Looking Towards My Future

[El Curandero]

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Hello,
I'm new to these forums. Right now I'm a junior attending Rutgers University as a psychology major. First and foremost, I would like to say that in no way am I trying to start a flame way between Psychiatrists and Psychologists. I really just want the expertise of a mental health professional concerning the task of choosing my future educational opportunities.

Time to get to the point. I am trying to decide between going to medical school with the plan to specialize in psychiatry or a PsyD program to become a clinical psychologist. Here is my question, (if you did not read my first paragraph please understand that I am not trying to start a flame war) is there any reason at all to go to medical school to become a psychiatrist when I can prescribe as a psychologist with a post-masters specialization in psychopharmacology? I heard the reimbursement rates are the same, is this true? If so, then do medical psychologists have the same salary as psychiatrist. Thank you for your time.

 

[Doctor Eliza]

There are very few places where you can rx as a psychologist (New Mexico, Louisianna, and Illinois is working on it). The AMA is powerful and good at protecting its turf. The APA is comparatively weak and we are losing ground all the time to master's level providers. If you want to live in say, NJ, and rx as a psychologist, you have to do your PsyD and nurse practitioner, which is way more school and hassle than just becoming a psychiatrist. If you want to be a practitioner, rx, and enjoy you medicine, I would not think twice about becoming a psychiatrist. They are very in demand and are reimbursed at a rate roughly 3x the rate of non-rx'ing psychologists (perhaps edieb can chime in on the reimbursement differences between psychiatrists and rx'ing psychologists).

I'm a licensed psychologist in PP, and if I could do it over I would definitely become a psychiatrist.

Best,
Dr. E

 

[erg923]

Hello,
I'm new to these forums. Right now I'm a junior attending Rutgers University as a psychology major. First and foremost, I would like to say that in no way am I trying to start a flame way between Psychiatrists and Psychologists. I really just want the expertise of a mental health professional concerning the task of choosing my future educational opportunities.

Time to get to the point. I am trying to decide between going to medical school with the plan to specialize in psychiatry or a PsyD program to become a clinical psychologist. Here is my question, (if you did not read my first paragraph please understand that I am not trying to start a flame war) is there any reason at all to go to medical school to become a psychiatrist when I can prescribe as a psychologist with a post-masters specialization in psychopharmacology? I heard the reimbursement rates are the same, is this true? If so, then do medical psychologists have the same salary as psychiatrist. Thank you for your time.

If you want options outside 2 states and the DoD, it might be good to go ahead and go to med school.

Psychiatrists also manage existing medical conditions (within reason) and will generally view themselves as physicians who specialize in mental health treatment. That's obviously not how Rxing psychologist view themselves/their role. Which one do you want

 

[Therapist4Chnge]

...so you just want to prescribe?

If so, become an NP or PA...but you *will not* have even 10% of the training in psych that you would receive as a psychiatrist or psychologist. Those paths barely touch the subject and will result in you doing 15min med checks, 30min intakes, and grinding out paperwork because you will be reimbursed less than a physician and be more limited. Depending on your background you can probably get done in 3-4ish years.

Keep in mind that a psychiatrist is a physician first, and you will need to complete 5 years (4 med school, 1 intern year) that is 90% not psych related....and then 3 more years of residency and probably a 1yr fellowship. It will be 9 years before you are out and prescribing.

Pursuing training as a psychologist to prescribe will require at a minimum 8-9 years (4 school, 1 intern, 1 post-doc, 2 yr. MS program, and 1 year supervision). You will then be limited to a couple of states, 1 US territory, and the US military. There will probably be a few more states with RxP rights by then, but not anywhere close to the other paths.

*full disclosure...I'm finishing up my requirements to be eligible for psych Rx, though I will not be practicing in that area.*

 

[erg923]

*full disclosure...I'm finishing up my requirements to be eligible for psych Rx, though I will not be practicing in that area.*

Then what was is all for, T4C?

 

[pretzels]

OP are you premed? If not, you will need to (likely) go back and take a lot of prerequisite classes to apply for med school if you wanted to pursue psychiatry. Similarly psychology programs will often require you to have background classes in stats, research methods, personality psychology and others. Sorry maybe I missed where you explained this

 

[JeyRo]

If you want options outside 2 states and the DoD, it might be good to go ahead and go to med school.

