OMS-2 with zero desire to practice clinical medicine

[Stagg737]

Some of the most grateful patients I've met were in substance use treatment through MAT. I think you will find that to be the case in most places that follow a harm reduction model. CMHCs also vary widely, and depending on the site you could have very reasonable or unreasonable, very grateful or ungrateful patients.

Sure, I would say that some of my most rewarding patient interactions have been with substance treatment as well. However, these patients are very much the minority in addictions unless you're at a long-term residential program and you'll very frequently see the worst of people in this field. Especially those with Cluster B pathology who were already significantly dysfunctional before throwing the substances in. Part of why I chose my program was because of the opportunity to do an addictions fellowship there, but I got burnt out in that area and dropped that track pretty quickly.

CMHCs can vary a lot, but chances are patients will be very high need and that resources will be limited requiring the physician to handle some SW aspects. For what OP is looking for, seems like CMHC would be a terrible fit.

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[hallowmann]

Sure, I would say that some of my most rewarding patient interactions have been with substance treatment as well. However, these patients are very much the minority in addictions unless you're at a long-term residential program and you'll very frequently see the worst of people in this field. Especially those with Cluster B pathology who were already significantly dysfunctional before throwing the substances in. Part of why I chose my program was because of the opportunity to do an addictions fellowship there, but I got burnt out in that area and dropped that track pretty quickly.

CMHCs can vary a lot, but chances are patients will be very high need and that resources will be limited requiring the physician to handle some SW aspects. For what OP is looking for, seems like CMHC would be a terrible fit.

My experience in our MAT clinic has been very different than yours. Inpatient side where Addiction gets consulted regardless of whether or not they want to quit/want help is one thing, but the vast majority of people coming to the clinic want to be there and appreciate the help. We have a fellowship and track here as well. Maybe it's my experience, but I have not seen "the worst of people" there. I think we'll just have to agree to disagree.

 

[Stagg737]

My experience in our MAT clinic has been very different than yours. Inpatient side where Addiction gets consulted regardless of whether or not they want to quit/want help is one thing, but the vast majority of people coming to the clinic want to be there and appreciate the help. We have a fellowship and track here as well. Maybe it's my experience, but I have not seen "the worst of people" there. I think we'll just have to agree to disagree.

We also have an addictions fellowship here with a VA and academic clinic. The academic side is better, but maybe I'm jaded by the VA. Idk, I've had both the most rewarding and most degrading experiences with addiction patients.

 

[hallowmann]

We also have an addictions fellowship here with a VA and academic clinic. The academic side is better, but maybe I'm jaded by the VA. Idk, I've had both the most rewarding and most degrading experiences with addiction patients.

Our VA MAT clinic is certainly different than the general one. I think there's compulsion and conditions pushing people to treatment in that setting than there is in other clinics and there's also a lot more rigidity and quality metrics involved that make treatment feel more punitive, which I think certainly changes how grateful pts are.

 

[deleted1100659]

I would argue that psych is becoming more competitive based upon the caliber of applicants that have been applying and matching to my program, which is mid tier. Sure may not be as competitive as derm so to speak, but people falsely assume that psych isnt competitive; perhaps if you dont care if you end up in a low tier malignant program...

Of note, for the last two years, all the candidates that matched here were in the top half of their class and above average board scores so do what you want with that info.

OP, psych is great if you hate gross stuff, youre interested in pharmacology, and you have a strong tolerance for people. Working with difficult people who arent grateful will happen in any specialty, but we do see many of them in psych. I understand the desire for gratitude, but at the end of the day you chose the job, and theyre coming to see you because its your job. Gratitude doesnt put food on the table.

Whats nice about psych, is there is a a large amount of different things you can do with it, and the demand is always insanely high.

 

[EcnarM]

Yeah pay seemed to be the biggest issue at our school. Know a few FM/IM doctors who left to join urgent cares/private practice because the pay wasn't high enough (they openly told students this).

Good point, somewhat. The lower pay is often offset by a better work/life balance. Average primary care faculty salary is usually around the 200K mark, plus some possible clinic work incentives. However, the job usually gives you most weekends without any commitments, many evenings free, etc. Vs. being in a clinical practice taking call all week on your patients and sharing call every few weekends. All that for some some extra money coming in annually? Figure out which path is preferable and don't worry about comparing what you make to others. Do you make enough to be happy and live the life you want? If so, you make enough.

 

[VA Hopeful Dr]

Good point, somewhat. The lower pay is often offset by a better work/life balance. Average primary care faculty salary is usually around the 200K mark, plus some possible clinic work incentives. However, the job usually gives you most weekends without any commitments, many evenings free, etc. Vs. being in a clinical practice taking call all week on your patients and sharing call every few weekends. All that for some some extra money coming in annually? Figure out which path is preferable and don't worry about comparing what you make to others. Do you make enough to be happy and live the life you want? If so, you make enough.

I take one day of home phone call every other month and one weekend per year.