Psy even getting bombed on DIT

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J ROD

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I am used to most folks in medicine putting Psy down. I know it is not "real" medicine. 🙄

But, I am doing DIT right now for Step 1 and the guy is like I know you probably don't care about this stuff so lets just get through so we can get back to the real stuff. I am paraphrasing here of course but I was just amazed even the prep companies are hating on Psy.

Glad I am going into a part of medicine that others don't respect. Maybe I can change their minds.

I just had to comment..............
 
Psych you learn for step 1: useless, not applicable in real life
Psych you learn after step 1: useful, real patients are involved

More or less.
 
It certainly doesn't help when you have stuff like this in the DSM-V
http://www.nejm.org/doi/full/10.1056/NEJMcp1313051?query=TOC
J DUB said:
I am used to most folks in medicine putting Psy down. I know it is not "real" medicine. 🙄

But, I am doing DIT right now for Step 1 and the guy is like I know you probably don't care about this stuff so lets just get through so we can get back to the real stuff. I am paraphrasing here of course but I was just amazed even the prep companies are hating on Psy.

Glad I am going into a part of medicine that others don't respect. Maybe I can change their minds.

I just had to comment..............
Click to expand...
 
CaptainSSO said:
What is the problem?
Click to expand...
Is hoarding d/o really a psy dz? I mean really?

I don't know, I just thought it was pretty funny that it was in NEJM. It doesn't seem to me to be a psy dz so much as just being weird and inefficient.
 
bulldogmed said:
Is hoarding d/o really a psy dz? I mean really?

I don't know, I just thought it was pretty funny that it was in NEJM. It doesn't seem to me to be a psy dz so much as just being weird and inefficient.
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But in the article, her hoarding has advanced far past the point of simply being weird and inefficient. She cannot eat or shower in her own house due to the clutter. Weird and inefficient would be something along the lines of eating cereal with a fork. Quirky, but not necessarily indicative of anything deeper.
 
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OP, don't expect too much from the jocks of medicine.
 
I remember having to memorize all that mumbo jumbo about Freud's defense mechanisms and the "stages of psychological development" when I was studying Psych for Step 1. I would consider this stuff to be completely useless and not real medicine, and I think that the vast majority of Psychiatrists would agree with me.
 
Psai said:
I had a bad opinion of psych before and then I realized that you guys were all medical students like me and I respect you as my colleagues
Click to expand...

I appreciate this measure of chivalry. And I give it to my colleagues in kind. But what we have to understand as neophytes in medicine is that our opinions about the full-fledged clinical practice of the specialties means diddly-f'n-squat.

It's difficult to communicate to some of the arrogant dolts in our midst just how little their opinion matters to anything or anyone. Until you arrive at that you haven't begun to study our art.

We don't do anything for anyone, colleagues or patients, until we are arrive at the point of marginal usefulness to the team in residency. Until...then we're dead weight. Period.

So any fartbag undergraduate medical student spewing opinion about the fields, resembles being a yipey little chihuahua. Barking, shaking, and pissing over confidently while attached to the leash of some more advanced mouthbreathing ***** who managed to get far in medicine without traveling anywhere in wisdom.

Beyond the playful chiding, real clinicians understand the value of each other's expertise. A surgeon who loses enough patients isn't the same cocky imitator of the maxim--often wrong, never in doubt--that so often permeates the minds of those drawn to what is considered real or heroic.

Their criticism will meet with real life soon enough. The sooner the better.
 
CaptainSSO said:
But in the article, her hoarding has advanced far past the point of simply being weird and inefficient. She cannot eat or shower in her own house due to the clutter. Weird and inefficient would he something along the lines of eating cereal with a fork. Quirky, but not necessarily indicative of anything deeper.
Click to expand...


...and here we explore the difference between a trait and a disorder. It's like those personality disorder clusters. We all have bits and pieces of them, but they aren't disorders yet.
 
there are loads of patients in hospital with psychiatric issues, and many develop them due to the physical disease. Countless are the patients on antidepressing drugs for mood disorders/depression related to the ongoing disease. I cant really comment on the adquacy of this practice.
 
