tatabox80

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hi there,
I'm currently on my final rotation of my 3rd year (psych). Up until this point I was thinking of doing fp. Did anyone here struggle between picking psych over another specialty? If so, what made you ultimately decide on picking psych? Thanks.
 

fiatslug

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tatabox80 said:
hi there,
I'm currently on my final rotation of my 3rd year (psych). Up until this point I was thinking of doing fp. Did anyone here struggle between picking psych over another specialty? If so, what made you ultimately decide on picking psych? Thanks.
I struggled so much b/w FP & psych that I applied--and interviewed--at both programs! There was even a point where I thought I'd rank both programs. FP appealed for so many good, humanistic reasons... but in the end I only ranked psych programs, and I've had no regrets. Lifestyle was the deciding factor: the residency is far more humane (do I miss OB call?... um, no!), and salary potential with psych is just much better than with FP, especially if you do a fellowship. Primary care is a noble and tough calling--you get worked. I still am occasionally wistful that I can't read the finer points of an EKG anymore... but I know for me personally, I would have had soul-crushing regrets had I stayed in FP, primarily around the lifestyle issue.
 

whopper

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I too felt the same. I had an easy solution. By the time I discovered how cool FP could be, it was too late--I hadn't applied into any FP residencies, only psyche!

One frustration I have with psyche although I do not regret my choice is that psyche doctors often forget their medicine--to the point where medstudents know it much better. It can be frustrating. E.g. order a med consult just because the patient coughed once.

If you want to treat the "whole patient", such as have a good relationship with the patient that will last years and involve treating their physical as well as psychiatric problems, and want to treat entire familes, FP may be better for you.

Psychiatry involves specialization in one field. In Psychiatry you will see a lot of negative things you don't see in FP, e.g. in urban settings you get a lot of malingerers, recurrent drug abusers who have no desire to quit their addiction but keep coming to the hospital for free food and housing. If this ticks you off and you can't handle it consider going to FP.

Now I didn't go to FP so I can't tell you the negatives in that field but I can imagine that because several fields are in FP, it can be difficult practicing in so many areas.
 

icebreakers

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I pretty much have been struggling with choosing between FP/meds and psych
. I found that I liked being someone's medical doctor and someone's mental health care provider. however, after more and more experiences...i found that psych allowed me to get much more intimate with people and their experiences and their problems. and with trust, there is no limit as to how much someone will share , and ultimately grow with you. its funny, sometimes stripping naked for aphysical is so much easier than sharing your thoughts, fears, and being honest. I found psychiatry to be the most rewarding for myself because of this aspect and more

i'm going to apply to psych for residency...but i have a question....
I do not want to forget how to treat a cough, or do a workup for pancreatitis when i'm a resident (and maybe even beyond if i'm worknig in a hospital).

any bare bones medicine book out there for non-medical specialists. s
 

OldPsychDoc

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icebreakers said:
I pretty much have been struggling with choosing between FP/meds and psych
...
i'm going to apply to psych for residency...but i have a question....
I do not want to forget how to treat a cough, or do a workup for pancreatitis when i'm a resident (and maybe even beyond if i'm worknig in a hospital).
....
Just keep whatever book gets you through internship--Wash Manual, or Lange's "Current Treatment", whatever.

If you really want to keep up on medicine, do hospital-based psychiatry--eith C/L or inpatient. As an inpatient attending, I'm ALWAYS dealing with minor issues and following up on the consult recs for many of the bigger ones.
 

Yersinia

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I did an internship in FP and now I am in General Practice. I plan to return to a residency and am very carefully thinking about psych. As an FP you do treat the whole patient *ideally* when you have the time and the stamina. I have seen some folks pull it off flawlessly. I unfortunately work a little slow at this, and so I prefer to have 45 min to discuss intimate details vice 15 minutes to squeeze it all in. But that has always been my preference. When doing my ER rotation I made friends with a particular crumudgeon of an attending by making a deal with him, "You take all the MVA's and I'll take all the nuts ;) " after that we got along great. I'd spend 45 minutes with some suicidal teenager and he'd treat & street about 5 patients. In addition if I see someone for their depression or anxiety and then spend 20min with them (in FP clinic) at the end they want to OBTW 3 things :eek: and when I can't fit in their toenail removal, UTI, and HA evaluation they got pissed! :mad: i just want to learn one specialty, know it well and do a good job with my patients.

If you are great at getting through the laundry list that comes in with the average FP patient then God Bless you and go into it b/c I couldn't. :)
 
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tatabox80

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jeff2005 said:
How about a combined FP/Psych residency?
I had considered that option, but I think I may want to go the child psych route if I do psych. One of the frustrating things is that I go to a heavy duty primary care school and this is the first exposure I've really had to psychiatry. I feel that the school has been pumping us full of fp since our first year. I don't feel that I've gotten enough exposure to psych on this rotation to really make a decision at this point. I plan on doing a psych elective in the fall and hopefull that will help.
 

Poety

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Hurricane said:
Then how about triple board?

Fromwhat I"ve heard, and now not just from my mentor, but those in medicinen ADN in psych, its almost impossible to be uptodate on everthing to be a great jack of all trades - if you do the med/psych, you're gonig to do one more than the other since both progress a lot (procedurally etc) if you want to do the fp/psych, you may be big into the psych part.

Its hard to lvoe it all isn't it?

What happened to those old gp days when we coulda just treated any damn thing that walked throught he door with some coca powder and lidocaine :laugh: Hell, I bet we coulda got reimbursed for eucalyptus leave wraps back then.

the more medicine Im doing the more Im burnt out - Im so over the chronic somatazizers, they're wearing me down - my back hurts, my leg hurts, my knee hurts, my ankle hurts. I can handle them ina psych aspect, but addressing EACH OF those complaints is driving me nuts - I'm leavin that to medicine, as fascinating as it is :oops: