Not a huge fan of research - MD or PsyD?

[anybutpretty]

I keep oscillating between whether grad school or med school is most appropriate for me given my career goals. I'm mostly looking at doing psychotherapy, but I don't want to abandon the hard sciences. I'm not hugely interested in doing research, but I don't want to be locked out of it either.

I hear that psychiatrists don't get trained in psychotherapy, and because of the managed health care system (for reference, I'm in the US), get pushed into doing med management (sounds boring). Then I hear PsyDs just get shat on by the MDs and clinical psych PhDs. They also end up with debt like med students, and then make about half the salary they do. Or that people with MAs can do their work just as well, so they aren't respected anyway.

I'm reluctant to pursue the PsyD because even though research isn't my primary goal, I definitely want to have research experience. I'm reluctant to pursue a clincal psych PhD because I *definitely* want to have clinical experience. And I'm reluctant to pursue the MD because I don't want it to prevent me from doing psychotherapy.

This was a bit redundant, but I'd really like to hear about your experiences with any of these programs and where they've led you. It's also possible I'm not getting the right impressions and it'd be nice to have any misconceptions cleared up.

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[jhymn]

How about either pursuing a clinically oriented PhD program or a well-respected university based PsyD (that would help pay for your schooling and living expenses)? For instance, I have heard that Rutger's PsyD program is pretty rigorous and well respected, whereas I go to a school that offers PhD and PsyD, but the PhD has a strong clinical/practical leaning.

This is coming from a 1st year PsyD, who is going to a non-profit, SoCal based private university's PsyD program, and slowly entering into debtland.

 

[Logic Prevails]

This is coming from a 1st year PsyD, who is going to a non-profit, SoCal based private university's PsyD program, and slowly entering into debtland.

Yeah, I took a wrong turn into debtland a few years ago - since you are just entering, could you take a look in your rearview and give me directions on how to get out of here?

 

[50960]

As I have said MANY times on SDN, when you get out into the working world nobody cares where you went to school, if you have a PhD or PsyD, or any of the stuff students talk so much about here; it is only CAN YOU DO THE JOB?? I am years past being a student, am licensed on a no-name PsyD, have multiple publications, teach in a family practice residency program, am on staff at multiple hospitals, and the only people who have ever cared where I got my degree have been other, usually alot older psychologists who are threatened by what I do, and by the evolution of psychology in general. Bear down and get your degree, and take the speeches you get on the state of the field at school with a grain of salt. Psychology will only survive if it and its students get out of the grip of the old-timers who cannot do so they teach, and fear progress.

 

[clearcolor]

Get the MD. It will open the most doors.

 

[docjohng]

Well said, psisci!

 

[YAVIS]

Well said, psisci!

I second that!! I took a lot of flak from people when I was looking into PsyD programs (but then, I'm in Canada and we don't have PsyDs up here yet), saying they weren't real degrees, etc. I was much more interested in the clinical than the research, but, same as you, anybutpretty, didn't want to close any doors. Personally, I thought all those ppl who told me that if I got a PsyD degree it would be worth crap were dorks, because like psisci says, I figured it was about how well I could do my job, not what school is on my transcript.

 

[BleepTastic]

I'm in a similar quandary. Now you have the Ph.D, the most competitive program on the planet and then M.D. which is like, second most competitive? Ph.D is for all intents and purposes, free, whereas M.D. is anything but.
Then Psy.D, far less competitive but almost as expensive as M.D., with about a 10th of the respect. With Psy.D, I'm worried whether my education will suffer and if I truly will be equipped to go where my heart, and maybe my pursestrings, will take me.

I want to treat and counsel patients. I'd also like to contribute a little to scholarly research on social and cultural psychology. At the same time, I am a huge fan of exploring the brain and biological bases of behavior and mental illness, BUT I am not ultrapro-medication. And I'd also like respect and money, just like any other person in America. Now I don't have good research experience and I have a modicum of clinical experience. People believe I can make it to medical school but I'm sure any of you would tell me that clinical psych requires a very well-qualified person with great research experience. All I can claim is Psi Chi membership. Is there a nonMed program which would satisfy these desires?

