the same thing.

 

[nitemagi]

but if someone was truly undecided, they would post it in the medicine forum as well.....

just a quick search over the last year in this forum shows literally > dozen original posts/threads from different people supposedly "deciding" between psych and (usually) IM.

Go over to the IM forum and I can't find many/any similar posts.......the reason is obvious- people don't want to hear what the IM people would say about IM vs psych because they have already made their mind up on psych.

Actually posting the same thread in multiple forums is against SDN rules. Therefore your conclusion doesn't hold.

 

[vistaril]

Actually posting the same thread in multiple forums is against SDN rules. Therefore your conclusion doesn't hold.

lmfao....for starters a lot of people don't know that. Second the ones that might know that still do sometimes....if the OP had just altered 2% of it, they could have asked the same question in both the psych and IM forums and nobody would have complained....

but regardless of the OP's decision, the same basic principle applies....even in some fantasy world where truly undecided people know of that rule and can only post in one forum, why are they seemingly always choosing to post that question/conflict in the psych forum....and not the medicine forum? Because like I said, their mind is already made up and they are looking for confirmation, which they will get here and not in medicine.

 

[nitemagi]

lmfao....

Sophisticated.

for starters a lot of people don't know that. Second the ones that might know that still do sometimes....if the OP had just altered 2% of it, they could have asked the same question in both the psych and IM forums and nobody would have complained....

They don't complain, the moderator moves it or deletes it or just closes it.

but regardless of the OP's decision, the same basic principle applies....even in some fantasy world where truly undecided people know of that rule and can only post in one forum, why are they seemingly always choosing to post that question/conflict in the psych forum....and not the medicine forum? Because like I said, their mind is already made up and they are looking for confirmation, which they will get here and not in medicine.

Maybe. Or you could just be wrong a lot.

 

[notdeadyet]

I'm going to try to rise above a lot of the posts about your intentions.

Disorder preservations you have about psychiatry or not unusual.

In fact people have a lot of reservations that sounds very similar to yours about choosing any kind of specialty.

Many of us go into medicine with ideas of wanting to help other people in a somewhat vague way.

Many of us decide to specialize, and when we do that we struggle with what we lose. This happens with neurosurgeons, pediatricians, physiatrists, and infectious disease.

I can only say that I had similar struggles, before I decided upon psychiatry. The best advice I got, was the idea that everyone who specializes has to give something up. The trick in deciding a specialty isn't so much deciding what you want to do that's what you don't want to give up.

I didn't want to give up dealing with my patients mental illness. I didn't want to give up the intersection between medicine and social services. I didn't want to give up dealing with the whole person.

You can make a case for doing what I want to do in family practice. But ultimately the complexities of dealing with mental illness was so profound, that I felt that any other specialty would give short shrift to something that I found amazingly complex so rewarding, that to deal with it as an ancillary complaint, would ultimately not be fulfilling for me.

My only advice is this: don't focus so much on what you will give up when you pursue a particular specialty. Every specialty needs to do this, by definition. Focus on what you can't bear to lose, and focus on a specialty that holds onto that tightly and passionately.

If you do that, you will find a specialty that satisfies you and fulfills you. There are many ways that can excell, don't focus on what you will lose, focus on what you want to devote your life to excel at. Do that, and you'll be happy, and by God, your patients will appreciate you for it.

 

[Mezo]

And why should we try to analyze the OP instead of answering his questions? 🙂
I think most people already know what is IM is about so no need to ask a lot of questions. On the other hand, psychiatry have always been the "weird side of medicine" during med school, so I guess it is normal to ask in psychiatry.

 

[vistaril]

Sophisticated.

They don't complain, the moderator moves it or deletes it or just closes it.

Maybe. Or you could just be wrong a lot.

well it is the only reasonable explanation there is for why it happens. Every month(sometimes ever couple weeks) there is one of these posts....they are pretty darn easy to see through.

Im not saying there is anything wrong with you guys giving them some feel good speech. It's what they came for and what they want to hear. But in 9/10 cases, they arent undecided in any way

 

[vistaril]

Many of us decide to specialize, and when we do that we struggle with what we lose. This happens with neurosurgeons.

oh please....neurosurgeons do not experience this.

 

[notdeadyet]

oh please....neurosurgeons do not experience this.

Yep, I know several folks who toyed between neurosurgery and neurology out of concern for losing the physical exam and physical medicine component of a neurology career that would be lacking in neurosurgery.

Your blanket statements (such as "neurosurgeons do not experience this") conveys a pretty black and white thinking that just doesn't exist in the world as most people see it.

 

[nitemagi]

well it is the only reasonable explanation there is for why it happens.

Incorrect. More of your generalizations.

Every month(sometimes ever couple weeks) there is one of these posts....they are pretty darn easy to see through.

