Repeatedly answering the "Why don't you become a REAL doctor?" question

[shan564]

I know that this topic has been beaten to death, but I think I have a slightly different question.

I'm sure that many of you guys have had family members say "Really? You're choosing psychiatry? I thought (generic misconception). Why don't you go into cardiology?"

And yes, I shouldn't care about what other people think, but the fact is that I have a large extended family, and because I love them, I do care what they think.

Interestingly enough, my close friends and family are different. The people who really know me always say "yeah, psychiatry is a good fit for you; I'm glad you're choosing that."

But with the scores of others, I repeatedly find myself going through long and elaborate explanations to address everybody's individual misconceptions and concerns. Like, "no, psychiatrists don't just sit on a couch and do therapy" or "no, psychiatrists make more money than you think" or "no, mental illness IS a real thing, and here's how I know" or "no, I'm not just doing this because I couldn't get into anything else" and on and on and on.

I'm sure that many of you have gone through the same process. Has anybody found a shortcut? I'm thinking about just writing up a little "FAQ" page and handing it out at family gatherings and saying "please read this first; it will answer all of the questions that you are about to ask me... and many of the ones that you have in your head but are too polite to ask (i.e. the one about money).

Or maybe somebody has already made that page? An FAQ page specifically designed for family/friends of students who have chosen to pursue a career in psychiatry? If it already exists, it would save me a lot of headaches. If it doesn't, I'm pretty sure I'll be the one to make it.

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[Leukocyte]

And yes, I shouldn't care about what other people think, but the fact is that I have a large extended family, and because I love them, I do care what they think.

Please, please, please do not go into ANY career because you care about what others think. It is not worth it. There is MUCH MORE to life than careing about what others think. If you think Psych will make you happy in your life (on a daily bases), then go into it. Other people would care less if a person is miserable in their career. And as far as medicine goes, every medical specialty is very different than the other...so you have to be very carefull when picking a medical specialty. Your happiness is that what should be your ONLY guide. If you chooses a medical specialty, and end up not liking it, it is VERY difficult to turn back and go into something else.

I'm sure that many of you have gone through the same process. Has anybody found a shortcut? I'm thinking about just writing up a little "FAQ" page and handing it out at family gatherings and saying "please read this first; it will answer all of the questions that you are about to ask me... and many of the ones that you have in your head but are too polite to ask (i.e. the one about money).

NO!. Again, as a person who USED to care about what others think, and thus went to clinical medicine, instead of following what I really liked, this idea you are proposing is pointless. I am paying the price of my stupidity for careing about what others think. I hate my current medical specialty, and now going for another residency just to correct my stupid thought process that I took when choosing my old specialty.

Only do what you like. PERIOD.

 

[shan564]

Please, please, please do not go into ANY career because you care about what others think. It is not worth it. There is MUCH MORE to life than careing about what others think. If you think Psych will make you happy in your life (on a daily bases), then go into it. Other people would care less if a person is miserable in their career. And as far as medicine goes, every medical specialty is very different than the other...so you have to be very carefull when picking a medical specialty. Your happiness is that what should be your ONLY guide. If you chooses a medical specialty, and end up not liking it, it is VERY difficult to turn back and go into something else.



NO!. Again, as a person who USED to care about what others think, and thus went to clinical medicine, instead of following what I really liked, this idea you are proposing is pointless. I am paying the price of my stupidity for careing about what others think. I hate my current medical specialty, and now going for another residency just to correct my stupid thought process that I took when choosing my old specialty.

Only do what you like. PERIOD.

I think I may have left out a couple of important points in my initial post. Just to be clear, I'm DEFINITELY not reconsidering my career choice because of what others think.

I'm doing what I do because that's what I want to do.

The point is, I'm sick of repeatedly answering the same questions from different people. It's not that I'll let their misconceptions influence my decision... rather, I actually care enough about them so that I want to correct their misconceptions (not change my own career path).

 

[peppy]

Interestingly enough, my close friends and family are different. The people who really know me always say "yeah, psychiatry is a good fit for you; I'm glad you're choosing that."

I think that says a lot. There are still distant relatives in my family who refer to me as a "psychologist". I don't bother to correct them because the people who really need to understand me already "get it".

I've always liked OldPsychDoc's posts on here about the "real doctor" issue such as this post

Misconceptions about medical careers are rampant in the general public. There are many laypeople out there who have no idea that the people who read X-rays are "real doctors" and think that a "radiologist" is someone who took rad tech classes at the community college. Then you have all the people out there who perceive that doctors in general are all just rich jerks who don't take time to listen to patients, so being identified as a doctor isn't always such a good thing after all.

