RN to Psychiatrist

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PSnowden

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Hello everyone.

I am new to this forum and have a question. I graduated from nursing school 3 years ago, and have been highly interested in changing my career choice to becoming a psychiatrist. Funny thing is, I have always wanted to be a psychiatrist, but ended up becoming a nurse instead. Although I do love my job as a nurse, I feel, as I am still young, I should go for my dream job. I was wondering if there were any of you who were a nurse first, or maybe know more about what moves I should take in order to become a psychiatrist. I do understand it will take quite a few years of studying, which I do not mind, at all. I am hoping that many of my credits can get transferred to my psychology degree. I apologize if I posted this in the wrong category. Thank you all so much for your help 🙂

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Psychiatrists are physicians, so it's not directly RN --> psychiatry. You would have to go to medical school first.

Now, there are options available - psychology is one, or you could do a nurse practitioner mental health program. I know NOTHING about those (and I'm not a psychiatrist). Also, in some areas, MSW providers do the psychotherapy/psychiatric work.

Physicians can prescribe meds. Psychologists cannot. MSWs cannot. I don't know about psych NPs.

That's just a very cursory overview. Hopefully people "in the biz" will chime in.
 
Hello,

Thank you for your reply. Yes, I think maybe my best bet would be to jump into medical school. As I stated, I have always wanted to be a psychiatrist, so I will do anything it takes to get there. It might also be a great idea to become an NP also, as you mentioned. I just feel so confused as of what is the best thing to do. I have no children, and a very supportive fiance' so I just want to make sure I make the best choice. Thanks so much for your help. I will definitely look into some RN-NP programs, and medical schools as well. As of right now I live in the country, so there aren't many schools to choose from within an hour from my home. I had to travel an hr and back to go through nursing.

Oh, and another Q. Not sure if you or anyone can help me with this one. I work in a hospital setting and was wondering if hospitals pay for schooling? Probably sounds like a dumb question, and I really should ask my hospital. I will check up with them Saturday when I am at work. But, just wondering if anyone has had their job pay for their schooling as well. Sorry for all the questions and confusion. Have a great day, and again thanks for your replies 🙂
 
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Physicians can prescribe meds. Psychologists cannot. MSWs cannot. I don't know about psych NPs.

Psychologists in Louisiana and New Mexico can prescribe medication after completing a post-doctoral master’s degree in clinical psychopharmacology and they must pass a national exam approved by the state board of examiners of psychologists.

In a handful of states, psych NPs can practice independently and prescribe medications without physician supervision.
 
Hello,

Thank you for your reply. Yes, I think maybe my best bet would be to jump into medical school. As I stated, I have always wanted to be a psychiatrist, so I will do anything it takes to get there. It might also be a great idea to become an NP also, as you mentioned. I just feel so confused as of what is the best thing to do. I have no children, and a very supportive fiance' so I just want to make sure I make the best choice. Thanks so much for your help. I will definitely look into some RN-NP programs, and medical schools as well. As of right now I live in the country, so there aren't many schools to choose from within an hour from my home. I had to travel an hr and back to go through nursing.

Oh, and another Q. Not sure if you or anyone can help me with this one. I work in a hospital setting and was wondering if hospitals pay for schooling? Probably sounds like a dumb question, and I really should ask my hospital. I will check up with them Saturday when I am at work. But, just wondering if anyone has had their job pay for their schooling as well. Sorry for all the questions and confusion. Have a great day, and again thanks for your replies 🙂

I have never heard of a hospital paying for schooling (other than indirectly shouldering part of the cost of GME by hiring residents). Most hospitals -- which are financially strapped, as a general rule -- would prefer to pay for health care services rendered.
 
OP, I think you need to do a bit more research about the actual amount of schooling, time, competition, pre-requisite courses, and cost involved in the process. Check out the allopathic FAQ's, and Pre-med forums. Not to discourage you, but your posts seem to indicate you have a broad goal but not much information about the process involved. It's a long road. (8-10 years).
 
1) complete all necessary undergraduate prerequisites.
-1 full year of lab based chemistry
-1 full year of lab based physics
-1 full year of lab based biology
-1 full year of lab based organic chemistry. This requires general chemistry as prequisite though. Also some medical schools will accept a substitution of one semester for biochemistry.
-Some schools have other trivial requirements of so many english, literature, humanities, math, etc. So start sampling a few schools websites to get an idea.

