Ph.D in Psychology after MD instead of Psych?

[psych7711]

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I am in such a state of confusion about what to do with my career.

I have a MD but hate practicing medicine, meaning I do not enjoy studying or practicing internal medicine, family practice, pediatrics, etc and hate performing physical examinations. I do enjoy talking to patients and completing the history, etc. Is is normal for psych residents to hate physical exam this much??

I enjoy outpatient psychiatry especially psychotherapy and know that I would be very content with this job once I'm in private practice in the future.

I understand to most people it seems silly not to go to residency at this point, but I know I will hate the first two years of inpatient psych training yet there is a great chance I will love the last two years and private practice when I'm out. I become extremely anxious and want to get out of the hospital when I'm in inpatient psych or any other medical rotation although I feel at ease on oupatient psych.

Lately, I've been thinking about getting a Ph.D in psychology so that I could do private practice therapy and be a professor at an undergraduate university. Does this seem like backtracking to you???

I just feel that I don't fit in the medical world I am so disinterested in medical problems that it's almost dangerous.

What should I do? The Ph.D will take 5-6 years which seems crazy to start after medical school, debt, etc.

 

[SheSpawn]

i am a non-traditional pre-med\psych major and I have plans of going this route and I will be like, well old when I finish and I still don't think it is that crazy if that is what will make you happy. I LOVE neurology, psychopharmacology but absolutely adore psychotherapy. I may get guff for this but I see no reason why a psychiatrist couldn't provide quality therapy, you would provide someone with a unique ability to go to one doctor to get really good and well qualified therapy as well as work with medication if it is necessary. It is hard enough to find one therapist you feel comfortable pouring your heart out to and many in psychotherapy are reffered to psychiatrists when you have to be put on medication and that can be difficult. It may have been easier if you had decided to do this prior to your MD but honestly, do what makes you happy life is too short to be miserable just because it seems crazy to others 🙂 Good luck on your route if you take it and let me know how it goes!

 

[sunlioness]

I think you should do what you want. However having said that, I would still do a psychiatry residency if it were me. You got through med school, right? So you can get through your medicine, neurology, and inpatient psych rotations. You may hate them, but it's temporary. And when you graduate residency you can still structure your career to do mostly psychotherapy if this is what you want. It just seems counterproductive to spend several more years and accrue greater and greater debt (especially given that psychologists do make less than psychiatrists) to end up in a place you could get to anyway on your current path. Also you might want to think about getting treatment for your anxiety, if you haven't already. It's totally ok not to like something, but I think it's different kettle of fish to dislike something because it scares you. I had a mentor in med school who would often ask me when I said I didn't like something if it was really dislike or discomfort? Sometimes it was both. But a lot of the time, my discomfort got in the way of truly being able to say whether I liked something or not. And anxiety is very treatable through meds and therapy. Good luck with everything.

Edited to add: Not to mention that becoming a PhD/PsyD psychologist is really competitive. Apparently only 40% of applicants are able to match into APA approved internships, which is a requirement for licensure. I was really quite flabbergasted when I learned that. Not saying at all that you would not be a competitive applicant or be able to secure one of those spots when the time comes, but to me it just seems beyond awful to spend all those years in graduate school only at the very end to learn you can't fulfill your career dreams. At least med school is the most competitive at the BEGINNING of the process (for psychiatry people, anyway). Good luck again.

 

[Anasazi23]

I think the key for you will be to just select a relatively light, therapy-oriented residency program. Starting the Phd application process and going through dissertation at this stage is, in my opinion, incredibly wasteful. Many of the best psychotherapists in history have, and are, physicians. Intership year is a pain, but it's relatively easier the remaining years, depending on where you do residency.

Trust me, the grass is not always greener.

--money
--prestige
--job opportunities
--advancement opportunity

are all things to consider.

 

[East Coast]

I would agree with the above. Try looking into community programs such as Cambridge Health Alliance. I am sure there are others with a light medicine component and a focus on community out-patient psychiatry.

 

[Psychotherapy]

It's so amazing to know someone else is going through what I'm going through! I'm also pre-med/psychology (undergrad) major, looking to enter psychiatry for the purpose of one to one psychotherapy practice. I've been struggling with my path as well. From this "beginners" view point, hopefully this will help... I truly am not a fan of the "medication nation" trend we have now of prescribing meds for every single last thing; I also don't believe that neurotransmitter mishaps just happen and should only be controlled with meds. I think it's both, brain and environmental factors that effect the mind. I also realize that entering psychiatry with this mind set isn't going to be the popular vote. However, I feel that as a physician I will have a higher level of expertise when it comes to understanding the body and brain. For the mind, my psychology major broadens my view; as well as intensive psychoanalytic training when I finish my residency. To top it all off, I really believe in this type of treatment, and I have a very empathetic ear. If this sounds like something you feel for also; To treat with a listening ear, you don't need to go very far. As a psychiatrist you only need to be diligent and attentive, with the required therapeutic training. You will be great, don't forget about what you want. You have all you need to be successful in your mind. Don't go backwards.

 

[East Coast]

"I also realize that entering psychiatry with this mind set isn't going to be the popular vote."

In interviewing for residency this year at many big-named programs I would have to say that this "mind set" is more popular than many make it out to be, and that those who have it in addition to a strong science background are highly sought-after.

