Psychology vs medicine (help)

[MustIReallyThough]

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Hi all! I'm a junior psych major who really has no idea which path would be best for me after my degree. The other threads on this have been immensely helpful (thanks everyone for that) but I'm still very undecided. I feel split in 3 directions. I think research is interesting (so PhD) but I mainly want to provide comprehensive, expert therapy to SMI populations (so masters in counseling or SW). BUT I don't want to limit my job options to just therapy (what if I hate it?). So PhD. BUT since I have more of a clinical career in mind why don't I just go to med school and gun for psychiatry. Mostly clinical, might can still dabble in therapy one day in PP, and I think I could hack the early science and doctor stuff. But a gamble getting into a psych residency and I might not can hack the doctor stuff.

See what I mean? Since I'm so undecided I plan to work as an EMT for awhile after grad and maybe get involved in some psych research plus much volunteering. Do you guys think that'll help? Not sure what else to do. I'm hoping to connect with both psychs and MDs in the future and see how they decided.

I just want to be the best clinician/practitioner possible I guess. Psychology has been my lifelong dream job but I'm not sure if it fits my goals. Is a PhD for therapy truly overkill as I've read?

Thanks for reading!!!

 

[parametric]

If you want to work clinically with SMI populations, a PhD isn’t overkill at all. Of the clinicians I’ve worked with who have had mostly or fully clinical positions in treating SMI, nearly all have had doctoral degrees in Psychology. IMO you need the higher level of expertise for working with folks w/SMI - they deserve the very best, most competent, evidence-based, treatment. As a generalization, Masters level programs will not adequately prepare you for this type of specialized work or give you the background to develop the skills you need. Check out the ABCT PASS special interest group for a description of how clinical psychologists can play a vital role in working with people with psychosis and other SMI: Welcome | Schizophrenia and Other Serious Mental Disorders Special Interest Group | Nebraska

 

[parametric]

That said, the best way to figure out what you want to do is to try different things - so I encourage you to get involved in research, volunteer, work as an EMT, etc. to see what you really love! It’s typical for people to take a couple years (usually 1-3) post-bacc to get experience before applying to clinical psych PhD programs.

 

[summerbabe]

Glad you're thinking about all this stuff as a junior and not a postgrad.

BUT since I have more of a clinical career in mind why don't I just go to med school and gun for psychiatry. Mostly clinical, might can still dabble in therapy one day in PP, and I think I could hack the early science and doctor stuff.

From a practical perspective, how far along as you in your premed sequence and how are your grades? Are you a good standardized test taker and think you can do well on the MCATs?

I think research is interesting (so PhD) but I mainly want to provide comprehensive, expert therapy to SMI populations (so masters in counseling or SW). BUT I don't want to limit my job options to just therapy (what if I hate it?). So PhD.

Have you worked in a psychology research lab yet? Experience and ideally, poster or journal publications are often a pre-req for getting into a reputable and funded PhD/PsyD program.

Practically speaking, there aren't a ton of people who get to do a split in research/teaching and clinical work. And if they do, it's more likely that they have a small fraction of their time allotted to research. More likely, if you come to dislike therapy or get burned out but still want to use your degree, you could try to move into an administrative role.

As for SMI, a doctorate is very beneficial because a strong background in differential diagnosis, experience with assessment and knowledge of evidence-based treatments is often needed. The Master's level folks in these setting tend to provide social work services (e.g., court commitment, discharge planning, etc) and their clinical work can be more limited to providing general group therapies (e.g., coping skills).

You'll also almost certainly not be in private practice due to the psychosocial and socioeconomic challenges that this population often experiences. Instead, you'll probably work in hospital settings such as acute inpatient units (where patients turn up with unclear histories and unclear diagnoses, hence the need for assessment), state hospitals that provide short, intermediate or long-term care, first episode psychosis treatment centers that's usually part of a well-known AMC or in outpatient community mental health settings.

 

[MustIReallyThough]

If you want to work clinically with SMI populations, a PhD isn’t overkill at all. Of the clinicians I’ve worked with who have had mostly or fully clinical positions in treating SMI, nearly all have had doctoral degrees in Psychology. IMO you need the higher level of expertise for working with folks w/SMI - they deserve the very best, most competent, evidence-based, treatment. As a generalization, Masters level programs will not adequately prepare you for this type of specialized work or give you the background to develop the skills you need. Check out the ABCT PASS special interest group for a description of how clinical psychologists can play a vital role in working with people with psychosis and other SMI: Welcome | Schizophrenia and Other Serious Mental Disorders Special Interest Group | Nebraska

Excellent! This is exactly what I was looking for. I suppose my view might change once I'm out in the field, but the range of options would be great as well as top quality treatment. I guess I just need to know if I can hack the research!

Do you think psychiatry would be a better fit if I wanted to work with SMI? I came across this thread below, which somewhat argued that point. It was also where I got the idea that an MD would lead to a more clinically satisfying career. However, I can definitely see a bit of bias and am curious what people think over here on the psychology forum. I'm still not sure its the type of work I'd want to be doing (med checks etc.).

 

[MustIReallyThough]

Excellent! This is exactly what I was looking for. I suppose my view might change once I'm out in the field, but the range of options would be great as well as top quality treatment. I guess I just need to know if I can hack the research!

