Jack Napier

7+ Year Member
Mar 30, 2010
49
5
151
Status
Attending Physician
Trying to decide between Psychiatry and Internal Med.

I prefer long-term patient relationships, slower pace atmosphere, and cerebral thinking vs. mechanical skill.

Has anybody else debated the two? How did you decide? What questions are appropriate to ask myself?

Appreciate it!
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,218
3,778
281
57
Left of Center
Status
Attending Physician
Trying to decide between Psychiatry and Internal Med.

I prefer long-term patient relationships, slower pace atmosphere, and cerebral thinking vs. mechanical skill.

Has anybody else debated the two? How did you decide? What questions are appropriate to ask myself?

Appreciate it!
Many of us have. All of your preferences are definitely present in psych.

Main question you need to answer is whether you really like the idea of working with mental illness and a lot of psychosocial problem-solving as a primary focus. As you'll see in the other threads here, there's generally more than enough "real medicine" in psych to keep that appetite sated, particularly if you work in an inpatient context.

The thing that "tipped me over" to psych was seeing the power of our interventions early in adulthood to save life-years, vs. perceiving much of outpatient primary care medicine as tweaking treatment of chronic illnesses such as diabetes & HTN with considerably less life impact.

Also: lifestyle of 3rd year IM resident vs lifestyle of senior psych resident.
 

Sneezing

Even Bears do it!
10+ Year Member
Jan 27, 2009
598
8
41
Above Center
Status
Resident [Any Field]
Psychiatry is glorious. I strongly debated the two. Now, I'm starting to laugh at myself for even having a debate!

Look within yourself. You will find the answer. Ask yourself what could you see yourself doing years from now? Which journal articles do you like to read? You will have to stay up to date (otherwise, one of your colleagues might try to suggest you can be replaced by psychologists or some new fancy degree). What are the things that drew you to the two fields? Can it sustain you for 30+ years?

Both fields you can still have free autonomous practices by going cash only and getting out of the system. Both have the potiential to develop long term continuity with patients. Both have the same income potential (in the system). Both have great job prospects currently. Both will crapped on to some degree by other specialties (all do really). Both can make those big impact moments where patients will thank you for changing/saving their lives. Both have patients you just can't really help. You can wet you appetite of the other specialty while practing the opposite one.

Don't choose one over the other because of money. Maobama isn't done yet, and things are going to be getting far worse for everyone.