Schizophrenia fellowship

[NeuroKlitch]

A waste of time and money ? This and schizoaffective disorder are my main interests in the field . The advise these days is to find a niche and excel. What are your thoughts . My ideal life would be a mix of inpatient and outpatient (of mainly schizophrenia /affective ) with some visits to the prison between my week. Is there a better fellowship to prepare me for his type of focus . Is forensic a better fit ?


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[NeuroKlitch]

I basically love the acutely psychotic , the criminally insane , and people with interesting delusions / dementia .


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[Shikima]

Go work PT at a community hospital InPt and then go to the CMH afterwards.

 

[SmallBird]

I basically love the acutely psychotic , the criminally insane , and people with interesting delusions / dementia .


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How far are you in training? Those things don't seem very connected...

 

[TexasPhysician]

Forensic is a better fit imo

 

[clausewitz2]

Schizophrenia fellowships are really aimed at people intending to primarily do schizophrenia research for a living. If you are gunning for a research career, not unreasonable. They are not really designed to make you more of a clinician.

 

[Nasrudin]

Yeah. I don't get it. Without the research....it would just be ... residency. And it would beg the question: do you just hate making an attending salary? Love unpaid call?

Why would anyone do that fellowship?

That's like a primary care doc doing a fellowship in diabetes or hypertension.

 

[HarryMTieboutMD]

The OP is a med student in the Carribbean just now getting clinical exposure- hence multiple posts on this forum that we might consider "ridiculous".

Anyway, there is no such thing as a clinical schizophrenia fellowship (at least as far as I know). Schizophrenia affects 1% of the population and is part of the basic skill set of a psychiatrist. Most interns can learn basic antipsychotic management in a couple of months.

 

[NeuroKlitch]

Yeah just for clarification, I am an IMS MS3, on my second to last rotation. Already did my Psychiatry rotation, and only have OBGYN and Family med left.

From what I've researched, schizophrenia fellowships exist although they are not necessarily accredited. That just happens to be where my interest in psychiatry is, and the programs usually focus on early symptom identification, Clozaril clinics, and so on. My idea is that while Schizophrenia is part of everyone's basic training, this added expertise, could possibly help to create a good referral base or incentive for clinicians to send all their Schizophrenic/Schizoaffective patients to my practice so that I could build a practice mostly comprising of that patient population.

" acutely psychotic , the criminally insane , and people with interesting delusions / dementia ."

How are these connected? well, they aren't but was essentially asking for advice on what is in the realm of possibility for me to practice and what fellowships if any to pursue. For example, a fellowship in geriatrics or neuropsychiatry could satisfy my desire to work with the delusional/demented population, and then could possibly work 3 days/week Inpatient with admitting privileges in the ER's ASU (satisfy acutely psychotic presentations and stabilization) , have an outpatient clinic 2 days per week ( hopefully with over 50% of patients with schizophrenia) and then work part time (I've seen job offers for 10 hours a week) at correctional facilities.

I mean that is my plan. But my question (and I see its gotten very off track and taking all sorts of directions in this thread) what fellowships would help me accomplish this, and would allow me to have the greatest skill set/knowledge to not just be good, but to be excel and be the best in my community. I plan to be great regardless of a fellowship in case that was your next point, but I imagine there are clear benefits to being an expert beyond general training. I would appreciate any responses that are directed towards answering my questions.

 

[deleted736562]

The OP is a med student in the Carribbean just now getting clinical exposure- hence multiple posts on this forum that we might consider "ridiculous".

Anyway, there is no such thing as a clinical schizophrenia fellowship (at least as far as I know). Schizophrenia affects 1% of the population and is part of the basic skill set of a psychiatrist. Most interns can learn basic antipsychotic management in a couple of months.

Actually there is one in MGH.

If you're really passionate about schizophrenia, want to stay in academia and want to be mentored by the best in the business then it's definitely not a bad idea.

 

[HarryMTieboutMD]

Actually there is one in MGH.

If you're really passionate about schizophrenia, want to stay in academia and want to be mentored by the best in the business then it's definitely not a bad idea.

I briefly looked this up, and if you are doing purely clinical work this still seems like a waste of time/lost income. Most residencies offer enough time in the PGY 4 year for electives to do things like early recognition/first episode clinics, and if you don't get enough exposure using clozapine (or, more broadly, treating treatment resistant SCZ), then your program has soul searching to do. If however, you want to be on the cutting edge of early recognition research, etc, this could be a foray into that but doing a T32 would probably be a better use of time.

