Just curious about this, I'm not actually considering it... Yesterday, a friend who is getting her PhD in psychology told me that when she's done with her PhD, she has the option to do the 1st 2 years of med school and be awarded an MD, and practice as a psychiatrist. That seems strange to me, and my dad (who is an MD) said no way. Has anybody heard of this? Is it true?
Psych question
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there's no way this is true. and practicing psychologists earn PsyD, not PhD if i know this right
Yeah I couldn't believe it either! She said they have to do a ton of clinical experience in psych obviously, so that counts. But an MD without doing any other clinical rotations? Doesn't make any sense at all! I'm curious to see if anyone here knows what she was talking about!
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Yeah, an MD has always been a degree in general medicine; hence the necessity to do a residency afterwards to start practicing in a specialty. I have trouble believing this is true... I've certainly never heard anything like that, anyways.
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They could be mistaken in the years of med school being taken. I know oral max surgeons, have to do years 2 and 3 at our school to get their MD. This is a world of difference as these guys already have a DDS and that's a great deal more clinical in course work than PsyD I'd imagine.
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no
if she's going into clinical psych
she'll get a psyD
theres a big ass difference between clinical psychology and psychiatry
you need to know alot of neuroscience and regardless you'd still need a 3 year residency if anything
if she's going into clinical psych
she'll get a psyD
theres a big ass difference between clinical psychology and psychiatry
you need to know alot of neuroscience and regardless you'd still need a 3 year residency if anything
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Nope, no way. An enormous difference between psychiatry and psychology is the ability to diagnose physical causes that lead to psychological disorders, and also to prescribe medication. There's no way she could do this without having to go through the clinical years of med school and doing a residency on top of that.....all psychiatrists have to do the full four years and then a 3 or 4 year residency so if a psychologist says she can bypass all that then I call BS.
well practicing psychologists can get a phd. and yes, if they complete extensive training, live in certain state(s) (e.g. new mexico, louisiana), live in rural areas with low access to psychiatrists, then they can. also, they have to chill under a doc's supervision for 2 years. so basically...they spend a long time to be able to prescribe drugs, but they end up as "psychiatrists" perse.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1172104/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1172104/
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Visit the Psychiatry thread off of the main page....there are quite a few psychiatry vs. psychology threads. After reading them you will see a clear and distinct difference between the two. IMO I don't think anyone should ever go to a psychologist because there is no way of knowing if there is a physical root cause without running proper medical tests, and only a psychiatrist with med school training can do this.
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No, they don't end up as psychiatrists, no matter where they live. The OP's story is that they end up as MDs. They clearly do not and your link even says so. Having prescribing rights doesn't make one an MD.
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There's not even a bridge between PA to MD so the chances of there being a bridge between PhD to MD... basically null.
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For me, I would go the psychologist route if I just wanted therapy. If I wanted to get an actually diagnosis, then I would go to a psychiatrist.
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Actually, you might want to try it the other way around... the diagnosis part, I mean. I have a Bachelors in Psych, and did the usual Psych clerkship in med school. Psychiatrists first loosely rule out physical causes of mental illness (toxicity, thyroid, etc.), then they manage the illness on the medical model - medications, behavioral modificatoins. Then they just hope for the best. They dont often make a clear diagnosis at all. In fact, if they want a clear diagnosis, they will consult a psychologist. The psychologist will sit with the patient for an hour or more, and come to a diagnosis. Apparently its not always important to have a clear diagnosis. Treat the presumptive diagnosis aggressively. If it gets better... you were probably right. Watch House.
As for the OP... that scenario is impossible.
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I guess what I was trying to say is that, if I had a mental problem, and I though medication would help, I would got to a psychiatrist. But if I wanted to talk through it, I would got to a psychologist. Make sense? I am sure that psychologists are more than qualified to diagnose mental disorders after going to school for 11+ years.
EDIT: By the way, interesting that you mentioned the thyroid. My mom had thyroid problems and was going to psychologist because she thought she just had mental problems. Turned out it was her thyroid. Luckily the psychologist she was going to referred her to a good psychiatrist who spotted the thyroid problem.
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Clinical Psychologists can be PhDs or PsyDs. PhDs are more research-oriented programs and PsyDs are more for clinical practice (to put it very simply).
She is probably referring to a prescribing psychology program. These are basically quick and dirty bridges to prescriptive privileges in several states where psychiatrists are in limited supply. They have about as much if not slightly more autonomy in prescriptive privileges than do NPs but their scope of practice is much more limited (to about 100 drugs, which are all common psych-related drugs).
