Neuropsychologist or Psychiatrist for Autism Treatment

[UponReflection]

I'm currently an undergraduate student who is torn between getting my PhD in Clinical Psychology/Neuropsychology or going to Med School to become a Psychiatrist. I know what I want to in my career but I am not sure what the best path to take is to get there.
I want to eventually work in an academically affiliated hospital/treatment center and develop treatment plans/provide treatment for children with Autism using research-based therapies while conducting translational research studies.
My concern lies with which career path will allow me to reach this point. Will I be more likely to be employed at an Autism Research Center if I have a PhD or an MD? Will I be able to lead treatment teams if I am not an MD? What would my role be as a psychiatrist vs a neuropsychologist in this setting?

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[singasongofjoy]

In the 2 academically affiliated autism centers where I have worked, psychology and psychiatry have been pretty collaborative and defer to one another when it comes to respective areas of expertise and each handles their area of the treatment plan. I don't think you need to look at this as weighing which one is "better." You should do whichever you personally think you'll find more fun and rewarding because then you'll be more invested in and better at your work, which will make you a good candidate for jobs. Both can lead research, just depends on what type of research project you're working on and who is getting the grants.

 

[WisNeuro]

I'd say, if research is your passion, the PhD is probably your better route. That's where you'll get years of research training and exposure. In the past, I've worked on several RCTs with million dollar grants, with PhD PIs. MD and PhDs can both be treatment team leads. My caveat would be, if you are more interested in pharmacological interventions, the MD route may be better, but you'll need to get a lot of your research training on the back end.

 

[clausewitz2]

PhD is clearly the superior degree for research. Major advantage of the MD would be that if the whole research dream does not work out (which often it doesn't), an MD is an infinitely superior degree for working in other lucrative settings wherever you d*mn well please.

 

[WisNeuro]

PhD is clearly the superior degree for research. Major advantage of the MD would be that if the whole research dream does not work out (which often it doesn't), an MD is an infinitely superior degree for working in other lucrative settings wherever you d*mn well please.

I wouldn't say infinitely regarding the lucrative part. If someone has a jonesing for forensics or consulting work in neuropsych, mid 6 figures are the norm for full-time work.

 

[clausewitz2]

I wouldn't say infinitely regarding the lucrative part. If someone has a jonesing for forensics or consulting work in neuropsych, mid 6 figures are the norm for full-time work.

That's fair, I know less about those practice settings for neuropsych folks. I guess I have heard a lot more neuropsychologists complaining about finding jobs, whereas psychiatrists who are unable to find jobs usually have very specific requirements, pending criminal charges, or are @vistaril

 

[WisNeuro]

That's fair, I know less about those practice settings for neuropsych folks. I guess I have heard a lot more neuropsychologists complaining about finding jobs, whereas psychiatrists who are unable to find jobs usually have very specific requirements, pending criminal charges, or are @vistaril

I haven't seen much about neuropsychs having a hard time finding a job. If you are very geographically restricted, like wanting to be in a specific city, it can be harder, but if you're open, you can find a job in most places. If you want to start a PP, even easier. If you're boarded, easier still. But, as a specialty provider, our options are more limited than say, a general psychologist, but that also comes with a higher salary, on average. But, I would agree that psychiatry definitely has much more mobility in general given the shortage in many areas.

 

[ctaim]

Another aspect to consider is that you'll need to apply to PhD programs with an emphasis on neurocognitive disorders. When I applied 2 years ago, there were only a few. Here's a list of clinical neuropsych programs: TrainingPrograms - SCN Division 40 Also, Keep in mind that a Psy.D., versus a PhD will not get you where you want to go in terms of research.

 

[leslieknope2]

PhD is clearly the superior degree for research. Major advantage of the MD would be that if the whole research dream does not work out (which often it doesn't), an MD is an infinitely superior degree for working in other lucrative settings wherever you d*mn well please.

Good call.

 

[leslieknope2]

I wouldn't say infinitely regarding the lucrative part. If someone has a jonesing for forensics or consulting work in neuropsych, mid 6 figures are the norm for full-time work.

Like $500,000 a year, really?

 

[WisNeuro]

Like $500,000 a year, really?

Full-time forensics? Easy. Just make sure you know all of your legal precedents, and can drop psychometrics in deposition at the drop of a hat. Low level forensic work, no, but if you do depos, especially in court, billing for that is borderline absurd.

