Pyschiatry vs Neurology

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Fireboy

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Pyschiatry vs Neurology

Hi guys,

I’m currently a M2, and my interests are lean towards both psychiatry and neurology. I was hoping for input as to how these two fields compare, in terms of the different types of satisfaction that they offer and their pros/cons relative to each other. Additionally, details as to how these two fields differ in their practice models post-residency would be very helpful.

Thanks so much for any input!

(note: I’ve cross-posted this in the Neurology forum)

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Pyschiatry vs Neurology

Hi guys,

I’m currently a M2, and my interests are lean towards both psychiatry and neurology. I was hoping for input as to how these two fields compare, in terms of the different types of satisfaction that they offer and their pros/cons relative to each other. Additionally, details as to how these two fields differ in their practice models post-residency would be very helpful.

Thanks so much for any input!

(note: I’ve cross-posted this in the Neurology forum)

My answer to this eternal question is in the third post of this thread.

Good luck with your decision--but CHOOSE PSYCH!😀
 
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There are more differences than similarities between psychiatry and neurology. They both share the fact that they are about the nervous system. In the strictly clinical sense, neurology deals with the nervous system as a tissue. It is concerned with the mechanisms by which damage occurs in the brain, without real interest in where that damage occurs or what functional consequences that damage has. You may think that neurologists are masters of "where's the lesion?" and they are, but they don't really use this information to help their patients. Basically, you can be an excellent neurologist without knowing anything about functional neuroanatomy. As I've said elsewhere, neurology is basically internal medicine for the brain. Psychiatry, on the other hand, is deeply concerned with the mind and how it arises from brain processes. Historically, so little was known about the brain that it was treated largely as a black box as far as mental illnesses such as schizophrenia or drug addiction are concerned. This is why most psychiatrists today, especially the older guard, are pretty clueless about neuroscience. However, the last 20 years have brought an explosion of neuroscience research that is directly relevant to treatment of these diseases.

The other issue relates to what you like to do day-to-day. Are you into doing physical exams and looking at MRIs, or are you more interested in talking to people and understanding how they feel and why? This is an important point, since even though many psychiatrists are certainly interested in brain anatomy and function (some even have PhDs in neuroscience) and many neurologists are interested in behavior and cognition, few psychiatrists really spend a lot of time doing neurological exams and few neurologists really want to hear about their patients' childhoods for more than 2 minutes. There are certainly exceptions, but I'm saying this to illustrate a point about where clinicians tend to derive satisfaction from their work.

Finally, there is this idea that psychiatry is not really medicine while neurology is. Many medical students grapple with as they choose their future specialty. You spend 3 years learning all of this great stuff about physiology, anatomy, biochemistry, physical exams, etc., and then you get to your psychiatry rotation and find that you are really interested in why your psychotic patient thinks that the government is controlling his thoughts with lasers, or how her childhood sexual abuse contributes to her borderline personality disorder. Then you start to think, Why did I go through all of this medical school stuff just to go into a specialty that my parents wouldn't even consider medicine?

My advice would be: Don't avoid psychiatry just because you are concerned about the "doctorliness" of this specialty. Do what you love. Of course, if you really love doing physical exams and are fascinated by mechanisms of stroke, epilepsy, dementias, and headache, then neurology would be a good specialty for you. Definitely don't go into psychiatry if you aren't interested in listening to your patient's "personal" problems, or tend to zone out when the discussion in rounds comes around to where your homeless patients will go after they get discharged from the hospital. Psychiatry is not just about biological disorders of the brain, but also how people with these disorders fit into a social fabric. However, don't go into neurology thinking that it is the only specialty that will allow you to indulge your fascination with the mind/brain. That may have been the case 50 years ago. These days, it's the psychiatrists who are trying to figure out how specific neural systems are involved in complex cognitive functions, while the neurologists are busy trying to figure out the best way to lower your cholesterol or cure your headache or keep the plaques and tangles (wherever they may reside) from spreading. I'm generalizing, of course, but you get the picture.

Anyway, good luck and I wish you luck in making your decision. Also, OldPsychDoc's post in that other thread is very helpful.
 
Do a DUAL RESIDENCY you'll have so many options! Psychiatry is turning so medical, Dual units are great places to work, or just having both degrees is wonderful. You'll also know more after you do both rotations. It's early yet for you!
 
Pyschiatry vs Neurology

Hi guys,

I'm currently a M2, and my interests are lean towards both psychiatry and neurology. I was hoping for input as to how these two fields compare, in terms of the different types of satisfaction that they offer and their pros/cons relative to each other. Additionally, details as to how these two fields differ in their practice models post-residency would be very helpful.

Thanks so much for any input!

(note: I've cross-posted this in the Neurology forum)


Briefly-

Go for Psych if you have a pleasant personality, are confident, like to learn by discussing, and hate to cram things.

Go to Neurology if you like to be by yourself and read a lot, are good at cramming tracts / pathways and are ready to do two years of Internship-one of Prelim, one of Neurology.

Both are good - I chose Psych. You will discover by your self.

All the best.
 