Yes, clinical psychologists tend to focus on Psych dx and are the experts on psych dx via testing. No other mental health occupation is trained to their level in psychological testing, just as no other health profession is trained to the level of an MD/DO in the use of biochemically-derived medications, surgical operations and related treatments.
She is probably referring to a prescribing psychology program. These are basically quick and dirty bridges to prescriptive privileges in several states where psychiatrists are in limited supply. They have about as much if not slightly more autonomy in prescriptive privileges than do NPs but their scope of practice is much more limited (to about 100 drugs, which are all common psych-related drugs).[/QUOTE]
Yes, this is probably what she meant. She definitely didn't mean internship/residency, because she talked about that as a separate thing that she has to do. She must have been confused because she used the word MD which is obviously incorrect. Thanks everyone for confirming what I thought!
Yes, this is probably what she meant. She definitely didn't mean internship/residency, because she talked about that as a separate thing that she has to do. She must have been confused because she used the word MD which is obviously incorrect. Thanks everyone for confirming what I thought!
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And if the cause of your disorder were biochemical in nature you would never know.
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So then when do you propose that people do go to psychologist?
Also, who said anything about a disorder. People sometimes just feel like talking out their problems. That does not mean that there is anything wrong with them medically.
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I'm a psych resident. There is ABSOLUTELY no way this is true.
She may be able to do 2 years and get a limited license to prescribe some psych meds (some states have worked on legislation allowing things like this, not sure of which ones) but there is no way you could get a medical degree without attending 4 years of med school.
And without a medical degree (MD, DO, MBBS, etc) you aren't a psychiatrist.
bth
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For comprehensive mental health care, you need a clinical psychologist and a psychiatrist working in cooperation. Each is an expert in a different area and their scopes of practice, while having some overlap, are quite different. Clinical psychologists are diagnosticians of mental health and experts in psychological therapies. Psychiatrists are specialists in medication for mental health. Efficacy studies have shown therapy + tapered medications are generally most effective for quite a few different illnesses.
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I get that. I was kind of being sarcastic to the person I quoted, because if I follow their logic correctly there would be no need to go to a psychologist.
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I dont think that the poster's logic entailed that there was never a need to see a psychologist.
I was kinda thinking the same thing, but had decided to let it go.
How can you know if your own mental illness is biochemical in etiology? Ergo, how can you know if you need to see a psychiatrist or a psychologist?
One indicator can be severity - psychosis and suicidality need to be seen by a psychiatrist.
Other than that, Im not too sure myself.
But Im also not sure that you go to a psychologist or a psychiatrist to just talk about your problems. These guys are there to manage mental illness, not existential unrest. At best, they'll give you tips on how to improve your own social support structure with friends and family. Because that's who would help you, so the issue from the psych standpoint is simply that you aren't utilizing your social support effectively. Maybe.
Other than that, if you thought you had a mental illness, I suppose you'd have to go through the usual broken healthcare system and hope you end up in the right place. You'd have to go to the local emergency room - preferably in a hospital with a psychiatry service to avoid being dumped in the corner. Then you'd just let the clinical social worker take it from there.
I was kinda thinking the same thing, but had decided to let it go.
How can you know if your own mental illness is biochemical in etiology? Ergo, how can you know if you need to see a psychiatrist or a psychologist?
One indicator can be severity - psychosis and suicidality need to be seen by a psychiatrist.
Other than that, Im not too sure myself.
But Im also not sure that you go to a psychologist or a psychiatrist to just talk about your problems. These guys are there to manage mental illness, not existential unrest. At best, they'll give you tips on how to improve your own social support structure with friends and family. Because that's who would help you, so the issue from the psych standpoint is simply that you aren't utilizing your social support effectively. Maybe.
Other than that, if you thought you had a mental illness, I suppose you'd have to go through the usual broken healthcare system and hope you end up in the right place. You'd have to go to the local emergency room - preferably in a hospital with a psychiatry service to avoid being dumped in the corner. Then you'd just let the clinical social worker take it from there.
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http://forums.studentdoctor.net/showthread.php?t=653884
I fully stand by my statement...I'm not sure why someone would go to a psychologist when you can get identical treatment from a psychiatrist AND you can also get blood work done and have medical tests done to exclude any physiological root causes.
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Good Points. I did not really think of it that way. I guess from my experience, which is not much I will admit, there seems to be psychologist who work in hospitals, and psychologists who have private practices for therapy. Obviously if one knew for certain that they had no serious mental problems, yet still wanted to go to a psychologist to talk, it would not be prudent to go to a psychologist in a hospital to do so.