I don't really see any harm in writing up an explanation about psychiatry if you think that your family truly wants to know more about it. I think sometimes people make comments because they're just trying to "make conversation" and it doesn't really matter that much to them, but you know these people and if they'll be receptive. If you do put up a webpage trying to better explain psych to people then definitely let us know about it on here.

 

[OldPsychDoc]

Thanks for the "blast from the past", but this works for countering misconceptions as well...
http://imgur.com/y2uQz

 

[OldPsychDoc]

...
But with the scores of others, I repeatedly find myself going through long and elaborate explanations to address everybody's individual misconceptions and concerns. Like, "no, psychiatrists don't just sit on a couch and do therapy" or "no, psychiatrists make more money than you think" or "no, mental illness IS a real thing, and here's how I know" or "no, I'm not just doing this because I couldn't get into anything else" and on and on and on.

I'm sure that many of you have gone through the same process. Has anybody found a shortcut? I'm thinking about just writing up a little "FAQ" page and handing it out at family gatherings and saying "please read this first; it will answer all of the questions that you are about to ask me... and many of the ones that you have in your head but are too polite to ask (i.e. the one about money).

Or maybe somebody has already made that page? An FAQ page specifically designed for family/friends of students who have chosen to pursue a career in psychiatry? If it already exists, it would save me a lot of headaches. If it doesn't, I'm pretty sure I'll be the one to make it.

Seriously, there's no shortcut--just as there's no shortcut for explaining to a patient why we aren't wanting to continue benzos for the rest of their life to "fix" their anxiety. You pretty much have to get used to developing that skill of answering the individual's question "where they're at"--so the answer you give at your high school reunion might be similar to the one you give Aunt Millie, but will have certain differences depending on their familiarity with you and what they are talking about.

I do like to recommend this book--assuming the questioner is motivated enough to read a book. (Disclaimer: Dr Hanson and I go way back...)

 

[nitemagi]

I agree there's no shortcut. I do a 3-second gauge as to how much of an explanation to give. Often the "myths" have an inkling of truth. SOME psychiatrists do just throw meds. SOME psychiatrists do a lot of therapy.

Mostly I act indifferent to misconceptions and ignorance, and try to throw on contradictory quips like "Yeah, that's just completely wrong."

 

[whopper]

I went into medschool specifically to be a psychiatrist.

Only other fields I had an interest in were FP, IM, and surgery. What attracted me to the first two fields were these were what I saw as a lynchpin of all of medicine. Kinda like House. You have to know a little of everything and it's kind of an executive branch of medicine.

As for surgery, I have a knack for sitting down and fixing things with my hands. I like to build models in my spare-time and the same zen I get with building models I get with surgery.

But ultimately, I stayed with psychiatry. In fact I wanted to do forensic psychiatry before I even knew there was a fellowship for it. I guess reading too much Batman, having the hairs on the back of my neck stand up when mental illness and crime was involved, almost going to lawschool, and wanting justice for all played a factor there.

It bugs me how several doctors think it's better for a person to go into a specific field out of their own egocentric judgment. I equate it with how in the Eastern-Asian culture (and I'm an Asian-American) there's a too prevalent mentality that you're worthless if you don't get into Harvard. Several doctors in medschool create this bogus sense of what are appropriate fields to go into, often-times citing the competitiveness over several other important factors such as personal interest, personal fit, and society's needs. We need great PCPs, but it's not seen as a sexy field because it's not as competitive as say, dermatology.

Too freaking bad. Doctors ought to be encouraging students to go into the field where they can do the most good and where the person will be happiest. Fields like neurosurgery, opthamology, surgery, what have you, they are great fields but in medschool the profs and the students tend to get a mentality that they're better fields because of a type of intellectual and academic elitism that develops.

And as for psychiatry, we're more removed from the medical field and bluntly, several physicians in medschool don't understand it.

I'd retort back, what is a "real" doctor?

 

[Leukocyte]

I'd retort back, what is a "real" doctor?

My response to a person asking this question is...Who cares?!

I mean, really who cares? And why should anyone care? You do not see people asking around "who is a real janitor"? You do not see people asking "who is a real engineer"? Who cares? It is a JOB. The purpose of a job is to make money. BUT the difference in medicine (as opposed to any other job) is that one HAS TO like his/her job (because if they do not, the stakes are very high for the physician and the patient).

