Psychiatry vs hospitalist

[Onigiri]

Hello,

Applications are looming around the corner and I narrowed down my selection to the two choices. I enjoyed psych and internal med ward. I hate procedures and I'm quite introverted as a person. Money is not an issue for me, but time to be with family, sleep, lifestyle are high up there. So far, I have really enjoyed the intellectual stimulation from "outpatient" internal med and is the main reason why i came into medicine to be able to consult for family and friends when in need, but weary about the the burn out, stress, night shift, and possibly getting sued for my lack of attention to details. I feel like I might regret not going into something more rigorous later on in life. Psych on the other hand, was always fascinating to me, even in preclinical years. Loved studying the subject. I appreciate the significance of the mind's perspective and it's ties to our quality of life, especially bc I had to battle through my own share of demons.

Any input is appreciated! Thank you.

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[docbsb2015]

Going into a completely unrelated field but it sounds like psych would be a better fit for you.

 

[libertyyne]

are you going to miss the intellectual part of IM or will you be happy with the trade-off for better lifestyle.

 

[Horners]

IM can have a pretty good lifestyle too, but you won’t make as much (which isn’t a problem for you as you said).

The joy(?) of your friends/family consulting you for Med stuff won’t happen when you’re a psychiatrist lol, in fact when I tell some people that I want to do psychiatry, 50% of the time they think I’m talking about psychology lol


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[NITRAS]

I'm a hospitalist, and I work usually 14 on , 14 off, 8-5 with calls till 8pm. I never have to do nights, we don't have swing shift. Money is good enough for me, (I'm not knowledgeable about what psychiatrist make). I do work half the holidays. There are outpatient IM stuff all day long, and you can find as easy a schedule as you are willing to lose salary over.

Hospitalist groups come in a shapes and shades with various schedules. Some, like mine, have very good schedules. Others require nights, swing shift, and tons of admissions and transfers.

Its night a day from psychiatry. . . . so good luck.

 

[y123]

Psych for sure

 

[Angus Avagadro]

Psych. It's becoming more competetive, more money going into mental health and addiction. I never liked the hospitalist model. I realize practices come in many practice models, but my personal experience with the hospitalist model is not good. They don't know their patients as well as their PCP, they dont communicate or send a discharge letter to the PCP. I have seen this with my friends, family, and my University PCP. Psych for sure.

 

[NotYou20]

are you going to miss the intellectual part of IM or will you be happy with the trade-off for better lifestyle.

Psych is far more intellectually stimulating than IM to me. Sounds like it might be for the OP too

 

[Marasmus1]

If life outside of medical field is more important for you then I would quit it before it is too late. Starting from residency it will suck up your life energy whichever field you choose.

 

[nimbus]

If life outside of medical field is more important for you then I would quit it before it is too late. Starting from residency it will suck up your life energy whichever field you choose.

It’s really not that bad. Most people need to work for a living. There are many worse, low paid, mind numbing jobs than being a physician. Most doctors have rich lives outside of work, even when they work a lot.

 

[Merely]

are you going to miss the intellectual part of IM or will you be happy with the trade-off for better lifestyle.

You think IM is more intellectual than psychiatry? Lol...

 

[libertyyne]

You think IM is more intellectual than psychiatry? Lol...

pure medicine wise yes. Plus read OPs post. it is the only positive thing OP said about IM.

 

[sinombre]

100% psychiatry based off of the original post. They make more and work less, which is hard to ignore when comparing two things you have equal interest in. I would have gone into psych if I had any interest in it. The starting salary is very high for the hours they have to work (at least where I grew up and went to med school).

 

[anbuitachi]

actually psychiatry is super chill during residency relatively to other fields, and even better as an attending. IM varies depending on programs, but ive noticed many top IM programs to be pretty decent as well in terms of having a life outside of work. And of course IM attendings afterwards can have a good life. You can find jobs that are regular 40 hr jobs, paying decent money.

 

[Mass Effect]

Psych is your answer. If you miss medicine, there's a subspecialty of psych called consultation/liaison (aka psychosomatic medicine aka medical psychiatry) to do consults to your medicine colleagues. It requires you to hold on to quite a bit of your medicine.

Psych is growing in popularity and there are so many models: general outpatient, integrated care (outpatient, but you do consults for primary care practices), outpatient consult contractors (you form contracts with nursing homes, colleges, etc. where you would do consults for them), general inpatient, inpatient (7 on, 7 off in a psych unit), inpatient consultation-liaison, telepsychiatry (work from your house).

Psych also has a ton of subspecialties -- addiction, child/adolescent, consultation/liaison, reproductive, neuropsych, psych-oncology, forensics, college mental health, etc, etc, etc

The money is crazy depending on where you want to work. Academics is always less, but I routinely get emails with starting pay in the 300K range. I'm not sure where those jobs are located. The ones I'm looking at are in the east and range from 150 - 250/275.

 

[Onigiri]

@Mass Effect, do you see psychiatry being saturated in populated states on the coast and physicians having to turf battle for stable pt population in outpatient especially bc everyone is saying how its blowing up. Although, you did mention the diversity of the field.
Maybe for adolescent and college there will always be a stream flow of new teenagers growing into their mental illnesses.

How much vacation time do psychiatrists have??? Looking on medscape but saw only the data that shows quality of life and happiness outside of work, which was extremely high compared to internal medicine.

What about the midlevels coming in getting more rights in this field? Maybe we can use them to have an easier life?

Lastly, which sub field is most popular right now and why might that be the case?

Lately, I have been leaning towards psychiatry for my own sanity and the value of time. (sadly, money will help me get more time)

 

[Mass Effect]

@Mass Effect, do you see psychiatry being saturated in populated states on the coast and physicians having to turf battle for stable pt population in outpatient especially bc everyone is saying how its blowing up. Although, you did mention the diversity of the field.
Maybe for adolescent and college there will always be a stream flow of new teenagers growing into their mental illnesses.

How much vacation time do psychiatrists have??? Looking on medscape but saw only the data that shows quality of life and happiness outside of work, which was extremely high compared to internal medicine.

What about the midlevels coming in getting more rights in this field? Maybe we can use them to have an easier life?

Lastly, which sub field is most popular right now and why might that be the case?

Lately, I have been leaning towards psychiatry for my own sanity and the value of time. (sadly, money will help me get more time)

There will always be psych patients to care for, no matter where you are. Yes, some areas are more saturated than others, but even those areas (ahem, northeast) are in need. The area of psych most popular right now I think is addiction for obvious reasons, but all of psych is popular at the moment. The more nuanced niches aren't a thing everywhere, but could be for someone with the right experience and ability to market him/herself.

In terms of reproductive psych, there will always be pregnant women with a hx of bipolar disorder needing someone to dose their lithium during pregnancy and monitor for psychosis after childbirth. There will always be women with postpartum depression or postpartum psychosis. There will always be women with PMDD. There will always be women in menopause with mood fluctuations.

In neuropsych, there will always be people with psych manifestations of strokes, TBIs, developmental delays, autism, dementia, etc.

In geriatric psych, same as neuropsych in terms of dementia. Also, all those people diagnosed with first break in college mental health eventually grow up and age. A regimen that worked for an 18 year old may not work for an 80 year old.

In psych onc, there will always be people with psych issues due to GBM or CNS lymphoma or just plain adjusting to being sick and receiving chemo or end-of-life and palliative issues.

Child and adolescent and forensics speaks for itself.