So do you think said people should just go to a licensed therapist, aka social worker? In other words, do you think that both clinical psychologists and psychiatrists would be wasting their training by doing simple therapy?
I understand you point of view. I just don't fully agree. I will admit that I don't know everything there is to know about this subject, but it seems to me there is both psychologists and psychiatrists for a reason. Both have a ton of training ( I believe psychologists is 11 years, and we all know how long MDs go to school for).
I was simply saying/thinking that it seems that a psychiatrist would not want to waist their time with Joe Blow who's wife just left him but otherwise is a healthy guy. It seems that their time is better spent diagnosing/treating serious mental disorders.
But like I said, I am no expert.
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Do you have any actual experience working w these patients?
On what basis do you presume their needs as a population?
Have you worked closely with clinical psychologists, psychiatrists, LCSWs, LPCs, and case workers yourself? If so, please enlighten us about a psychiatrist's ability to provide comprehensive dx, about his availability, about the time spent w/ pts, and about the type of training they receive. Now let's hear the same for the other 3 major types of clinical mental health workers (LCPs, LCSWs & LPCs).
A thorough understanding of the mental health system & its gateways would be helpful here. I'd say non-medical personnel should be trained more medically...
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WTF are you talking about?! I presume based off of your pompous response that you do know what you're talking about? For awhile I had considered going into psychiatry and had done a great deal of research including the first hand accounts of the doctors on SDN's thread (very important).....
I can put the food on your plate, but I refuse to feed it to you; go do your own research.
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What does this even mean? If a non-medical personnel is medically trained wouldn't that make them medically trained personnel?
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My aunt is an LCSW. She does private practice therapy for families and teenagers in California. She seems to do well. She often gets patients referred from psychologists and psychiatrists.
Now that I am thinking of it, that might be the way to go if one just wants to talk about their problems. But I don't think all states give the same freedom to LCSWs.
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Yes, I've worked in the field (at a variety of levels and with multiple mental health populations). Your post basically stated a lack of need for different types of mental health workers, which is simply not true. The questions I asked are ones I can answer myself, but I think you should do a little research on each of those professions before you make such sweeping generalizations about patient's needs. Simply put, I responded that way because your comments were, at minimum, completely ignorant if not somewhat offensive to many, many people in the mental health community -- from psychiatrists and psychologists all the way down to your non-degreed mental health techs (and just about everyone in between). A psychiatric resident saying something like that just makes him look like a jerk (and probably one who has never actually stepped outside the hospital to look at the mental health system outside the controlled and well-staffed hospital psych ward), but a premed stating that is just plain ludicrous. You looked at a forum dominated by psych residents and med students considering that specialty. Of course you felt like psychiatry was the only thing necessary. Most of those students live in some sort of idealistic world where their specialty can overcome all wrongs.
The fact is that on the outs that's not the case. It'd be like a cardiothoracic surgeon getting on his soapbox about how EMTs and paramedics aren't really necessary because cardiac patients should just come straight to him in the OR for surgery because he's going to have to see them anyway. For one thing, such a statement is entirely false, as most cardiac patients won't need to see a cardiothoracic surgeon -- to oversimplify, for many, prescribed nitro or similar meds will do. Furthermore, these EMTs and paramedics are performing a necessary service -- providing access (via transport). Caseworkers and FPs (and ER docs) provide much the same service by referring pts into the system.
Furthermore, psychiatrists usually have wait times of 3-9 months and are generally only available in large metro areas. Their training is limited to medical with very little therapy (most of which is usually psychodynamically-grounded, which is one of the least-supported therapy modalities in psychology). Psychiatrists also get such a small amt of time w/ pts (abt 15 min/pt billable) and lack any objective diagnostic tools. While I respect psychiatrists hugely, it is also noteworthy that most other specialties view psychiatrists as the least worthy specialty of being called "medicine" and don't tend to view psychiatrists as having a good understanding of the entire human body.
As far as stronger biomed trng for other (non-medical) clinical mental health workers... by this I mean I think they should be receiving stronger biological training early on. I think the level of training a clinical psychologist receives in human A&P and biopsych is grossly under what it ought to be. I'd like to see maybe 30-50% of their research & stats training replaced with biopsych coursework as I suspect it would help them work together better as a team with other healthcare professionals, but that's just my opinion. (It'd also provide a better basis for psych RxP.)
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Because you don't get identical treatment. Psychologists spend vastly more time studying psychological theory, personality theory, learning and conditioning, motivation, etc etc. They learn more about behavior modification, cognitive behavioral therapy, and that sort of thing. They also spend a whole lot more time training in talking therapy. The end product is, that on top of being better trained in talking therapy, they have a better understanding of normal and abnormal psychology, and so have a better idea of the subconscious and antecedent factors which got the patient to their presentation. And so, they can directly address some of those issues. Double trouble.