So if a happy janitor and a disgruntled neurosurgeon enter into a hotel at 12 midnight. The hotel has only one room left. The happy janitor has cash in his pocket to pay for the hotel room. The disgruntled neurosurgeon has a VISA credit card (but because he is unhappy with his career choice, and thus always disgruntled, his wife divorced him and emptied his bank account and maxed his credit cards). Who do you think will get that single available hotel room? Will the hotel make an exception for the neurosurgeon just because he is a VERY REAL doctor?

So do what will make you happy, and do not care about anyone else. In the end it is just a job. There is more to life than one's job.

 

[splik]

Incidentally when the Chair of Psychiatry at my med school was preparing my for my job interviews back home was 'why psychiatry? why don't you want to be a proper doctor?'. I said 'surely they wouldn't ask me this?' - not in so many words, but I was pretty much asked by a non-psychiatrist in my interview for a fellowship considering I had done so well at medical school, why did I not think of doing another specialty!

 

[splik]

Will the hotel make an exception for the neurosurgeon just because he is a VERY REAL doctor?

neurosurgeons, indeed all surgeons aren't real doctors either. they still get respect. In the UK a surgeon might be offended to be called 'doctor'.

 

[vistaril]

psychiatrists are not viewed as real physicians by many outside of medicine. And some in medicine. And many in medicine will be respectful/cordial outwardly, hiding their real feelings. If this is going to be a problem, I wouldn't do psychiatry.

 

[F0nzie]

I just started my new moonlighting gig this weekend. The cafeteria man was like "you look really young to be a quack doc!". We had a good laugh. Gave me a free meal too.

 

[dl2dp2]

Well I think the "real doctor" question should be convincingly dispelled in stating that psychiatry is a medical specialty. If you are really serious about engaging a discussion about this, you can go a bit in depth, and you'll shockingly discover how many people are on meds, and how many people are in therapy. In more educated circles this is becoming less of an issue--thank pharma for that? Arming yourself with some neuroscience trivia is often also useful. You would sound more convincing if you launch into a complicated discussion about various neurocircuits and transmitters, and they would likely tune out and stop bothering you.

I find this is what happens to other specialties as well--if you are a cardiologist people either try to engage you with their aunt's recent triple bypass or get tuned out when you start yapping about coronary anatomy. This is why as time goes on doctors only have doctor friends.

PS I never pictured whooper as being Asian. INTERESTING...

 

[vistaril]

Well I think the "real doctor" question should be convincingly dispelled in stating that psychiatry is a medical specialty. ..

most people are aware of that, and many of these same peoplestill don't really believe of it as such. Regardless of what we believe, there is little point in psychiatrists trying to convince other people that we are "real doctors"......who cares anyways?

 

[belle54321]

I'm sure that many of you have gone through the same process. Has anybody found a shortcut? I'm thinking about just writing up a little "FAQ" page and handing it out at family gatherings and saying "please read this first; it will answer all of the questions that you are about to ask me... and many of the ones that you have in your head but are too polite to ask (i.e. the one about money).

Or maybe somebody has already made that page? An FAQ page specifically designed for family/friends of students who have chosen to pursue a career in psychiatry? If it already exists, it would save me a lot of headaches. If it doesn't, I'm pretty sure I'll be the one to make it.

Please don't do that. I know you love your family and want them to understand what you are doing, but I think you are really making a big deal out of this. I think most laypeople are just making conversation when they say stuff like that, and really aren't questioning your career choice. Unless they have gone thru medical school or have a close friend or relative who has done it, most people have no idea about the medical school or residency. For example, most people don't know that you have a MD when you graduate from medical school, but having a MD doesn't really mean you are a doctor. Also, most people have no idea that you have to choose a specialty and do a residency. Some even think you get paid a lot during residency. Anyway, my point is your friends and relatives will have many misconceptions about what you will be doing. You can explain until you are blue in your face and some of them still won't understand.

 

[markglt]

tell them to go climb a tree

 

[whopper]

PS I never pictured whooper as being Asian. INTERESTING...

I'm also active on a model-building forum. I met a bunch of the guys on the forum at a model-building convention. Everyone told me they envisioned me as a tall Caucasian fat guy with an big mouth and an attitude though a friendly one probably working in an ER.

Funny. I used to be in a fraternity, so that I think pushes the White male thing, I used to enter eating contests in college hence the name "Whopper", so I think that pushed the big guy thing.....

