Psychology vs medicine (help)

[MustIReallyThough]

Med school is a lot of moderately difficult material. Imagine intro chem, now imagine taking that ten times per semester. Not super hard but there's a lot of it. Matching in paych is kind of hit or miss, honestly, but who knows whether it'll be more or less competitive in a few years

Sounds like a challenge honestly. I'm sure it would abuse me more than I'm thinking of course, but I do like a challenge. Any particular thoughts or advice? Also, do you think you'd have been happier as a psychologist?

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[Merovinge]

what excites you so much about it?

Being there at the beginning of SMI is both more intellectually interesting with differential diagnosis as well as working with the patient as they experience these intense symptoms. There is also a real opportunity to educate pt/family, engage family, use fresh medications, share in human disease in an empathic and healing manner as well as the possibility to improve someone's life trajectory dramatically. This is actually one of the reasons I think adult psychiatrists really like college mental health.

 

[nowaysanjose]

Being there at the beginning of SMI is both more intellectually interesting with differential diagnosis as well as working with the patient as they experience these intense symptoms. There is also a real opportunity to educate pt/family, engage family, use fresh medications, share in human disease in an empathic and healing manner as well as the possibility to improve someone's life trajectory dramatically. This is actually one of the reasons I think adult psychiatrists really like college mental health.

Was actually wondering about this as a viable career path—do you end up just writing stimulants all day and dealing with substance use, or is there legit a lot of FEP?

 

[Merovinge]

Was actually wondering about this as a viable career path—do you end up just writing stimulants all day and dealing with substance use, or is there legit a lot of FEP?

Not the right person to ask but I gather there is plenty of column A (although this type of SA is more interesting then 20 years of coc/heroin/etoh), plenty of FEP/bipolar, undertreated depression/anxiety/trauma from childhood years. The work demands are also generally pretty low (although so are the salary's), but it's probably a good range of psychopathology so I can see the appeal.

 

[parametric]

As far as research goes, I can read it but have no interest in conducting it really.

This alone would make me say med school > psychology PhD, in your case. Research will be a major aspect of any reputable psychology program, and the majority of applicants will have a few years of research experience (pretty much a requirement to get in to most funded programs these days.)

 

[MustIReallyThough]

This alone would make me say med school > psychology PhD, in your case. Research will be a major aspect of any reputable psychology program, and the majority of applicants will have a few years of research experience (pretty much a requirement to get in to most funded programs these days.)

Not enough to just wanna help people eh? Which may not be enough for medicine either I've read, but it's probably way more in line.

I think that's one of the main reasons I'm leaning med school. It might would surprise me, but honestly I know I'm not gonna be publishing breakthrough papers. Nor do I see that being an enjoyable part of a career post grad (even if they were). I really just wanna work with patients and be the best clinician possible. I'm also currently looking into working as an emt rather than a paid RA, which would make the experience needed for grad school harder to gain. That being said, I will look into volunteer opportunities in research to make sure I'm not talking out my ass. Thanks for chiming in!

 

[AcronymAllergy]

Not enough to just wanna help people eh? Which may not be enough for medicine either I've read, but it's probably way more in line.

I think that's one of the main reasons I'm leaning med school. It might would surprise me, but honestly I know I'm not gonna be publishing breakthrough papers. Nor do I see that being an enjoyable part of a career post grad (even if they were). I really just wanna work with patients and be the best clinician possible. I'm also currently looking into working as an emt rather than a paid RA, which would make the experience needed for grad school harder to gain. That being said, I will look into volunteer opportunities in research to make sure I'm not talking out my ass. Thanks for chiming in!

Very, very few people (even career researchers) publish "breakthrough papers." Most research work, and most science in general, is just iterative baby steps on past work. Some of it is very good, some of it is crap, but it's almost all baby steps. My most-cited paper has just north of 60 citations, and most of the rest are in the single-digits. I'm no career researcher, but I suspect that's pretty common.

However, I'd say not to count research out until you've had the chance to participate (in a meaningful way) in conducting it. There are a fair number of people who get to the stage of starting a graduate program thinking they hate research only to find out they really enjoy it once they're actually leading it themselves.

All that being said, if your career goal is a relatively straightforward path to strong pay for a "standard" clinical job, psychiatry is a better bet than psychology.

 

[MustIReallyThough]

Very, very few people (even career researchers) publish "breakthrough papers." Most research work, and most science in general, is just iterative baby steps on past work. Some of it is very good, some of it is crap, but it's almost all baby steps. My most-cited paper has just north of 60 citations, and most of the rest are in the single-digits. I'm no career researcher, but I suspect that's pretty common.

However, I'd say not to count research out until you've had the chance to participate (in a meaningful way) in conducting it. There are a fair number of people who get to the stage of starting a graduate program thinking they hate research only to find out they really enjoy it once they're actually leading it themselves.

All that being said, if your career goal is a relatively straightforward path to strong pay for a "standard" clinical job, psychiatry is a better bet than psychology.

Can you expand on that? I'm assuming you're noting the pay increase and job market in medicine. I'm also not completely sure I understand the role of a generalist psychologist in typical clinical practice (hospitals? etc.) since it always seems to vary so much. Do you think these jobs are hard to come by? Excluding the VA which seems to be a consistent employer.