I think you can also prescribe in the Indian Health Service.

 

[Therapist4Chnge]

Then what was is all for, T4C?

I thought it'd make me a better clinician (which I believe it did) and it is/was my Plan C if things go to hell w. psychology and neuropsychology, as I love Louisiana and I don't mind New Mexico. I have very mixed feelings about the training and the push for RxP across states, as I think it is a good idea in theory, but it has not be implemented very well. I am against online training and watering down the requirements for the masses, so the current legislative iterations out there are problematic. Finishing my training has been on the back burner for the last few years bc of my career path, though I now have the support of my dept. (sit for the PEP, etc), so I decided to do it.

If someone wants to be a prescriber...and they know that from the outset...there are far easier and shorter paths that offer more flexibility to prescribe.

 

[JeyRo]

I thought it'd make me a better clinician (which I believe it did) and it is/was my Plan C if things go to hell w. psychology and neuropsychology. I have very mixed feelings about the training and the push for RxP across states, as I think it is a good idea in theory, but it has not be implemented very well. I am against online training and watering down the requirements for the masses. Finishing my training has been on the back burner for the last few years bc of my career path, though I now have the support of my dept. (sit for the PEP, etc), so I decided to do it.

If someone wants to be a prescriber...and they know that from the outset...there are far easier and shorter paths that offer more flexibility to prescribe.

From what I understand, it's potentially quite lucrative for a well-trained psychologist to have additional training in prescribing, even if they can't write the scrips themselves. Lots of primary care docs have trouble finding psychiatrists they can work with (in my field, geropsychiatrists are incredibly hard to find) - and they are willing to pay quite well to secure competent medication consultation.

 

[El Curandero]

I was actually beginning to take pre med courses since last year. I received two B+s in general biology, not bad for a "soft science" major . I definitely am interested in providing both therapeutic, assessment, ans prescription services for my clients. Even if I couldn't prescribe I would do the post-masters program in psychopharm anyway because behavioral pharmacology is something I'm very interested in academically. The thing is..I'm taking general chemistry now and it blows, I don't really want to go to medical school, it's not my interest. I have a really hard time focusing on things that are very abstract and seem useless. If I could see anything a bit related to psychopharmacology in the class I think I would do a lot better...and medical school is mostly going to be unrelated to the behavioral sciences...

Basically I would become a medical psychologist over a psychiatrist if I knew that they are on equal footing in terms of reimbursement and salary. So in states where they can prescribe, is this true? Ii have no problem moving to Louisiana (not New Mexico lol).Thank you for your input.

 

[Therapist4Chnge]

From what I understand, it's potentially quite lucrative for a well-trained psychologist to have additional training in prescribing, even if they can't write the scrips themselves. Lots of primary care docs have trouble finding psychiatrists they can work with (in my field, geropsychiatrists are incredibly hard to find) - and they are willing to pay quite well to secure competent medication consultation.

I am content with my current path, though who knows with healthcare and the economy what the field will look like in another 3-5 years. I have a number in my head that I'd like to hit within the next 2 years, so if that doesn't happen then I may revisit my options because I have some expensive hobbies I need to support.

 

[JeyRo]

I am content with my current path, though who knows with healthcare and the economy what the field will look like in another 3-5 years. I have a number in my head that I'd like to hit within the next 2 years, so if that doesn't happen then I may revisit my options because I have some expensive hobbies I need to support.

No one really knows, but I think essentially a psychogist with RxP (even in a state where they can't write the scrips) will probably be in even higher demand in the next 3-5 years then they are now. My take is that Obamacare will make getting an appointment with a doctor even more challenging, and more and more disciplines (NPs, PAs, etc) will get leaned on as extenders than they ever have before.

But everything else will go to hell too... but that's just my guess.

