Psychiatry: What Medical School?

[Maeloryne]

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Hey guys! I'm fairly new to this website (I just made my account an hour ago) so I'm not sure if this is in the right place..

I just was curious to know if aspiring psychiatrists should go to any specific med schools and if the DO/MD title really matters?

Any feedback is appreciated - Thank you!

 

[vistaril]

it's extremely important. BCBS just released a new reimbursement guide, and I'm getting dinged 15% on my 99214s because I picked one med school over another. The good news is Im getting 18% more for my 99213s than I would if I had gone to a DO school, and 23% more than an SGU or Ross grad.

 

[OldPsychDoc]

it's extremely important. BCBS just released a new reimbursement guide, and I'm getting dinged 15% on my 99214s because I picked one med school over another. The good news is Im getting 18% more for my 99213s than I would if I had gone to a DO school, and 23% more than an SGU or Ross grad.

This is either bald-faced B.S. or the person that negotiated your contracts with BCBS is a *****.

 

[splik]

This is either bald-faced B.S. or the person that negotiated your contracts with BCBS is a *****.

i think this was vistaril's way of saying it doesn't really matter in the end

 

[vistaril]

i think this was vistaril's way of saying it doesn't really matter in the end

c'mon it's never better when it's explained🙂

 

[OldPsychDoc]

c'mon it's never better when it's explained🙂

It's not nice to tease the pre-meds, now.

 

[vistaril]

I guess so...I just wonder how many of those types of questions from people with less than 5 posts are just longtime users under another handle looking to troll/start a flame war. The classic being "should I do psychiatry or psychology".

 

[OldPsychDoc]

I guess so...I just wonder how many of those types of questions from people with less than 5 posts are just longtime users under another handle looking to troll/start a flame war. The classic being "should I do psychiatry or psychology".

C'mon. give them the benefit of the doubt. We usually do with you.

 

[hamstergang]

I don't think the school really makes any significant difference.

I guess so...I just wonder how many of those types of questions from people with less than 5 posts are just longtime users under another handle looking to troll/start a flame war. The classic being "should I do psychiatry or psychology".

Why would you think this is the case? Seems a touch paranoid.

 

[wolfvgang22]

We were all newbies once. (Except for me, I'm a perpetual newbie)

 

[Armadillos]

In all seriousness, just go wherever you can get an MD for the cheapest (so long as its in the USA). Fwiw, in my opinion this advice wouldn't be any different if you wanted to be a neurosurgeon.

 

[heroesjourney]

I'm also curious about this. I'm really gunning for an in-state allopathic school because of the low cost and I can stay around my friends and family. That being said, I don't want to burn bridges for great residency training if I'm still set on psych in the future. So would a relatively low profile med school be a deal breaker at a competitive program with a competitive but not insanely high STEP 1 score?

 

[Mad Jack]

US MD>US DO>Don't bother with anything else.

You can definitely do psych as either, but MD opens up certain doors DO doesn't.

 

[MacDonaldTriad]

US MD>US DO>Don't bother with anything else.

You can definitely do psych as either, but MD opens up certain doors DO doesn't.

This /\, and don’t be too rapped up into upper tier vs. lower tier allopathic schools. Everyone knows the best students at the low end schools are ten times better than the so-so students at the best schools. Medical school is hard enough to shine competitively even at the so called worst schools.

 

[notdeadyet]

I'm really gunning for an in-state allopathic school because of the low cost and I can stay around my friends and family. That being said, I don't want to burn bridges for great residency training if I'm still set on psych in the future. So would a relatively low profile med school be a deal breaker at a competitive program with a competitive but not insanely high STEP 1 score?

I would agree with MacDonaldTriad and Mad Jack to a point.

For allopathic medical schools, the middle 80% are all pretty interchangeable. I'd avoid the bottom 10% medical schools if I could and I'd give good consideration to attending a top 10% school due to the fact that it might kick open doors and has alumni potential. But for the vast majority of us that end up at the middle 80%, the difference between one and the other is going to be largely personal. If you're looking at a so-so allopathic state school and comparing it to a good but not top 10 medical school, I would definitely go with price and support of family and friends.

Happy medical students perform better in medical school, and performing better in medical school will definitely help you more than going from one pretty good medical school vs. a good medical school. I might take the hit in happiness at Harvard, but that was neeeeeeever in my cards...