You have no independent confirmation that your hypothesis is correct, only your self-assuredness which some might posit is arrogance masquerading as expertise.

 

[vistaril]

Incorrect. More of your generalizations.


You have no independent confirmation that your hypothesis is correct, only your self-assuredness which some might posit is arrogance masquerading as expertise.

the confirmation that my hypothesis is correct is me checking the medicine forum and seeing that it never happens over there.....if there were really large numbers of people on the fence about medicine vs psych, it's only logical to assume that some of those would be posting to medicine instead of psychiatry forums......as for it being "independent", you're welcome to go over to those forums and link any such "conflicts" over there.....there are very few to none (depending on what you count).
It's an obvious observation a 7 year old could make.

 

[vistaril]

Yep, I know several folks who toyed between neurosurgery and neurology out of concern for losing the physical exam and physical medicine component of a neurology career that would be lacking in neurosurgery.

Your blanket statements (such as "neurosurgeons do not experience this") conveys a pretty black and white thinking that just doesn't exist in the world as most people see it.

there isn't a single neurosurgeon alive who has "concens" in the slightest about not being able to do something as well as a neurologist hehe.....

very few people are undecided between neurosurgery and neurology. Most people who are now neurosurgeons who considered doing something other than neurosurgery considered things like ent and other surgical subspecialties.....

 

[nitemagi]

the confirmation that my hypothesis is correct is me checking the medicine forum and seeing that it never happens over there.....if there were really large numbers of people on the fence about medicine vs psych, it's only logical to assume that some of those would be posting to medicine instead of psychiatry forums......as for it being "independent", you're welcome to go over to those forums and link any such "conflicts" over there.....there are very few to none (depending on what you count).
It's an obvious observation a 7 year old could make.

7 year olds think very concretely. I see the similarity.

Absence of evidence does not equate to evidence of absence.

 

[F0nzie]

It's an obvious observation a 7 year old could make.

As many times as I've seen this type of statement from you, sometimes I wonder if we really do need a 7 y/o consult for you in these threads. 😉

 

[OldPsychDoc]

As many times as I've seen this type of statement from you, sometimes I wonder if we really do need a 7 y/o consult for you in these threads. 😉

I have one handy if anyone wants to pose a question.

 

[digitlnoize]

there isn't a single neurosurgeon alive who has "concens" in the slightest about not being able to do something as well as a neurologist hehe.....

Really? Not a single living neurosurgeon? Not a single one? One. Living. In the world.

More black and white thinking.

Can we have a Vistaril diagnosis party? I'm going to start with:

Axis I: Adjustment disorder, chronic, with MDEC (309.4)
Axis II: Cluster B Traits

Anyone other theories?

 

[diagonal]

the confirmation that my hypothesis is correct is me checking the medicine forum and seeing that it never happens over there.....if there were really large numbers of people on the fence about medicine vs psych, it's only logical to assume that some of those would be posting to medicine instead of psychiatry forums......as for it being "independent", you're welcome to go over to those forums and link any such "conflicts" over there.....there are very few to none (depending on what you count).
It's an obvious observation a 7 year old could make.

It's pretty clear that posting about psychiatry in a medicine forum would fall flat. Most people in medicine residencies look cross-eyed at even faint notions of psychiatry, they don't get it, they have no interest in it, and it's a burden. Psychiatry to them was a single rotation with generally good hours. Whereas all psych residents and attendings have had far more experience in medicine, given that medical school is nearly entirely medicine. They have been forced by nature of the system to ponder medicine to a far greater degree than IM folks have had to ponder psych.

In more simpler terms: 95% of IM people don't give 2 ****s about psych. In a psych forum however, everyone has an interest in psych, and I'm sure a far greater degree of psych residents had an interest in IM that they chose to forgo vs IM residents that had a psych interest they chose to forgo.

 

[nancysinatra]

I would do the prelim year, if it were me. It IS hard to back out of psych later on and you may well miss things about IM or whatever else you are considering. That's just my 2 cents. They're really different fields.

oh please....neurosurgeons do not experience this.

Not sure why people jumped on this--I sort of agree that most neurosurgeons don't have any sense of regret or loss. If anyone thinks they do, have you TALKED to a neurosurgeon? They speak in hieroglyphics, at most. They're not people you sip chai tea with and talk about feelings together and then make yoga plans with. Plus they don't have time to "struggle," and why would they anyway, when they are rolling in all that dough?

And what's with all the CBT and psychobabble being thrown around here? It really annoys me when psychiatrists analyze their peers. Its one reason WHY people in other specialties look down on us.

Plus people engage in black and white thinking all the time. My grandma has some black and white ideas about whether I should be home for Christmas, for example, but I don't haul out the CBT on her. If I did, I don't think she'd want me home for Christmas anymore.

