non-practicing MD wanting to make transition to PsyD/PhD, or a Master's

[fy6190]

Hi, I have a MD but I did not finish residency. After stepping away for a few years, I am heavily considering going into Clinical Psychology, which I have become increasingly passionate about in the last few years. My only experiences with mental illness include: my rotation in Psychiatry in med school (which I found very subpar and disappointing; no wonder the vast majority of medical professionals are ill equipped for mental health situations), and some consulting work for a psychedelic-assisited psychotherapy center (not necessarily what I am interested in for my own future practice) a couple of years ago. I have some research experience as well in neuroscience, but none in psychology. I would greatly appreciate any advice on getting more hands-on experience (like a volunteer position in practice, research or hybrid of the two) and applying to doctorate or master's programs. My career goal would be counseling, whether in private practice or in a larger settting is undecided. I would also be interested in research, but counseling work would need to be part of it at least. I am currently in CA, but I would also consider relocating for the right opportunities. Thank you!

PS. I've considered a residency in Psychiatry, but ultimately decided against it.

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[WisNeuro]

What do you want to do for a career, exactly? If it's therapy/intervention, I'd strongly suggest just trying to get residency in psych if you can, and then just get a ton of extra training on the side to become competent in it.

 

[fy6190]

What do you want to do for a career, exactly? If it's therapy/intervention, I'd strongly suggest just trying to get residency in psych if you can, and then just get a ton of extra training on the side to become competent in it.

thanks I've edited my original post to be more clear.

 

[PsyDr]

You're going to face some barriers.

1) Pretty much every single program is going to wonder why you did not finish residency. The most common assumption is that you did something wrong. If I were in your shoes, I would have a rock solid explanation at the top of my application why this should not be concerns. Professionalism concerns, substance abuse, your likelihood of leaving the program, your ability to follow orders, etc will be significant assumptions.

2) You're going to have to explain why you are choosing this career path. It seems strange that you want to pursue the highest degree possible in an unfamiliar field. That's like me saying I want to get a PhD in political science focusing on Narodnaya Volya, when I barely know how to vote. Admissions are going to want a reason, and they want it to be good.

3) Programs usually want someone who does work, and kisses the ring. You are going against a bunch of 22 year olds who are willing to do anything, and whose first career choice is psychology. Your age and education will lead some to assume you are less likely to spend 80hrs in the lab, or write papers that follow the party line. Figure out a way to sell yourself as a worker, who is submissive. Your experience is a liability here. Also, I would wager that some professors would be intimidated by having an MD listen to their lectures.

4) Psychedelics is one of the more controversial subjects in our field. It's 30% similar to telling med school admissions that you want to go to med school to give late term abortions.

5) The training requires geographic flexibility. Imagine telling med school admissions, "I am willing to do this, but not this, or this." Then the next 22 year old comes in and says, "I'll do anything, move anywhere, and I read your last article and it was so great, can you teach me more?". Who are they going to pick? Your statements seem to indicate you have not the forum's typical advice.

 

[fy6190]

You're going to face some barriers.

1) Pretty much every single program is going to wonder why you did not finish residency. The most common assumption is that you did something wrong. If I were in your shoes, I would have a rock solid explanation at the top of my application why this should not be concerns. Professionalism concerns, substance abuse, your likelihood of leaving the program, your ability to follow orders, etc will be significant assumptions.

2) You're going to have to explain why you are choosing this career path. It seems strange that you want to pursue the highest degree possible in an unfamiliar field. That's like me saying I want to get a PhD in political science focusing on Narodnaya Volya, when I barely know how to vote. Admissions are going to want a reason, and they want it to be good.

3) Programs usually want someone who does work, and kisses the ring. You are going against a bunch of 22 year olds who are willing to do anything, and whose first career choice is psychology. Your age and education will lead some to assume you are less likely to spend 80hrs in the lab, or write papers that follow the party line. Figure out a way to sell yourself as a worker, who is submissive. Your experience is a liability here. Also, I would wager that some professors would be intimidated by having an MD listen to their lectures.