The thing in my opinion that gives psych such a bad rap, is essentially the constant push in the field to basically give everything that society deems in-ideal, to have a medically justifiable condition associated with it. It's going to get to the point where everyone has a mental disorder and we all need to be medicated for something or another. At some point, there's just conscious decision that someone makes without any medically significant intervention. I'm not attacking the concept of mental disease, it's just that it's getting to a point where literally everything is a mental disease. If you watched someone for a day under close scrutiny, I feel like a psychiatrist could make a justifiable case for literally everyone having some mental problem. That's not acceptable in my opinion.
 
PL198 said:
The thing in my opinion that gives psych such a bad rap, is essentially the constant push in the field to basically give everything that society deems in-ideal, to have a medically justifiable condition associated with it. It's going to get to the point where everyone has a mental disorder and we all need to be medicated for something or another. At some point, there's just conscious decision that someone makes without any medically significant intervention. I'm not attacking the concept of mental disease, it's just that it's getting to a point where literally everything is a mental disease. If you watched someone for a day under close scrutiny, I feel like a psychiatrist could make a justifiable case for literally everyone having some mental problem. That's not acceptable in my opinion.
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Hence the need for significant functional impairment in most criteria.
 
alicealicealice said:
Hence the need for significant functional impairment in most criteria.
Click to expand...

Ok, but at some point that's just someone liking what they do. I could look at a star athlete who is obsessed with their craft and how it negatively affects other attributes of their life and that could be a viable medical condition. That's not alright. We look for too many excuses as a society.
 
Why is it a surprise that DIT would **** on psych? They're regular people.
 
PL198 said:
The thing in my opinion that gives psych such a bad rap, is essentially the constant push in the field to basically give everything that society deems in-ideal, to have a medically justifiable condition associated with it. It's going to get to the point where everyone has a mental disorder and we all need to be medicated for something or another. At some point, there's just conscious decision that someone makes without any medically significant intervention. I'm not attacking the concept of mental disease, it's just that it's getting to a point where literally everything is a mental disease. If you watched someone for a day under close scrutiny, I feel like a psychiatrist could make a justifiable case for literally everyone having some mental problem. That's not acceptable in my opinion.
Click to expand...

Well. You put some words together and made sentences. That's great.
 

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notbobtrustme said:
unless it's OI
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Blue sclera's usually lurking around in the vignette for that one. Most questions I've seen haven't had OI in the answer choices when it's child abuse, and when it's OI, there's usually only one choice for child abuse.
 
Most people who constantly make fun of other specialties are insecure or desperately need an ego boost.
 
PL198 said:
The thing in my opinion that gives psych such a bad rap, is essentially the constant push in the field to basically give everything that society deems in-ideal, to have a medically justifiable condition associated with it. It's going to get to the point where everyone has a mental disorder and we all need to be medicated for something or another. At some point, there's just conscious decision that someone makes without any medically significant intervention. I'm not attacking the concept of mental disease, it's just that it's getting to a point where literally everything is a mental disease. If you watched someone for a day under close scrutiny, I feel like a psychiatrist could make a justifiable case for literally everyone having some mental problem. That's not acceptable in my opinion.
Click to expand...

For some reason people seem to forget that almost every set of criteria for any psychiatric diagnosis includes the qualifier that the symptoms must cause significant functional impairment or distress.

By definition, then, most people will not have a psych diagnosis. I'm not sure why this is so easily forgotten and difficult to understand.


Sent from my iPhone using Tapatalk
 
Nasrudin said:
I appreciate this measure of chivalry. And I give it to my colleagues in kind. But what we have to understand as neophytes in medicine is that our opinions about the full-fledged clinical practice of the specialties means diddly-f'n-squat.

It's difficult to communicate to some of the arrogant dolts in our midst just how little their opinion matters to anything or anyone. Until you arrive at that you haven't begun to study our art.

We don't do anything for anyone, colleagues or patients, until we are arrive at the point of marginal usefulness to the team in residency. Until...then we're dead weight. Period.

So any fartbag undergraduate medical student spewing opinion about the fields, resembles being a yipey little chihuahua. Barking, shaking, and pissing over confidently while attached to the leash of some more advanced mouthbreathing ***** who managed to get far in medicine without traveling anywhere in wisdom.

Beyond the playful chiding, real clinicians understand the value of each other's expertise. A surgeon who loses enough patients isn't the same cocky imitator of the maxim--often wrong, never in doubt--that so often permeates the minds of those drawn to what is considered real or heroic.