Also, I'll definitely keep what you've said about research in mind. I do want to experience it to be sure of my decisions. As it stands I'd much rather see a patient than do meta analysis and such but who knows! Thank you very much for your time.

 

[AcronymAllergy]

Can you expand on that? I'm assuming you're noting the pay increase and job market in medicine. I'm also not completely sure I understand the role of a generalist psychologist in typical clinical practice (hospitals? etc.) since it always seems to vary so much. Do you think these jobs are hard to come by? Excluding the VA which seems to be a consistent employer.

Also, I'll definitely keep what you've said about research in mind. I do want to experience it to be sure of my decisions. As it stands I'd much rather see a patient than do meta analysis and such but who knows! Thank you very much for your time.

Pretty much this, yes. If you want to walk straight into a salaried, "9-to-5," 100% clinical job, psychiatry is going to have more options and offer better pay. There may be more responsibilities relating to call, but I imagine that can vary by employer and job type. And of course everyone in this forum can tell you more about this work than I can.

As for what a generalist psychologist does in typical clinical practice, in many/most settings, it's going to be a lot of psychotherapy combined perhaps with some psychological assessment. It can vary depending on what service the psychologist is embedded in and what services the hospital itself has available, although then you're moving away from generalist practice--for example, in addition to psychotherapy (e.g., CBT for chronic pain in a pain team, adjustment-related psychotherapies in an oncology clinic or medical inpatient unit, targeted intakes and brief interventions in primary care mental health, etc.), the psychologist may perform pre-surgical evals for organ transplants, living donors, or spinal cord stimulators.

The psychologist may also have some research involvement (more likely in AMCs or VAs with an affiliated MIRECC), participation in training, and/or program evaluation as a part of their duties.

I wouldn't say generalist jobs are hard to come by, but in many systems, they seem to be increasingly offered to masters-level therapists.

 

[MustIReallyThough]

Pretty much this, yes. If you want to walk straight into a salaried, "9-to-5," 100% clinical job, psychiatry is going to have more options and offer better pay. There may be more responsibilities relating to call, but I imagine that can vary by employer and job type. And of course everyone in this forum can tell you more about this work than I can.

As for what a generalist psychologist does in typical clinical practice, in many/most settings, it's going to be a lot of psychotherapy combined perhaps with some psychological assessment. It can vary depending on what service the psychologist is embedded in and what services the hospital itself has available, although then you're moving away from generalist practice--for example, in addition to psychotherapy (e.g., CBT for chronic pain in a pain team, adjustment-related psychotherapies in an oncology clinic or medical inpatient unit, targeted intakes and brief interventions in primary care mental health, etc.), the psychologist may perform pre-surgical evals for organ transplants, living donors, or spinal cord stimulators.

The psychologist may also have some research involvement (more likely in AMCs or VAs with an affiliated MIRECC), participation in training, and/or program evaluation as a part of their duties.

I wouldn't say generalist jobs are hard to come by, but in many systems, they seem to be increasingly offered to masters-level therapists.

Very informative, I believe I've been exhausted of questions for now. Mid level creep was what I was referencing when I spoke of job availability, but I suppose I shouldn't be worried about that. I'd probably want to specialize anyway for the flexibility. I would be content as long as there remained some non-competitive jobs that involved clinical practice and therapy.

I suppose it all hinges on how I feel about research. If I can't hang the choice seems to be rather clear.

Also, I'm curious about your own journey to neuropsychology (how it happened, how you felt about research as an undergrad/new grad student). If you or anyone else reading this in either field would like to share their story I'd love to hear it.

 

[AcronymAllergy]

Very informative, I believe I've been exhausted of questions for now. Mid level creep was what I was referencing when I spoke of job availability, but I suppose I shouldn't be worried about that. I'd probably want to specialize anyway for the flexibility. I would be content as long as there remained some non-competitive jobs that involved clinical practice and therapy.

I suppose it all hinges on how I feel about research. If I can't hang the choice seems to be rather clear.

Also, I'm curious about your own journey to neuropsychology (how it happened, how you felt about research as an undergrad/new grad student). If you or anyone else reading this in either field would like to share their story I'd love to hear it.

Yes, there's definitely mid-level creep for generalist psychotherapy positions. Some people will still pay for a well-trained therapist (mid-level or doctoral) and/or a psychologist specifically, but that may require establishing a treatment niche, local networking, and an adequate supply of financially-stable patients.

As for my journey, I'll try to keep it brief so I don't highjack a psychiatry thread with non-psychiatry info. I largely stumbled into neuropsychology by dumb luck based on the advisor whose lab I applied to (although I knew I was interested in what he did); it worked out well, as it's much more in line with my interests than many other areas of clinical psychology. I had a couple years' worth of research experience in undergrad that I enjoyed; I had no plans of becoming an academic and/or a career researcher, but I was open to participating and being productive while in school, and I've stayed involved to various degrees since finishing my training.

You don't need to want to be a research superstar, but you do need at least some desire to produce and consume it. If not, much like if someone wanted to be a psychiatrist but had no desire to learn medicine, you'd be pretty miserable for perhaps the better part of a decade.