 

[PHD12]

I was actually beginning to take pre med courses since last year. I received two B+s in general biology, not bad for a "soft science" major . I definitely am interested in providing both therapeutic, assessment, ans prescription services for my clients. Even if I couldn't prescribe I would do the post-masters program in psychopharm anyway because behavioral pharmacology is something I'm very interested in academically. The thing is..I'm taking general chemistry now and it blows, I don't really want to go to medical school, it's not my interest. I have a really hard time focusing on things that are very abstract and seem useless. If I could see anything a bit related to psychopharmacology in the class I think I would do a lot better...and medical school is mostly going to be unrelated to the behavioral sciences...

Basically I would become a medical psychologist over a psychiatrist if I knew that they are on equal footing in terms of reimbursement and salary. So in states where they can prescribe, is this true? Ii have no problem moving to Louisiana (not New Mexico lol).Thank you for your input.

I believe the salary is still going to be higher for a psychiatrist than prescribing psychologist and fewer restrictions. We have one person who is doing this path and can comment more. Medical school (or NP) will be a shorter path compared to a prescribing psychologist. Once you are done with your training as a psychologist, you will still have to go through rigorous coursework and training to rx. Why go through 9 years of training to be a prescribing psychologist and only be able to practice in Louisiana? I think an NP program makes a lot more sense.

 

[erg923]

I Why go through 9 years of training to be a prescribing psychologist and only be able to practice in Louisiana? I think an NP program makes a lot more sense.

I'd live in Shreveport..but that's probably it...

 

[Therapist4Chnge]

Baton Rouge is nice. I looked down in New Orleans too, but living there and visiting there are two very different experiences. The humidity rivals that of S. FL too....so that alone may be a dealbreaker for some (but wasn't for me). The limited outside work in N.O. was an issue for me, as most people do not have the means to afford a cash pay practice.

JeyRo...I hope you are right because insurance reimbursements aren't getting any better. 👎 I would be perfectly fine doing part-time boutique/concierge consulting, though I'd need other outlets to keep things interesting. I have kicked around a few different models for practice, and getting hooked in w. a concierge practice is a great option for someone who has the right kind of personality and approach to practice.

 

[El Curandero]

I believe the salary is still going to be higher for a psychiatrist than prescribing psychologist and fewer restrictions. We have one person who is doing this path and can comment more. Medical school (or NP) will be a shorter path compared to a prescribing psychologist. Once you are done with your training as a psychologist, you will still have to go through rigorous coursework and training to rx. Why go through 9 years of training to be a prescribing psychologist and only be able to practice in Louisiana? I think an NP program makes a lot more sense.

Well if you go the PsyD route wouldn't it be 3 years of school + 1 year of internship + 2 years of post-masters= 6 years after undergrad? Isn't a psychiatrist 8 years after undergrad?

 

[erg923]

Well if you go the PsyD route wouldn't it be 3 years of school + 1 year of internship + 2 years of post-masters= 6 years after undergrad? Isn't a psychiatrist 8 years after undergrad?

Most Psy.Ds are 4+1. And that counting on matching the first time around, which over 25% dont...

 

[PHD12]

JeyRo...I hope you are right because insurance reimbursements aren't getting any better. 👎 I would be perfectly fine doing part-time boutique/concierge consulting, though I'd need other outlets to keep things interesting. I have kicked around a few different models for practice, and getting hooked in w. a concierge practice is a great option for someone who has the right kind of personality and approach to practice.

I thought you did worker's comp and some forensic work as well. These two areas are always going to be in demand in PP. I have met several psychologists who specialize in worker's comp, but neither are trained neuropsychologists so I was wondering what types of skills folks need to do worker's comp evals? It seems to also be in the domain of health psychologists. What is the future like for worker's compensation? The folks I know have a practice with someone else doing the billing/insurance work.

 

[El Curandero]

Hmm, well it seems you guys believe I should go to medical school. I just want to cover all my bases. Do you see psychiatry salaries going down in the near future due to NPs and prescribing psychologists? If I'm going to invest $250,000 into my education I want to know that I'll be good for the next forty years..

 

[PHD12]

Well if you go the PsyD route wouldn't it be 3 years of school + 1 year of internship + 2 years of post-masters= 6 years after undergrad? Isn't a psychiatrist 8 years after undergrad?

Any decent PsyD is going to be 4 years minimum of school (and many folks don't match so it can easily be 5 years without internship).