4) Psychedelics is one of the more controversial subjects in our field. It's 30% similar to telling med school admissions that you want to go to med school to give late term abortions.

5) The training requires geographic flexibility. Imagine telling med school admissions, "I am willing to do this, but not this, or this." Then the next 22 year old comes in and says, "I'll do anything, move anywhere, and I read your last article and it was so great, can you teach me more?". Who are they going to pick? Your statements seem to indicate you have not the forum's typical advice.

Thanks for the detailed reply!
I have good personal reasons for not following through with my residency training, which undoubtedly would be discussed in any application process. I also understand there will be significant barriers to entry, which is why I am asking for advice on how to navigate these difficulties in an unfamiliar field. I mentioned psychedelic psychotherapy as part of my very limited professional experience with counseling, not because I am interested in pursuing that angle in future practice. Thanks again!

 

[WisNeuro]

If you primarily want to do therapy, what's stopping you from trying to get a residency in psych and doing that? As opposed to taking a few years to beef up your CV/research experience, 5 years of grad school, 1 year internship, and possibly an additional 1 year fellowship?

 

[futureapppsy2]

Additionally, if you primarily want to do therapy, a master's degree in Counseling or an MSW is a much quicker route to that.

 

[clausewitz2]

If you primarily want to do therapy, what's stopping you from trying to get a residency in psych and doing that? As opposed to taking a few years to beef up your CV/research experience, 5 years of grad school, 1 year internship, and possibly an additional 1 year fellowship?

If OP has been out of residency for more than a year or two the chances of successfully matching in psychiatry approach zero. I agree with other posters suggesting a master's-level degree of some kind. The traits that let you succeed in medical school will also let you do the extra self-directed education after your formal program you will almost certainly need in order to be a top-notch therapist.

 

[deleted1129370]

If money is no issue, you could just do a Ph.D. or Psy.D. in Clinical Psychology at Nova Southeastern University, do all your training there in South Florida. Most sites down there love Nova students so, given your background, you could have an advantage to stay there for a bulk if not all your training. Nova has massive cohorts, so, given you completed a M.D., I think you'd be a shoe in.

 

[fy6190]

If money is no issue, you could just do a Ph.D. or Psy.D. in Clinical Psychology at Nova Southeastern University, do all your training there in South Florida. Most sites down there love Nova students so, given your background, you could have an advantage to stay there for a bulk if not all your training. Nova has massive cohorts, so, given you completed a M.D., I think you'd be a shoe in.

why this school specifically? any other programs in other parts of the country that you would recommend? Thank you!

 

[WisNeuro]

why this school specifically? any other programs in other parts of the country that you would recommend? Thank you!

Depends on what you want. Do you want a school with very little in the way of admission requirements, but reputation issues, or programs in which you'd likely have to spend time beefing up your CV, but much better reputation?

 

[fy6190]

If OP has been out of residency for more than a year or two the chances of successfully matching in psychiatry approach zero. I agree with other posters suggesting a master's-level degree of some kind. The traits that let you succeed in medical school will also let you do the extra self-directed education after your formal program you will almost certainly need in order to be a top-notch therapist.

I have thought about this path as well, like a Masters in Counseling or Clinical Psychology. Do you have any further advice? In-person, online, hybrid? Ways to gain hands-on experience? Programs that might see my MD as an advantage rather than obstacle? Counselors I can reach out to who might have gone through a similar experience? Thannk you!

 

[fy6190]

Depends on what you want. Do you want a school with very little in the way of admission requirements, but reputation issues, or programs in which you'd likely have to spend time beefing up your CV, but much better reputation?

Well, I would want a solid education that prepares me well, rather than a foot in the door on paper but having bad mentorship. I did well on MCAT (top 3%), did well in med school and did well in residency.

 

[WisNeuro]

Well, I would want a solid education that prepares me well, rather than a foot in the door on paper but having bad mentorship. I did well on MCAT (top 3%), did well in med school and did well in residency.

What's your timeline? How long are you comfortable taking, and how much of a financial hit are you willing to bear?

 

[AcronymAllergy]

What's your timeline? How long are you comfortable taking, and how much of a financial hit are you willing to bear?

