miserable fm pgy-2

[markglt]

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starting fam. med pgy2 in a month. totally miserable in family...planning on doing addiction medicine fellowship after residency.
always wanted psych, went to undergrad. for psychology...
had bad step 1.... passed on third attempt..bad basic sciences grades..did well on step2s and step 3....did well on fm intraining this year.
doing fine in all of my rotations.
basically im just wondering if there is any way i can practice psychiatry after i finish fm residecny and addiction fellowship??
i would love to do a psychiatry residency after this.... is there any way that could happen..would i apply for pgy1 or pgy2.
i know the gov. won't reimburse the program...
but is there a chance?
where do i go from here?

 

[sunlioness]

You could try to find a PGY-2 spot. Though if you wanted to do addiction anyway, I question how much practical day to day difference there is between FM + addiction vs. psychiatry + addiction. Or did you also want to practice general psychiatry?

 

[markglt]

yeah i had one pgy2 spot brewing, but they took a look at my step 1 and said take a hike.
i have a strong interest in addiction and i am trying to use that fellowship after family to get into the psych world...but if i got a psych residency after this i would probably just do general psychiatry.

 

[famdoc66]

PM me and i'll explain the usual scenario

 

[famdoc66]

It is certainly possible....if the program has the money then funding likely isn't a problem

 

[belle54321]

As someone who is changing specialty, and who went thru the process last year, you may consider applying to programs that regularly take on new pgy-2s. Also you may consider contacting other programs that you are interested in and asking about possible open pgy-2 spots. Personally, I applied to one program outside of ERAS and others I applied as a pgy-1 thru ERAS. For many of the programs, they automatically offered me an interview for a pgy-2 spot, which was not necessarily advertised. Unfortunately, you will be competing with current psychiatry residents (who are looking to transfer) or residents/physicians from other fields. So, programs often have many options and can be choosy. I have found that a lot of programs who are well funded will not mind taking on residents who will not have full funding.

The funding of residency is complex and has been discussed extensively in other threads on SDN.

In addition, do you have any mentors in psychiatry? I found talking to a psychiatry professor at my med school to be really helpful in determining what I was planning to do was realistic or not.

 

[markglt]

thanks

 

[markglt]

up

 

[Leukocyte]

starting fam. med pgy2 in a month. totally miserable in family...planning on doing addiction medicine fellowship after residency.
always wanted psych, went to undergrad. for psychology...
had bad step 1.... passed on third attempt..bad basic sciences grades..did well on step2s and step 3....did well on fm intraining this year.
doing fine in all of my rotations.
basically im just wondering if there is any way i can practice psychiatry after i finish fm residecny and addiction fellowship??
i would love to do a psychiatry residency after this.... is there any way that could happen..would i apply for pgy1 or pgy2.
i know the gov. won't reimburse the program...
but is there a chance?
where do i go from here?

I was miserable too when I was in Family Medicine residency...I HATE Family Medicine. The Family Medicine scope and practice model just does not fit my personality. However, I went through my FM residency, with the goal of applying to an another residency after FM. I completed my FM residency, then applied to other residency programs in the Match. I applied to different fields. My #1 choice was Pathology. My #2 choice was Radiology. My #3 choice was Preventive Medicine. My 4# choice was Psychiatry. I applied to (I applied late):

-67 Pathology programs

-30 somthing Radiology programs

-30 somthing Psychiatry programs

-9 Preventive Medicine programs (there are very few programs in this specialty)

I had NO Radiology interviews. Only ONE Pathology interview. I received many Psychiatry interviews and offers for PGY-2 positions. I received 3 Preventive Medicine interviews.

In my situation, it is not that I only disliked FM. I disliked clinical medicine in general. That is why I applied to non-clinical specialties like Pathology, Radiology and Preventive Medicine. I applied to Psychiatry really as a "back-up" (I know you Psych people will get mad at this), since I thought that Psychiatry was more focused and "less clinical" than FM. But the reality is that Psychiatry is a clinical medical field. Since I hated clinical medicine altogether, I decided to go for Preventive Medicine and not Psychiatry. I would have loved to go into Pathology, but I did not get any offers in Pathology.

So, if you apply to Psych after finishing your FM residency, you will most likely get Psych offers for PGY-2 spots. Make sure you like Psych though. If you dislike clinical medicine in general, do not apply to Psych. The patient interaction in Psych is MUCH MORE intense than FM...so make sure you like (love) patient interaction clinical medicine.

 

[markglt]

yeah, if i need to do another residency in psych, i will.....it is somewhat daunting considering the time committment, but there is no way i ever see myself practicing fp, i cant stand it. it is a daily struggle.

 

[st2205]

There are a couple of places that do programs like this http://gsm.utmck.edu/family_medicine/behavioral.cfm

I'm not sure what your scope of practice is after completing something like that, but it'd probably make you at least somewhat desirable. As FP you can technically do "anything" within reason and have it be justified. I know of a few hospitals having a hard time finding psychiatrists so they have some PCPs giving some on call coverage or weekends and whatnot. Not sure what your possibilities are, though. A lot of it probably depends on how well you can sell yourself to an employer.

 

[st2205]

Also this one http://fmr.ua.edu/files/2010/03/Behavioral_Health_Fellowship_in_FM_flyer.pdf

I remember seeing on MGH's website for their CL fellowship that, at least on paper, they take IM guys as well. Now, obviously you're not IM and perhaps they may be somewhat more selective against those with board failures at MGH, but perhaps it would be worth inquiring with some other CL programs regarding whether or not they'd take a FM grad into their fellowship. It could perhaps be possible, but I'm just an OMSIV so I could be blowing smoke here.