Depends on one's point of view, really...😎

You mean that you don't use Jedi mind control to read your patients' thoughts and change their behaviors? 🙄

MBK2003
 
I prefer to rely on the electrical energy waves that I channel through my hands*. :meanie:

(*every M-W-F AM at 0730 in the PACU.)

Dude, does that come with passing Part II of the boards or something? I'm kind of upset I finished adult training without this handy skill. Come on, OPD, 'fess up, did you buy this through the Osler Board Review Course for $995? :laugh:
 
Dude, does that come with passing Part II of the boards or something? I'm kind of upset I finished adult training without this handy skill. Come on, OPD, 'fess up, did you buy this through the Osler Board Review Course for $995? :laugh:

You want this, don't you?
The hate is swelling in you now.
Take your Jedi weapon. Use it. I am unarmed.
Strike me down with it. Give in to your anger.
With each passing moment you make yourself more my servant.




(Actually, I just did an ECT elective in PGY4, and had my first month on staff here supervised so my Sith Lord could sign off on the hospital credentialling. )
 
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You know, since the OP said he was going to post on both the psych and neuro boards, I went to the neuro boards to see what they said over there.

And, hark! No replies!

If THAT doesn't demonstrate the difference between the specialties, I don't know what does 😀

I'm on a neuro elective right now, and while I really respect the folks I'm working with, I've had tons of politely uncomfortable moments when I say I'm planning on doing child psych, especially from the neuro residents. They feel, somehow, infiltrated! Given that like 2% of the m4 class takes a neuro elective, they only have students every few months, and I'm overall just one big enigma for them.
 
You know, since the OP said he was going to post on both the psych and neuro boards, I went to the neuro boards to see what they said over there.

And, hark! No replies!

If THAT doesn't demonstrate the difference between the specialties, I don't know what does 😀

...

We ARE a helluva lot more fun, aren't we? 😉
 
(Actually, I just did an ECT elective in PGY4, and had my first month on staff here supervised so my Sith Lord could sign off on the hospital credentialling. )[/SIZE].

So when will you become the Master? As we know, there can only be one Sith Lord...are you still an apprentice?
 
u could do psych and then do a fellowship in neuropsychiatry or u can do neuro and then do behavioral neurology.
 
Dear Dark Lords of the Sith,

Would anyone care to elaborate on the two subspecialties listed below? Also, so if anyone has any perspective on the dual residency program that was previously mentioned in the thread, that would also be cool.

Thanks a lot!!


u could do psych and then do a fellowship in neuropsychiatry or u can do neuro and then do behavioral neurology.
 
Dear Dark Lords of the Sith,

Would anyone care to elaborate on the two subspecialties listed below? Also, so if anyone has any perspective on the dual residency program that was previously mentioned in the thread, that would also be cool.

Thanks a lot!!

There's a little bit of info on neuropsychiatry fellowships in the fellowships sticky in this forum. Still very new and not much info out there yet. Plus, the fellowship is not APA accredited, and therefore there will be no ABPN board certification in this. You'll certainly be able to practice as a neuropsychiatrist, however, and will most likely be board eligible if and when the ABPN does accredit the fellowship or create their own.
 
To contribute to the discussion, I offer into the evidence the following:

12+stereotypes+panel+04.jpg


12+stereotypes+panel+02.jpg
 
i thought i wanted to go into neurology; now i'm sure of it; i'm exactly like that dude 😉 it's just too bad that you can do so little for so many terrible neurological afflictions
 
As several have pointed out, a major difference between neurologists and psychiatrists is the different approach they take to abnormalities of the mind/brain. Another difference is that neurologists also deal with disease of the spinal cord/peripheral nerves.
 
You want this, don't you?
The hate is swelling in you now.
Take your Jedi weapon. Use it. I am unarmed.
Strike me down with it. Give in to your anger.
With each passing moment you make yourself more my servant.




(Actually, I just did an ECT elective in PGY4, and had my first month on staff here supervised so my Sith Lord could sign off on the hospital credentialling. )

Snap son.
 

I think it would be more appropriate to say that the patient is depressed and so takes poor care of his diabetes which then causes him to be more depressed.

What I tell all my students who bring up the neurology vs psychiatry question is that neurology is fine if you like strokes and seizures with a few other things mixed in. I also tell them that I would personally rather gouge my eyes out with dull spoons than go into neurology. :barf: Then I tell them that they will hate their lives and themselves and wonder why they didn't listen to that incredibly insightful psychiatry resident if they don't go into psychiatry. Then I laugh and act like I'm just joking. I'm not. Well, maybe a little. And I mean, somebody has to deal with...er, I mean, help the stroke and seizure patients, right?
 
The answer to your question will become clear to you during your M3 year. I know that's not that satisfying an answer, but it's true.

During M1 and M2 years, I was equally interested in psych and neuro. During M3 year, I LOVED my psych rotation, and really didn't care for my neuro rotation. The two are really different once you're doing clinical work. Like someone else said, it depends whether you like doing neuro exams and looking at brain scans or like talking to patients about their lives and feelings and then talking to other doctor types about that. I think neuro is fascinating intellectually, but I was pretty bored and often confused on day to day rounds.
 
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