radiology resident considering switch to psych...

[Apache]

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[engineer]

hi. yes. psych is good for having time to do outside stuff. that is the only reason why i chose it. and you are right. in rads there is too much reading. you could easily get psych with those scores.

 

[engineer]

how about if you switch to anesthesia or is that just as bad as radiology for outside reading and lack of time for a life?

 

[PsychMD]

The problem is still getting through the first 1 1/2 years if you switch to Psych; since you've got the 6 months of Medicine/Neuro, and the inpatient work, which does include call. In general, for "cushier" programs, do try to stay away from the coasts (aim South West), and also ask about whether they have a night float schedule. If you're a competitive candidate with interesting/solid pre-Med background/credentials, you might even try cold-calling programs, even if they don't publicly advertise open spots, since you might have a pretty good chance of getting a spot off-match, even off schedule. They might question the "weirdness" of leaving Radiology for Psychiatry, but I assume, based on your interests, that you already have a good story lined-up!

 

[Miklos]

But I already did a whole year of medicine -- and I already took a boatload of call -- doesn't that count as a psych internship? Thanks for the input...

It should. From the ABPN http://www.abpn.com/Downloads/2005part1_ifa.pdf

An applicant seeking admission to examination for certification in psychiatry must have satisfactorily completed an ACGME accredited PGY-1 (See below.) and three full years of postgraduate, specialized residency training in a psychiatry program accredited by the ACGME.

Different requirements apply for applicants who began training in psychiatry prior to 1986. These candidates should call the Board office if they have any questions.

Two patterns of training are acceptable:

1. Three-Year Psychiatry Residency Program

A broad-based clinical year of ACGME-accredited training in internal medicine, family practice, or pediatrics; or an ACGME-accredited transitional year program that included a minimum of four months of primary care; or an ACGME accredited residency in a clinical specialty requiring comprehensive and continuous patient care.

AND

Three full years of postgraduate, specialized residency training in a psychiatry program accredited by the ACGME.

OR

2. Four-Year Psychiatry Residency Program

Four years of training in an ACGME-accredited program in psychiatry is acceptable. A psychiatry PGY-1 must include at least four months in internal medicine, family practice, and/or pediatrics. This training must be in a clinical setting that provides comprehensive and continuous patient care. No more than one month of this requirement may be fulfilled by an emergency medicine rotation, as long as the experience predominantly involves medical evaluation and treatment, rather than surgical procedure. Neurology rotations may NOT be used to fulfill this four-month requirement.

 

[SeaviewMD]

Although psychiatric residencies are sometimes considered more "lifestyle friendly" than other residencies, I would caution you against switching into psychiatry soley on the basis of this (largely undeserved) reputation. I've found that management of psychiatric patients often requires intellectual and emotional reserves utilized far less frequently in other areas of medicine. Remember, "difficult" patients are often referred to psychiatry by other providers, and these are the patients you will be seeing the majority of the time! Additionally, keeping up with the explosion of new literature on both the biologic and psychotherapeutic aspects of psychiatry, as well as understanding current modes of practice and historical perspectives (which remain very important in psychiatry) can be very demanding; I can't imagine it being significantly less than in a radiology residency. In sum, this is an incredible field for physicians interested in psychiatric illness, but if manageable work hours are your primary concern, you may be better off exploring other specialties that consider "quality of life" for their residents an important consideration.

 

[gmonavydoc]

[
PMR OR PUBLIC HEALTH OCC MED ARE THE EASIEST RESIDENCIES FOR WHAT YOU WANT. REMEMBER PSYCH HAS ALOT OF INPTS


QUOTE=Apache]I'm currently a PGY-2 radiology resident at a U program in the south. I'm somewhat disenchanted with my experience in residency thus far and am contemplating a career switch. You see although my vocation is a resident, my passion is business and entrepreneurship. One of the main reasons I chose radiology is b/c I thought it afforded one the lifestyle that would allow him to pursue other things in life. I was wrong. Although it is true that rads residents work less in house than most other residents, the reading and studying demands placed on us is enormous, and if you factor those hours in (and they should be factored in), the work week easily comes to >80hrs. So I am finding myself feeling somewhat suffocated, with no time or energy to pursue anything meaningful outside of residency -- and looking at 3 1/2 long years ahead of me.