2) The prerequisite stage is often a 'wash out' area for many nurses because the chemistry and organic chemistry they took for their BSRN was a watered down version that isn't on par with normal undergraduate science courses, and won't transfer/meet the requirements for prerequisites. This means it might very well take you two years, if appropriately planned, of taking undergraduate courses. These classes must be done well. Because of this stage, some nurses will pursue NP or the emerging new standard of degree creep the DNP (i.e. greater tuition costs for same job description). Admission to prequisites into these programs is geared more towards nurses, naturally.

3) At some point you also need to take the MCAT which is based on those 4 main core courses above.

4) Assuming your GPA and MCAT are good enough you'll need to apply to MD and/or DO schools. They have different standardized application services.

5) Start medical school, and take on the debt. Very few people get large scholarships or full rides. It can happen but isn't something you should count on. Choose your school based on lowest cost.

6) Prepare for one heck of a mental gauntlet of 4 years.

7) Psychiatry residency is 4 years following medical school.
 
What about psychiatric nurse practitioner? Sorry if that was already mentioned...
 
I have never heard of a hospital paying for schooling (other than indirectly shouldering part of the cost of GME by hiring residents). Most hospitals -- which are financially strapped, as a general rule -- would prefer to pay for health care services rendered.
It's not uncommon in my area for tuition reimbursement to be a benefit for hospital employees. Some offer it for FT and PT employees, others just for FT. It may be a benefit that's going away with budget tightening, but it definitely exists.

That said, there are often restrictions to the benefit: having to work a certain amount of time for the company after receiving the money (eg, one year), only being able to use it to advance your current career (eg, LPNs taking classes to become a BSN), only being able to use it for undergraduate-level classwork, etc.

Best advice: talk to a Human Resources benefits specialist at your hospital to find out what, if anything, is available.
 
Former nurse here, currently in my 3rd year of medical school bound for psychiatry. I can share a bit of my experience if it'll help you

I enjoyed being a nurse, and it was hard to make that leap to medical school. If I could give you just one piece of advice: if you must go into medical school it must be because you desire to become a doctor, not because you get fed up from nursing.

I'll also give you some frank points about what I learned from my switch that will hopefully assist you in your decision.

(1) 'Sneezing' is absolutely right: nursing courses are incredibly simple. I took 'human anatomy' and other seemingly technical classes in nursing school (as I'm sure you did) that looked pretty impressive on a transcript.

The difficultly of nursing school will not prepare you for the aforementioned undergrad prereqs. If you struggled at all getting your BSN, you need to seriously question if you are ready to start those requirements. There will be no 'filler' classes that are just busy work (aka 'nursing theory'), nor will there be a subclass of marginal performers providing you with a favorable comparison.

I'm not purposefully trying to insult our nursing training. It's just the truth, and you should be aware of these facts.

(2) Like me, you will be old in medical school. "Age is just a number!", I hear you cry. Also, "If you just follow your dreams...", and "I heard about a 90 yr old..."etc etc. Sure non-trads get in and do OK, I'm proof of that, but it is more difficult for us. Standing for hours during surgery is physically challenging for someone not in their early 20s. That's life.

You are 12 or more years away from being a psychiatrist. Like others pointed out, consider that sort of commitment.

(3) Now for the good part. Nursing has prepared me very well for actual patient contact. Interviews and note writing get better with practice, so due to sheer numbers, I'm pretty good at both. And that means a lot in medicine as I'm sure you know.

I'm also much better than other students -- and most doctors -- at jobs considered too lowly for the elite. This includes starting IVs, urinary caths, and especially dealing with wound care. Not that all nurses are good with wounds mind you, but if you know when to use polymem vs mepilex, you'll be miles ahead. For some reason physicians don't think learning bandages is worth their time (wound specialists excluded of course)

Good luck to you in your decision
 
Thank you everyone for all of your replies. I am feeling lost as of what to do. But, all of your replies helped me tremendously. I think I will check with my job, and also ask a counselor what would be best. Sorry if I confused anyone. I am just feeling lost at the moment what I should do. I don't really mind the years and years of studying. I just want to make sure I take all the courses I need to take, and steps I should take.

