Questions from an entering medical student

[vonburen]

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Entering medical school I have some fairly concrete and perhaps highly peculiar interests. For instance, I know that I absolutely want to be involved in treatment and diagnostics of autonomic disorders and peripheral nervous system disorders, but I'm also interested in sleep medicine, cognitive behavioral therapy, and treating psychological factors that are maintaining pt distress in chronic illnesses w/ psychotherapy and psychopharmacology. Managing bipolar/schizophrenic pts, treating anxiety disorders, and depression as well. Also general diagnostics.

Right now I'm fairly strong on psychiatry and neurology, I do very much want to incorporate psychotherapy into my practice, but also want access to drugs like cycloserine for anxiety disorder treatment augmentation, and have access to other medicinal modalities to help pts get quality of life back. Also sleep medicine/exercise in realizing inflammatory/sleep issues that contribute and/or cause depression/severe pain.

But I absolutely am enthralled at the new emerging science on peripheral nervous system disorders and especially the esoteric autonomic nervous system disorders.

I realize there are dual neurology/psychiatry programs, but I also know they're few and 5-6 years long.

Would it be possible to practice as a psychiatrist and have an autonomic nervous system lab without board certification in neurology? Also, what is the feasibility of running one's own sleep lab if they're in private practice with a fellowship in sleep medicine?

 

[nitemagi]

Entering medical school I have some fairly concrete and perhaps highly peculiar interests. For instance, I know that I absolutely want to be involved in treatment and diagnostics of autonomic disorders and peripheral nervous system disorders, but I'm also interested in sleep medicine, cognitive behavioral therapy, and treating psychological factors that are maintaining pt distress in chronic illnesses w/ psychotherapy and psychopharmacology. Managing bipolar/schizophrenic pts, treating anxiety disorders, and depression as well. Also general diagnostics.

Right now I'm fairly strong on psychiatry and neurology, I do very much want to incorporate psychotherapy into my practice, but also want access to drugs like cycloserine for anxiety disorder treatment augmentation, and have access to other medicinal modalities to help pts get quality of life back. Also sleep medicine/exercise in realizing inflammatory/sleep issues that contribute and/or cause depression/severe pain.

But I absolutely am enthralled at the new emerging science on peripheral nervous system disorders and especially the esoteric autonomic nervous system disorders.

I realize there are dual neurology/psychiatry programs, but I also know they're few and 5-6 years long.

Would it be possible to practice as a psychiatrist and have an autonomic nervous system lab without board certification in neurology? Also, what is the feasibility of running one's own sleep lab if they're in private practice with a fellowship in sleep medicine?

Pardon the skepticism, but you haven't even started medical school yet. Your understanding of these interests at this point is likely at best superficial. Don't overly narrow your focus at this point. neuro/psych is 6 years. These are interests you have. Plan to do some shadowing and rotations in your areas of interest, and ask yourself as you're there "Is this something I want to do for the rest of my life?" Narrow from there.

I'm fully in favor of being a good generalist, but you may be aiming to be specialized in somewhat disparate areas. There are people who stack up board certifications, or degrees, but I haven't seen a whole lot who DO all the things they're trained to do. So ask yourself - how long do you really want to be training, and at what cost (financial, lifespan, quality of life, loss of other life experiences). It's a sacrifice. Whatever you do, just go in with your eyes open.

 

[Daedra22]

I agree with nitemagi here. Definitely explore those interests more and see what you really think about them, but try not to get more specific than you need to right now. I don't know you, so I can't make a lot of judgments about your interests and how you came to them (and I don't mean to be presumptuous)... however, when I started med school I thought I was absolutely going to be a medical geneticist. I had a lot of good reasons why I wanted to do that, except when I finally went and spent a few days with a geneticist I discovered that the work was not nearly as interesting to me in practice as it was in my head. I also thought I would like doing bench research, which I had done and enjoyed in undergrad. Med school made me realize that I enjoy patient care way more than I like lab work.

Forgive the use of the cliche, but med school really is a marathon. Focus on your first task - doing well in your preclinical years and the boards. Everything else will come into focus as you progress in your education.

 

[michaelrack]

Would it be possible to practice as a psychiatrist and have an autonomic nervous system lab without board certification in neurology? Also, what is the feasibility of running one's own sleep lab if they're in private practice with a fellowship in sleep medicine?

1. without a phd or similar experience, this couldn't be done without board cert in neurology.

2. check out the sleep medicine forum

 

[hamstergang]

For instance, I know that I absolutely want to be involved in treatment and diagnostics of autonomic disorders and peripheral nervous system disorders, but I'm also interested in sleep medicine, cognitive behavioral therapy, and treating psychological factors that are maintaining pt distress in chronic illnesses w/ psychotherapy and psychopharmacology. Managing bipolar/schizophrenic pts, treating anxiety disorders, and depression as well. Also general diagnostics.

It sounds to me that you don't know what doctors actually do (which is entirely reasonable, you need to be there to really understand it). I wouldn't attach yourself too much to this idea you've created of what your practice is going to be. It's good to have interests, but don't lose touch with reality. Go through medical school and see what you actually like doing.