Please don't misunderstand me -- I'm not lazy or slothful -- I don't want time off to watch football, drink beer, and eat potato chips. I want it to pursue the entrepreneurial dreams I've had for many years, but have been squelching due to professional priorities. And now I think I've had enough of "delayed gratification" -- I'm ready to live by "carpe diem" .

I've been looking for jobs as an MD consultant, writer, or editor -- something that would provide a modest salary of 40k -- just enough to "pay the bills" -- while at the same time affording me enough time off to pursue other things. And this morning I thought about Psychiatry. No offense intended, but isn't psych residency supposed to be pretty benign? I'm a carib grad with 244, 241, and 211 on Steps 1, 2, and 3 respectively. I can't help but wonder if there's a psych program out there that would suit my needs that might be interested in me. Of course I don't intend to do nothing and get paid -- I will certainly fulfill my duties as a resident -- I just value my time away from residency.

"Two paths diverged in the woods, I chose the one less traveled on, and that has made all the difference" -- Robert Frost

Any guidance would be invaluable and greatly appreciated. Thank you.[/QUOTE]

 

[OldPsychDoc]

Although psychiatric residencies are sometimes considered more "lifestyle friendly" than other residencies, I would caution you against switching into psychiatry soley on the basis of this (largely undeserved) reputation. I've found that management of psychiatric patients often requires intellectual and emotional reserves utilized far less frequently in other areas of medicine. Remember, "difficult" patients are often referred to psychiatry by other providers, and these are the patients you will be seeing the majority of the time! Additionally, keeping up with the explosion of new literature on both the biologic and psychotherapeutic aspects of psychiatry, as well as understanding current modes of practice and historical perspectives (which remain very important in psychiatry) can be very demanding; I can't imagine it being significantly less than in a radiology residency. In sum, this is an incredible field for physicians interested in psychiatric illness, but if manageable work hours are your primary concern, you may be better off exploring other specialties that consider "quality of life" for their residents an important consideration.

On top of that, if you're a self-serving A****** and demonstrate that your heart really isn't in it, you'll just piss off everyone you work with: attendings, fellow residents, nurses, social workers, AND your patients.

 

[jdog]

I heard dermatology has a really good lifestyle and is really easy for foreign grads to get into. That is probably a better lifestyle than psychiatry in my opinion. Derm is basically an 8 to 5 job in residency. And you get to look at people's skin all day too. It is awesome. That is your best bet

 

[ILikeGas]

Apache, I'm already interviewing for quite a few radiology positions at some great programs, but now I'm thinking of bailing out.

I too, had heard, of the enormous time spent in reading radiology texts. It's clearly way more than any other field from what other radiology residents have told me, about 2 hours a day!

Plus, with the outsoucing issue, I don't want to train for such a long residency only to find at the end of it a bad job situation from outsourcing or a bad job situation from declining reimbursements with 5-7 year partnership tracks, which would really blow.

You're smart to pursue entrepeneurial interests--most physicians I know seem to be sheep-like in their personalities with not much in testicular fortitude.

Plus, when you come right down to it, isn't radiology kind of boring?
Unfortunately, my scores and credentials were so good, I kind of got sucked into the I gotta get into the "hottest" speciality of the moment. I should've given more thought about what would make me happy. Like not being constantly pestered with learning radiology and keeping up with the flood of "knowledge" coming from that field.

I agree that PMR would be a good field with business and indepence/autonomy opportunities. And Occupational Medicine also has freedom. But Public Health is notoriously low-pay, unless you use that as a jumping point to be an executive somewhere (and then you really aren't a public health doc anymore).

Just interested in your thoughts about anesthesiology? My impression is that it's way easier to learn that radiology, it's shorter at 3 years for residency. What do you think?

Betcha one thing for sure though--as soon as you tell your PD that you're leaving radiology for something else, he'll probably think you'll need a psych referral, ironically enough.

 

[musicman1991]

Hey Apache,

Radiology is a very challenging field. The learning curve is steep and it also seems that your program may not be the best either.

Do you think that maybe you are hitting the wall as people say??

My friends in radiology and psych all seem disenchanted with their residency for different reasons.

 

[engineer]

hi. i checked gas out and it is kind of like rads. you have to wake up at 4:30 am and work long days and read alot. psych is your way to go. get there at 8 or 9 and sometimes leave super early.

