Psychiatry Residency As a Pathway to Research In Neuroscience

[cyneuron]

Hello there

I recently had started a thread titled " Various Pathways After MD To Pursue Translational Research in Neurology " in Neurology forum. (you don't need to go through this thread to follow this discussion)

It was quite a good discussion with several valuable advice relating to the topic.

One thing came up which was new to me (& possibly new to many people) was the view of Psychiatry residency as a pathway to research in Neuroscience.
some noteworthy lines were:
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Though neurology is historically the specialty that has been concerned with brain-behavior relationships, this is largely due to the fact that neurologists are the ones who have had access to people with focal brain damage who manifested interesting behavioral deficits. Now that the lesion method has largely fallen out of favor due to the emergence of functional brain imaging, neurology no longer has a special relationship to cognitive neuroscience research. Neurology research now is largely concerned with things like inflammation and cell death. It's sort of like internal medicine for the brain. In other words, clinically, it doesn't matter where the lesion is or what interesting behvioral deficit it produces, your neurologist will still give you aspirin and Plavix. Some neurologists will be versed in and even do research on localization of brain function, but (sadly) this is a dying breed. Psychiatry, on the other hand, is all about how the brain gives rise to the mind. Granted, in the past there was relatively little known about the brain bases of mental illnesses, but this is changing very fast. There is an immense quantity of functional brain imaging research going on in psychiatry departments these days, much more than in neurology departments (and the NIH sees this type of research as more relevant to solving problems like drug addiction and schizophrenia than problems like stroke and epilepsy)


The other great thing about psychiatry is that you actually can have time to do research, since it is one of the less demanding specialties in terms of clinical commitments and call. Also, the last year of psychiatry residency is mostly elective, which gives you some time to spend in the lab.

also, of note is that there is a separate category of Research Fellwship in Neuroscience after psychiatry residency, with quite promising opportunities. interested people may have a detailed look here : Research Training Opportunities In Psychiatry
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Not much discussion took place further on these lines in the Neurology forum.

It will great to hear the point of view of many residents & fellows of the Psychiatry forum on this. Will really help lot of people looking forward to a career in Neuroscience.

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[cyneuron]

anyone....?

 

[whopper]

Psychiatry, on the other hand, is all about how the brain gives rise to the mind. Granted, in the past there was relatively little known about the brain bases of mental illnesses, but this is changing very fast.

Psychiatry is the treatment of mental illness through a medical model. That is different from trying to understand how the brain gives rise to the mind.

Yes there are things we psychiatrists can offer in the understanding of neuroscience, but its not quite a metaphysically interesting as you put it.

I have on several occasions on my own used my training to try to see if I could come up with a better understanding of the mind-brain connection. While I am more versed than the layman, and can come up with more insights, no I still do not claim to understand it.

To answer your question, you can do what you mentioned, though the route is extremely unorthodox. One of the greatest neuroscientists of all time--Eric Kandel is a psychiatrist by training.

Since psychiatry is extremely unorthodox, I suggest you go to a program that recognizes your desire to pursue neuroscience. I'd suggest a research heavy institution with the equipment to handle your needs.

 

[cleareyedguy]

Psychiatry, on the other hand, is all about how the brain gives rise to the mind. Granted, in the past there was relatively little known about the brain bases of mental illnesses, but this is changing very fast. There is an immense quantity of functional brain imaging research going on in psychiatry departments these days, much more than in neurology departments (and the NIH sees this type of research as more relevant to solving problems like drug addiction and schizophrenia than problems like stroke and epilepsy)
.

If you are going to attack imaging, the brain, and the mind, you should look hard for programs that combine neuroimaging facilities, allied basic scientists, and strong psychiatric clinicians/psychoanalysts/philosophers; the former two groups are present--to my mind--in only about a dozen psych departments in the U.S., and the latter group has become extinct in many of those dozen departments; the former two are expensive and obvious, but, to my mind, without the latter group of clinically-oriented thinkers, you won't be helped into asking the right theoretical questions. And I think that's why the strongest MD/PhD applicants cluster in a half dozen places around the country.

Having said that, if you have a specific mentor, imaging access, and tenacity, you can get great training at any of 30 places around the country.

 

[worriedwell]

You would be very welcome and maybe even pampered in a number of the most prominent psychiatry departments in the country (and that would probably be the best place to look with your interests). You actually might even have leverage to try to carve out a specialized residency scenario in one of these programs if you are a compelling enough candidate but at the very least, there are research tracks at most of them.

Look for the ones with a lot of NIH dollars.

I generally agree with the sentiment that psychiatry is the place to be for interesting neuroscience research (and we need more people like you interested in it).

I think the poster that you quoted is right on. But of course, keep in mind that you have to do the residency in psychiatry which involves a few years of the "clinical work of a psychiatrist" which in general, has very little interface with neuroscience other than thinking about practical psychopharm. So you have to be able to "handle" that.

 

[strangeglove]

If the NIMH Outstanding Resident Program (http://intramural.nimh.nih.gov/orap/home.do) is any guide, there is a very strong interest in developing psychiatrists who are well-versed in the connection between mind and brain. They are pouring a lot of money into this stuff, and it's not just going to a few departments. Any department that has a functioning fMRI scanner is doing this kind of research. That would be probably more than 50% of all academic (i.e. university-affiliated) departments, by my estimate. The whole psychoanalyst/philosopher nexus is not a requirement for this kind of research, since most of the cognitive neuroscience work, especially that on emotion, memory, executive function and the like, is more directly relevant to questions like: How does CBT work? What are the brain-based endophenotypes that predict response to an SSRI? What are the neural correlates of cognitive deficits in schizophrenia and how are these affected by cognitive enhancers? There is a rarified breed of researcher who is interested in the neural mechanisms of unconscious conflict, countertransference and the like, but this is indeed rare.

And regarding Whopper's point: Psychiatry is indeed the treatment of illness through the medical model. However, understanding how the brain gives rise to the mind can only help in the development of more effective medical treatments for psychiatric illnesses. So, psychiatry and the study of the mind-brain connection are intimately intertwined. And, yes, even the study of funky things like consciousness, that get philosophers all excited, is important for the mission of psychiatry (no less so, in my opinion, than the study of the expression of serotonin receptors).

 

[johnny9]

As strangeglove mentioned, there are several areas of research into neuroscience and it is very very much a current and future theme of psychiatry.

One program is the programme on Affective Neuroscience in Maastricht (NL). At other major european centres, Cambridge, IoP in London, etc., there is huge research into psychopharmacology and brain development.

Neuroscience is basically the future of psychiatry, so I would advise focussing on psychopharmacology, brain development and neuroscience as a combination of targets for which residency you want to pursue. Certainly, it is the direction on this side of the atlantic at major institutions, e.g., Kyriakopoulos on schizophrenia development. Things will move towards DTI and fMRI as standard for research and more advanced drug development, and much much earlier detection and use of treatments developed from those.