Please don't murder me

[dopaminesurge]

or immediately tell me I'm unfit for medicine.

I'm trying to decide if to reapply for medicine with the intention to become a neuropsychiatrist or to apply for Ph.D. programs in neuropsychology. I want to be able to understand psychiatric diseases from all perspective and using all relevant tools (blood tests, EEGs, etc.) but ultimately, it seems clear that the life of a clinical psychology student is probably more pleasant and relaxed. I'm not a competitive person, by nature. How much do you guys know about the roles of clinical neuropsychologists? Will my diagnostic tools be too limited? I'm not too concenred with ability to prescribe - my mother's a clinical psychologist who works closely with a psychiatrist for medicinal purposes - it's a functional system. It's not a matter of money. It's just a matter of happiness.

Why did you decide on psychiatry rather than psychology (unless it was decided after medical school)?

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[Doc Samson]

or immediately tell me I'm unfit for medicine.

I'm trying to decide if to reapply for medicine with the intention to become a neuropsychiatrist or to apply for Ph.D. programs in neuropsychology. I want to be able to understand psychiatric diseases from all perspective and using all relevant tools (blood tests, EEGs, etc.) but ultimately, it seems clear that the life of a clinical psychology student is probably more pleasant and relaxed. I'm not a competitive person, by nature. How much do you guys know about the roles of clinical neuropsychologists? Will my diagnostic tools be too limited? I'm not too concenred with ability to prescribe - my mother's a clinical psychologist who works closely with a psychiatrist for medicinal purposes - it's a functional system. It's not a matter of money. It's just a matter of happiness.

Why did you decide on psychiatry rather than psychology (unless it was decided after medical school)?

I didn't decide until well into my clinical experience in medical school. It's very rare that someone goes into medical school to be a psychiatrist. If you have no interest in at least learning about other areas of medicine, then I'd discourage you from going to medical school because it's a long, hard haul.

 

[Anasazi23]

or immediately tell me I'm unfit for medicine.

I'm trying to decide if to reapply for medicine with the intention to become a neuropsychiatrist or to apply for Ph.D. programs in neuropsychology. I want to be able to understand psychiatric diseases from all perspective and using all relevant tools (blood tests, EEGs, etc.) but ultimately, it seems clear that the life of a clinical psychology student is probably more pleasant and relaxed. I'm not a competitive person, by nature. How much do you guys know about the roles of clinical neuropsychologists? Will my diagnostic tools be too limited? I'm not too concenred with ability to prescribe - my mother's a clinical psychologist who works closely with a psychiatrist for medicinal purposes - it's a functional system. It's not a matter of money. It's just a matter of happiness.

Why did you decide on psychiatry rather than psychology (unless it was decided after medical school)?

Murder, no. manslaughter, perhaps.


The simple truth is, if you want to have all tools available to you, with all medical privilages and rights owed to you in full unsupervised medical practice, there is no comparison between gettting an MD/DO vs. a PhD or PsyD. The standard of care in the treatment of medical patients is the medical degree. Psychologists do not practice medicine, have no real medical training, and are trained under a completely different model than medical doctors. They specialize in different aspects of the field, often graduating without working with actual patients to any appreciable degree. This isn't worse or better, just different.

Psychology grad school is demanding - in a completely different way. There is a lot of focus on research, and a lot of independent 'down time' to work on papers, come up with hypotheses, etc. Medical school affords no such luxury, and you are slaved to a rigid schedule (generally speaking).

You asked specifically about neuropsychologists. They generally have someone do testing for them, while they write reports on other patients based on previously completed testing results. In increasingly rare circumstances, they do the testing themselves. This is assuming a clinical career. Your diagnostic tools will in no way be limited, since neuropsychologists are experts at diagnosing certain types of conditions. Treatment is a different ballgame. But, I don't think they'll routinely see
psychiatric patients per se. Normally, referrals are given to them to help rule in or rule out a particular disorder or syndrome. An example would be degree of cognitive impairment post head injury.

Blood tests, and eegs, as you state, are normally the domain of psychiatrists and neurologists.

As for deciding on psychology vs. psychiatry...it's a personal choice. It depends on what you ultimately want to do, how much money you want to make, how you want to approach patients, how much time you want to spend with them, the knowledge base you hope to gain, and the professional identity to which you wish to subscribe.

Medical vs. philosophical/theoretical.

 

[50960]

"You asked specifically about neuropsychologists. They generally have someone do testing for them, while they write reports on other patients based on previously completed testing results. In increasingly rare circumstances, they do the testing themselves."

What are you smoking Sazi? Who draws the blood on the test you order, who runs the machinery to process that bloodwork...not you! Who interprets the results not having a clue who collected it and processed it? YOU. Same story with testing, but we generally supervise those who gibe and process our tests.

YES it is Friday!!

 

[Poety]

"You asked specifically about neuropsychologists. They generally have someone do testing for them, while they write reports on other patients based on previously completed testing results. In increasingly rare circumstances, they do the testing themselves."

What are you smoking Sazi? Who draws the blood on the test you order, who runs the machinery to process that bloodwork...not you! Who interprets the results not having a clue who collected it and processed it? YOU. Same story with testing, but we generally supervise those who gibe and process our tests.

YES it is Friday!!

You sonofabitch.

 

[50960]

Under any other situation this comment would be followed up with a stern warning from the mod, and/or maybe some sort of ban. However, we know this is different, and why, and I support that double standard in this instance.

 

[Anasazi23]

"You asked specifically about neuropsychologists. They generally have someone do testing for them, while they write reports on other patients based on previously completed testing results. In increasingly rare circumstances, they do the testing themselves."