My response to a person asking this question is...Who cares?!

Very much agree, but I do want to point out that several people, not knowing what field to go into, and being surrounded by people who are supposed to be mentors are very impressionable, and unfortunately there's a niche in the culture of medical school to encourage people to go into the fields that may not be a best personal fit or best for society.

 

[Leo Aquarius]

If someone asks me why don't I become a real doctor, I will tell them they need to go see a psychiatrist.

 

[notdeadyet]

OP- I'm glad your family and friends are supportive. Like others have mentioned, the fact that they see this as being a good fit for you, without you needing to qualify, probably speaks volumes.

As for the others, all I can say is this: as an older dude, I can almost promise that as you get on in years, your concern for what everyone thinks about your career choice (or life choices period, for that matter) diminishes dramatically. Maybe I'm a curmudgeon, but I notice that once you hit a certain point (30 or so?), your concern about what your casual friends and extended family think about you goes way down. Having a pat answer about psychiatry is helpful (I usually tell people that I am a plain old physician who happens to specialize in diseases that affect the mind), more comforting is that you will likely soon find that you won't care as much about the question.

Hmmm... reading that, I do sound like a curmudgeon...

 

[billypilgrim37]

It's interesting how the question changes when you're in child psychiatry. There are plenty of people who have intense visceral anti-child psychiatry reactions, but there aren't a lot of questions about whether you're a real doctor or not. I don't know if this is particularly better, but it's definitely different. I also think people have "child psychologist" programmed into their brain much more directly than "child psychiatrist," so the chance of people benignly getting the two backwards is pretty high. I live in a pretty straight forward lower-middle class neighborhood, and generally my neighbors are just really confused as to why a doctor is living beside them.

Usually my answer about what I do is "I work over at [psychiatric hospital]." Either they don't care to ask more, or they say something like, "oh, are you a therapist?" or "what do you do there?", and I say, "I'm a physician." I might say I work mainly with kids. I find this approach actually gives people the answer they want and clarifies any benign confusion they might have. If somebody knows what a psychiatrist is, they'll probably put it together that's what you are. If they don't, well, you've established the important part: you're a physician who treats patients at the psychiatric hospital.

 

[Jorje286]

So taking care of people's mental health doesn't make you a real doctor? What's a real doctor anyway? Medicine is in the service of people's suffering, and mental health/illness can be a huge burden on people's well being.

To add to leukocyte's point of view that you really should make up your own values in life and not follow up on other people's, I find the question incredibly silly conceptually not to warrant more than a few moment's reflections.

Then also, who the hell cares if you're a "real doctor" or not, whatever that means. That shouldn't matter one bit. At the end of it, what matters most is finding out something you truly love to do that makes life really worth it.

 

[F0nzie]

Doctor is a title not an occupation.

 

[sunlioness]

I'm also active on a model-building forum. I met a bunch of the guys on the forum at a model-building convention. Everyone told me they envisioned me as a tall Caucasian fat guy with an big mouth and an attitude though a friendly one probably working in an ER.

Funny. I used to be in a fraternity, so that I think pushes the White male thing, I used to enter eating contests in college hence the name "Whopper", so I think that pushed the big guy

If I'd thought about it, I'd have pegged you for a white guy too. But I think that's because of the white guys in your icons. Even though I know you're not David Hasselhoff. Now I'm wondering if people here are assuming I'm some kind of big cat. [I'm a white female human. At least I think I am most days.]

Fortunately, I don't get asked the real doctor thing very much. If I did, I'd probably just make a joke out of it.

 

[Leukocyte]

Now I'm wondering if people here are assuming I'm some kind of big cat. [I'm a white female human. At least I think I am most days.

Well now. Are "white female humans" considered "real" doctors?

Outch!!!!

 

[sunlioness]

If not, be sure to let me know. 'Cause if I'm not a real doctor, I think I'm gonna knock off work a bit early today.

 

[whopper]

Hasslehoff was there because I just thought it was funny. Not that I'd wear a leather jacket and speedos, but in college I'd be the type of guy to wear a t-shirt of that old Hasslehoff avatar as a joke.

I don't know what it is, getting older, being a doctor longer, or knowing that one day some lawyer on the opposite side might try to bring up my Hasslehoff avatar in court to make me look less credible, I thought it was time to change it.