So Psychiatry then?

 

[50960]

For what it is worth you will not get respect just because you have an MD. I know psychiatrists who get no respect either because they deserve none, or they present themselves as whiny, needy, and dependent. Don't choose a coure of training bases on how cool people will think you are or you are bound to be disappointed by any degree.

 

[Sanman]

Well, in all honesty, mental health isn't the place to go if you want a ton of respect from colleagues because psychologists don't have MDs and psychiatrists are the bastard step children of the medical profession and "not real doctors". If you want respect, be a neurosurgeon.

 

[BleepTastic]

psychiatrists are the bastard step children of the medical profession and "not real doctors". If you want respect, be a neurosurgeon

My question is based on the fact that I want to be involved with psychology, rather than slicing and dicing brains. I'm not comparing Psychiatry to, let's say, trauma surgery, because that's not what I want to do. Residencies and internships may change my mind, but that's not where I am now. And I am aware that there is a sliding scale of respect that probably goes along with the sliding scale of school selectivity, assuming that I won't become a snivelling excuse for a Psychiatrist. Am I wrong in thinking that a Psy.D gets less respect and more limitations than a Ph.D or a MD?

So, barring the respect factor, the points of comparison that I need to evaluate are the MD versus the variety of NON-MD options.

In the realm of the occupational tasks which include: counseling, understanding biological bases, NOT overmedicating but having the ability to medicate if necessary, treating patients and contributing a lil something to scholarship, which programs afford similar opportunities (without having to take an additional 3 years off to get "research" experience)?

 

[Sanman]

well, you can do just about all of that in some way depending on the degee.

You can't prescribe with a PhD/PsyD unless you are in NM/LA. However, psychiatry will require you to prescribe. Not doing so will severely limit your income. As far as counseling/therapy, most insurance companies will not let you see patients as a psychiatrist because they have other, cheaper alternatives. You can attempt to have a cash only therapy practice, but that is becoming rarer. In this day and age, it is difficult to do both and in all likelihood you will have to choose. This may change if psychologists get prescribing rights.

A psyd will only limit you in trying to perform hardcore research as compared to a PhD. However, most quality PsyD progrmas will want research and clinical exposure before they except you. I'd be wary of those that did not.

 

[Livethedream]

You can't prescribe with a PhD/PsyD unless you are in NM/LA. However, psychiatry will require you to prescribe. Not doing so will severely limit your income. A psyd will only limit you in trying to perform hardcore research as compared to a PhD. However, most quality PsyD progrmas will want research and clinical exposure before they except you. I'd be wary of those that did not.

forgive my ignorance but what exactly is a NM or an LA?

 

[PublicHealth]

A psyd will only limit you in trying to perform hardcore research as compared to a PhD.

Always exceptions to the rule: http://synapse.hitchcock.org/bios/saykin.shtml

He's a PsyD: http://www.dhmc.org/providers/dhmc_provider_706.html

 

[PublicHealth]

forgive my ignorance but what exactly is a NM or an LA?

New Mexico and Louisiana. Two US states that allow psychologists with RxP training to prescribe psychotropics.

 

[amy203]

I think that anybutpretty's post is a good example of how the current clinical Ph.D. is actually causing the field to lose some very good candidates. I think it takes a pretty unusual person to actually enjoy research - and I DO NOT mean a more intelligent person - because it can be very solitary work and you spend a lot of time "living in your head." I think most people major in psychology because they are interested in working with people. The current system is so focused on research that it isn't surprising that many people choose a different career path.

anybutpretty - In response to your question, one of my advisors is a clinical psychologists, but he really regrets it now and wishes he had become a psychiatrist instead. He is very interested in research, and psychiatrists definitely have an opportunity to perform research, so you don't need to worry about that. On the other hand, I think the main reasoning behind his interest in psychiatry is that they are better paid and more likely to find a job after finishing school. This doesn't seem to be your main concern, but it is something to consider.