Non-medical personnel are trained to do their jobs non-medically because that's that their job is. They focus on the psychosocial issues. Working together with the medical personnel, theres a team approach which is better for the patient. If we treated all psych patients with the medical model, we'd still have asylums.
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Haha, I dare you to post that in the psychiatric forum 😀
Did you even read the thread I had posted? "Psychiatrists (depending on the breadth of their training) can provide exactly the same quality and "depth" of psychotherapy as any other mental health profession."
That statement was given by an Attending, not a resident. And what's more DocSampson is one of the more credible and respected doctors to post on SDN. So if you have any arguments, take it over there.
And on what planet does your cardiologist/emt analogy make any sense? Are you saying that a psychologist should drive people to the psychiatrist? Or is your analogy to state that psychologists offer a more ephemeral service until the person arrives at the doorstep of the real doctor?
If I've hit a tender spot with you then I'm sorry for your delicate sensibility; I was simply stating that I (ME) do not see the need for a psychologist, and still in spite of all your huffing and puffing, I still do not see a need for a psychologist! If someone makes a lucid, compelling argument for a psychologist that does not in any way overlap with the capacities of a psychiatrist then I will be open-minded enough to listen.
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just because there's an overlap doesn't mean there's no need. should MDs start all IVs, administer all meds, etc? be realistic here.
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Apparently abstract thinking and open-mindedness are not your strong suits? If you were open-minded you'd actually have looked around and considered why we might need more than just one type of professional in the field. It is obvious you lack any real-world experience relating to the field of mental health or any desire to understand it. The problem for me with that is two-fold: 1) yes, I am offended for my colleagues that such ignorance is being peddled, but I am even moreso concerned that 2) if you do end up a physician, you might steer patients toward not getting the help they need because of your own uninformed opinions and prejudices. Read a few actual journal articles looking at efficacy of therapy and medication and then consider the types of training each of these people get.
The EMT/MD analogy is primarily one of access. You do not go directly to a mental health professional in most cases. Instead, it is usually by referral from a PCP or CW. They will refer as they see fit. Where I see some add'l biomedical trng being helpful would be in terms of understanding illness well enough to make a more educate guess as to when an MD should be a part of the equation. I also, and more importantly, see this being critical for psychologists having RxP privs as I do not think their 30-unit curriculum is sufficient at this point (and neither do some of the psychologists pursuing it that post here on SDN).
As far as the statement by an attending. I'm not so sure that the fact that an attending said it makes it true (I have heard statements by attendings that were patently false statements about another specialty or profession). Have studies been performed? There is a definite difference in therapy training b/w the professions so, sure, if a psychiatrist rec'd the level of clinical training a psychologist does (4 years UG foundation w/ bx science & some clinical coursework & usually 1 semester clinical internship + 5-6 years clinical trng in grad school + 1 yr/2000-hr internship + 2/3000+-hr year residency), s/he would be on-par w/ the LCP, but the fact is that most psych programs are 4 years long (w/ peds being 6 IIRC) and little (basically no) psych background in med school or UG. They're medical doctors, MDs, not really therapeutically-trained. They have training, sure, but it's minimalistic be design and most psychiatrists don't spend much time w/ pts b/c they can't. Psychiatrists are known for med mgmt for a reason. It's not why you go into it (I don't think), but oftentimes that's where they end up. The psychiatrists I've known in clinical settings have had to handle ~100 pts at just our facility as a single psychiatrist working part-time at our facility as well as several others. (So he was taking 25 kids per 8 hour time period he came in -- so each kid would get 20 min w/ the psych every other wk -- and these were inpatients. If all we had was a psychiatrist, it would have been impossible to run the facility.... Even if more psychiatrists were available, expenses would easily overrun our budget as each pt costs about $5,000/month as it is -- and we are an extremely inexpensive facility b/c most of our nonprofessional staff are far underpaid. A team of psychologists, even, would be completely unfeasible. Instead, we have a psychiatrist, Psych NP, & PsyD who work as a team to supervise the rest of the clinical staff of LCSW therapists and bachelors/masters-level CWs.)