As for Sidney Freedman, my current avatar, in case you're too young, he was the psychiatrist that occasionally did consults for the M*A*S*H show. Hawkeye, who was one of my medical role models, would occasionally need Freedman to figure out a case he couldn't that had more to do with the physical aspects. I was thinking of putting Hawkeye as my avatar but he's not a psychiatrist. But the more I thought about it, Freedman was an incredibly good psychiatrist so why not have him instead of Hawkeye?

 

[sunlioness]

M*A*S*H was slightly just before my time and I didn't recognize the picture. I've loved the episodes I've seen though and should probably think about watching the whole series at some point. I liked your Hasselhoff avatar, but this one certainly works.

 

[vistaril]

So taking care of people's mental health doesn't make you a real doctor? What's a real doctor anyway? .

if you ask a lot of people(including many educated professional people), many will tell you that they don't consider psychiatrists to be "real" doctors. Not making a value judgement on that, but it's the truth.

 

[strangeglove]

Hasslehoff was there because I just thought it was funny. Not that I'd wear a leather jacket and speedos, but in college I'd be the type of guy to wear a t-shirt of that old Hasslehoff avatar as a joke.

I don't know what it is, getting older, being a doctor longer, or knowing that one day some lawyer on the opposite side might try to bring up my Hasslehoff avatar in court to make me look less credible, I thought it was time to change it.

As for Sidney Freedman, my current avatar, in case you're too young, he was the psychiatrist that occasionally did consults for the M*A*S*H show. Hawkeye, who was one of my medical role models, would occasionally need Freedman to figure out a case he couldn't that had more to do with the physical aspects. I was thinking of putting Hawkeye as my avatar but he's not a psychiatrist. But the more I thought about it, Freedman was an incredibly good psychiatrist so why not have him instead of Hawkeye?

Interesting, too, that was the only Jew in M*A*S*H.

 

[notdeadyet]

Interesting, too, that was the only Jew in M*A*S*H.

COL Flagg portrayed a Jewish chaplain once. Probably doesn't count.

 

[nitemagi]

I'm definitely a weirdo.

 

[belle54321]

As for Sidney Freedman, my current avatar, in case you're too young, he was the psychiatrist that occasionally did consults for the M*A*S*H show. Hawkeye, who was one of my medical role models, would occasionally need Freedman to figure out a case he couldn't that had more to do with the physical aspects. I was thinking of putting Hawkeye as my avatar but he's not a psychiatrist. But the more I thought about it, Freedman was an incredibly good psychiatrist so why not have him instead of Hawkeye?

Random trivia, Sidney Freedman was played by Allan Arbus, who was married to Diane Arbus, the photographer.

 

[splik]

is it possible to be a psychiatrist in the media without being a *****? for better or for worse those in the spotlight get more attention and thus have more power to change things than academics should they choose. this is a sad truth i am coming accept and wondering whether the best way for me to do that is to do the whole media thing. i have a great voice for radio...and a great face for radio haha...

 

[DOC PENGUIN]

is it possible to be a psychiatrist in the media without being a *****? for better or for worse those in the spotlight get more attention and thus have more power to change things than academics should they choose. this is a sad truth i am coming accept and wondering whether the best way for me to do that is to do the whole media thing. i have a great voice for radio...and a great face for radio haha...

I heard Nathan Kline was pretty good as he pioneered psychopharmacology. I know Dr.Robert Cancro, his friend.

 

[DOC PENGUIN]

I went into medschool specifically to be a psychiatrist.

Only other fields I had an interest in were FP, IM, and surgery. What attracted me to the first two fields were these were what I saw as a lynchpin of all of medicine. Kinda like House. You have to know a little of everything and it's kind of an executive branch of medicine.

As for surgery, I have a knack for sitting down and fixing things with my hands. I like to build models in my spare-time and the same zen I get with building models I get with surgery.

But ultimately, I stayed with psychiatry. In fact I wanted to do forensic psychiatry before I even knew there was a fellowship for it. I guess reading too much Batman, having the hairs on the back of my neck stand up when mental illness and crime was involved, almost going to lawschool, and wanting justice for all played a factor there.

It bugs me how several doctors think it's better for a person to go into a specific field out of their own egocentric judgment. I equate it with how in the Eastern-Asian culture (and I'm an Asian-American) there's a too prevalent mentality that you're worthless if you don't get into Harvard. Several doctors in medschool create this bogus sense of what are appropriate fields to go into, often-times citing the competitiveness over several other important factors such as personal interest, personal fit, and society's needs. We need great PCPs, but it's not seen as a sexy field because it's not as competitive as say, dermatology.