I supervise undergraduate interns in the lab I work at and part of my job is to help them make decisions about their career paths. Unfortunately, I still don't know what to tell them about PsyDs! (Other than John Snow's excellent advise to not get themselves too far into debt paying for the program because there's no guarantee they'll be able to pay it off when they get out!) There's a pretty good discussion of PsyD programs in The Insiders Guide to Graduate Programs in Clinical and Counseling Psychology, and I think it also includes a section on whether to apply to medical school. I also have my interns check out the Ph.D./Psy.D. comparison thread. It's a bit vitriolic at times, but it offers a great range of opinions that you should consider before choosing a Psy.D. program.

 

[psychanon]

Always exceptions to the rule: http://synapse.hitchcock.org/bios/saykin.shtml

He's a PsyD: http://www.dhmc.org/providers/dhmc_provider_706.html

There are always exceptions to every rule. There are also a few MSW's out there producing world-class research. It doesn't mean that the MSW- or the PsyD- offers the best opportunities to develop as a researcher, or that there aren't substantial barriers to those degree-holders who want to get into research. Also, another thing to note about this guy is that 1) he got his PsyD in 1982, which i think was well before the onslaught of professional schools, so his degree may have been more respected when he was originally on the job market, 2) he got his PsyD from Hahnemann, a well-respected medical school that has now merged with Drexel (which does not offer a PsyD anymore, just a PhD), NOT a professional school.

I think that anybutpretty's post is a good example of how the current clinical Ph.D. is actually causing the field to lose some very good candidates.

Ha-- most well-respected clinical Ph.D. programs get about 100 applicants for every 1 they accept. We can afford to lose some people. Besides, if you're not interested in research, you're not really interested in psychology, you're interested in applications of psychology. I'm not saying there's anything wrong with that. There are plenty of alternative degree programs designed for those with solely clinical interests.

I think it takes a pretty unusual person to actually enjoy research - and I DO NOT mean a more intelligent person - because it can be very solitary work and you spend a lot of time "living in your head." I think most people major in psychology because they are interested in working with people.

Really?? Maybe I'm having a hard time understanding this because I love research, and know many people who do, and don't consider myself to be particularly unusual. My research isn't really solitary. I interview people about their lives and their symptoms, generate ideas jointly with my mentor and labmates, present ideas at conferences, network with other researchers, etc. It's not like I (or most clinical psych researchers) sit around in a white coat and dishevelled hair measuring out chemicals in beakers all day.

 

[anybutpretty]

Really?? Maybe I'm having a hard time understanding this because I love research, and know many people who do, and don't consider myself to be particularly unusual. My research isn't really solitary. I interview people about their lives and their symptoms, generate ideas jointly with my mentor and labmates, present ideas at conferences, network with other researchers, etc. It's not like I (or most clinical psych researchers) sit around in a white coat and dishevelled hair measuring out chemicals in beakers all day.

This is reassuring to read. Still, it's not my primary interest, but I like to hear that doing research at the graduate level (and beyond) is enjoyable. I want a job that embraces science (and the scientific method) that allows me to really work with people. Unfortunately, most PsyD programs (the professional schools, anyway) don't seem to provide this, and I suppose that's not really their goal. This isn't to bash the PsyD, but the more I read about it, the less versatile and less appealing it looks to me.

Someone else mentioned that it isn't a problem for psychiatrists to get involved with research - this is also reassuring. I think I would feel really disconnected from the field if I weren't involved with research somehow. I guess the biggest thing for me now is whether or not psychiatrists get a chance to learn how to do (and practice) psychotherapies. It is a bit disconcerting for me how psychiatry and psychology are so dichotomized. At this point I'm thinking a MD/DO wouldn't close any doors - it just might take longer to get to where I want to go.

 

[amy203]

A topic frequently addressed in this forum is how the field can attract better candidates. I'm not as concerned about the students who are not accepted to clinical PhD programs as with the ones who never apply. Of course I don't have any evidence to back this up, but I wander how many students who want to work with people choose medical school instead. In addition, considering the current focus on the importance of empathy and therapeutic alliance in effective clinicians, is it possible that the field is screening out extroverted, people-oriented individuals who would make great psychologists? Again, no evidence, just thinking out loud.