Their criticism will meet with real life soon enough. The sooner the better.
Click to expand...
 
NickNaylor said:
For some reason people seem to forget that almost every set of criteria for any psychiatric diagnosis includes the qualifier that the symptoms must cause significant functional impairment or distress.

By definition, then, most people will not have a psych diagnosis. I'm not sure why this is so easily forgotten and difficult to understand.


Sent from my iPhone using Tapatalk
Click to expand...

Don't worry, they'll get schooled on the Psych shelf exam...where virtually every question is based on distinguishing normal variants from pathologies.
 
@JackShephard said:
Most people who constantly make fun of other specialties are insecure or desperately need an ego boost.
Click to expand...


It depends. There's always the playful ribbing aspect... which is predicated on being able to take someone else poking fun at your specialty.
 
It's mainly old school docs and those trying to emulate old school docs that seriously crap on psych. I think it's an inexact science just because of how differently people can respond to the same drugs (which can happen in other fields as well), but I'm glad there's a whole specialty to deal with them, because there's no chance in hell I would want to deal with them regularly.

As to the GoT cross-over, I lol'd at Hodor as well.
 
NickNaylor said:
For some reason people seem to forget that almost every set of criteria for any psychiatric diagnosis includes the qualifier that the symptoms must cause significant functional impairment or distress.

By definition, then, most people will not have a psych diagnosis. I'm not sure why this is so easily forgotten and difficult to understand.


Sent from my iPhone using Tapatalk
Click to expand...

That's so relative and incredibly subjective that it's not an accurate means to decide if something is or is not an illness. Everything is a functional impairment of some kind, so where we draw that line at significant and not is pretty difficult. I'm not attacking psych and I think it's great that the mental aspect of things is starting to be looked at much more. However I think this is a huge potential place for exploitation, and it could lead into a witch hunt where everyone has an illness. So far, its look like my thoughts are true. Mental illness is an unfortunate occurrence, but physicians should be vigilant to avoid over-diagnosis, something that is becoming very real right about now.
 
PL198 said:
That's so relative and incredibly subjective that it's not an accurate means to decide if something is or is not an illness. Everything is a functional impairment of some kind, so where we draw that line at significant and not is pretty difficult. I'm not attacking psych and I think it's great that the mental aspect of things is starting to be looked at much more. However I think this is a huge potential place for exploitation, and it could lead into a witch hunt where everyone has an illness. So far, its look like my thoughts are true. Mental illness is an unfortunate occurrence, but physicians should be vigilant to avoid over-diagnosis, something that is becoming very real right about now.
Click to expand...

I had this same view, and I sometimes still believe it wholeheartedly. However, I started to think to myself: "How do I normally refute other people when I think they're might be wrong? How do I verify my own views if I'm not sure?"

And then I realized that I could not just believe this anymore. I can think about it and muse over it, but overall, I only have one thing to say to myself when I think about the topic of overdiagnosis in psych:

Citation Needed.
 
tantacles said:
I had this same view, and I sometimes still believe it wholeheartedly. However, I started to think to myself: "How do I normally refute other people when I think they're might be wrong? How do I verify my own views if I'm not sure?"

And then I realized that I could not just believe this anymore. I can think about it and muse over it, but overall, I only have one thing to say to myself when I think about the topic of overdiagnosis in psych:

Citation Needed.
Click to expand...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949440/

http://dev.europepmc.org/abstract/MED/19646366/reload=2;jsessionid=B21pxs4NikX9D2RiczLm.0

Those are just a few of many. These occurances are only increasing as the DSM becomes more and more broad to where like I said, you can look at any person for an hour and classify them as ill.
 
PL198 said:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949440/

http://dev.europepmc.org/abstract/MED/19646366/reload=2;jsessionid=B21pxs4NikX9D2RiczLm.0

Those are just a few of many. These occurances are only increasing as the DSM becomes more and more broad to where like I said, you can look at any person for an hour and classify them as ill.
Click to expand...

Just search over diagnosis and _______ and arrive at the same conclusion about any field.

The over diagnosis of Bipolar is a well known problem. Depression and other disorders have elements of under and over diagnosis.

I can assure you, a psychiatrist's office is full of people with serious problems. No one has time to go finding perfectly healthy people to label them somethingorother in the DSM--for what purpose?