Too freaking bad. Doctors ought to be encouraging students to go into the field where they can do the most good and where the person will be happiest. Fields like neurosurgery, opthamology, surgery, what have you, they are great fields but in medschool the profs and the students tend to get a mentality that they're better fields because of a type of intellectual and academic elitism that develops.

And as for psychiatry, we're more removed from the medical field and bluntly, several physicians in medschool don't understand it.

I'd retort back, what is a "real" doctor?

Since the advent of media psychs (carlat) there has been a movement to make psychs a separate thing, or at least make psychologist able to prescribe. Carlat also thinks having to go through medical school to be a mental health doctor is stupid. I can rebutt that in this: A psychiatrist is someone to prevent, cure and discover mental illness. And there is a strong biological component. the biology of manic depression and schiezophrenia is the same one of delivering babies and nephrology. i think when people think of "real" doctors, they think of surgery and GP's.

 

[zenman]

As a psych NP I don't have to deal with all this crap....

 

[whopper]

Carlat also thinks having to go through medical school to be a mental health doctor is stupid.

I've read his articles on this and he even appeared on the forum to address this issue. His response was to the effect that psychiatrists have dropped the much needed psychotherapeutic aspects of treatment and in giving psychologists prescription power it would lead to a reform within our own profession to give better psychotherapy.

I disagree. I think it's just going to create another provider that's going to flub ob the psychotherapy, but to get more detailed, he specifically backed an Oregon state bill that would allow psychologists to prescribe. The overwhelming response from the people on the forum was disagreement with him.

Several aspects of psychiatry require the M.D. Consults in the hospital, administration of Clozaril, lithium, Depakote, all antipsychotics require metabolic follow-up, and in the hospital, the psychiatrist is expected to do some primary care. I'm going to cut myself here because I can explain why an M.D. is needed for several pages worth of information.

 

[sciking1]

http://www.youtube.com/watch?v=70loMcIqd9Q&feature=youtu.be

Show your family this video

 

[DOC PENGUIN]

http://www.youtube.com/watch?v=70loMcIqd9Q&feature=youtu.be

Show your family this video

I dont know where i would be without going to a psychiatrist. While i still have problems, and my parents neglect them, i can always count on my doctor on some objective advice. Yet, if you read the comments, it reveals that the stigma has stayed.

 

[vistaril]

Several aspects of psychiatry require the M.D. Consults in the hospital, administration of Clozaril, lithium, Depakote, all antipsychotics require metabolic follow-upQUOTE]

but one could counter that by saying it shouldn't require 4 years of medical school to be able to order and understand the labs and monitoring to do this.......

on large inpatient services nurse practioners are hired all the time to help manage patients, and by lunch on their first day they understand when and why to check depakote and lithium levels for example.

no doubt we all like the way things work now because this is a forum largely populated by psychiatrists and medical students.

 

[Leukocyte]

but one could counter that by saying it shouldn't require 4 years of medical school to be able to order and understand the labs and monitoring to do this.......

on large inpatient services nurse practioners are hired all the time to help manage patients, and by lunch on their first day they understand when and why to check depakote and lithium levels for example.

no doubt we all like the way things work now because this is a forum largely populated by psychiatrists and medical students.

The same can be said in regards to any medicial specialty outside the general medical fields (Family Medicine, Internal Medicine, Peds, and GYN):

Do Pathologists, Radiologists, Rad Onc, Dermatologists, PM&Rs, Opthalmologists, Anesthesiologits (CRNAs can almost do everything), ect.......do they really NEED to go to medical school to get an MD?

Using this logic, only Family Medicine docs, Internists, and Pediatritions need to go to medical school, and thus are "real" doctors.

 

[whopper]

posted in the wrong thread (how did that happen?)

 

[shan564]

The same can be said in regards to any medicial specialty outside the general medical fields (Family Medicine, Internal Medicine, Peds, and GYN):

Do Pathologists, Radiologists, Rad Onc, Dermatologists, PM&Rs, Opthalmologists, Anesthesiologits (CRNAs can almost do everything), ect.......do they really NEED to go to medical school to get an MD?

Using this logic, only Family Medicine docs, Internists, and Pediatritions need to go to medical school, and thus are "real" doctors.

