Should I become a psychiatrist or clinical psychologist

[mmiller1998]

Hello all!
Was just hopping on here to get some opinions. I am in undergrad finishing up my bachelors.. for the longest time I wanted to become a clinical psychologist, however, recently my interests are expanding and I’m not sure if I should still pursue a PsyD or become a MD/DO. I would like to have a multiple treatment option structure when I am practicing in the future. I know some psychologists can prescribe but if all possible would love non-biased opinions on this. I’ve been stuck and am unsure of what to do. Thank you.

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[comp1]

Good question! Much like joining the military, where your first role is soldier...you may need to rephrase your title question. Do I want to become a physician? The focus of four years of med school (plus half of your first year of residency) will have little to nothing to do formally with psychiatry or even mental health. What have you thought about the science pre-requisites? Do you think you'll enjoy anatomy and physiology?

 

[mmiller1998]

Good question! Much like joining the military, where your first role is soldier...you may need to rephrase your title question. Do I want to become a physician? The focus of four years of med school (plus half of your first year of residency) will have little to nothing to do formally with psychiatry or even mental health. What have you thought about the science pre-requisites? Do you think you'll enjoy anatomy and physiology?

Hello, thanks for your response. I like how you rephrased the title... personally I never really saw myself as a physician first.. when I was younger I wanted to be a doctor however my passion for mental health grew very strong following those years of youth. I have to say I love anatomy physiology but cannot stand chemistry... I’m sure I could get through physics. I love my psychology classes as they come naturally to me. I know some psychologists can prescribe in certain states so I have thought about that as well. I feel stuck in a sense.

 

[wolfvgang22]

You'll need to learn to love chemistry if you want to prescribe medications Psychologists that have no understanding of chemistry have no business prescribing. This is one reason I left my psychology grad program for med school years ago.

 

[When is graduation again?]

Hello, thanks for your response. I like how you rephrased the title... personally I never really saw myself as a physician first.. when I was younger I wanted to be a doctor however my passion for mental health grew very strong following those years of youth. I have to say I love anatomy physiology but cannot stand chemistry... I’m sure I could get through physics. I love my psychology classes as they come naturally to me. I know some psychologists can prescribe in certain states so I have thought about that as well. I feel stuck in a sense.

What draws you to mental health treatment? What do you enjoy about it? When you imagine your life as a mental health expert, how do you imagine your life? How much does lifestyle play a role in your decision? What is your student loan situation? What are your scholarship prospects? Are you okay having 8 or more years of your life in which you have little control over your life/schedule and when you can see your family?

These are a lot of questions, but ultimately should all go into your consideration. I'm sure there are many other questions I could ask, but I think these questions should indicate a bit about where you should be gravitating towards.

 

[mmiller1998]

What draws you to mental health treatment? What do you enjoy about it? When you imagine your life as a mental health expert, how do you imagine your life? How much does lifestyle play a role in your decision? What is your student loan situation? What are your scholarship prospects? Are you okay having 8 or more years of your life in which you have little control over your life/schedule and when you can see your family?

These are a lot of questions, but ultimately should all go into your consideration. I'm sure there are many other questions I could ask, but I think these questions should indicate a bit about where you should be gravitating towards.

I feel like what draws me to mental health is using my voice, but at the same time I would love to use multiple tools to help my future patients. I see myself helping them and guiding them through their mental health struggles. I see myself in private practice doing mostly therapy but also prescribing when needed.

 

[mmiller1998]

You'll need to learn to love chemistry if you want to prescribe medications Psychologists that have no understanding of chemistry have no business prescribing. This is one reason I left my psychology grad program for med school years ago.

I agree chemistry is a very important topic when it comes to having that ability and either or I will need to learn it and know it well. I think there are many prescribers who can do that however only some have sufficient training in psychopharmacology. Thanks for your response!