 

[splik]

It could perhaps be possible, but I'm just an OMSIV so I could be blowing smoke here.

You are blowing smoke here. I am familiar with the C/L service at MGH and they do not take non-psychiatrists into their psychosomatic medicine fellowship. The whole point of a C-L service is to provide an expert psychiatric opinion to other colleagues - if you are not a psychiatrist, having completed training in psychopathology, psychopharmacology, psychotherapeutics in patients throughout the lifespan in different settings and so on you are not going to be able to do this. I cannot say whether there are C-L fellowships around that are so desperate they take non-psychiatrists, but a C-L fellowship does not a psychiatrist make, and you are not going to get a job on a consult service without being a psychiatrist, indeed even at academic centers you don't need to have completed a psychosomatic medicine fellowship to work on the psychiatry consult service. There's no quick back door into psychiatry.

 

[sunlioness]

I don't mean to derail the topic, but I didn't realize that preventive medicine was non-clinical. I thought it largely had to do with workman's comp type stuff.

 

[belle54321]

Are you thinking about occupational health? But I don't think they deal with workman's comp (only) either. A college friend if mine went into preventive health and works at the CDC mainly on public policies.

 

[vistaril]

starting fam. med pgy2 in a month. totally miserable in family...planning on doing addiction medicine fellowship after residency.
always wanted psych, went to undergrad. for psychology...
had bad step 1.... passed on third attempt..bad basic sciences grades..did well on step2s and step 3....did well on fm intraining this year.
doing fine in all of my rotations.
basically im just wondering if there is any way i can practice psychiatry after i finish fm residecny and addiction fellowship??
i would love to do a psychiatry residency after this.... is there any way that could happen..would i apply for pgy1 or pgy2.
i know the gov. won't reimburse the program...
but is there a chance?
where do i go from here?

you can do addiction and just manage the routine non-substance psych issues yourself as well.....you'd see a lot of psych patients, even outside of addiction.

And as someone else said, I really don't see a difference in the day to day clinical duties between people who work as addictionologists whether they are IM, FM, or psych trained......

if you want to just do psych though, no...I think unfortunately you have to do a residency in psych or a combined program where you can get board eligible in psych.

Just like I can't go out and get hired by hospitals or hospital groups as a general hospitalist without any FM/IM training, I don't think psych hospitals or community mental health centers are going to hire people to work as psychiatrists without psych training....

 

[notdeadyet]

Just like I can't go out and get hired by hospitals or hospital groups as a general hospitalist without any FM/IM training, I don't think psych hospitals or community mental health centers are going to hire people to work as psychiatrists without psych training....

True. In fairness, I'm wondering how many addiction patients you really get who don't have a comorbid psychiatric diagnosis…

 

[Leukocyte]

I don't mean to derail the topic, but I didn't realize that preventive medicine was non-clinical. I thought it largely had to do with workman's comp type stuff.

Please do not scare me sunlioness! I do not what to make the mistake again of going into a clinical specialty. Preventive Medicine is divided into 3 sub-types:

-General Preventive Medicine
-Occupational Medicine
-Aerospace Medicine

You are thinking of Occupational Medicine, which is preventive medicine that is dedicated to preventing and treating occupational and enviromental injuries (workman's comp stuff et. al).

Me on the other hand, I am going into General Preventive Medicine. Yes, it does include occupational medicine, but it is more dedicated to public health epidemiology and service administration. These are the guys that work in local, state and federal agencies to prevent and control disease (CDC, FDA, NIH, ACS,......)

Aerospace Medicine is preventive medicine that is dedicated to preventing and treating occupational and enviromental injuries in air crew. Mostly work in the militarty, NASA, and the FAA.

Talking about "real" doctors (from the other thread). If people think Psychiatrists are not "real' doctors, imagine what would they think about the "lowly" Preventive Medicine docs!!!!😱 Thank goodness that I am aready BE/BC in Family Medicine (before getting into Preventive Medicine) so that people can still call me a "real" doctor. 😎

Now...Family Medicine IS considered a "real" doctor, right? Right! Please say yes! Please say yes!

 

[splik]

Now...Family Medicine IS considered a "real" doctor, right? Right! Please say yes! Please say yes!

family medicine is one of few specialties that does make you real doctor.

 

[sunlioness]

That's so cool, Leukocyte. I'm kinda envious now. I've always really loved epidemiology, but thought I'd have to go into ID to do anything with it. What kind of work do you plan to do?

And I was thinking of occ med. I have a high school friend who switched into a preventive residency from neurology and workman's comp type stuff is what she does.

 

[Leukocyte]

What kind of work do you plan to do?

I want to work as a Medical Officer in the U.S. Dept. of Health and Human Services. I am willing to work as a pulbic health medical officer in one of its federal branches (ex. CDC) or as a medical officer at a local health department. My program though is sponsored by the ACS, and I will be doing lots of cancer prevention and control work at a big government research facility...so I will gain lots of experience in cancer prevention and control. While I prefer ID public health over cancer public health, it is still cool. I will not mind working at that national cancer reaserch facility after graduation.

But do not be surprized one day if you see me on the evening news dressed like this!!! 😎

How do you like THEM apples?! 😎

 

[OldPsychDoc]

True. In fairness, I'm wondering how many addiction patients you really get who don't have a comorbid psychiatric diagnosis…

Plenty, actually.

The majority of my "dual diagnosis" evals from CD counselors in our IOP are basically either for substance-induced sx (e.g. insomnia or anxiety d/t subacute withdrawal), or for adjustment issues related to consequences of their addiction (lost lover, lost kids, lost housing, lost job, lost dog, lost pickup truck...) 🙄

 

[markglt]

return topic to op.

 

[markglt]

up