 

[whopper]

I might get flack for saying this and if I'm wrong please correct me.

While I was a medstudent at an MD program (foreign medschool but rotations in the US), several of my friends and colleagues that were DOs were able to do their rotations in hospitals with psych units without an attached residency program. MD programs required they be attached to a residency program.

If this is still going on, I would have to say that this puts MD programs in a better position. Let's make this clear. I've said this several times, I do not believe that DOs should be considered lesser vs MDs. I do not like the elitism that pervades several aspects of medicine.

It's pretty much obvious why being in a rotation that's attached to a formal residency program would be better. There'd be an organized didactic/lecture schedule, residents can teach medstudents, and shadowing an attending is usually the student not doing anything other than watching someone do their work with little if any interaction.

I just talked to a DO student a few days ago and he told me that this policy hasn't changed. My immediate response was that if there was anything I could do to get DOs at his program to rotate where I'm at I'd like to do something to help out because I didn't think their current situation was up-to-par.

Several DO programs are already in a situation where they are in schools in the midwest where's there's already a serious shortage of psychiatrists making it even harder to get one willing to teach students.

If there's any MD programs that do not have students rotate in a hospital without an attached residency let me know because my current understanding is there has to be a residency.

 

[clusterF]

You know, the older I get, the more I realize it is all relative. You could be 4H member, that is to say harvard for undergrad/med school/residency/fellowship and still lose skills over time even if you are in an academic setting. I've seen it happen more than a few times. I've also seen IMGs excel. I feel like I have learned more each year after residency that in the whole 8 years of med school and residency. I have also seen people just decline in horrible horrible ways.

Generally I have found that as physicians age, they get into a groove and eventually that groove becomes so deep that they have a hard time getting outside of it. Over time, they lose touch with modern medicine. It is one of the few things that make me think that this whole MOC may be a good thing. As much as I don't like the idea of recerting every 10 years, I am starting to see the value.

 

[MacDonaldTriad]

I see your point about the MOC thing, yet I don’t think that the good intentions of it are being practically implemented. It has something like a +98% pass rate and the hoops required to take the test are a pain and can be done such that they add little to the filtering process. I get the tight situation the ABPN is in telling senior psychiatrists that they just are not cutting it after a full life of practice, but checking a few boxes saying you did lifelong practice improvement and then managing to stay out of the bottom 2% in a knowledge test isn’t going to do much. Maybe it should be more like the DMV. You can renew on an on line with an on line test and just to catch the cheaters, we randomly make them test at testing centers. Poor performances are required to remediation courses and retesting. As doctors get into their 70s or 80s, the requirement for live testing gets more frequent. Just my thoughts on how to make this more effective. As it stands, people who see the current system as a way of just milking $2K out of us have a point.

 

[WillburCobb]

I might get flack for saying this and if I'm wrong please correct me.

While I was a medstudent at an MD program (foreign medschool but rotations in the US), several of my friends and colleagues that were DOs were able to do their rotations in hospitals with psych units without an attached residency program. MD programs required they be attached to a residency program.

If this is still going on, I would have to say that this puts MD programs in a better position. Let's make this clear. I've said this several times, I do not believe that DOs should be considered lesser vs MDs. I do not like the elitism that pervades several aspects of medicine.

It's pretty much obvious why being in a rotation that's attached to a formal residency program would be better. There'd be an organized didactic/lecture schedule, residents can teach medstudents, and shadowing an attending is usually the student not doing anything other than watching someone do their work with little if any interaction.

I just talked to a DO student a few days ago and he told me that this policy hasn't changed. My immediate response was that if there was anything I could do to get DOs at his program to rotate where I'm at I'd like to do something to help out because I didn't think their current situation was up-to-par.

Several DO programs are already in a situation where they are in schools in the midwest where's there's already a serious shortage of psychiatrists making it even harder to get one willing to teach students.

If there's any MD programs that do not have students rotate in a hospital without an attached residency let me know because my current understanding is there has to be a residency.

My school (US MD) has a psych residency, but 3rd and 4th year are divided between 4 campuses. Only students who do their 3rd and 4th on the campus where the psych residency is located will actually rotate with psych residents.