Thanks again 🙂
 
Psych- Thank you for your reply. I am so glad to hear of another nurse wanting to go into psychology. It's been a tough decision, but I have always wanted to do this. As of right now I am 27, I don't have any children, although some day would definitely like to. So, it's going to be hard to fit schooling, my job, my fiance, and having children into my schedule, lol. I give credit for those who have done this, and more. But, I will definitely go through great lengths to make this happen. I have always pushed myself to be the best, and will continue to through medical school (should that be the path I take).

Thanks everyone for all your help.
 
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Michael Rack, there is no need to get upset. It was an honest mistake. I listened to everything Psych4Sure said, and appreciate the advice. They mentioned they are in their third year of medical school, which is why I had mentioned that. It's not a big deal. It's definitely nothing to get upset about. We all make mistakes. I apologize for upsetting you. It was not my intention.
 
Michael Rack, there is no need to get upset. It was an honest mistake. I listened to everything Psych4Sure said, and appreciate the advice. They mentioned they are in their third year of medical school, which is why I had mentioned that. It's not a big deal. It's definitely nothing to get upset about. We all make mistakes. I apologize for upsetting you. It was not my intention.


I don't think MichaelRack is upset or insulted, but I think a lot us reading your posts have some concerns with the nonchalant way that you are talking about going from being a RN to a psychiatrist and your confusion with psychology and psychiatry. I think you are exploring career opportunities, which is great. But you need to know becoming a psychiatry is more than merely "studying hard."

First, I think you need to find out what a psychiatrist does. You mentioned that you have always wanted to be one, but what about psychiatry do you like? As a nurse, if you hospital has a psych unit, then I would recommend you to work there for some experiences. Yes, psychiatry has an outpatient side, but working in a psych unit will give some exposure to the field. It will give you opportunities to speak with other psych nurses, psychiatrists, and other mental health workers.

Second, being psychiatrist is a long,arduous and expensive process. Getting into medical school is tough, even for great student with a brilliant resume. Besides taking those basic sciences over again, you will have to take the MCAT and apply for medical schools. Depending on your grades and MCAT, you may have to consider osteopathic medical schools and caribbean medical schools. Once you get into medical school, you will accrue a large student loan debt-more than 100K+. Many students going into medical school thinking that they want to be psychiatrists, and many do end up as psychiatrists. But it is best to go into medical school with an open mind. Medical school is not like college, you can't pick a major. They will teach you "everything" about medicine. You will be spending most of waking time the first two years in class, studying for many exams, etc. During these 2 years, everyone takes the same basic medicine courses. You will have a little exposure to psychiatry via lectures and probably some interview classes. During your third year, you will do your core clinical rotations-usually IM, peds, obgyn, general surgery, psychiatry, FM (school dependent). In your fourth year, you will be doing elective rotations along with some school required rotations. So, you may elect to do a few months of psychiatry in your fourth year. You will be spending many hours either in hospitals or reading. On top of this, you will have to take the board exams or USMLE-step 1, CS and CK.

Third, to get into the residency that you want, you have to go thru an extensive interview and selection process that is called "the match." I won't go into it, please read the following wiki page:
http://en.wikipedia.org/wiki/Residency_(medicine)
Basically, you won't have 100% control of if and where you will end up doing your psychiatry training. Once you get into a psych residency, the training is 4 years. Get ready to work 60 hours a week the first two years for $40-60,000 a year. There are also fellowships available if you wish to subspecialize.

So, you say that your fiance is very understanding, but it is very important that he is ready to spend the next 10-12 of your lives being in school/work constantly and may not be emotionally available for him. I have seen too many marriage failed in my medical school. It doesn't sound like you want to move, but being willing to relocate maybe necessary for medical school and residency.
 