Apparently, even going to med school isn't enough to learn how to spell the word "pediatrician" or "ophthalmologist"... (yeah, I know, I'm a spelling/grammar Nazi)

But on a marginally-more-relevant note, "this logic" is not the logic that most people use, so that argument doesn't really address their question. I agree that it's a mischaracterization to say that psychiatrists aren't "real doctors", but it's no big secret that a lot of people think that doctors are people who diagnose and treat physical illness. That often leads to underrecognition of medical illness, which consequently leads to undertreatment of medical illness. And of course, that's an issue that should matter to all of us.

And I agree that this shouldn't influence our career decisions. I just thought it'd be an interesting topic to discuss. A lot of people are just misinformed, and most of them are happy to become better-informed. I think I could have done a better job of expressing my initial point... it's not so much that I care about what people think I'm doing, but rather that I prefer not to let my friends and relatives be grossly misinformed about something that is so important to my life.

Some of the people on this thread have pointed out excellent methods for helping to make people better-informed:

http://www.youtube.com/watch?v=70loM...ature=youtu.be

I usually tell people that I am a plain old physician who happens to specialize in diseases that affect the mind

You would sound more convincing if you launch into a complicated discussion about various neurocircuits and transmitters, and they would likely tune out and stop bothering you.

I do like to recommend this book--assuming the questioner is motivated enough to read a book. (Disclaimer: Dr Hanson and I go way back...)

Great insight.


Others have said that you shouldn't care about other people's beliefs... I respect that viewpoint, but I think we'll have to agree to disagree about that... if I care about a particular person, I'd like them to have a better understanding of what I do.


For all of the people who simply said "who cares?" - I understand that you don't care, but that doesn't mean that nobody cares. Different people have different reasons for caring about different things. A lot of the discussions I have with my friends are happening for purely intellectual reasons... sometimes, it's interesting just to think about a concept regardless of whether it has a direct impact on your own life.

So do what will make you happy, and do not care about anyone else. In the end it is just a job. There is more to life than one's job.

Of course there's more to life, and of course we'll all do what's best for us. The question isn't whether psychiatrists are "real doctors" - I think everybody on this forum would agree on the answer to that. And the question is also not whether psychiatrists should be treated differently from neurosurgeons or janitors. The question was just about strategies to educate people whose opinion is important to us.

I hope that didn't sound antagonistic... I just meant it as another (hopefully) interesting discussion point.

I don't really see any harm in writing up an explanation about psychiatry if you think that your family truly wants to know more about it. I think sometimes people make comments because they're just trying to "make conversation" and it doesn't really matter that much to them, but you know these people and if they'll be receptive.

Yeah, in this particular case, I think it's more than just trying to "make conversation"... I do think that they genuinely want to learn, but most of them are a bit too polite to ask me directly.

 

[vistaril]

The same can be said in regards to any medicial specialty outside the general medical fields (Family Medicine, Internal Medicine, Peds, and GYN):

Do Pathologists, Radiologists, Rad Onc, Dermatologists, PM&Rs, Opthalmologists, Anesthesiologits (CRNAs can almost do everything), ect.......do they really NEED to go to medical school to get an MD?

Using this logic, only Family Medicine docs, Internists, and Pediatritions need to go to medical school, and thus are "real" doctors.

most of those fields have much more of a medical foundation imo. And why, with the exception of pathology(which is really in it's own category) all of the above have a pgy-1 year that is structured very differently than psychiatry.

 

[deleted310399]

" Psychiatrists aren't real doctors ". Man If I had a nickel for every time someone has said that to me.....well , I'de have about 7 nickels,that's still a lot right ?

 

[nitemagi]

most of those fields have much more of a medical foundation imo. And why, with the exception of pathology(which is really in it's own category) all of the above have a pgy-1 year that is structured very differently than psychiatry.

Historically psychiatry training tried to reduce training to 3 years. The results were much poorer psychiatrists and they switched back quickly.

Your points are those that everyone who hasn't gone through the training can have -- but you don't know what you don't know. It's easy to check labs and learn what the basics of abnormalities mean, but missing the larger context of what's happening. Physicians have a broader and more in depth medical training than an NP or any psychologist.

Yes we all have investment in why our profession is important, because we want to value our own effort and identity. But in the context of medications and medical problems, less training leads to more medical errors. We know that from the data on residents and from the Institute of Medicine (less trained-->more errors). Listing single areas of competency such as checking a lithium level, deconstructs the depth of training as if knowing a couple of factoids is equivalent to the totality of hours of immersion, regular supervision, general pathophys training, etc.