Additionally, a psychiatrist cannot legally give a psych dx as the DSM, while a good guide, is meant simply as a diagnostic guide (or manual). Psychiatrists can give their opinion on a presentation but as they generally do not give neuro exams nor do they give psych tests (they cannot legally administer nor interpret them), they don't really have anything but subjective tools. These tools can, of course, indicate the possibility of such and such an illness but they are still making a very subjective dx. Clinical Psychologists spend a huge amount of time studying statistics and research methods for a reason. Unless you have worked w/ psych pts and their files, etc., it isn't likely you would understand why this is, but suffice it to say psych dx is an extremely difficult and inexact art and science. It is far more abstract than is biomedical dx. As a result, it's quite a bit different of an animal and you want the practitioner in charge of your care to be able to determine the problem whenever possible. Psychiatrists tend to make a subjective, probable dx and then treat it. Probably 70-80% of the time this works but when it doesn't, I have seen missed dx's cause pts HUGE problems down the road b/c the wrong Tx & meds were administered for 5-10 years before the condition actually became life-threatening and pts have ended up in the ER repeatedly b/c their condition excalated. Finally, a psychologist is able to give a correct dx and the person receives appropriate care (indicated therapy & meds).
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hahaha. ftw.
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To the OP: I apologize for the digression from the original topic. I came across this and think that it is what your friend may have been referring to:
http://forums.studentdoctor.net/showthread.php?t=601423&highlight=psychologists
http://forums.studentdoctor.net/showthread.php?t=601423&highlight=psychologists
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You win based off the mere fact that there is no way in hell that i'm going to read all that. So whatever it says, your right...congrats.
I read "Apparently abstract thinking...." and my mind wandered off after that. Go, fight, win, psychologists! (cheer)
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This post, on the other hand, I did read and find it fascinating...not even sure where to begin to pick it apart. Don't psychiatrists go through med school after going through undergraduate school? Yet they understand the human body less....
To all observers/lurkers: this is a disclaimer to notify all purveyors of the preceding messages that the content contained therein is in no way indicative of my typical SDN behavior and/or attitude. I make focused attempts at avoiding any and all arguments and debates.
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This post, on the other hand, I did read and find it fascinating...not even sure where to begin to pick it apart. Don't psychiatrists go through med school after going through undergraduate school? Yet they understand the human body less....
To all observers/lurkers: this is a disclaimer to notify all purveyors of the preceding messages that the content contained therein is in no way indicative of my typical SDN behavior and/or attitude. I make focused attempts at avoiding any and all arguments and debates.
haha. yes, they do go through med school, etc. I think the perception stems from the fact that psychiatrists exam people differently and don't have the same kind of practice and experience in identifying physical ailments. I did not say it is a right perception, just that I have heard it from many a physician.
I am also a little surprised to be in a debate w/ you icalz! lol... I feel like you are usually pretty laid-back on this forum..well, relatively speaking by comparison to many premeds at least!
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👍 Friends 😀
Couldn't find the "hug" smily....wouldn't have used it anyways because I think we're both guys lol.
yay homophobia ftw
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But that's just it, if you're not medically trained how can one suspect there is a medical problem (read that question in a calm, smooth tone...not in an inflamed high pitch scream)? I'm trying hard to find an anecdote from one of the doctors in the psychiatry forums who says he made an appointment with a patient who was supposedly suffering from some psychological disorder. The doc ran a couple of tests and found some type of blockage in the lungs and after the necessary treatments the patient was good to go.
Look, to make myself perfectly clear I am in no way intending to convey the impression that I am being dismissive or am otherwise devaluing mental health practitioners of any acronym, level, or field. Each of these people are helping other people and I give them much respect for that. What I've been trying to say from post #1 is that it seems to me (purely IMO) that I (me, myself and I) would want to get some medical tests done to rule out physiological causes.
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Hah, I'm not touching that one...but not hugging guys isn't homophobic; and why would you read any sexuality into it at all? A masculine man does not have a tendency to go around hugging strange men...that's why we created fist bumps and bro-hugs.
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lol.... by "bro-hug" I assume you mean the same as "man-hug"? (bump-shake, fast one-armed hug) wow.... yeah...good times
Your thing about ruling out medical causes is one reason I'd like to see psychologists receive for biomedical training (just the very basics) -- so that they are familiar enough with the body to better identify when something is outside their scope of practice. At the same time, I've generally known therapists of all levels to be pretty quick to refer out when something is beyond their scope of practice and a pt w/ something in his lung is likely to have some complaints (such as pain) that a competent mental health practitioner would be likely to refer you out for. Nobody treats malingering or conversion d/os w/o first ruling out a medical dx. Realize, too, though, that conversion d/os do exist -- a recent thread on vaccinations crossed into that arena, actually.
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Fair enough...I would be all for increasing/broadening the training for psychologists. It would definitely make sense so that they could refer the patient to some type of specialist in the event that the dx is outside their particular area of expertise.
