Psychiatry

[Dave1980]

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Genuinely curious what others in the medical field think. I've always thoughts it was by far the least "mediciney" field and wonder why it still exists as a field of medicine.

seems like you can throw out almost everything you learn in med school and still be a great psychiatrist

 

[Doctorows]

I suspect this question comes from someone who has very little direct experience with and/or very poor understanding of the field.

seems like you can throw out almost everything you learn in med school and still be a great psychiatrist

I strongly disagree.

 

[GoSpursGo]

Yeah I think this thread is intentionally designed to be provocative or "edgy," but it's a clear no.

You can say this about several fields, like rad onc or pathology or radiology. There are always going to be parts of med school you don't need for your eventual practice. At the same time you wind up being occasionally surprised when a factoid from a field that you thought would never be relevant actually comes up.

 

[Crayola227]

Miss the "do not feed the troll" emoji.

 

[hallowmann]

There's a lot of medicine in psychiatry. Like a lot. Even doing barebones psychiatry medication management requires a good understanding of a number of medical conditions, medication mechanisms/interactions, and screenings. Then throw in fields like Addiction, C-L, neurointerventional, ED consults, sleep med, geriatric psych, etc. and there is quite a bit of real medicine in there.

You can't be a good psychiatrist without medical school. Really it's just psychotherapy that you can do outside of it, and there already is a non-medical school pathway for that, which is arguably better at providing that training.

 

[hamstergang]

seems like you can throw out almost everything you learn in med school and still be a great psychiatrist

Definitely not true. Sure, many patients I treat as a psychiatrist will feel as though they don't require my medical training, but my outpatient caseload certainly requires it. I needed medical school to be able to accurately evaluate the causes of the psychiatric symptoms, understand how my treatments interact with other medical treatments, and assess for adverse effects. To understand studies that investigate the various ways psychiatric medications affect the human body, I need a medical degree (I've recently reviewed articles about QT prolongation and risk for TdP, the underlying mechanisms for serotonin syndrome, proper evaluation of bruising in a patient on an SSRI, and how to use lamotrigine in a patient on an OCP).

When this question came up elsewhere last year, I said:

There are certainly many psychiatrists who act like they're not doctors, but that's just bad practice. As a child psychiatrist, in the past 2 days I've had to address the following:

1) monitoring/working up mild neutropenia in a 9 y.o. girl I prescribed Abilify

2) interpreting the QTc in a patient with severe bradycardia stemming from restrictive eating so I know if Zyprexa is safe

3) determining how the medications I prescribe for anxiety interact with the 13 other medications a patient is on for other conditions

4) monitoring for renal and other adverse effects of Lithium

 

[Ludwig2000]

Dave1980 got offended by a post in a different thread where a consult psychiatrist said “we are magicians in their eyes,” referring to primary medical team. Posted this like 6 minutes later as some kinda revenge I guess

 

[Dave1980]

i saw that thread and wondered how other people thought of psych. it always seemed out of place in medicine to me. guess im in the minority

 

[Neuronix]

You can say this about several fields, like rad onc or pathology or radiology. There are always going to be parts of med school you don't need for your eventual practice. At the same time you wind up being occasionally surprised when a factoid from a field that you thought would never be relevant actually comes up.

Rad onc? Really? You absolutely need to go to med school to be a rad onc.

I deal with general medical issues constantly in my practice.

When a patient comes to see me for cancer but also has another medical issue, I do not punt that to another doctor.

 

[gutonc]

Rad onc? Really? You absolutely need to go to med school to be a rad onc.

I deal with general medical issues constantly in my practice.

When a patient comes to see me for cancer but also has another medical issue, I do not punt that to another doctor.

Are you sure you don't want to come work here? I get people sent upstairs from Rad Onc all the time "to treat their pain" of "they might need to go to the ER, can you evaluate them and find out?".

But seriously OP, solid troll thread.

 

[GoSpursGo]

Rad onc? Really? You absolutely need to go to med school to be a rad onc.

I deal with general medical issues constantly in my practice.

When a patient comes to see me for cancer but also has another medical issue, I do not punt that to another doctor.

OF COURSE you have to go to med school for rad onc, or any of the other specialties I mentioned. That was my point 🙂 I do think it’s fair to say that rad onc is very different from most other fields.

 

[HemeOncHopeful19]

I think OP is confusing "Psychiatry" with "Ortho Surgery" because I swear those guys try to pretend they never attended medical school when they call me do stuff for them.

 

[Apollyon]

I think OP is confusing "Psychiatry" with "Ortho Surgery" because I swear those guys try to pretend they never attended medical school when they call me do stuff for them.

Well what's that adage? "Ortho - taking the smartest students and turning them into the dumbest doctors"

On the flip side, though, if I need Ortho, I want them to be A+ with the ortho. I don't want C- or D internal medicine from them.

 

[robellis]

Genuinely curious what others in the medical field think. I've always thoughts it was by far the least "mediciney" field and wonder why it still exists as a field of medicine.

seems like you can throw out almost everything you learn in med school and still be a great psychiatrist

I definitely think it requires Med school there’s a lot that goes into the field and it’s quite diverse in treatment setting

 

[GoSpursGo]

21-1. That seems clear enough to close the thread.