Psychiatrist vs. Psychologist

[Dash]

Hey all,

I'm trying to figure out which career path is best given what I want to do in the future. I'm very interested in working with others with anxiety and mood disorders so I want to specialize in that probably. I also have a great interest in neuroscience, pharmacology, etc. as well. I want to do research, work with patients and possible teach as well eventually. So would med school and a psychiatry/ psychopharm path be better or a Ph.D. in psychology?? I want to be able to have the greatest amount of options but also don't want to be stuck in a role as a "pill pusher" and not be able to provide therapy and do research in my areas of interest. Any suggestions or advice??

Dash

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[CoffeeCat]

All right, I'm going to take a crack at your question since no one else has tried. Wise med students, please feel free to correct me.

When talking about psychology, you really have to draw a distinction between clinical and research psychology.

Clinical psychology is generally a masters program which licenses you to conduct therapy. So you do see patients but you are allowed to write few, if any perscriptions. From my understanding, clinical psychologists are currently fighting for the right to write perscriptions. Also, I believe they generally do not conduct research. Clinical psychology is also very difficult to get into, nearly as hard as med school.

Research psychology is are PhD programs with many concentrations - social psych, industrial psych, neuropsych/biopsych, etc. After this program you might go into industry but it sounds like you'd want to be a professor. So in this case, you would teach, advise grad students, and conduct research. No seeing patients.

A psychiatrist would have gone to MD school and chosen psychiatry for a residency. Psychiatrists see patients but generally write perscriptions instead of therapy, they can also be professors, and conduct research. In this case you might be stuck with the "pill pusher" stereotype, however, I think psychiatrists can also do therapy.

From my understanding since you're interested in research, patients and teaching, I would go the MD path. From there, you can go anywhere.

Good luck 🙂 .

 

[Winged Scapula]

Since you offered...I'll disagree with you slightly Coffeecat.

At least in the state of California, it is illegal to call one's self a Psychologist without the TERMINAL degree - either a PhD or PsyD. This doesn't mean that you can't counsel or conduct therapy sessions, something frequently done by people with an LCSW, MSW or Master's in Clinical Psychology. Clinical Psychologists or therapists (ie, those without the terminal degree) can and do conduct research, depending on their academic environment - ie, easier to do if employed by a hospital or university.

Psychiatrists as well often do counseling and are no simply pill pushers. However, given the relative cost of hiring an MD Psychiatrist compared with a master's degree trained counselor, many HMOS will send patients to the non-physician and only require them to see the Psychiatrist for certain diagnoses or for med refills (ie, once every couple of months or so). Most psychiatrists conduct group and private counseling sessions and many are research oriented as well - again, depends on the individual's interests and academic environment/resources.

Given the increasing ability to prescribe medications by non-medically trained personnel, you might wish to ask yourself how important is that ability? Frankly, if I KNEW I wanted to do mostly counseling, I'd advise people to go the Psychology route - you spend a great deal more of your time doing training in clinical skills and less time doing basic science, which will important to know, doesn't often affect the skills needed for the daily practice of a counselor/Psychologist.

Just my two cents...

 

[halothane]

I checked up, clinical Psychologists are PhDs. They do non pham therapy. May soon do pham too, and why not they have 5-8 years training in Psych. prescribing Psych. med is not too tough, when CRNAS can try to replace MDA with just 2-3 years of training after undergrad for something as crucial as anesth. where a small mistake in the OR can be catastrophic. Basically Clinical Psychologists have a more profound understanding of the theories and psychology of the mind ( and they are not paraprofessionals), whereas psychs typically are pill pushers. In my whole life i have never seen a Psych. MD spend more than a half hour with the patient. Its the clinical Psychs. who do the talk work. A masters cannot entitle one to become a therapist....you can kinda become a counselor ( with a MSW) but not have all the therapy priviliges of a PHD.

 

[Sanman]

Well I'm a psych major, so I'll take a stab at this. Clinical psych's are usually PhD's. They essentially have the same ability as psychiatrists, except that they can't prescribe drugs. Though, this may change in the future.A masters in psych allows you to be a clinical psych assistant or therapist. They can cousel, but don't have autonomy and generally work for PhD psych's. A PhD in clinical psych can do research or clinical. A psyD can only do clinical psych. A PhD can specialize in health,neuro,educational,sports, etc. psych. they do just about everything that a pychiatrist is able to do and can overlap w/ neurologists too ( neuropsych's evaluate brain function in patients w/ traumatic brain injury). Personally, I want to be a neurologist, but am considering neuro psych PhD as a back up if I don't get into med school. The question is whether you want to specialize in something that requires meds, or a pysch specialty that I mentioned that may not.

