Neuro vs. Pysch

[zilly]

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I am a 4th year med student and I can't seem to decide between psych or neuro. There are aspects of both that I really like. I was a psychology major in college and I have always found psychiatric disorders very interesting. I also like the opportunity to spend time talking to patients (not always the case in some other areas of medicine). At the same time, I am fascinated by the organic causes for psychiatric and neurologic illness. However, in the realm of neuro, I am more interested in CNS disease (epilepsy, MS), and I am not particularly interested in the PNS or neuromuscular disorders. Also, I hope to have an outpatient-based practice in the future regardless of what field I choose. Thus, I don't think I would enjoy specializing in stroke or other areas that require lots of inpatient hours.

I enjoyed both rotations during medical school, and I have done additional electives in both fields. I know that there are some combined programs out there, but I really would like to choose one. Another consideration I have is that I would like to raise a family someday, so I want to eventually have some flexibility as far as hours and call.

It would be great if I could get opinions from any neurology or psychiatry residents/attendings out there. I would like to know if you enjoy what you do, if you would make the same career choice if you had to do it again, and if you feel that you have enough free time that you can accomplish your endeavors outside of medicine.

Thanks, you have no idea how much I appreciate your help!
(Sorry if the fact that I posted this on both psych and neuro forums is bad SDN etiquette!)

 

[OldPsychDoc]

I am a 4th year med student and I can't seem to decide between psych or neuro. There are aspects of both that I really like. I was a psychology major in college and I have always found psychiatric disorders very interesting. I also like the opportunity to spend time talking to patients (not always the case in some other areas of medicine). At the same time, I am fascinated by the organic causes for psychiatric and neurologic illness. However, in the realm of neuro, I am more interested in CNS disease (epilepsy, MS), and I am not particularly interested in the PNS or neuromuscular disorders. Also, I hope to have an outpatient-based practice in the future regardless of what field I choose. Thus, I don't think I would enjoy specializing in stroke or other areas that require lots of inpatient hours.

...

You're one of us. You want psych. It's OK. Just come out and say it...

 

[VMSmith]

Yep you sound a lot like me as a third year med student. I think you're already leaning toward pysch for the same reasons OPD does.

 

[CaMD]

Another thing to consider is how much are you going to miss the physical exam or looking at MRIs, etc if you do psych. How much do you need concrete physical findings.

 

[OldPsychDoc]

Another thing to consider is how much are you going to miss the physical exam or looking at MRIs, etc if you do psych. How much do you need concrete physical findings.

overrated. 😀

 

[MoodDoc]

I took off a year during medical school because I could not choose between neurology and psychiatry. I did research in human sleep during that year. I wound up going into psych and have been happy there. I do both clinical work and research in severe mood disorders which has provided an excellent balance for me. I think one of the things that got me into psych is that it feels I can do much more to heal severe illness than I could as a neurologist. It has evolved since the 80's when neurology seemed largely to me--"let's guess what the CT will show." At the end of the day just figure out which docs and which patients you want to spend your working hours with.

 

[zilly]

Thanks so much for all your comments. I am leaning toward psych - I guess you all can read me better than I can read myself. I'm a nerd and I actually think reading MRIs is kind of fun, but I don't feel that I will miss needing croncrete tests or physical exam findings to treat patients. Does anyone know anything about neuropsych fellowships and what exactly a neuropsychiatrist does? That might be something right up my alley.

 

[Brany]

Just posting in the psych forum tells me this is what you want to do....you just want reassurance and it's OK, we all like reassurance before committing ourselves to anything as important as this.

best of luck...

 

[NJWxMan]

My program has its interns complete their medicine and neurology all at once during the first six months of the year. In the recent past, a number of psych interns made the switch over to neuro, leaving the psych program basically unfilled. I always wonder why the psych program would allow for such a situation. At least get the interns involved once per week with the psych program to prevent this sort of thing from happening. Interestingly enough, I too, was approached by a 4th year neuro resident about filled a PGY-2 spot for next year. I enjoy neuro; but I'm staying with psych.