I think it comes down to what you want to do as a career. I've written at length about this topic (and I am too lazy to do a search to find it
), but I'll share my synopsis here.
I considered med school as a backup, but then I realized it really didn't fit my overall career goals. In the end I wanted to be a bit more diversified, and short of an MD/Ph.D....I wouldn't have been able to pull it off. In the end a psychiatrist is a physician first, and a Ph.D./ Psy.D. is a scholar-practitioner. My heart is in the scholarly work, not in medicine. I believe in medicine, but I wouldn't want to do it every day. Academically I think it would have been really interesting and challenging, but on a practical level I thought I'd get more out of a scholarly training that clinical psych provides.
I enjoy the philosophical side of psychology, though I really like where psychology is going. The focus is moving towards biological factors working in conjunction with psychological factors....which I think is where pathology resides. I like the research integration, and the grounding in theory. I think medicine is too quick to look for the biological cause, and discounting psychological pathology....though I think they too are realizing that these two areas are converging (in cause...not so much in work).
I think psychology offers a great deal of opportunity, and I think I could best use my skills in that arena. Though my earning potential is higher as a psychiatrist (at least in a clinical setting), the work wasn't what I wanted. With the changes in healthcare and managed care dilution of services, I'm a bit concerned with the role of the psychiatrist moving forward. There will always be a spot for psychiatry (there is already more demand than there is supply), but it seems to really be in meds management and supervisory. It seems that there are more people getting involved with pharma research, which is an area of great need. Of course, clinical psychology is seeing supervisor roles being more prevalent than actual clinician positions, and services are being discounted and going to the lowest bidder.
The issue of RxP is also something I've kept an eye on. I think it adds more depth to clinical psych, but more in the vein of being a sub-specialty like neuro or forensics. I don't think it will ever take off nationwide. Overall I think it can be helpful, and NOT a threat the psychiatry because of the few numbers.
-t