Agreed--I think the answer to these questions will significantly affect your potential course of action.

As for Nova, if you're wanting a funded program, it probably wouldn't be your best bet. They produce some good students, but quality has gotten much more variable over the years, in part probably because of the very large cohorts. I suspect the opportunities for solid mentorship could also be variably. But if you're a self-starter with good discipline, I imagine you could get some good training experiences there (i.e., better than a typical for-profit program without Nova's in-roads, history, and faculty).

 

[Sanman]

A question, if you are not willing to attempt a psychiatry residency, have you thought about using your MD in any way? I know some states will provide a license and allow supervised practice. Have you thought about getting masters level training in therapy and functioning as essentially psychiatry PA in private practice? It would be faster and possibly more lucrative.

If not, to do this well you are essentially starting from scratch and looking at the better part of a decade. To so this poorly (diploma mill), doesn't really do much for you above a master degree.

 

[fy6190]

What's your timeline? How long are you comfortable taking, and how much of a financial hit are you willing to bear?

I honestly have not thought these parts through. I don't have any student debt currently, but I would like to not collect a large sum of debt again. The more research I do, the more I am leaning towards a Master's degree. Getting another doctorate on top of my MD seems pretty excessive unless I want to do top-notch academic research.

 

[fy6190]

A question, if you are not willing to attempt a psychiatry residency, have you thought about using your MD in any way? I know some states will provide a license and allow supervised practice. Have you thought about getting masters level training in therapy and functioning as essentially psychiatry PA in private practice? It would be faster and possibly more lucrative.

If not, to do this well you are essentially starting from scratch and looking at the better part of a decade. To so this poorly (diploma mill), doesn't really do much for you above a master degree.

I have not thought about this - one apparent downside appears to be that I would not be able to practice privately if I chose to.

 

[fy6190]

Agreed--I think the answer to these questions will significantly affect your potential course of action.

As for Nova, if you're wanting a funded program, it probably wouldn't be your best bet. They produce some good students, but quality has gotten much more variable over the years, in part probably because of the very large cohorts. I suspect the opportunities for solid mentorship could also be variably. But if you're a self-starter with good discipline, I imagine you could get some good training experiences there (i.e., better than a typical for-profit program without Nova's in-roads, history, and faculty).

Can you recommend any programs at the master's level?

 

[deleted1129370]

why this school specifically? any other programs in other parts of the country that you would recommend? Thank you!

Again, if money is no issue for you, NSU is actually a pretty good school. Their APA data shows that. If you are looking for a solid education, high probability of getting excellent training experiences (NSU students had priority at most of the name brand training sites in South Florida just FYI), and going on to attain gainful employment, they are decent. I didn't go to NSU just FYI, so I am not biased towards them. I just think that if you want increased probability of getting in somewhere that also will give you really good training experiences that translate to you getting a good job, then they are an option. You could do worse. I am practical. I approached finding a doctoral program from a different set of lenses than many others you will find on here.

 

[futureapppsy2]

Can you recommend any programs at the master's level?

Honestly, a lot of this reputation is going to be at the local level--most masters grads stay in the same general area of where they attend school, at least initially, so program-level reputation is really a local thing, much more so than in medicine or doctoral-level psychology.

 

[summerbabe]

One question that I haven't seen posed yet or spoken to is whether you've researched and considered the ROI of a typical mid-level therapist or psychologist salary with the required time for schooling and tuition/living expenses while in school.

Even if you get a funded PhD offer, you're barely scrapping by and likely taking out some loans to cover living expenses for 5-7 years (unless you have a partner making good money or access to generational wealth), which is a significant period without drawing an income.

Or if you do a PsyD, you'll likely be on the hook for $100k+ in loans with growing interest.

There are certainly ways to ultimately earn significantly higher than average compensation (such as owning a successful group practice) but a typical MD salary and a typical therapist salary is obviously very different, especially while in the 1-3 years of post graduation but pre-licensure stage.

I'm not saying all MDs went into medicine for the money but I also think med school would be way less of a desired path if the typical MD made the average psychologist salary.