Sure many psychiatrists leave aside their medical training, but that's their choice. This has been rehashed over and over in the RxP thread on the psychology forum. As much as the propaganda from mid-levels and RxP's that they can be as good as psychiatrists at managing medications, there's no data in favor of this (they often cite the lack of data of complaints filed as proof of competency), and plenty of data from the IoM that lesser trained residents have many more errors than more trained, AND that the DoD RxP's at best had the medical knowledge of a mid-level medical student. Go back to the RxP thread because this can easily derail this thread. Apologies for contributing to that.

 

[deleted310399]

psychiatrists are not viewed as real physicians by many outside of medicine. And some in medicine. And many in medicine will be respectful/cordial outwardly, hiding their real feelings. If this is going to be a problem, I wouldn't do psychiatry.

I actually have to battle another prejudice... being an IMG and all. If I cared about what people think , I would not be here, I know I am good ...and I have worked very hard to be where I am. That's too many I"sss....I know.

 

[vistaril]

Historically psychiatry training tried to reduce training to 3 years. The results were much poorer psychiatrists and they switched back quickly.

Your points are those that everyone who hasn't gone through the training can have -- but you don't know what you don't know. It's easy to check labs and learn what the basics of abnormalities mean, but missing the larger context of what's happening. Physicians have a broader and more in depth medical training than an NP or any psychologist.

Yes we all have investment in why our profession is important, because we want to value our own effort and identity. But in the context of medications and medical problems, less training leads to more medical errors. We know that from the data on residents and from the Institute of Medicine (less trained-->more errors). Listing single areas of competency such as checking a lithium level, deconstructs the depth of training as if knowing a couple of factoids is equivalent to the totality of hours of immersion, regular supervision, general pathophys training, etc.

Sure many psychiatrists leave aside their medical training, but that's their choice. This has been rehashed over and over in the RxP thread on the psychology forum. As much as the propaganda from mid-levels and RxP's that they can be as good as psychiatrists at managing medications, there's no data in favor of this (they often cite the lack of data of complaints filed as proof of competency), and plenty of data from the IoM that lesser trained residents have many more errors than more trained, AND that the DoD RxP's at best had the medical knowledge of a mid-level medical student. Go back to the RxP thread because this can easily derail this thread. Apologies for contributing to that.

I think you misinterpreted what I meant. I'm not saying that psychiatry training is too long(it def isnt) or that psychiatrists shouldnt have some training in pharmacology, pathophys, etc.......I'm saying in an ideal world I don't know that that training would be in an MD/DO school model. There isn't any real reason psychiatry couldnt have it's own training within a larger umbrella of a mental health grad program(where psychologists and psychiatrists have some differences in training).......podiatrists get relevant training in physiology, some pharm, etc but they dont have to go to medical school.

As for residents((and attendings) and skill set in certain settings, there is a tremendous amount of individual variability. I see the weekend people come in to round who have been in an exclusively outpt setting for years and they have lost pretty much all their "medical" oriented training.....Im sure they knew far more wrt that stuff by the end of their second or third year of residency than they do now. And Im at a fairly large uni program. Obviously with a C-L attending or whatever it's different. I'm interested in that sort of stuff so I plan on doing electives in it as a pgy-4 starting in a month, but if I didn't want to there is no reason I would ever have to function in such a setting again.....and a good number of psychiatrists dont.

Consider three professionals- a clinical psychologist, a psychiatrist, and a nephrologist. Everyone would(hopefully) agree that a psychologist and psychiatrist have far more in common than with a nephrologist and a psychologist/psychiatrist, but in total % of training over 50% of the post undergrad training/education of the psychiatrist and nephrologist is EXACTLY the same, whereas it's a much lower % with the psychologist and psychiatrist. That can't be efficient in any way......

It is what it is and due to several reasons I don't think it is changing anytime soon....which, in a lot of ways, is certainly good for me. Med school was expensive, and knowing I have stable and rewarding financial prospects during and after residency is nice....but from an education/training perspective it seems pretty obvious that it is inefficient.

 

[billypilgrim37]

Consider three professionals- a clinical psychologist, a psychiatrist, and a nephrologist. Everyone would(hopefully) agree that a psychologist and psychiatrist have far more in common than with a nephrologist and a psychologist/psychiatrist...

Consider an ophthalmologist, an optometrist, and a nephrologist...

I want my ophthalmologist to go to medical school, even if she has a lot more in common with an optometrist.