I think a practicing clinical psychologist should be interested in research in terms of applying it to their practice. However, doctors, lawyers, and dentists are NOT required to complete dissertations or spend six years in school because they are not planning to be research scientists. I think the Vail Model was originally created to address this issue, but I don't think the system is being implemented very well. As for clinical Ph.D. programs (especially the "well-respected" ones), I have heard from several professors and admissions counselors that students applying to competitive clinical Ph.D. programs should LIE about their interest in becoming clinicians rather than researchers, because it's the only way they'll get in!

By the way, I love research too and I don't think I'm that weird or anti-social! But I do think research involves spending a lot of your time reading, writing, and thinking, as opposed to working with clients which is a much more "in the moment," extroverted type of job.

 

[Psyduck]

Ha-- most well-respected clinical Ph.D. programs get about 100 applicants for every 1 they accept. We can afford to lose some people. Besides, if you're not interested in research, you're not really interested in psychology, you're interested in applications of psychology. I'm not saying there's anything wrong with that. There are plenty of alternative degree programs designed for those with solely clinical interests.
...
Really?? Maybe I'm having a hard time understanding this because I love research, and know many people who do, and don't consider myself to be particularly unusual. My research isn't really solitary. I interview people about their lives and their symptoms, generate ideas jointly with my mentor and labmates, present ideas at conferences, network with other researchers, etc. It's not like I (or most clinical psych researchers) sit around in a white coat and dishevelled hair measuring out chemicals in beakers all day.

Yes!
I don't know about this losing PhD candidates thing as I actually know many people who don't like research but are considering this route for the greater opportunities for scholarships and the prestige over PsyD and counseling psych.
I also don't think that I am "unusual" because I want to do research. Perhaps (well obviously) we have a "different" set of skills and interests than those focused soley on clinical pursuits

 

[Psyduck]

As for clinical Ph.D. programs (especially the "well-respected" ones), I have heard from several professors and admissions counselors that students applying to competitive clinical Ph.D. programs should LIE about their interest in becoming clinicians rather than researchers, because it's the only way they'll get in!
QUOTE]

I've also heard this before. I'm wondering about schools like Washington University, St. Louis which say that they are concerned with preparing students for careers in both research and practice but emphasize research. I want to do both and I'm not sure if I should try to show my strong commitment to each of them, or if I'll have a better chance saying that I only want to do research (If I say I want both will they mistakenly think I'm one of the ones who really wants to practice?)

 

[PublicHealth]

As for clinical Ph.D. programs (especially the "well-respected" ones), I have heard from several professors and admissions counselors that students applying to competitive clinical Ph.D. programs should LIE about their interest in becoming clinicians rather than researchers, because it's the only way they'll get in!
QUOTE]

I've also heard this before. I'm wondering about schools like Washington University, St. Louis which say that they are concerned with preparing students for careers in both research and practice but emphasize research. I want to do both and I'm not sure if I should try to show my strong commitment to each of them, or if I'll have a better chance saying that I only want to do research (If I say I want both will they mistakenly think I'm one of the ones who really wants to practice?)

Say you want to do both. These are scientist-practitioner programs.

 

[amy203]

Yes!
I don't know about this losing PhD candidates thing as I actually know many people who don't like research but are considering this route for the greater opportunities for scholarships and the prestige over PsyD and counseling psych.
I also don't think that I am "unusual" because I want to do research. Perhaps (well obviously) we have a "different" set of skills and interests than those focused soley on clinical pursuits

Right, and I know quite a few psychology majors who found that they didn't like research, wanted to work with people, wanted a prestigious job, and weren't interest in devoting six years of their lives primarily to research, so they went to medical school!

I was in a very research-oriented psyc department in college, and I supervise undergraduate interns from that same department. Still, the vast majority of undergraduate psychology majors I meet are not interested in research as a career - they want to be clinicians.

I guess we don't currently have any way of knowing how many people who dislike research but want to be psychologists tough it out in clinical Ph.D. programs, and how many choose other career paths. It would be interesting to study!