Your conception of what the DSM is to a psychiatrist is completely imaginary. Your thoughts on the matter lack the rigor or creativity or originality to be worthy any more of my time. But I just couldn't let a google search for your loaded buzz words sit unchecked.
 
Nasrudin said:
Just search over diagnosis and _______ and arrive at the same conclusion about any field.

The over diagnosis of Bipolar is a well known problem. Depression and other disorders have elements of under and over diagnosis.

I can assure you, a psychiatrist's office is full of people with serious problems. No one has time to go finding perfectly healthy people to label them somethingorother in the DSM--for what purpose?

Your conception of what the DSM is to a psychiatrist is completely imaginary. Your thoughts on the matter lack the rigor or creativity or originality to be worthy any more of my time. But I just couldn't let a google search for your loaded buzz words sit unchecked.
Click to expand...

You're putting words in my mouth. Again, I said I completely respect psych, and that yes the office is full of people with serious problems. However, there is a reason the DSM continues to proceed in terms of spectrums and making everything as broad as possible. If it's a well known problem, then what I said is valid. I don't even know what you are arguing. You are just saying no, without saying anything else. If you read my posts a little bit more thoroughly and put less time into attempting to trash me, you could probably provide a more coherent response.
 
PL198 said:
You're putting words in my mouth. Again, I said I completely respect psych, and that yes the office is full of people with serious problems. However, there is a reason the DSM continues to proceed in terms of spectrums and making everything as broad as possible. If it's a well known problem, then what I said is valid. I don't even know what you are arguing. You are just saying no, without saying anything else. If you read my posts a little bit more thoroughly and put less time into attempting to trash me, you could probably provide a more coherent response.
Click to expand...

Do tell...what reason is that?
 
Nasrudin said:
Do tell...what reason is that?
Click to expand...

Clearly so clinicians have more and more power to group people into diagnoses, which can lead to over-diagnosing. Unless you just think they're doing it for sh*ts and giggles.
 
J DUB said:
Yeah, I mean depression, schizo, bipolar. That is real medicine.
Click to expand...
The kind of doctors I associate with not respecting psych are the type that are cavemen and belong in a previous time. I find psych very daunting, actually.
 
J DUB said:
I am used to most folks in medicine putting Psy down. I know it is not "real" medicine. 🙄

But, I am doing DIT right now for Step 1 and the guy is like I know you probably don't care about this stuff so lets just get through so we can get back to the real stuff. I am paraphrasing here of course but I was just amazed even the prep companies are hating on Psy.

Glad I am going into a part of medicine that others don't respect. Maybe I can change their minds.

I just had to comment..............
Click to expand...
Behavioral Science (which includes Psych) on USMLE Step 1 does not equal Psychiatry in clinical medical practice and this varies even further in an academic medical center vs. community private practice.
 
J DUB said:
Child abuse seems important. Not sure if it is on Step 1 but DIT is teaching it.
Click to expand...
Yes, and the key Step 1 fact to know is that you are obligated to report it, as well as elder abuse, but NOT domestic abuse of an adult spouse
 
PL198 said:
Clearly so clinicians have more and more power to group people into diagnoses, which can lead to over-diagnosing. Unless you just think they're doing it for sh*ts and giggles.
Click to expand...

So the DSM is for the purpose of labeling more and more people as ill, to benefit...the people who organized its contents?
 
majestic red said:
I remember having to memorize all that mumbo jumbo about Freud's defense mechanisms and the "stages of psychological development" when I was studying Psych for Step 1. I would consider this stuff to be completely useless and not real medicine, and I think that the vast majority of Psychiatrists would agree with me.
Click to expand...
Yeah, if you're memorizing it. Human psych development, how we learn, etc. and how we are what we are is interesting to most human beings.
 
PL198 said:
The thing in my opinion that gives psych such a bad rap, is essentially the constant push in the field to basically give everything that society deems in-ideal, to have a medically justifiable condition associated with it. It's going to get to the point where everyone has a mental disorder and we all need to be medicated for something or another. At some point, there's just conscious decision that someone makes without any medically significant intervention. I'm not attacking the concept of mental disease, it's just that it's getting to a point where literally everything is a mental disease. If you watched someone for a day under close scrutiny, I feel like a psychiatrist could make a justifiable case for literally everyone having some mental problem. That's not acceptable in my opinion.
Click to expand...
Uh, no. Just...no.
 
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