 

[HarryMTieboutMD]

Yeah just for clarification, I am an IMS MS3, on my second to last rotation. Already did my Psychiatry rotation, and only have OBGYN and Family med left.

From what I've researched, schizophrenia fellowships exist although they are not necessarily accredited. That just happens to be where my interest in psychiatry is, and the programs usually focus on early symptom identification, Clozaril clinics, and so on. My idea is that while Schizophrenia is part of everyone's basic training, this added expertise, could possibly help to create a good referral base or incentive for clinicians to send all their Schizophrenic/Schizoaffective patients to my practice so that I could build a practice mostly comprising of that patient population.

" acutely psychotic , the criminally insane , and people with interesting delusions / dementia ."

How are these connected? well, they aren't but was essentially asking for advice on what is in the realm of possibility for me to practice and what fellowships if any to pursue. For example, a fellowship in geriatrics or neuropsychiatry could satisfy my desire to work with the delusional/demented population, and then could possibly work 3 days/week Inpatient with admitting privileges in the ER's ASU (satisfy acutely psychotic presentations and stabilization) , have an outpatient clinic 2 days per week ( hopefully with over 50% of patients with schizophrenia) and then work part time (I've seen job offers for 10 hours a week) at correctional facilities.

I mean that is my plan. But my question (and I see its gotten very off track and taking all sorts of directions in this thread) what fellowships would help me accomplish this, and would allow me to have the greatest skill set/knowledge to not just be good, but to be excel and be the best in my community. I plan to be great regardless of a fellowship in case that was your next point, but I imagine there are clear benefits to being an expert beyond general training. I would appreciate any responses that are directed towards answering my questions.

You honestly don't know enough psychiatry (or medicine in general) given your other posts to know what you want to do at this point- residency is entirely different. You should probably concentrate your efforts on matching into a psych residency in the first place

 

[NeuroKlitch]

You honestly don't know enough psychiatry (or medicine in general) given your other posts to know what you want to do at this point- residency is entirely different. You should probably concentrate your efforts on matching into a psych residency in the first place

Very helpful, and to the point . Thanks


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[Bartelby]

I have never heard of a schizophrenia fellowship, though I don't doubt they exist. To do what you are proposing, you don't need such a fellowship. Pick a program with good exposure to that patient population and good faculty, then plan a fourth year that centers around getting more in-depth experience with that population and reading up about the topic on your own. If, when application time comes, you believe this plan is insufficient you can always still apply for the fellowship.

A forensic fellowship is not needed to work in prisons. It can be helpful if you want to do expert witness work, or have a burning curiosity about the workings of the legal system as applied to mental health.

As for your planned job, inpatient roles are usually going to want five days per week. It is not unusual, though, to be done by the afternoon and to see clinic patients or do other work (such as forensic reports, teaching, etc.) in the afternoon.

Finally, be aware that outside of some very unusual roles (such as working on a specialty inpatient service at Hopkins) you will be seeing a wide range of mental disorders in any setting. You can still skew toward psychotic disorders, but be ready for personality disorders, affective disorders, and everything else too!

 

[NeuroKlitch]

I have never heard of a schizophrenia fellowship, though I don't doubt they exist. To do what you are proposing, you don't need such a fellowship. Pick a program with good exposure to that patient population and good faculty, then plan a fourth year that centers around getting more in-depth experience with that population and reading up about the topic on your own. If, when application time comes, you believe this plan is insufficient you can always still apply for the fellowship.

A forensic fellowship is not needed to work in prisons. It can be helpful if you want to do expert witness work, or have a burning curiosity about the workings of the legal system as applied to mental health.

As for your planned job, inpatient roles are usually going to want five days per week. It is not unusual, though, to be done by the afternoon and to see clinic patients or do other work (such as forensic reports, teaching, etc.) in the afternoon.

Finally, be aware that outside of some very unusual roles (such as working on a specialty inpatient service at Hopkins) you will be seeing a wide range of mental disorders in any setting. You can still skew toward psychotic disorders, but be ready for personality disorders, affective disorders, and everything else too!

Thank you ! This is the kind of feed back I was looking for . Really appreciate it !


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[ItsNotMe_ItsYou]

We have similar interests! If a prison has a dedicated mental health unit, that would be interesting; however, state hospitals have the most pure pathology that I've encountered.

 

[Shikima]

Bring back the old asylums from the days of yesteryear. That would solve a lot.