 

[cchoukal]

As a former doctoral student in counseling psych, let me throw in my two cents. Who can be called a "psychologist" varies from state to state, but is often limited to those who not only have PhD's or PsyD's but who are liscensed w/in the state. Licensure often requires 1-2 years of supervised clinical work BEYOND the typical 1 year required internship as part of the doctoral work. "Therapists," and "counselors" can be licensured with certain masters degress.

Counseling psych is a little different from clinical psych in that it focuses less on hard-core psychopathology and more on counseling emotional problems and vocational issues. Many clinical programs also focus a lot on testing and evaluation of psychological, developmental, and neuropsychological problems.

PsyD's are often considered to be substandard in that no research is required to obtain one and that admissions standards are thought to be less rigorous at PsyD schools. These private schools often churn out dozens of students a year in comparison to academic PhD programs that graduate 2-4. Can you tell where my bias lies?

Anyway, when I applied in the mid-90s, clinical and counseling psych programs were actually harder to get into than med school in terms of applicants per opening. Some schools had hundreds of applicants for 2-3 spots.

Clinical and counseling psychologists will probably get limited prescription privelages w/in 10 years, if that's your concern. At the same time, I've worked in a few psychiatric settings and I've noticed 2 things: I've never seen the head of the treatment team be anyone but the psychiatrist, for better or worse; and I've never seen a psychiatrist do counseling that wasn't cash-and-carry.

 

[Anasazi23]

I checked up, clinical Psychologists are PhDs. They do non pham therapy. May soon do pham too, and why not they have 5-8 years training in Psych. prescribing Psych. med is not too tough,

😱
.....until they kill someone for not recognizing their induced neuroleptic malignant syndrome, cause a fatal arrhythmia for not understanding the P450 system or cause someone a permanent disability from serotonin syndrome.

.....for the love of God

 

[kristing]

In AZ, you can have a PhD in Educational psychology and be called a psychologist. (It's one of the few states that you can do this.)

And you can go to DO school, too (osteopathic med school) to become a psychiatrist, not just MD medical school. (Just wanted to clarify that a bit!)

👍

kristin

 

[Arginine]

I have a master's degree in social work (MSW) and I have been licensed for 7 years (LCSW). During most of my social work career, I was mainly a psychotherapist (providing individual, group, and couples therapy). While I was in graduate school at U.C. Berkeley, I was required to complete a research project. It is possible to see patients, do research, and teach with a master's degree in social work. Currently we do not have the power to prescribe medication. In California, you can also get a master's degree in counseling psychology; when you obtain your license, you become a marriage & family therapist (MFT). With this type of degree, there is more emphasis on psychotherapy and very little emphasis on research. With a PhD in Clinical Psychology, you can see patients, conduct psychological testing, do research, and teach. Many years ago, there was a program at UCSF that conferred the equivalent of a PhD in Clinical Psychology with the power to prescribe medication, but that program no longer exists. Another option would be to go into psychiatric nursing: many psychiatric nurses work in hospitals, but I know of some who have private psychotherapy practices, prescribe meds,teach, and conduct research. Finally, psychiatrists as a group do tend to prescribe medication more than they conduct longterm psychotherapy; however, if you choose psychiatry, you can look for a residency that emphasizes clinical training and build up a practice in which you conduct psychotherapy in addition to prescribing meds. If you are very interested in pharmacology and neuroscience, it might be more fulfilling to pursue the MD/DO.

 

[Sheon]

Wow, pscychologist perscibing medications. I am not ususally the elitist type, but of all medications psychotropic drugs are by far the most commonly involved in adverse drug reactions.

With the complexity of these drugs and the number of them that patients will frequently have to take, I can't see a psychologist being able to perscribe them. They interact with so many drugs, and the dosages and titrations are complex (to say the least). Even the safest of psych drugs (SSRIs) have serious drug interactions to worry about. Spooky stuff. 😱

 

[Methyldopa]

clinical Psychologists are PhDs. They do non pham therapy. May soon do pham too, and why not they have 5-8 years training in Psych. prescribing Psych. med is not too tough

5 years of training in Psychology does in no way equate to 8+ years of Psychiatry. Psychologist are not in any way trained to know anything about medicine. It's like letting a layman prescribe drugs.


Psychologist prescribing drugs=bad news for patients

And in my state, psychologist can now give out meds!!!!!