Psychiatry vs dermatology and neurosciences

[Matt Alex]

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Hello,

Graduated recently from med school, I always thought I wanted to do psychiatry, especially for my love of neurosciences (especially lab neurosciences, not clinical), cognitive psychology and social& cultural psychiatry (i did cultural anthropology before starting medicine).

Although i really like psychopharmacology and the chemistry beyond the drugs utilized in psy, I didn't enjoy my psy rotations, while I really like the visual study and procedures of dermatology.

Further I don't like the lack of procedure in psychiatry, and I especially fear to not use (and lose) my medical knowledge in doing psy residency.

For some aspects I'd prefer dermatology, but i fear I'd really miss all the neuroecience thing.

In particular, I like lab neurosciences, the arising of consciousness, neurons properties, and so on..

What should I choose (if I will match both, of course)? Is there any possibility to do research in fundamental neuroscience being a dermatologist?

Thanks for the help

 

[allantois]

I don't wanna loose my medical knowledge.

- applies to derm.

On a serious note, I'd argue psych has more interface with general medicine, especially neurology. But ultimately if you did not like your rotations, it maybe is not a good fit (although outpatient vs inpatient settings often have very different patients). You can always be an armchair intellectual in any field, however, I do not think lab neuroscience even deals with arising of consciousness.. You will certainly have a better bet doing research in neurosciences as a psychiatrist than a dermatologist

 

[Celexa]

If you didn't like your psych rotations, hard to find any way to recommend psychiatry to you.

Why not neurology itself? The residency is rough but the physical/visual exam is key, there are even procedures (LP, EMG, botox for migraine). I've met plenty of happy neuro attendings, for all that the residents are miserable at my instituion.

 

[FlowRate]

Do you intend to have a research career? How certain are you of this? There are lots of people who start interested in research and ultimately decide the academic rat race isn't for them. Sounds like you're more interested in derm clinically. If you're intending to have a mostly clinical career, I'd gravitate toward whatever you like most from that standpoint. Also, ask any dermatologist and they'll tell you they still get a lot of psych, although sounds like that might not be what you'd like to hear given it's some of the more difficult to treat/lower insight clinical stuff.

 

[comp1]

If you just graduated and didn't match, what you are doing this year before residency? Also, can you clarify what you didn't like about your psych rotations? What type of rotations were they? Definitely second that you're more likely to lose contact with general "medical knowledge" in derm. A lot of psych settings, particularly inpatient but definitely some outpatient, will involve heavy use of such knowledge. Procedures, we can't help you with. Thankfully (for me), psychiatry has very few procedures. You've got TMS and ECT, neither of which are really conceptually similar to what derm does.

 

[Matt Alex]

First of all thank you all for the replies.

1) about my rotation and exam in psychiatry, during COVID they didn't let us do almost anything, just giving some dumb questionnaires to patients to help residents in their research, and assisting some very short consultations.

For the rest i didn't see any diagnosis, no experience in addiction (field that I like) or anything else. Probably I should state that I don't have a good idea of what the job of a psychiatrist is, differently from other rotations where this was clearer.

The exam was very boring,no etiology, no psychopathology, just memorizing DSM- lists. But this means also that there is a lot of potential in psychiatry since we still know little about the causes and processes.

2) That said, i really like talking with patients, and I love both psychotharapies and psychopharmacology deeply.

Probably it's right saying that clinically I prefer dermatology, but I fear I'd regret that choice and miss too many things that psychiatry could give me (psychology and psychotherapies, neurosciences research, philosophy of mind, cultural psychiatry, all things that interest me a lot. Yes I'm aware that for example in neurosciences you need a PhD and I'd be happy to, after residency, but I see it has much more sense from Psy than dermatology)

 

[allantois]

Do you want to talk to patient for a few mins, look at their skin and perform biopsies all day? Or do you want to sit and have conversations with patients for 30-90 mins at a time? Or do you want to work in a lab? All these activities seem very different to me. I understand you didn't have a good psych rotation, but psych patients present in all fields of medicine, and I am sure you have had exposure in other rotations. I mean if you are that unsure, I would maybe just pick internal medicine where you can do a little bit of everything.

 

[Matt Alex]

For sure I would never do IM, I've found it extremely boring.

Yes I love long talks with patients, but I'd be happy also in the lab.

 

[medhead1990]

P

For sure I would never do IM, I've found it extremely boring.

Yes I love long talks with patients, but I'd be happy also in the lab.

psych with intention of doing pain?

 

[J ROD]

Neurologist

 

[painballer27]

P

psych with intention of doing pain?

Why do you say this?

 

[dl2dp2]

Neuroscience is a fun subject, but making it a career is an incredibly harsh life. I don't think you truly appreciate what it's like. It's about being paid $50k as a postdoc for 10 years with no job in sight, then applying for grants that get funded 10% of the time 3x/year for the rest of your life and getting paid 100k a year, if you are lucky enough to get them. I would discount this facet entirely out of your career planning, especially if you don't have a PhD and have no full awareness of this track.

Clinical psychiatry would expose you a larger part of the type of subjects you are interested in, and can incorporate many more of these wishy-washy humanities-oriented interests "cultural psychiatry", etc. This is definitely not possible with derm. Derm however gives you procedures and instant gratification, which is rare in psych.

 

[clausewitz2]

Neuroscience is a fun subject, but making it a career is an incredibly harsh life. I don't think you truly appreciate what it's like. It's about being paid $50k as a postdoc for 10 years with no job in sight, then applying for grants that get funded 10% of the time 3x/year for the rest of your life and getting paid 100k a year, if you are lucky enough to get them. I would discount this facet entirely out of your career planning, especially if you don't have a PhD and have no full awareness of this track.

Clinical psychiatry would expose you a larger part of the type of subjects you are interested in, and can incorporate many more of these wishy-washy humanities-oriented interests "cultural psychiatry", etc. This is definitely not possible with derm. Derm however gives you procedures and instant gratification, which is rare in
psych.

OP, philosophy of psychiatry is a recognized subdiscipline of philosophy of medicine with its own journals and everything. Meaning no disrespect, dermatology is literally skindeep. I know which seems to suit your intellectual interests better.

 

[gyngyn]

This thread can be followed here: Dermatology vs Psychiatry and neurosciences