So, you say that your fiance is very understanding, but it is very important that he is ready to spend the next 10-12 of your lives being in school/work constantly and may not be emotionally available for him. I have seen too many marriage failed in my medical school. It doesn't sound like you want to move, but being willing to relocate maybe necessary for medical school and residency.
Relocation is most likely necessary through this process. Of the people who stick through all the prerequisites, study and take the MCAT, 1/2 do not get accepted to medical school. Of those that do, many-to-most have to move to go to medical school. In the state I'm from (California), when I applied to medical school a full 2/3rds of those accepted had to leave the state. After you move somewhere for 4 years for medical school, there's a good chance you'll have to move again for residency. Slight chance you'll have to for fellowship, if you go that path.

In addition to having a fiance who is very, very understanding about your being emotionally, financially, and physically unavailable for the next 10 or so years, he has to be comfortable with you and he paying back $200-$800k in loans (depending on tuition and how much interest you let accrue).

I was a career changer and married when I went to medical school and am now in residency. It was tough and extremely taxing on my wife through it all. We don't regret the decision (especially this half of we), but there's no way I would have undertaken it without my wife's full support with both eyes open, and without knowing that I would not have been satisfied with my life had I not done so. She committed to a huge sacrifice in her life for 10 years, for which I will constantly remind myself and behave accordingly.

Do not pursue a career in medicine unless you can't imagine doing anything else. There are just too many good careers where you can help people and challenge yourself intellectually that require much less sacrifice. Pursuing medicine is usually a one way street as extricating yourself with all the time and financial commitment is very difficult to do.

The reason folks are trying to make sure you do not make the decision lightly is that we all see folks who did. Many of them are bitter, resentful of patients, and watching the clock so they can leave as early as possible (this actually describes some nurses we all know, but they do have the more realistic option of changing careers). They are draining to work with and everyone is saddened by watching a life misspent.

Again, many/most career changers to medicine are happy with their decision. Just make it wisely. Best of luck with your decision...
 
Hello everyone. Thanks for the replies. I agree, I need to look more into psychiatry and psychology. I did some research today and realize there is way more into it than I thought. I am still very interested, but I need to do some more research before making my decision. I realize (if) I choose to go this route, I will have to put everything on hold in my life, but I am willing to do that for my career. As for my fiance' we have been together for 11 years, and he is very supportive, so he is not whom I am worried about 🙂. I will keep you all updated on my decision. I appreciate all of your feedback. Thanks for all of your help 🙂

I am sure I will have more Q's later 🙂
 
I am a long time reader but have never posted a lot on these boards. I just wanted to say that it sounds like you're doing a lot of great research and thinking about your future career plans. I was a social worker prior to starting medical school and am planning on going into psych (will apply for residency next year.) Everything people are saying is true, it's an incredibly long and hard path. Not sure yet if I would do it again. I started medical school without kids and am now expecting my second one this summer. It really changes everything.

No one can tell you what the right path is for you, but I have worked with some really great psychiatric nurses who have a lot of autonomy in their work and I think this could be a great path for someone with a nursing background.

I was a hospital social worker and my hospital had tuition reimbursement so I got most of my prereqs paid for. My employer was very supportive and allowed me to flex my schedule so I could take classes when I needed to. I couldn't have continued working during medical school and I don't know anyone that did, but I'm sure some people do it.

Good luck with your decisions. It's a fun and exciting time.
 
Hello everyone. Thanks for the replies. I agree, I need to look more into psychiatry and psychology. I did some research today and realize there is way more into it than I thought. I am still very interested, but I need to do some more research before making my decision. I realize (if) I choose to go this route, I will have to put everything on hold in my life, but I am willing to do that for my career. As for my fiance' we have been together for 11 years, and he is very supportive, so he is not whom I am worried about 🙂. I will keep you all updated on my decision. I appreciate all of your feedback. Thanks for all of your help 🙂

I am sure I will have more Q's later 🙂



Just to make it clear. Clinical psychology and Psychiatry are not the same.


Clinical Psychology = 4/5 years of doctorate (PhD or PsyD) which involves modules, practica and a research thesis + 1 year of internship + 2 years of fellowship (this is according to APA standards but you don't have to do the fellowship, atlhough a lot people do it these days). It involves a lot of psychological testing (e,g, personality, intelligence) and psychological interventions and therapy like cognitive-behavioural therapy, psychodynamic or humanistic (among others) for mental health problems (e.g. depression, anxiety, panic, obsessions, personality problems etc.), behavioral interventions for those with various deficits (e.g. alzheimers) or developmental problems (like autism) etc. Also a lot of research (at least during the doctorate!) and even administrative stuff. Psychologists don't prescribe drugs, unless they have extra training (another 2-3 years) in ONLY two specific States (which are mentioned in a previous post). Mean salary is around 70.000 (i think) but some sub-specialties like clinical child psychologists or clinical neuropsychologists can make a bit more (up to 110-120.000).


