Psych or IM???? Please Help!!!

[confused28]

---

Members don't see this ad.

I am finishing my 3rd year in medical school and applying to residency programs is looming around the corner. I wasnt interested in psych until I completed my psych rotation and I loved it. Primarily, I loved the hours, the histories were always far from boring. However, before the psych rotation my heart was set on IM. Now I am completely torn especially due to what I am hearing about the discrepancies in salaries between IM and psych. Not that money is everything but I do want all this hard work to pay off and have a comfortable lifestyle. I also want to get married and have kids and actually be a mom. So, I need a career that will be conducive to those needs without me wallowing in debt from med school loans. Can someone help me with the realistic pros and cons of psych vs IM? more specifically in south florida?

 

[OldPsychDoc]

I am finishing my 3rd year in medical school and applying to residency programs is looming around the corner. I wasnt interested in psych until I completed my psych rotation and I loved it. Primarily, I loved the hours, the histories were always far from boring. However, before the psych rotation my heart was set on IM. Now I am completely torn especially due to what I am hearing about the discrepancies in salaries between IM and psych. Not that money is everything but I do want all this hard work to pay off and have a comfortable lifestyle. I also want to get married and have kids and actually be a mom. So, I need a career that will be conducive to those needs without me wallowing in debt from med school loans. Can someone help me with the realistic pros and cons of psych vs IM? more specifically in south florida?

Can't speak specifically for FL, but in general, Psych typically out-earns primary care IM, though not the more interventional (GI, Cards) subspecialties. And Psych is much more family-friendly in residency and early career, especially for moms.

 

[confused28]

Thank you so much for your reply! 🙂

 

[zac16125]

but in general, Psych typically out-earns primary care IM,

Is that true? From what I've seen (although its hard to figure out whats a legit source) its the other way around. Especially with the surge in hospitalist and how they are being payed at some places around the country. The numbers I've seen show general IM significantly out earning psych.

I'm in the same boat as the OP tho. Psych has been my favorite rotation so far but I also enjoy hospital medicine. If theres a significant pay difference it makes the choice of residency very tough.

 

[Manicsleep]

Lifestyle and money are generally not compatible with IM. You can make a decent living and have a good lifestyle or make a killing with crazy hours, often in a specialty like GI, cardiology etc.

Of course you can always do boutique medicine with internal medicine.

 

[nitemagi]

Is that true? From what I've seen (although its hard to figure out whats a legit source) its the other way around. Especially with the surge in hospitalist and how they are being payed at some places around the country. The numbers I've seen show general IM significantly out earning psych.

I'm in the same boat as the OP tho. Psych has been my favorite rotation so far but I also enjoy hospital medicine. If theres a significant pay difference it makes the choice of residency very tough.

There are psychiatric hospitalists, who often do emergency psych, C/L, or inpatient.

I think the pay in psych depends on what avenue you want to pursue. Psych probably has a higher ceiling is you're entrepreneurially minded, such as starting a practice with psychologists or other therapists working under you, or in forensics. $/hr for inpatient work also depends a bit based on where you go. If not in an academic center, most psych job listings I see range anywhere from $170 - 235k/yr across the country, for inpt or outpt.

Some senior well known psychiatrists commonly charge $3-400/hour in their outpatient practice. Often cash. Little overhead. Do the math. But as I've heard outpt practice can be a headache as well.

I say do what you love, and figure out how to make what you want in that venue.

 

[zac16125]

There are psychiatric hospitalists, who often do emergency psych, C/L, or inpatient.

I think the pay in psych depends on what avenue you want to pursue. Psych probably has a higher ceiling is you're entrepreneurially minded, such as starting a practice with psychologists or other therapists working under you, or in forensics. $/hr for inpatient work also depends a bit based on where you go. If not in an academic center, most psych job listings I see range anywhere from $170 - 235k/yr across the country, for inpt or outpt.

Some senior well known psychiatrists commonly charge $3-400/hour in their outpatient practice. Often cash. Little overhead. Do the math. But as I've heard outpt practice can be a headache as well.

I say do what you love, and figure out how to make what you want in that venue.

This is reassuring. The numbers I heard were significantly less than that. Thanks for the info.

 

[carlosc1dbz]

This is reassuring. The numbers I heard were significantly less than that. Thanks for the info.

I know, I annoying how all the salary websites put psych around 140K, but I guess its good to keep the real salary a secret to reduce how competitive nature of the admission process, and we can get people that truely love the specialty.

 

[michaelrack]

I know, I annoying how all the salary websites put psych around 140K, .

A BE/BC psychiatrist should never take a job for less than 150 K (even if it is a government position)

edit: I guess it is ok to take an academic position for less, if you enjoy giving away your services.

 

[Addiction]

Here is my posting from another thread copied here:

If your sole reason for not going into Psychiatry is money even though it is the specialty you love the most you have been misinformed about the financial opportunities in Psychiatry. Hard-working psychiatrists can easily make $300-$500K. My cousin is an attending in New York and completed an Addiction fellowship after general psychiatry residency. He works two jobs (ER and a dual diagnosis attending) and pulls in $400K+ putting in around 50+ hours a week with most of his weekend time free to spend time with his kids.

If you are willing to put in the same hours that other specialities put in (50-60 hours/week) you can make just as much as the ROAD specialties. And if you're business savvy you can make a lot more.

 

[HiScarlett]

You can make a decent living in any specialty of medicine, so don't let that be your deciding factor.... That being said, I can offer that fact that psychiatrists are currently hired in at $175k at the VA, and that is going to be lower than in the private sector. A lot of groups in the private sector are advertising jobs across the country hiring in at $220k. These are general numbers, and if you want to make more than that, you obviously can, you just have to put in the hours.

If you are considering psych, use some electives to do more rotations! There is a lot more out there than your 1 month core rotation has to show.