What are you smoking Sazi? Who draws the blood on the test you order, who runs the machinery to process that bloodwork...not you! Who interprets the results not having a clue who collected it and processed it? YOU. Same story with testing, but we generally supervise those who gibe and process our tests.

YES it is Friday!!

Yeah, but PsiSci, 'ol buddy...you know that machines run the differentials on my blood, and even manual differentials and platelet counts done by a lab guy is fine with me - and every other doctor.

THe comment wasn't meant to be a slight. But you know it's reality. All psychologists think they've "arrived" when they get an underpaid and frustrated grad student to do their testing for them, while they do their reports and interviews. In fact, the states have even addressed this issue in the legislature to determine what is acceptable in terms of psychologists not doing their own testing.

In the case of blood draws (which I often do myself, btw), there are no behaviors to monitor, or observations to record while I'm doing it. I do it for a specific purpose that is medically, and often not psychiatrically, related.

Most psychologists, when they feel their tester is 'ok,' let them test all day long, without supervision - and they interpret the results. At best, they'll ask the psych tech for behavioral observations. It was one of the peeves I had in psych grad school and in undergrad when I did testing. Arguably, the most important part of the testing component, the approach to the test and behavioral observations, and 'style' is ignored in lieu of raw data.

 

[Psyclops]

I'm gonna have to agree with you ana on this one. I think that ideally a psychologist would be administering their own tests. I say this as a young and idealistic gradate student.

 

[Solideliquid]

"You asked specifically about neuropsychologists. They generally have someone do testing for them, while they write reports on other patients based on previously completed testing results. In increasingly rare circumstances, they do the testing themselves."

What are you smoking Sazi? Who draws the blood on the test you order, who runs the machinery to process that bloodwork...not you! Who interprets the results not having a clue who collected it and processed it? YOU. Same story with testing, but we generally supervise those who gibe and process our tests.

YES it is Friday!!

So we should be in the room when a machine analyzes a few tubes of blood? What's the point? If the TSH is high the machine will spit out a sheet of paper saying so.

 

[50960]

Sazi, point well taken, and I basically agree. However, to trust the lab 100% is a bad idea. Science labs are run and operated by well educated people, but medical labs are not. In the last month alone I have re-ran 3 separate thyroid panels that seemed "off" to me based on Sx, and 2 of them were significantly different over the course of 2-3 weeks. TSH of .2, and the retest at 2, and then a TSH of 6 with retest at 1.3; both of which could have prompted tx that would have worsened the condition of the patient. I made my point because it is Friday, but I really hope people are not being trained to blindly trust lab results if they do not fit with other relevant clinical information...

 

[Poety]

Under any other situation this comment would be followed up with a stern warning from the mod, and/or maybe some sort of ban. However, we know this is different, and why, and I support that double standard in this instance.

Oh now we can't joke around anymore? Lacking smileys doesn't mean not smiling sonofabitch. better?

 

[PublicHealth]

I'm gonna have to agree with you ana on this one. I think that ideally a psychologist would be administering their own tests. I say this as a young and idealistic gradate student.

Aren't there new CPT codes that pay substantially more for psychologist hours than technician and computer hours?

 

[Anasazi23]

Sazi, point well taken, and I basically agree. However, to trust the lab 100% is a bad idea. Science labs are run and operated by well educated people, but medical labs are not. In the last month alone I have re-ran 3 separate thyroid panels that seemed "off" to me based on Sx, and 2 of them were significantly different over the course of 2-3 weeks. TSH of .2, and the retest at 2, and then a TSH of 6 with retest at 1.3; both of which could have prompted tx that would have worsened the condition of the patient. I made my point because it is Friday, but I really hope people are not being trained to blindly trust lab results if they do not fit with other relevant clinical information...

Your lab sucks.

 

[Anasazi23]

In the last month alone I have re-ran 3 separate thyroid panels that seemed "off" to me based on Sx, and 2 of them were significantly different over the course of 2-3 weeks.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2742708&dopt=Abstract

Sounds like you're doing something wrong. Do you know about the differential of pediatric fluctuating tsh levels? It's medically complex and probably best left to a pediatrician.

It's not as easy as "low tsh = hyperthyroidism" and vice versa.

 

[Psyclops]

Aren't there new CPT codes that pay substantially more for psychologist hours than technician and computer hours?

I don't know the codes or whats going on there, one would think so though. Although if so, K wonder what the discrepancy is.

 

[PublicHealth]

I don't know the codes or whats going on there, one would think so though. Although if so, K wonder what the discrepancy is.

Found it: http://abpn.net/about-news.php?id=12

More: http://www.apapractice.org/apo/toolkit.html#

 

[50960]

Our new lab is having a few problems. Peds? None of these people were even kids, and all new pts to me.

 

[PopoZao]

I think that you should try to shadow some people in both fields to see what interests you the most. Either way there is a lot of schooling involved and you want to make an informed decision.

And although it might be "rare" for people to know they are interested in psych going into med school (as the other poster reported) doesn't mean it doesn't happen. I know of 2 in my class, and 2 in the class ahead that were psychology undergrads and knew we would persue this field.

 

[Anasazi23]

I think that you should try to shadow some people in both fields to see what interests you the most. Either way there is a lot of schooling involved and you want to make an informed decision.

And although it might be "rare" for people to know they are interested in psych going into med school (as the other poster reported) doesn't mean it doesn't happen. I know of 2 in my class, and 2 in the class ahead that were psychology undergrads and knew we would persue this field.

That's true, Popo. I entered med school for the sole purpose of psychiatry. But, there was a time I thought I'd switched my interest to surgery, neurology, or a couple other fields.

Overall, I'm glad I decided to stay.