 

[mmiller1998]

I agree chemistry is a very important topic when it comes to having that ability and either or I will need to learn it and know it well. I think there are many prescribers who can do that however only some have sufficient training in psychopharmacology. Thanks for your response

 

[mmiller1998]

What draws you to mental health treatment? What do you enjoy about it? When you imagine your life as a mental health expert, how do you imagine your life? How much does lifestyle play a role in your decision? What is your student loan situation? What are your scholarship prospects? Are you okay having 8 or more years of your life in which you have little control over your life/schedule and when you can see your family?

These are a lot of questions, but ultimately should all go into your consideration. I'm sure there are many other questions I could ask, but I think these questions should indicate a bit about where you should be gravitating towards.

Basically therapy is what drove me towards mental health treatment. It helped many of my friends tremendously.. and that is where my passion grew from.

 

[WisNeuro]

Basically therapy is what drove me towards mental health treatment. It helped many of my friends tremendously.. and that is where my passion grew from.

Depends on what you want. A good clinical psych program will give you years of therapy experience and accompanying supervision in multiple therapy modalities. You'll also learn how to conduct and evaluate research as well as at least a minimum competency in psych assessment. Psychiatrists do therapy as well, but not nearly as much. It'll come late, and most that I know who regularly engage got additional training and supervision outside of their formal training. People in this forum can give you more detailed advice on that as I assume there is a lot of variability in residencies in this respect. Also, do you want to work in private practice, or within a hospital system? In my years in hospital systems, I've met less than a handful of psychiatrists doing therapy. Systems are pretty much only hiring prescribers for med mgmt in a lot of places.

 

[mmiller1998]

Depends on what you want. A good clinical psych program will give you years of therapy experience and accompanying supervision in multiple therapy modalities. You'll also learn how to conduct and evaluate research as well as at least a minimum competency in psych assessment. Psychiatrists do therapy as well, but not nearly as much. It'll come late, and most that I know who regularly engage got additional training and supervision outside of their formal training. People in this forum can give you more detailed advice on that as I assume there is a lot of variability in residencies in this respect. Also, do you want to work in private practice, or within a hospital system? In my years in hospital systems, I've met less than a handful of psychiatrists doing therapy. Systems are pretty much only hiring prescribers for med mgmt in a lot of places.

Hello! I’m definitely more interested in the therapy aspect as I’ve seen the positive effects it had on friends and family. I agree that most psychiatrists now are solely for Med management. I definitely want to get into private practice. I’ve seen psychologists can prescribe too... I mean I know I don’t want my practice to consist of mostly prescribing. I would rather do mostly therapy and meds if needed.

 

[WisNeuro]

Hello! I’m definitely more interested in the therapy aspect as I’ve seen the positive effects it had on friends and family. I agree that most psychiatrists now are solely for Med management. I definitely want to get into private practice. I’ve seen psychologists can prescribe too... I mean I know I don’t want my practice to consist of mostly prescribing. I would rather do mostly therapy and meds if needed.

If being a prescriber is a must, then it's either the med school route, or plan on being in an RxP state.

Society for Prescribing Psychology

Div. 55 (Society for Prescribing Psychology) was created to enhance psychological treatments combined with psychopharmacological medications.

www.apadivisions.org

 

[Sushirolls]

If I had to help a family member choose between a new graduate of an online ARNP program and a prescribing Psychologist, I would recommend my family members see the ARNP every time.

I'm curious to see how @medium rare feels about the two.

 

[dl2dp2]

If I had to help a family member choose between a new graduate of an online ARNP program and a prescribing Psychologist, I would recommend my family members see the ARNP every time.

I'm curious to see how @medium rare feels about the two.

lol

 

[mmiller1998]

If I had to help a family member choose between a new graduate of an online ARNP program and a prescribing Psychologist, I would recommend my family members see the ARNP every time.

I'm curious to see how @medium rare feels about the two.

Hey all thoughts are welcome here. We all are entitled to our own opinion. Thanks for replying on this thread.