 

[leslieknope2]

Full-time forensics? Easy. Just make sure you know all of your legal precedents, and can drop psychometrics in deposition at the drop of a hat. Low level forensic work, no, but if you do depos, especially in court, billing for that is borderline absurd.

That's a lot of money! Why don't more people do it? Is it competitive?

 

[WisNeuro]

That's a lot of money! Why don't more people do it? Is it competitive?

Fairly competitive, and it takes a certain kind of mindset to want to do it. You're not doing clinical work anymore. It's all high leverage IME work, high stress, very adversarial. I know plenty of people who do forensics part-time, but far fewer who are doing this full-time. I'm one of those who would consider doing some forensics here and there, but probably never full-time. I need fulfilling clinical work, even if it pays less.

 

[MedMan80]

I would say psyD's earning 500K is the exception rather than the rule. For becoming a psychiatrist you have to be mentally ready for all that comes with entering medicine in this day and age, 1) large student loans 2) likely postponing any major life decisions 3) delayed gratification, likely being in your 30's until you start earning a decent wage. I would wager most people at some stage in their education, med school, residency seriously question themselves whether they made the correct decision entering medicine. For me it was in residency, now in Fellowship I think I did make the right decision..but I must say that it was a very tough road.

 

[michaelrack]

General psych can make 500 k plus, but probably need to work a few more hours than forensic psych

 

[WisNeuro]

I would say psyD's earning 500K is the exception rather than the rule. For becoming a psychiatrist you have to be mentally ready for all that comes with entering medicine in this day and age, 1) large student loans 2) likely postponing any major life decisions 3) delayed gratification, likely being in your 30's until you start earning a decent wage. I would wager most people at some stage in their education, med school, residency seriously question themselves whether they made the correct decision entering medicine. For me it was in residency, now in Fellowship I think I did make the right decision..but I must say that it was a very tough road.

Definitely the exception rather than the rule. Especially for PsyDs, on average they earn less than PhDs anyway. Although, salaries into the 6 figures are the rule, rather than the exception. Especially for neuropsychology. The PhD course is the same as your points in terms of the path, except for the debt, anyway. Many if get through debt free, and actually make money during our grad school career.

 

[michaelrack]

General psych can make 500 k plus, but probably need to work a few more hours than forensic psych

 

[Armadillos]

If your super confident that research is the path you want and you don't have a desire to prescribe meds then PhD seems pretty obvious. If your at all undecided or indecisive, you could go the MD route and have options to be a child psychiatrist or developmental pediatrician (or maybe you decide you want to do something completely different and choose to be a radiologist).

 

[57A]

I would say psyD's earning 500K is the exception rather than the rule. For becoming a psychiatrist you have to be mentally ready for all that comes with entering medicine in this day and age, 1) large student loans 2) likely postponing any major life decisions 3) delayed gratification, likely being in your 30's until you start earning a decent wage. I would wager most people at some stage in their education, med school, residency seriously question themselves whether they made the correct decision entering medicine. For me it was in residency, now in Fellowship I think I did make the right decision..but I must say that it was a very tough road.

Getting a Ph.d is hands down a very long and tough road too with a lot of delayed gratification.

 

[MedMan80]

Getting a Ph.d is hands down a very long and tough road too with a lot of delayed gratification.

Im not saying it's not, just that 4 years undergrad, 4 years medical school, 4 years residency all while carrying potentially 300,000 in loans accruing interest before seeing real money is a daunting task.

 

[WisNeuro]

Im not saying it's not, just that 4 years undergrad, 4 years medical school, 4 years residency all while carrying potentially 300,000 in loans accruing interest before seeing real money is a daunting task.

Fair enough, we have the same time frame, but without the debt load.

 

[PsyDr]

I might have a unique perspective for this. I could prescribe if I wanted to, am co-I in an autism study, and work almost purely in forensic neuro.

1) IMO, physicians will always have better career flexibility and income potential. Seems easier to go in and out of research and get funding.

2) psychiatry's interventions in autism are fairly limited. Psychologists seem to direct aba/floortime/greenwahtever programs with midlevels doing the work. In ops case, having extra time to dedicate to research might be preferable which might point towards med school.

3) forensic psychologists income potential is directly limited by ones area of speciality, performance history, and ones willingness to work. Be mediocre and can't produce? No one will hire you. Specialize in violent crime? Not committed by the most wealthy out there. Child custody? People will give their last dime for this. Personal injury? Gonna have a bunch of fakers and bad attorneys that you have to deal with on either side. There's a reason park dietz and hare moved into corporate consulting.