 

[DrIng]

Why not jsut take a break (from medicine not hard work) for a year or two and go work for someone like mcKisney- they hire doctors to work as consultants and it will give you useful practical business education and that way you don't have to go through a residency if you decide you don't want to actually practice medicine. After all the Micahel Dell's of this world don't haev time for medicine as a hobby...

 

[AlternateSome1]

You are going to have to do a lot of outside reading in Derm to, so this would probably not be what you want.

I heard dermatology has a really good lifestyle and is really easy for foreign grads to get into. That is probably a better lifestyle than psychiatry in my opinion. Derm is basically an 8 to 5 job in residency. And you get to look at people's skin all day too. It is awesome. That is your best bet

 

[musicman1991]

Apache: I completely agree. I like your assessment though.

Radiology though, is more creative and interesting than other fields like internal medicine. I mean most of medicine is an algorithm of some sort.

I have friends in consulting and they hate things about it too. Perhaps you are going through a quarterlife crisis??

Don't forget that consulting (especially McKinsey) weighs in heavily on pedigree. Coming from a foreign med school you might be at a disadvantage even with teh MD. You should try though.

Musicman: It's not radiology per se that I don't like, but rather the inherent mechanics of residency training. Regardless of specialty, to me it seems like it's all the same process:

10 Experience/read knowledge

20 Put knowledge in brain

30 Try to recall knowledge

40 If successful, GOTO 60

50 If not, GOTO 10

60 Spit knowledge out

70 If knowledge in sync with current expected response, GOTO 90

80 If knowledge not in sync with current expected response, GOTO COURT

90 Collect paycheck, buy large German auto, go to kids soccer games, build up 401K

100 Die

Not much room anywhere for independant thinking if you ask me. Not to knock people who do this -- different strokes for different folks -- we need good docs out there that's for sure. But it is just not for me. I am thinking/hoping that psych might be a little different, or if the same, at least less of the same.

DrIng: Good thought -- I dropped my appy to McKinsey a few days ago... thanks.

 

[jdog]

Michael Dell's dad also gave him 300,000 dollarsj to start the company. Sounds like riches to riches. And also, when you get your psych residency can you send me your contact infro so I can never refer you a patient. You sound so dedicated to the field and the well being of your patients

 

[DrIng]

Ummm... You seriously think that being a foreign trained doctor is going to worry a company which has multiple offices on every continent in this world except Antarctica!
I really do hope that you haven't thought this through. There are people in the medical community for a variety of reasons don't like FMG's but I would hope that a company in global business would be able to see the benefit in global employees. If they can't then I seriously worry about the future of the US, so much of it's prosperity has been built on the ability to draw 'the best and brightest' from around the world. If businesses can't see that to continue this trend is benficial then...

Sorry just an off topic rant I know.

Seriously McKinsey are looking for bright hard working people with an area of expertise, an analtyical mind and a willingness to learn. And I agree with the above, if you want to earn $$$ then medicine probably isn't the way to go. The richest bloke I know started with mcKinsey when he finished university- worked with them for a few years, left mcKinsey to form a venture capital firm and is now a multi-mulitmillionaire with multiple houses on multiple continents whose main worry is what to do with the rest of his life now that he's made it and can do anything he wants... It does sound like medicine might not be your thing right now and to take a detour may be a good thing for you.
Oh, but don;t think that McKinsey wont work you like a dog for several years- youll be spending a lot of nights at client dinners and so on but maybe that's your thing. I think selfknowledge and findign what you really want to do is a good thing. Too many people go into medicine or keep going at it because of how much they've already committed rather than because it's what makes them happy. Good Luck.

 

[musicman1991]

I am not anti-foreign trained grad at all. But an American Citizen going to a Carribean Med school doesn't exactly qualify as worldly experiences to me.

McKinsey, etc. may seem like the Holy Grail but I caution you about using anecdotal stories to judge it's ability to generate money. There are many radiologist who bought an MRI imaging center and don't do any clinical work and make a ton of cash too.

You don't need a certain job, degree, or residency if you truly have business vision. Like you said. Dell didn't go to college, Gates dropped out of Harvard, etc.