 

[whopper]

Attendings could make up for lack of residents if that attending has a strong passion for teaching. Often, unfortunately, is the situation where the medical student simply just follows the doctor, zones out, and doesn't actively participate in interactions, while the doc doesn't say much if anything.

A residency program has an active didactics schedule with classes, grand rounds, and on-site supervision in inpatient.
Some of the DOs I was with in the post I mentioned pretty much had no classes and their attending did miniscule poo-pooing such as telling the medical student to watch the movie Awakenings without much of anything else. Not surprising, the IM program in that hospital wanted that psychiatrist to do more teaching of the IM residents in psych issues and she refused. Kind of transparent she didn't want to teach.

Any place can have bad doctors but when you're in a situation where there's just one doctor to follow, it's very hit or miss. If you have several docs to work with it's like investing with a diversified portfolio where all your eggs are not in one basket.

 

[myPsychAlt]

I might get flack for saying this and if I'm wrong please correct me.

While I was a medstudent at an MD program (foreign medschool but rotations in the US), several of my friends and colleagues that were DOs were able to do their rotations in hospitals with psych units without an attached residency program. MD programs required they be attached to a residency program.

If this is still going on, I would have to say that this puts MD programs in a better position. Let's make this clear. I've said this several times, I do not believe that DOs should be considered lesser vs MDs. I do not like the elitism that pervades several aspects of medicine.

It's pretty much obvious why being in a rotation that's attached to a formal residency program would be better. There'd be an organized didactic/lecture schedule, residents can teach medstudents, and shadowing an attending is usually the student not doing anything other than watching someone do their work with little if any interaction.

I just talked to a DO student a few days ago and he told me that this policy hasn't changed. My immediate response was that if there was anything I could do to get DOs at his program to rotate where I'm at I'd like to do something to help out because I didn't think their current situation was up-to-par.

Several DO programs are already in a situation where they are in schools in the midwest where's there's already a serious shortage of psychiatrists making it even harder to get one willing to teach students.

If there's any MD programs that do not have students rotate in a hospital without an attached residency let me know because my current understanding is there has to be a residency.

I'm not sure what some of the rotations in satellite campuses like UIC Rockford,Michigan State Marquette etc, do. But yeah, DO schools tend to have a bad tendency to just stick their students wherever.

I just sat through a candidate review for next year's PGY1 class, and it's interesting how many new schools are out there now. I have doubts that someone coming out of the first graduating class of (for example) Oakland Beaumont is going to be any way deficient.

If you want a really really rough hierarchy for where you should go assuming you don't get any big scholarships..
1. Your state public MD school $$$$
2. OOS or Private MD school
3. DO school (public over private if you live in Michigan or Oklahoma)
4. Reapply next year
5. Carib.

 

[whopper]

As I've said before, I don't consider DOs in a worse category. This one thing, however, is something that is a sore spot that would lead me to say the DO curriculum could be worse than the MD curriculum. I do not say that with disdain against DOs. For all I know there's some MD programs doing the same but I'm under the current and possibly erroneous impression that MD core rotations must be attached to residencies. I'd also gladly help a DO get into a rotation attached to a residency if I could. While I'm currently at SLU I can't simply waive a want to let a student in. They have to go through bureaucracy that is out of my control.

 

[st2205]

As I've said before, I don't consider DOs in a worse category. This one thing, however, is something that is a sore spot that would lead me to say the DO curriculum could be worse than the MD curriculum. I do not say that with disdain against DOs. For all I know there's some MD programs doing the same but I'm under the current and possibly erroneous impression that MD core rotations must be attached to residencies. I'd also gladly help a DO get into a rotation attached to a residency if I could. While I'm currently at SLU I can't simply waive a want to let a student in. They have to go through bureaucracy that is out of my control.

They don't have to be. The medical school here has a number of clinical campuses. Only the students here rotate with us.

 

[Nasrudin]

I agree with NDY's analysis: if you have the opportunity to go to a school that is both a powerhouse in psych and a top med school in general, then you should do it. Then play that game again if you have a local preference. For instance UC Davis is known to Californians. People who train there might know other people in the state who they went to school with or trained with etc. I don't know if UC Davis is better or worse than Northwestern U. (I'm just picking these schools randomly). But I feel confident saying it's better to go to UCD if you're goal is to stay in California. This local game is only superseded by a significant performance difference, as has been discussed, or by going to one of the top schools in the country.