spacetygrss

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Hi all!!

I am an M3 (almost an M4) stuck between Anesthesiology and Med/Psych. Does anyone know anything about Med-Psych programs (which ones are considered good, etc)? Any info would be greatly appreciated.

Thanks.
 

axial

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your choices are interesting . the mindset required for anesthesiology and psychiatry are toatally different. anesthesiology is so much procedure based and psych revolves around the person
anyway to answer your question, i am not so sure about the good med psych programs but what i can tell you is that after doing that program you will eventually gravitate towards one of the two subjects as its extremely difficult to keep up to date with both
hope this helps
good luck
 

spacetygrss

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LOL. Yeah, I know the two fields are totally different, but I'm a different kind of girl. :laugh: I do 4 weeks of Anesthesiology next, so I'll see if I REALLY like it (or just the idea of it-I loved my required Anesthesia time during surgery rotation, but 4 striaght weeks is totally different).

Anyhow, thanks for the response.

Anyone else?
 

sdude

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I think if you want to be a really effective psychopharmacologist, a med/psych residency is the way to go. I will get flamed for this I'm sure, but I've been distressed at how the psych residency seems to "de-doctor" many psychiatrists. They often become very timid about doing anything involving bloodwork, cardiovascular evaluation, or prescribing creatively. For example, the TCA's and MAOI's are at the same time potentially dangerous and yet remain the most broadly effective AD's for life-threatening depression. Unfortunately, most psychiatrists (in practice) appear to reflexively give patients whatever the drug rep brought by that day, and won't touch the older, proven meds. With medical residency experience, you will be better equiped to use powerful, cardioactive drugs safely when you feel it is appropriate. You will also be able to treat patients with comorbid conditions like diabetes and hypertension much more effectively.

Actually, I think anethesiology is a great background. Treating mental illness with drugs requires a systematic approach, an open mind, and careful observation of the patient. You are concerned with observable results, and it would probably never occur to you to use a new form of anesthesia on a patient just because a handsome drug rep gave you some samples that day and told you it was the best new thing!
 

Asher

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I've heard good things about med-psych at MUSC and at Duke.

Another thing to consider is that some psych residencies have higher "medical" expectations than others. Hopkins has a very intensive medicine experience (eight months I think) the first year, including two ICU months and once you are on the psych wards you still do a fairly large amount of medical management of your patients.

I would also look at programs that have 'med-psych' wards. Rotating on these can help keep medical skills sharp.
 

Thewonderer

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Med-psych at Duke, MUSC and Rush all have at least a resident or two per year (Rush being the largest program). It is important to go to an established program like these because you don't want to be the only person doing med-psych and feel all alone and left out. You want to have the support of other residents.

I am not sure how great med-psych will be. It is a very intense experience since an IM residency beats out the most intense of all psych residency by far. Currently, the job market for med-psych is also not clear.

Lastly, I don't think that choosing a medicine-intensive psych residency will circumvent any problems. After all, just like medical school, if you don't use it, you forget it or are not comfortable with it anymore. Therefore, if you want to keep up with your medical skills, you need to do med-psych and then practice both medicine and psychiatry. It was only a short while ago that all psych residencies required a prelim year in medicine (or maybe transitional year was allowed) but those psychiatrists, who are now older, are no more comfortable with everyday medicine problems than the newly graduated.
 

Svas

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Thewonderer said:
Med-psych at Duke, MUSC and Rush all have at least a resident or two per year (Rush being the largest program). It is important to go to an established program like these because you don't want to be the only person doing med-psych and feel all alone and left out. You want to have the support of other residents.

I am not sure how great med-psych will be. It is a very intense experience since an IM residency beats out the most intense of all psych residency by far. Currently, the job market for med-psych is also not clear.

Lastly, I don't think that choosing a medicine-intensive psych residency will circumvent any problems. After all, just like medical school, if you don't use it, you forget it or are not comfortable with it anymore. Therefore, if you want to keep up with your medical skills, you need to do med-psych and then practice both medicine and psychiatry. It was only a short while ago that all psych residencies required a prelim year in medicine (or maybe transitional year was allowed) but those psychiatrists, who are now older, are no more comfortable with everyday medicine problems than the newly graduated.

A great post and absolutely on target!!! :thumbup: :thumbup: :thumbup:

Svas
 

phd2b

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gmonavydoc

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Knowing several MD's that completed med-psych residencies all seemed to regret the years spent in the combined program for three reasons. I noticed the following theme.

1) Jobs hard to find for Med-Psych ...it is either one or the other.
2) Ins co. recognize you as only one or the other not both thus reimbursements are low and you get ganked.
3) The skills-knowledge of whichever of the two you least use because of reason 1 or 2 fade drastically and you find yourself no better off than an Internist or psychiatrist who spent extra years in residency and in more debt because they did not know what they wanted to specialize in or had some insecurity about just becoming a psychiatrist because they would be thought of as a "nondoctor" by their MD peers.

Med Psych and Med Peds are boutique residencies and don't translate well into the real world. Peds- child psych is a different animal and a real useful dual board but the others self indulgent. If you like mental health become a psychiatrist and be happy don't run around defending why youare more than a psychologist who prescribes Prozac. Internists need to do Internal medicine training, pediatricians complete pediatric training and psychiatrists undergo psychiatric training not kid themselves they are something else for image sake. Also why are neurologists so ardent about separating themselves from shrinks even though they share the same board? Every neurologist I met claims they are more a subspecialty of IM rather than psychiatry. Most neurology residents and interns also do IM PGY-1 and are more aligned with IM for lectures , etc. The neurologists I've met all state" if it is organic and real we treat it ,if it is functional (in their head and made up) we let the shrinks handle it with therapy etc.
 

phd2b

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Interesting observations, navydoc. Would you be willing to expand on why peds-child psych is more useful than med-psych?

Also, if one were interested in pain or addiction, do you think that the IM background would make for a better background?
 

benjee

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What about FP/Psych? I plan to do this with the thought of FP closely related to psych and plan to practice both. Do u see any problems or any disadvantage/advantage eg. insurance reimbursement,..etc?