 

[diagonal]

I would do the prelim year, if it were me. It IS hard to back out of psych later on and you may well miss things about IM or whatever else you are considering. That's just my 2 cents. They're really different fields.



Not sure why people jumped on this--I sort of agree that most neurosurgeons don't have any sense of regret or loss. If anyone thinks they do, have you TALKED to a neurosurgeon? They speak in hieroglyphics, at most. They're not people you sip chai tea with and talk about feelings together and then make yoga plans with. Plus they don't have time to "struggle," and why would they anyway, when they are rolling in all that dough?

And what's with all the CBT and psychobabble being thrown around here? It really annoys me when psychiatrists analyze their peers. Its one reason WHY people in other specialties look down on us.

Plus people engage in black and white thinking all the time. My grandma has some black and white ideas about whether I should be home for Christmas, for example, but I don't haul out the CBT on her. If I did, I don't think she'd want me home for Christmas anymore.

Maybe she doesn't?

 

[nancysinatra]

Maybe she doesn't?

Huh?

 

[diagonal]

Huh?

 

[billypilgrim37]

I think we use "psychobabble" because saying what we really think might get us kicked off the forum.

An alternative explanation is that we do it specifically to annoy you. 😉

 

[nancysinatra]

I think we use "psychobabble" because saying what we really think might get us kicked off the forum.

It would be more honorable to get kicked off the forum though, wouldn't it?

 

[billypilgrim37]

It would be more honorable to get kicked off the forum though, wouldn't it?

Honorable? Would you rather vistaril and digitlnoize duel with flintlocks at dawn? Or nitemagi and vistaril with sabers?

 

[digitlnoize]

Honorable? Would you rather vistaril and digitlnoize duel with flintlocks at dawn? Or nitemagi and vistaril with sabers?

🤣

 

[F0nzie]

Honorable? Would you rather vistaril and digitlnoize duel with flintlocks at dawn? Or nitemagi and vistaril with sabers?

When conflicts arise that can no longer be mitigated by conventional discourse due to one or both party's unwillingness or inability to concede, accept, or compromise, irrational means such as epic battles or getting kicked off of online forums provides both entertainment for spectators and a perceived sense of complete resolution.

In short, my answer is yes I would like to see this battle. Yes indeed.

 

[Salpingo]

1. First of all, it makes sense to post these crises on the psych forum, since the majority of people going into psych are interested in going into medicine (being that they applied and went to medical school). The subset that were interested in psychiatry from the beginning of med school resolved their conundrums in their "psychology vs. psychiatry" threads. So there's a significant chunk of people in THIS forum who experienced cold feet as well that can share their experiences, if they still have regrets, etc. I would assume that the majority of people in the IM forum WEREN'T or AREN'T significantly interested in psychiatry (although it would be interesting to see a poll). So I wouldn't assume this post was an attempt at reenforcement, but rather tapping into the collective experience.
2. I also think its appropriate, if concerned about the negatives of psychiatry (the vagueness of diagnoses, the frustration of inexact psychopharmacy), to observe the negatives of other fields. That being said...
3. The OP would probably be happy in IM, but they will also probably be happy in psychiatry. I realize that happiness is so relative (just look at the recent pop studies showing bronze medalists are "happier" than silver medalists), that its easy to fall into the trap of "I have to be the achieve the maximum possible level of happiness." But these decisions become much less anxiety-provoking when you realize you're in a great position, deciding between two phenomenal specialties and you really can't go wrong either way.

 

[Leo Aquarius]

To the OP's original subject about last minute cold feet, I had last minute cold feet. Being 2 months into residency the cold feet are gone and I'm very happy with my decision for all sorts of reasons. Psychiatry becomes more interesting each month, and my co-residents feel the same. I thought I'd hate the vagueness of diagnoses, but now I like it because there's room for analysis and interpretation and personal touch. Other medical fields felt formulaic in the treatment protocols.

 

[SteinUmStein]

To the OP's original subject about last minute cold feet, I had last minute cold feet. Being 2 months into residency the cold feet are gone and I'm very happy with my decision for all sorts of reasons. Psychiatry becomes more interesting each month, and my co-residents feel the same. I thought I'd hate the vagueness of diagnoses, but now I like it because there's room for analysis and interpretation and personal touch. Other medical fields felt formulaic in the treatment protocols.

The feel formulaic because they are formulaic. That's why academic physicians love weird and rare cases, they get to actually think and make a decision without following a predetermined protocol. I'm exaggerating, but not by much.

 

[vistaril]

7 year olds think very concretely. I see the similarity.

Absence of evidence does not equate to evidence of absence.

(shrug)

I suggest you go talk to a good number of neurosurgeons......obviously out of the 10k or so(?) practicing neurosurgeons out there, at least one probably misses aspects of other fields....but in general they have less regret about things(especially with whatever it is neurologists do lmfao) than just about any other field.