 

[Firelambo]

What was your previous residency specialty? Why did you rule out psychiatry? Understanding why you didn't want to pursue psychiatry/ your initial medical specialty may provide a clearer path for what you ultimately want to pursue. Do you care about being called a Doctor? Do you want to work in academic institution conducting research/teaching as a professor? A PHD in psychology (require research experience and most preparation to enter program, provides opportunity to conduct high level research, most opportunity to attend a funded program, can do psychological testing), PsyD (less research focus, more clinically focused curriculum, generally unfunded, high tuition, can do psychological testing ), LMHC (license mental health counseling....master level therapist that can open practice and see clients, can teach some classes, can't really conduct high level research, can't do psychological testing ) MFT (master family therapy focus on family dynamic, can't really conduct high level research, can't do psychological testing), LCSW( can do therapy/ social work at hospital/agencies, can't really conduct high level research, can't do psychological testing), Psychiatric Mental health Nurse practitioner ( if you are ok with pursuing nursing pathway / want to be able to prescribe meds)

 

[PsyDr]

Thanks for the detailed reply!
I have good personal reasons for not following through with my residency training, which undoubtedly would be discussed in any application process. I also understand there will be significant barriers to entry, which is why I am asking for advice on how to navigate these difficulties in an unfamiliar field. I mentioned psychedelic psychotherapy as part of my very limited professional experience with counseling, not because I am interested in pursuing that angle in future practice. Thanks again!

@fy6190
1) You don't need to explain anything to me. Just giving information.
2) I am concerned that you don't understand how clinical psych doctorates work. It is not like getting a PhD in History. It's more akin to medical school. It's 2 ish years of year round coursework, followed by 2-3 years of part time clinical rotations (termed "practica") combined with classwork year round, followed by a one year full time residency (termed "internship"), followed by a near mandatory second year long full time residency (termed "post doc").... before you get licensed. Add another year if you want to specialize, add another 3-4 years if you want to prescribe. We use the exact same "match" program for our version of residency. That means that geographic inflexibility is generally considered to be a kiss of death in this entire process, from admissions to post doc. That's about a 7 year process, so you might want to consider the timeline for getting a psyd. Beware of any program that tries to sell something else. There are online BS programs that say they are equivalent, but you generally cannot get licensed with those programs.
3) If you want to do therapy, and therapy only, the simplest way to do that is a masters program. That is not going to be a great education in things, and there is limited exposure to severe mental illness. This type of education leads a lot of MA level providers to misdiagnose things (eg., They have have never seen someone who is full blown manic or psychotic, so they think that having trouble sleeping or being moody is evidence of Bipolar I). If you are okay with that type of hit to the ego, in service of practicality, then it's a way to go. CA is a saturated market for MA level providers, which you should consider from a financial POV.
4) If you are looking at doing research: I have worked with two MDs who did not complete residency, who exclusively do research.
5) There are also industry research options, ranging from legitimate research to "dude with a credential who signs off on things". Be careful about program development, if you have a DEA #. There were a few cases where innocent physicians were hired, and their DEA used without their knowledge, and ended up going to prison (eg., Sasaki & Randall case).
6) You could move to one of those states like TN, IL, etc where you can get licensed without a residency.
7) If I were in your shoes, I would look over the Non-clinical Careers google results. There are a ton of those things.

 

[fy6190]

What was your previous residency specialty? Why did you rule out psychiatry? Understanding why you didn't want to pursue psychiatry/ your initial medical specialty may provide a clearer path for what you ultimately want to pursue. Do you care about being called a Doctor? Do you want to work in academic institution conducting research/teaching as a professor? A PHD in psychology (require research experience and most preparation to enter program, provides opportunity to conduct high level research, most opportunity to attend a funded program, can do psychological testing), PsyD (less research focus, more clinically focused curriculum, generally unfunded, high tuition, can do psychological testing ), LMHC (license mental health counseling....master level therapist that can open practice and see clients, can teach some classes, can't really conduct high level research, can't do psychological testing ) MFT (master family therapy focus on family dynamic, can't really conduct high level research, can't do psychological testing), LCSW( can do therapy/ social work at hospital/agencies, can't really conduct high level research, can't do psychological testing), Psychiatric Mental health Nurse practitioner ( if you are ok with pursuing nursing pathway / want to be able to prescribe meds)

I was in Internal Med (intensive care to be specific). Because I've been away from practice for several years so matching back into medicine would be pretty unlikely. You ask some valid questions - stuff to think about for sure. Thanks!