 

[psychbb]

I was a psych major, too, and am now a 2nd year med student and intend to specialize in Psychiatry. From what I understand, as a Psychiatrist you can do everything a Psychologist can do PLUS prescribe meds. I have spoken to many psychiatrists and there are so many things you can do as a psychiatrist (private practice, community mental health, inpatient, consulting). Some also do therapy. Please don't think all you will be able to do is write 'scripts.
Some residencies are more therapy oriented than others. Take a look into those. I think not completing a residency and starting up a Ph.D. program is a step backwards. Just my 2 cents worth...

 

[Psychotherapy]

"I also realize that entering psychiatry with this mind set isn't going to be the popular vote."

In interviewing for residency this year at many big-named programs I would have to say that this "mind set" is more popular than many make it out to be, and that those who have it in addition to a strong science background are highly sought-after.

I think it's wonderful if more medical professionals look for alternative methods rather than reaching for the script pad as soon as they hear "my symptoms are.." I haven't had the good fortune to come across many psychiatry residents or professionals who fully adopt the psychotherapy approach. Many simply adapt to the view that it's ALL a matter of neurochemistry. (With the drug craze and all.) Which to me is very sad. I do hope that the classic behaviorist model of simply treating the symptom doesn't take over. It's far more than the symptom alone.

 

[psych7711]

Thanks for your insight everyone!!!

I have just become extremely ill with the way medicine is. Although I have to say that I don't actually find medicine extremely interesting, there is more to it than that....

Many times in the hospital wards (I resigned from a great residency program as a PGY-1), I felt surrounded by a group of robots who seem more like mechanics than emotional beings.

It got to the point where I had to leave because I thought that just being in that enviroment would make me worse of a person. It was suffocating.

I feel that I lose my creativity around people who treat patients like a mathematical algorithm. And I become so disenchanted that I can't function. Patient comes in with x, y, z, you believe symptoms are due to 1-3 so let's give them these medications A and B and send them on their way. It's ridiculous especially if I want to be an outpatient therapist....I'm so confused about what to do. I understand how following algorithms is important in internal medicine, surgery, peds, etc...

Is is honestly possible to survive a psychiatry residency program hating internal medicine and physical examination??? Does anyone have any ideas on how I can force myself to somehow become interested in order to survive? I'm so far in debt that the practical solution would be to keep going and do psychiatry...I understand this...

I really want to go through with psychiatry so that I can have a private practice and do mainly therapy, but I don't know if I have it in me to keep going in an environment where nobody seems to understand me.

Any other ideas for more therapy oriented programs which require less primary care involvement??? I will look into cambridge health alliance but there must be more choices? Is it possible for me to scramble into a decent position in psychiatry this year?

 

[Psychotherapy]

As is the case with anything, you don't always get what you like or want; and at the lowest end what you love. At least not right away. I would say tough it out as some posters mentioned. That's how you get through it. You know it's not for you, you know you don't like it. You don't have to like it, you're in pursuit of your own dream. Follow your path, in the meanwhile just ride this residency until you find your own destination. Dedication + Patients (patience too) = Your Goals. Who knows, in doing so maybe you will change the entire field! I'm sure these experiences will count for something later on. Keep at it.

 

[alanchan]

how about doing a residency in psychiatry and complete a phd in clinical psychology? is it common to have certification of both fields?

 

[Therapist4Chnge]

From what I understand, as a Psychiatrist you can do everything a Psychologist can do PLUS prescribe meds.

That's incorrect, though a topic for another day. If you are interested, there have been some good threads on here that talk about the differences, which should pop up with some key word searches.

 

[whopper]

From a purely monetary standpoint, I'd get the psychiatry training.

You could still do counseling & therapy without the Ph.D. through other routes. Doing a psyche residency for example, or getting a masters in counseling.

 

[Therapist4Chnge]

From a purely monetary standpoint, I'd get the psychiatry training.

You could still do counseling & therapy without the Ph.D. through other routes. Doing a psyche residency for example, or getting a masters in counseling.

Agreed. They have institutes (I only know psychodynamic ones, though I am sure there are others) that can offer quality training once you finish your med school stuff.

A Ph.D. would offer a strong basis in research and provide excellent training in complementary areas (assessment, therapy, etc) though it is a long road and doesn't really make sense unless research is a big part of what you want to do.

 

[whopper]

Thinking about this a bit more..

Would it be possible for you to enter as a PGY II if you already have a completed a non-psyche residency? I believe its possible if you did 1 year of IM.

Why would you hate PGY 1 & 2 aside from the call hours? There's a lot to learn in terms of psychiatric inpatient care during those years. IMHO inpatient is much more intense & educational than outpatient.

Another aspect is that psychiatry tends to focus tremendously more on the physiological causes of psychiatric disorders. As a Ph.D. in Psychology, you might not get as much oppurtunity to use your already existing M.D.

And yes, there are barriers to psychotherapy as a psychiatrist, but there still is a lot of psychotherapy you can do as a psychiatrist if you work it into practice. With the shortage of psychiatrists nationwide, you have more ability to pick the job you want--including outpatient and doing psychotherapy.

I'd choose a psychiatry residency with a strong psychotherapy training. This is coming from a guy with a degree in psychology and my wife's working on a masters in counseling. If you were to choose one of the Philadelphia programs (hey Camden too where my program is), the Aaron Beck Institute for CBT is there and you have the oppurtunity to work with the master himself.