4 years PsyD (if you match) + 1 year internship+ 1-2 year fellowship depending on specialty area/state + Psychopharmacology training (2 years?).

You are not going to be licensed once you graduate. Sometime states require more than 1 year of supervision hours (I believe your state in NJ is one of the states with crazy requirements).

 

[Pragma]

Hmm, well it seems you guys believe I should go to medical school. I just want to cover all my bases. Do you see psychiatry salaries going down in the near future due to NPs and prescribing psychologists? If I'm going to invest $250,000 into my education I want to know that I'll be good for the next forty years..

Much more of a sure bet with psychiatry.

I'd also consider what you are looking at for Psy.D. degrees. I don't think many folks would respect a 3+1 program.

 

[PHD12]

Hmm, well it seems you guys believe I should go to medical school. I just want to cover all my bases. Do you see psychiatry salaries going down in the near future due to NPs and prescribing psychologists? If I'm going to invest $250,000 into my education I want to know that I'll be good for the next forty years..

Even if they go down they will never get as low as a PsyD salary and they will always be in higher demand. You are looking to pay around the same amount to enter a field that already has an internship crisis and unpaid postdocs. PsyD's tend to fare the worst (unless you are going to the only fully funded PsyD program which is baylor).

I would recommend that you aim for a public medical school (state school or UC) to reduce cost or an NP program. Are you open to the NP degree?

 

[Therapist4Chnge]

Well if you go the PsyD route wouldn't it be 3 years of school + 1 year of internship + 2 years of post-masters= 6 years after undergrad? Isn't a psychiatrist 8 years after undergrad?

See my post above about the years...but 4+1+1+2 is the shortest option, and that is assuming you get matched during your first go around, you get your post-doc hours done in a year AND you can get your classes done on time.

I thought you did worker's comp and some forensic work as well. These two areas are always going to be in demand in PP. I have met several psychologists who specialize in worker's comp, but neither are trained neuropsychologists so I was wondering what types of skills folks need to do worker's comp evals? It seems to also be in the domain of health psychologists. What is the future like for worker's compensation? The folks I know have a practice with someone else doing the billing/insurance work.

I am still building up my out-pt referrals for neuropsych work, so for the time being I take most referrals (assuming they are physician referred, have clear medical necessity, and can cash pay or be pre-auth'd on one of the insurance plans I accepted). I do a mix of return to work (following a TBI, Stroke, etc), differential dx for dementia, post-concussion syndrome, etc. I prefer to see a range of cases, so I have made a point to not just see one type of patient because I'd probably get bored/burned out.

WC and forensic are definitely solid avenues, though there is a bit more of a learning curve. I am still learning the In's and Out's of the work...so TBD.

As for what background is needed.....depends on the type of case. I stick with my areas of expertise: TBI, etc.

 

[AnnoyedByFreud]

Hmm, well it seems you guys believe I should go to medical school. I just want to cover all my bases. Do you see psychiatry salaries going down in the near future due to NPs and prescribing psychologists? If I'm going to invest $250,000 into my education I want to know that I'll be good for the next forty years..

Become a psychiatrist (more debt, but more power, takes 8+ years) or a psych NP (less debt, faster, but less power, still really good earning potential... depends on the context).

 

[Doctor Eliza]

Your comment about not enjoying chemistry stood out to me. This is how I made the mistake of switching from premed to psych. Premed courses suck, particularly the early ones. Ask most physicians and they will tell you that they hated them and barely remember a thing. They have little to do with the day to day work of being a physician. They are hurdles. On the other hand, psych classes are pretty interesting right away. I was seduced into psychology because of this. I regret it because I think I have the interest and aptitude to have attended med school and become an MD. I just would have hated premed (like most physicians).

However, as others have pointed out, to be a psychiatrist you need to be a physician first. Can you handle blood and gross stuff? Are you interested in anatomy and bodily processes and all that jazz?

Also, never ever invest $250k in a PsyD. You will never earn enough to make that worthwhile. Reality check: I graduated almost 4 yrs ago and I am a licensed psychologist in PP. Last year I made 44k in a group private practice before taxes (I.e., no benefits) Fortunately, I have no loans as I went to a respected and funded PhD program and APA accredited internship. Not everyone can count on that.