Do you think psychiatry would be a better fit if I wanted to work with SMI? I came across this thread below, which somewhat argued that point. It was also where I got the idea that an MD would lead to a more clinically satisfying career. However, I can definitely see a bit of bias and am curious what people think over here on the psychology forum. I'm still not sure its the type of work I'd want to be doing (med checks etc.).

Clinical Psychology or Psychiatry?

Hello! Currently, I am an undergraduate student on a pre-med path. I am majoring in psychology and neuroscience. For me, intelligence is not a problem. I don't mean to come across as egotistical, but I am extremely smart. I have never failed a class (or an exam). The last time I got a B on a...

forums.studentdoctor.net

 

[MustIReallyThough]

That said, the best way to figure out what you want to do is to try different things - so I encourage you to get involved in research, volunteer, work as an EMT, etc. to see what you really love! It’s typical for people to take a couple years (usually 1-3) post-bacc to get experience before applying to clinical psych PhD programs.

Will do! That's exactly what I had in mind and I'm glad that's the accepted path. Hoping emt will still be looked at favorably if I go psych.

 

[MustIReallyThough]

Glad you're thinking about all this stuff as a junior and not a postgrad.


From a practical perspective, how far along as you in your premed sequence and how are your grades? Are you a good standardized test taker and think you can do well on the MCATs?


Have you worked in a psychology research lab yet? Experience and ideally, poster or journal publications are often a pre-req for getting into a reputable and funded PhD/PsyD program.

Practically speaking, there aren't a ton of people who get to do a split in research/teaching and clinical work. And if they do, it's more likely that they have a small fraction of their time allotted to research. More likely, if you come to dislike therapy or get burned out but still want to use your degree, you could try to move into an administrative role.

As for SMI, a doctorate is very beneficial because a strong background in differential diagnosis, experience with assessment and knowledge of evidence-based treatments is often needed. The Master's level folks in these setting tend to provide social work services (e.g., court commitment, discharge planning, etc) and their clinical work can be more limited to providing general group therapies (e.g., coping skills).

You'll also almost certainly not be in private practice due to the psychosocial and socioeconomic challenges that this population often experiences. Instead, you'll probably work in hospital settings such as acute inpatient units (where patients turn up with unclear histories and unclear diagnoses, hence the need for assessment), state hospitals that provide short, intermediate or long-term care, first episode psychosis treatment centers that's usually part of a well-known AMC or in outpatient community mental health settings.

I'm expecting a cGPA of 3.4 ish on graduation, which isn't really optimal I know. I'm hoping my sGPA would negate that a bit. I have A's in bio and I'll see if I can squeeze in chem as an elective. I would have to go the post bacc program route for all other prerequisites or a DIY community college route so I'll just have to 4.0 all the science stuff and hope that will be enough for both GPA's. I think I can swing that, along with a decent MCAT if I push myself. Tests are the best part of college hah, its exciting.

Sadly, I have not worked in research yet. I was gunning for a social work degree and MSW (as in, they'll take your body if its warm) until I realized I MUCH preferred the science in psych and biology. I think I'll take the 1-3 years recommended above to both iron out my head as well as experience as much research as possible. If I do end up wanting to go to med school it'll only help me land a residency right?

Ah ok so I'm thinking more of a hospital position or CMH. I'd be cool with that. Maybe even admin though I'm less sure about that. Is it even realistic to shoot for that kind of stuff? I imagine there's huge competition for those jobs and I'm a bit worried I wouldn't find one, as opposed to psychiatry where they're having shortages.

 

[summerbabe]

I imagine there's huge competition for those jobs

Generally speaking, no. There may be some jobs at academic medical centers that are more competitive but this is difficult work (think acutely psychotic patients often with active substance abuse, individuals who have become institutionalized due to lack of effective treatments, etc), the pay can be subpar for the degree (especially in state hospital and CMH settings), you may be required to work during non-business hours, and burnout can be high. This work can be super rewarding but it's generally not anybody's choice if they are looking for something comfortable and high paying.

 

[MustIReallyThough]

Generally speaking, no. There may be some jobs at academic medical centers that are more competitive but this is difficult work (think acutely psychotic patients often with active substance abuse, individuals who have become institutionalized due to lack of effective treatments, etc), the pay can be subpar for the degree (especially in state hospital and CMH settings), you may be required to work during non-business hours, and burnout can be high. This work can be super rewarding but it's generally not anybody's choice if they are looking for something comfortable and high paying.

Oh boy, yes that makes sense. Well, I suppose it would be foolish to think that's the job I'd want to do for the rest of my life but I do want have the opportunity to give it my best shot. I've heard about the CMH woes but I figured the hospital jobs at least would be high paying if not comfortable. So where do psychologists want to end up if not in a hospital? I've heard about the VA. Academic positions seems scarce and there doesn't seem to be much left besides PP?

 

[dcpsychdoc]

Oh boy, yes that makes sense. Well, I suppose it would be foolish to think that's the job I'd want to do for the rest of my life but I do want have the opportunity to give it my best shot. I've heard about the CMH woes but I figured the hospital jobs at least would be high paying if not comfortable. So where do psychologists want to end up if not in a hospital? I've heard about the VA. Academic positions seems scarce and there doesn't seem to be much left besides PP?

Folks have already made some very good points. And, things like pay are often location, organization, and position dependent. It is possible to make a comfortable living doing this work. I agree with other posters that it is challenging and rewarding work. Good luck to you as you figure this out! Maybe our paths will cross in the future.