 

[fy6190]

@fy6190
1) You don't need to explain anything to me. Just giving information.
2) I am concerned that you don't understand how clinical psych doctorates work. It is not like getting a PhD in History. It's more akin to medical school. It's 2 ish years of year round coursework, followed by 2-3 years of part time clinical rotations (termed "practica") combined with classwork year round, followed by a one year full time residency (termed "internship"), followed by a near mandatory second year long full time residency (termed "post doc").... before you get licensed. Add another year if you want to specialize, add another 3-4 years if you want to prescribe. We use the exact same "match" program for our version of residency. That means that geographic inflexibility is generally considered to be a kiss of death in this entire process, from admissions to post doc. That's about a 7 year process, so you might want to consider the timeline for getting a psyd. Beware of any program that tries to sell something else. There are online BS programs that say they are equivalent, but you generally cannot get licensed with those programs.
3) If you want to do therapy, and therapy only, the simplest way to do that is a masters program. That is not going to be a great education in things, and there is limited exposure to severe mental illness. This type of education leads a lot of MA level providers to misdiagnose things (eg., They have have never seen someone who is full blown manic or psychotic, so they think that having trouble sleeping or being moody is evidence of Bipolar I). If you are okay with that type of hit to the ego, in service of practicality, then it's a way to go. CA is a saturated market for MA level providers, which you should consider from a financial POV.
4) If you are looking at doing research: I have worked with two MDs who did not complete residency, who exclusively do research.
5) There are also industry research options, ranging from legitimate research to "dude with a credential who signs off on things". Be careful about program development, if you have a DEA #. There were a few cases where innocent physicians were hired, and their DEA used without their knowledge, and ended up going to prison (eg., Sasaki & Randall case).
6) You could move to one of those states like TN, IL, etc where you can get licensed without a residency.
7) If I were in your shoes, I would look over the Non-clinical Careers google results. There are a ton of those things.

I really appreciate the response.

 

[psych.meout]

I was in Internal Med (intensive care to be specific). Because I've been away from practice for several years so matching back into medicine would be pretty unlikely. You ask some valid questions - stuff to think about for sure. Thanks!

Do you still have med school debt?

 

[fy6190]

Do you still have med school debt?

no debt.

 

[deleted1129370]

no debt.

I have $445K

 

[eeor1006]

Have you thought of an accelerated program of psychiatric nurse practitioner? It is easier to get into for an applicant like you, shorter than doctoral training in psychology, quite a bit more overlap with your background, and you get to do basically everything a psychiatrist can do in private practice. If you get tired of therapy, you can always just prescribe medication.

 

[chicandtoughness]

I went the other way (masters level therapist to med school), in case you have any particular questions about how the skillsets transfer. I agree with the others that if you just want to do therapy, a masters level program is best. What state are you in? Certain states tend to prefer certain licenses over others so that will help inform your decision.

Do not do an online program. Hybrid is fine as long as all of your clinical courses are in person (this includes "technique" type classes as well).

 

[singasongofjoy]

A question, if you are not willing to attempt a psychiatry residency, have you thought about using your MD in any way? I know some states will provide a license and allow supervised practice. Have you thought about getting masters level training in therapy and functioning as essentially psychiatry PA in private practice? It would be faster and possibly more lucrative.

I second considering that option. I'm familiar with a practice in my area started by a retired psychiatrist with several psych- NPs and PAs who have addtl therapy training. I saw one of the NPs myself for a bit and it seemed like a pretty sweet role all around on her end, and i found it such a good approach that I've referred some of my other colleagues there who have had same experience. Very small N, that, but shows it can be done well and might be a more efficient path to your interests.