Also you are way underestimating time to completion. Everyone thinks they will get out in 4+1, but many many students do not, often due to things out of their control. I know a number of colleagues (even PsyD rather than PhD) who took more like 8-9 yrs to get their degrees. Some of them were stuck ABD for a long time (which is a nightmare in terms of employability). Med school is a straight shot through. You go to class, take your tests, in 4 yrs you are an MD. You do a psychiatry residency, which you are paid for and you are more likely to obtain than an APA internship. (cue psychiatry student popping up on our board to bitch and moan about how hard their lives are )

Good luck making your decision. I am contemplating going back to get an NP degree eventually because I would love to rx (mostly for clinical reasons, just a little financial). But it is much more of a hassle than just having gone to med school.

Best,
Dr. E

 

[PHD12]

It's frustrating to see that so many people think you can become a clinical psychologist in 3-4 years with a PsyD.

 

[El Curandero]

Looks like I'm going to medical school lol, thanks guys I'm glad I came here. While general chemistry is only interesting for the "gifted" of us I'm sure the 300+ class size per ONE professor doesn't help either.. *Puts nose back in chem book..*

 

[JeyRo]

Your comment about not enjoying chemistry stood out to me. This is how I made the mistake of switching from premed to psych.

This.

It probably costs a lot less to get a private tutor, if necessary, to get through chem, O-chem, physics and calculus prereqs for medical school than many of the alternatives.

 

[El Curandero]

For some reason I think I'm actually going to be decent at O-chem. People have told me your either a biology/O-chem person or a general chemistry/physics person. I am definitely the biology person lol. I should have jsut taken gen chem at my community college sigh..

 

[PHD12]

For some reason I think I'm actually going to be decent at O-chem. People have told me your either a biology/O-chem person or a general chemistry/physics person. I am definitely the biology person lol. I should have jsut taken gen chem at my community college sigh..

For what it's worth, most of my friends partied in medical school way more than I ever could in a clinical psychology program. Pre-med was definitely the worst part. There are also med schools out there that are pass/fail (I believe stanford?), and even if you fail classes you won't get kicked out (this happened to several friends).

 

[El Curandero]

For what it's worth, most of my friends partied in medical school way more than I ever could in a clinical psychology program. Pre-med was definitely the worst part. There are also med schools out there that are pass/fail (I believe stanford?), and even if you fail classes you won't get kicked out (this happened to several friends).

That's a relief. I assume I'll enjoy medical school better anyway as it isn't so abstract, even though I won't be using most of the information as a psychiatrist.

 

[Doctor Eliza]

That's a relief. I assume I'll enjoy medical school better anyway as it isn't so abstract, even though I won't be using most of the information as a psychiatrist.

Although it is that way for every medical specialty. My BFF is a pediatric neurologist. Her baby recently had some minor kid illness stuff going on. I asked if she agreed with her pediatrician's intervention. Her answer: oh, I don't know, it has been years since I did general peds.

Another good example: the oncologist next door asked my mom (whose sole qualification was having kids of her own) if she thought his kid had chicken pox.

It's the nature of the beast. If it's any consolation there are also tons of classes in psych grad school that I never use. 🙂

Dr. E

 

[edieb]

For some reason I think I'm actually going to be decent at O-chem. People have told me your either a biology/O-chem person or a general chemistry/physics person. I am definitely the biology person lol. I should have jsut taken gen chem at my community college sigh..

I am prescribing (medical) clinical psychologist in New Mexico. I graduated with my Ph.D. from Louisiana State University in 2009. Our program forced us to complete an APA-accredited internship so I pretty much did everything "right" before making the decision to pursue my post-doctoral masters at New Mexico State University. Although I am doing well now, sudying for the PEP, the exam to allow me to prescribe, was very diffiuclt. The time committment was 3 hours/night for 18 months or so. In addition, I had to complete a practicum that was very time consuming. Add onto all this that I was studying for the EPPP, the psychology licensing exam, at the same time

While I was taking the classes I was working at a V.A. hospital. Let me tell you - I would never, never choose clinical psychology wp prescriptive authority ever again. As a single female wanting children, I often wondered how people seem to think a V.A. salary is enough to live on comfortably and make up for 10 years + of school in which you have little income. Psychiatry would have been a much easier route because once you finish the struggle is over. You will always have employers wanting to hire you and you will always be compensated well.