 

[ILikeGas]

Musicman: It's not radiology per se that I don't like, but rather the inherent mechanics of residency training. Regardless of specialty, to me it seems like it's all the same process:

10 Experience/read knowledge

20 Put knowledge in brain

30 Try to recall knowledge

40 If successful, GOTO 60

50 If not, GOTO 10

60 Spit knowledge out

70 If knowledge in sync with current expected response, GOTO 90

80 If knowledge not in sync with current expected response, GOTO COURT

90 Collect paycheck, buy large German auto, go to kids soccer games, build up 401K

100 Die

Not much room anywhere for independant thinking if you ask me. Not to knock people who do this -- different strokes for different folks -- we need good docs out there that's for sure. But it is just not for me. I am thinking/hoping that psych might be a little different, or if the same, at least less of the same.

DrIng: Good thought -- I dropped my appy to McKinsey a few days ago... thanks.

Apache, I can see that you are a creative guy, what with the pseudo-software analogy of the whole residency/life-is-hard-and-then-you-die script you posted. Which is exactly what entrepeneurship is all about.

I too, am looking at this crap of residency and getting mighty sick of it.
But, I'm not bold enough or creative enough to start a business unfortunately.

There were also some posts about anesthesiology: about getting up at 4:30 AM and having to do lots of reading. I don't think that it's true, most gas residents may have to be in the hospital at 6:30 AM at the earliest. And about the reading? Have you ever compared an anthesiology text to a radiology text?

The anesthesiology text is way more readable and seems to place way less emphasis on memorization, IMO.

Did you find reading about radiology to be boring, to be truthful about it?

 

[ny skindoc]

I would strongly suggeast you try to stick it out and finish Rads,once its over you can do what you want.Plenty of opportunities to be a businessman with Radiology.Even with working a couple of days a week your income may be higher than a full time psychiatrist.A residency only lasts a few years but then comes the rest of your life.Dont make a choice just on a residency,every one is bad in one way or another and will make its residents miserable (except for Derm-good luck with that) Public Health residency I agree is the easiest of them all 9-5 but the jobs afterwards are mostly in the public sector.Some psych programs are easy and will give you free time but others can be as difficult as Rads,so be careful.

 

[volvulus]

Apache,
I agree with nyskin. You have come this far. You have busted your butt in college and for four years of medical school. You have been through a tough internship. Now you have 3 and a half more years left. (Of which 1 and a half are bad) Think about it? You can be a a board certified Radiologist. What does that mean? Options!!! Even if you decide not to practice you still have the ability to practice 1 maybe 2 days a week. Radiologists are very highly sought after by big business. They have a extremely vast knowledge of all of medicine. I to want to go the business route some day. I just look at Vikas Bhushan who did a radiology residency and then went on and made a medical books empire.

 

[danip]

it sounds to me like you took the spot of somebody who was possibly very interested in radiology. Why did you go to med school to begin with if you wanted to go into business. Medicine isn't really something that ppl go into just to fall back on. you should've become an accountant --then you would've had plenty of time to pursue other interests instead of being a half ass- radiologist or a half- ass psychiatrist who isn't really interested in the field. just my opinion

 

[Goober]

If you looking to go to psych so you can pursue business interests outside of medicine you should seriously consider whether you should be in medicine at all. You wouldn't be the first person to realize that medicine is not for them. I met a guy who finished an entire general surgery residency and than dumped it all to pursue real estate. His family was loaded so he wan't really taking that much of a financial risk.

Your radiology residency is going to get tougher not easier as you progress because most programs call schedules are loaded to years 2 and 3. Your last year (pgy-5) will be less call but actually more stress as you prepare for the radiology boards.

A little known secret is that most private practice jobs in radiology are much tougher than being a resident. I suppose you could work part time, but the huge differences in money and the inability to become a partner make most people reconsider that route especially if you have huge loans to pay off and you are trying to buy that big house and german auto.

 

[Whodathunkit]

These are human beings that you are dealing with, whether you are a resident or in private practice. I feel that it's highly unethical for you to go into a field that REQUIRES you to have empathy and personal qualities necessary to be a psychiatrist...purely for the purpose of having lots of free time. You chose correctly when you chose RADS...those films don't need to talk to their doctor. Maybe you should consider PATH. Tissues don't make much conversation either...and they could care less when their doctor keeps looking at their watch because they would much rather be someplace else.

 

[Voxel]

My advice to you is to finish radiology residency and then to re-assess your options. Residency is a temporary thing. There are plenty of opportunities in the radiology field to be an entrepeneur. You can make plenty of money working 9-5 in radiology. Think outside the box. Best of luck to you.