Psychiatry = 4 years of medical school (MD) + 4 years of residency in Psychiatry (+ 1-2 years of fellowship in a sub-specialty but it is not essential). It involves mainly diagnosing and treating mental-health problems (e.g. anxiety,panic, depression, obsessions but also a lot more "serious" mental health problems like psychotic disorders) from a medical standpoint. It is also possible to order medical tests and practice involves (mainly) treating with psychotropic substances (e.g. anti-depressants, anti-psychotics, anti-anxiety, among many others.). Some residencies also offer training in psychotherapy (like cognitive-behavioural and psychodynamic mentioned before for clinical psychologists) and some psychiatrists pursue that training on their own, but it is not obligatory. You don't have to get involved in research (like the doctorate in clinical psychology) unless you want to. Mean salary is around 180.000 (correct me if i'm wrong, it may be a bit more) but some sub-specialties like child-asolescent psychiatrists can make more (up to 200.000+ i think).



Just in case you confuse the two.
 
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Couple points of clarification on Petran's post -- All residencies require psychotherapy training now, per ACGME requirements.

Salary/income for psychiatrists varies based on many factors including location. Urban settings tend to make more. I work in a county clinic, and most psychiatrists here make 180-200k immediately when hired.
 
Word of advice and this goes for both fields. Despite the mean salaries, if you are sharp, look at the opportunities, and use them, you could make a hell of a lot more, with or without fellowship training.

I try to shy away from saying how much I make but to give you a straight example, got a 40 hour per week job, was making an average salary. After being in the area, checking things out, establishing a rep for consistent care, and networking, I'm now making much much more than an average salary. Of the things I'm doing that's making me the extra, I didn't need a fellowship under my belt. I actually got a problem now because I'm upsetting some people telling them I'm cutting my hours at one place I work to increase at another and turning out a lot of offers I'm given. The fellowship certainly helped, but don't get caught up in simply getting a job and staying in it without looking into what's available unless that's what you want.

Several other doctors I know simply go to work, go home, and that's the mental box they are in. I've established a good relationship with 3 hospital systems, my fellowship, the local courts, several local psychotherapists, and 2 private practices...and now I've got a headache with turning people down.
 
I think one thing you might want to consider, in addition to the ones mentioned, is what exactly do you picture yourself doing down the road, both professionally and for pleasure.
 
Whopper is spot on. If you play your cards correctly and have decent interpersonal skills, your problems will be the good kind - too many referrals and too much demand for your services. Triaging referrals takes up more and more of my time...

Word of advice and this goes for both fields. Despite the mean salaries, if you are sharp, look at the opportunities, and use them, you could make a hell of a lot more, with or without fellowship training.

I try to shy away from saying how much I make but to give you a straight example, got a 40 hour per week job, was making an average salary. After being in the area, checking things out, establishing a rep for consistent care, and networking, I'm now making much much more than an average salary. Of the things I'm doing that's making me the extra, I didn't need a fellowship under my belt. I actually got a problem now because I'm upsetting some people telling them I'm cutting my hours at one place I work to increase at another and turning out a lot of offers I'm given. The fellowship certainly helped, but don't get caught up in simply getting a job and staying in it without looking into what's available unless that's what you want.

Several other doctors I know simply go to work, go home, and that's the mental box they are in. I've established a good relationship with 3 hospital systems, my fellowship, the local courts, several local psychotherapists, and 2 private practices...and now I've got a headache with turning people down.
 
Depending on your grades and MCAT, you may have to consider osteopathic medical schools

..and depending on your performance in medical school, you may be forced to consider psychiatry.

While it's true that the maltriculants to DO schools and psychiatry residencies have comparatively lower stats, I would not make such important career decisions based on ease of entry.
 
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