Also, keep in mind that you may love therapy, testing, etc. However, over time, you are going to want to pursue other things in life other than work-related activities. Youre going to want to buy a house, a car, go on vacation, send your kids to college. Your job will eventually just be a job and, in psychology, you're probably not going to make enough to have the kind of life you want. The average psychologist makes $75K after 15 or so years of work. So it will take you 25 years (with school) to earn that. That is insane!! And a lot of people earning this amount live in high cost of living area like Los Angeles. Our standards are so low that we think a V.A. position that pays $69K is a lot of money but, when you get to the real world, you will realize how little that is! In most cases, choosing psychology is choosing a life of hardship!

.

 

[El Curandero]

I am prescribing (medical) clinical psychologist in New Mexico. I graduated with my Ph.D. from Louisiana State University in 2009. Our program forced us to complete an APA-accredited internship so I pretty much did everything "right" before making the decision to pursue my post-doctoral masters at New Mexico State University. Although I am doing well now, sudying for the PEP, the exam to allow me to prescribe, was very diffiuclt. The time committment was 3 hours/night for 18 months or so. In addition, I had to complete a practicum that was very time consuming. Add onto all this that I was studying for the EPPP, the psychology licensing exam, at the same time

While I was taking the classes I was working at a V.A. hospital. Let me tell you - I would never, never choose clinical psychology wp prescriptive authority ever again. As a single female wanting children, I often wondered how people seem to think a V.A. salary is enough to live on comfortably and make up for 10 years + of school in which you have little income. Psychiatry would have been a much easier route because once you finish the struggle is over. You will always have employers wanting to hire you and you will always be compensated well.

Also, keep in mind that you may love therapy, testing, etc. However, over time, you are going to want to pursue other things in life other than work-related activities. Youre going to want to buy a house, a car, go on vacation, send your kids to college. Your job will eventually just be a job and, in psychology, you're probably not going to make enough to have the kind of life you want. The average psychologist makes $75K after 15 or so years of work. So it will take you 25 years (with school) to earn that. That is insane!! And a lot of people earning this amount live in high cost of living area like Los Angeles. Our standards are so low that we think a V.A. position that pays $69K is a lot of money but, when you get to the real world, you will realize how little that is! In most cases, choosing psychology is choosing a life of hardship!

.

I see, I'm sorry you went through so much schooling just to feel unappreciated. I don't know the real world, so that's why I wanted to the advice of professionals, I am only 21 after all 🙄 . Thanks for the advice guys, it sounds like you saved me a lot of hardship. I hope you are recognized for your effort someday.

 

[El Curandero]

Although it is that way for every medical specialty. My BFF is a pediatric neurologist. Her baby recently had some minor kid illness stuff going on. I asked if she agreed with her pediatrician's intervention. Her answer: oh, I don't know, it has been years since I did general peds.

Another good example: the oncologist next door asked my mom (whose sole qualification was having kids of her own) if she thought his kid had chicken pox.

It's the nature of the beast. If it's any consolation there are also tons of classes in psych grad school that I never use. 🙂

Dr. E

I don't understand why they make us jump through all these useless hoops. I suppose they assume taking these courses will develop the critical thinking skills a physician needs,

 

[AcronymAllergy]

I don't understand why they make us jump through all these useless hoops. I suppose they assume taking these courses will develop the critical thinking skills a physician needs,

I'd imagine that even if individuals feel they don't use the knowledge/information very often, they've likely built on it more than they realize. The best way I can describe the amount of information thrown around in medical school (based on my limited experience with the classes) is this--in undergrad, you'll get into a topic and, after a little while, will eventually get to a point where the prof/instructor will essentially say, "and after this it gets really complicated, so you know enough now to understand the gist of it."

Conversely, in med school, for the topics you cover (e.g., pathology), you basically just keep going until you've exhausted most of what's (practically and biologically) known about a subject. That is, you'll look at the overall picture, then go deeper to get into why and how that happens all the way down to the cellular and genetic levels. There is no, "you know enough to be set;" it's more of a, "you're going to hear and attempt to learn everything we know about this stuff, and then just try to retain as much as you can." I'd imagine this occurs in part because in the end, no one is supposed to know more about this stuff than physicians.

With psych grad school, because you're often dealing with much "fuzzier" and theoretical concepts and constructs, there's a lot more time spent talking about the "what ifs" and "it depends." It's not necessarily so much about getting into all the nitty-gritty minutiae and mechanisms (although that happens to a degree, at least as much as is understood), but more so about approaching it as, "ok, this is what we know, now get used to A) being ok with knowing how much we don't know, and B) becoming adept at formulating the questions needed to try and figure some of that stuff out." Thus, for clinical applications, it's less a process of algorithmic determination based on the possession of massive amounts of learned information and more a miniature exercise in hypothesis testing and scientific exploration (at least theoretically and ideally).

 

[image187]

I'd imagine that even if individuals feel they don't use the knowledge/information very often, they've likely built on it more than they realize. The best way I can describe the amount of information thrown around in medical school (based on my limited experience with the classes) is this--in undergrad, you'll get into a topic and, after a little while, will eventually get to a point where the prof/instructor will essentially say, "and after this it gets really complicated, so you know enough now to understand the gist of it."

Conversely, in med school, for the topics you cover (e.g., pathology), you basically just keep going until you've exhausted most of what's (practically and biologically) known about a subject. That is, you'll look at the overall picture, then go deeper to get into why and how that happens all the way down to the cellular and genetic levels. There is no, "you know enough to be set;" it's more of a, "you're going to hear and attempt to learn everything we know about this stuff, and then just try to retain as much as you can." I'd imagine this occurs in part because in the end, no one is supposed to know more about this stuff than physicians.

With psych grad school, because you're often dealing with much "fuzzier" and theoretical concepts and constructs, there's a lot more time spent talking about the "what ifs" and "it depends." It's not necessarily so much about getting into all the nitty-gritty minutiae and mechanisms (although that happens to a degree, at least as much as is understood), but more so about approaching it as, "ok, this is what we know, now get used to A) being ok with knowing how much we don't know, and B) becoming adept at formulating the questions needed to try and figure some of that stuff out." Thus, for clinical applications, it's less a process of algorithmic determination based on the possession of massive amounts of learned information and more a miniature exercise in hypothesis testing and scientific exploration (at least theoretically and ideally).

This is mainly correct in terms of how in depth you'll go in a given topic. OP, before you make this decision you should consider that psychiatrists are physicians first and psychiatrists second, which means you should be interested enough in medicine to go through the entire process or else you're goin to hate it. In medical school, you start
off by dissecting a dead person, feeling with your hands every part of a human body you could imagine, inside and out. You memorize the name and course of just about every single nerve, artery, vein, muscle, bone, and other structure there is. You memorize metabolic pathways for just about every cellular process in the body, learn the names and relevant characteristics of all the infectious pathogens and the microbiological lab tests used to identify them, and spend much time learning physiology. You'll look at plenty of histological specimens, learn how to grade cancers of virtually every cell type, memorize changes to tissues during disease process and the immune systems reactions to them, learn criteria for different stages of heart failure, kidney disease, etc... memorize everything about every drug. You'll perform rectal exams, pelvic exams, insert foley catheters, ask people how much they pooped the day before. You'll get showered in someone else's amniotic fluid and grilled by attendings on which lab tests to order and how to interpret their values and read ekgs, MRI, cxrs, etc... and you get treated like crap. The other day i had to see a young kid die. This morning I went to school at 5:30 to change people's wound dressings and see how much urine came out of their catheter last night.

I think you can see my point. Behavioral sciences do make up about a few weeks in 1st year, and your psych rotation is about 4 weeks in 3rd year. Other than that, nothing except electives 4th year. Just try not to make it about the time in school. You'll potentially be doing something you have absolutely no interest in only to do psychiatry in your residency.