 

[nexus73]

I'm certainly biased as a psychiatrist. But I think if you can get into MD/DO school and go the psychiatry route, it is going to give you more flexibility to do what you want. The tradeoff is a longer route to psychiatry and learning a lot of biology, chemisty etc, so if you really don't want that psychology is probably better.

What I see in the community is psychologists almost all in private practice doing therapy or some have carved out a primarily psychological testing practice. There are very few employed positions (if any) for psychologists here so they've got to go on their own or join a group.

If you become a psychiatrist and go to a residency with good focus on psychotherapy, you can basically do the same private practice therapy work. Plus you can do medications anywhere (prescribing psychologists may be expanding but who knows what states will allow it over the next 20 years). As a psychiatrist you can also work in many more settings. There are many employed jobs, but easy to do private practice and do therapy taking cash or billing insurance. You could do therapy 3 days a week in your own practice and work employed in a clinic doing mostly meds for 1-2 days. You could work weekends at a hospital rounding on inpatients. You could do telepsychiatry med management. There are psychiatry jobs everywhere, so from a pure employment perspective psychiatry is better I think. And if you really want to do a pure psychotherapy practice, you have the same opportunities as psychologists. But if you find interest in evaluation and management of medications, psychiatry will allow you to do that knowing you have the appropriate training.

Psychiatrists are not going to have the same training in psychological testing, and would likely have to seek out specific training workshops to get any sort of exposure, and will not be as good as a psychologist most likely. They might be as good as a psychologist managing medications.

If you want the fastest route to do psychotherapy you could get a masters in social work.

 

[WisNeuro]

I'm certainly biased as a psychiatrist. But I think if you can get into MD/DO school and go the psychiatry route, it is going to give you more flexibility to do what you want. The tradeoff is a longer route to psychiatry and learning a lot of biology, chemisty etc, so if you really don't want that psychology is probably better.

What I see in the community is psychologists almost all in private practice doing therapy or some have carved out a primarily psychological testing practice. There are very few employed positions (if any) for psychologists here so they've got to go on their own or join a group.

I'd tend to agree that positions in many institutional settings are becoming fewer due to midlevel hiring, with the caveat of VAs. VAs still have a very strong psychology presence, with the larger med centers having many psychologists, particularly if they have a string training program.

 

[Sushirolls]

I'd tend to agree that positions in many institutional settings are becoming fewer due to midlevel hiring, with the caveat of VAs. VAs still have a very strong psychology presence, with the larger med centers having many psychologists, particularly if they have a string training program.

I'm seeing Big Box shops in my area having a token PhD / PsyD who sort takes on a manger role and loosely oversees the therapy side of the department.

Sort of like the impending future of one MD/DO overseeing the herd of ARNPs.

 

[WisNeuro]

I'm seeing Big Box shops in my area having a token PhD / PsyD who sort takes on a manger role and loosely oversees the therapy side of the department.

Sort of like the impending future of one MD/DO overseeing the herd of ARNPs.

Yeah, back in my old hospital job, they didn't even a doctoral level therapy provider in the entire OP clinic at one hospital, there was an OP mgr who was a PhD, but they were at an entirely different site.

 

[PikminOC]

You'll need to learn to love chemistry if you want to prescribe medications Psychologists that have no understanding of chemistry have no business prescribing. This is one reason I left my psychology grad program for med school years ago.

You know there's the rxp for psychologist to prescribe? Rudimentary chem and skills

 

[PikminOC]

If I had to help a family member choose between a new graduate of an online ARNP program and a prescribing Psychologist, I would recommend my family members see the ARNP every time.

I'm curious to see how @medium rare feels about the two.

I'd refer them to a Psychiatrist

 

[Sushirolls]

I'd refer them to a Psychiatrist

Yes, preferentially. But if your only choice was ARNP (even if a new graduate from an online program) versus a psychologist who some how got an Rx pad, I would preference the ARNP.

 

[PikminOC]

Yes, preferentially. But if your only choice was ARNP (even if a new graduate from an online program) versus a psychologist who some how got an Rx pad, I would preference the ARNP.

I'd say primary care physician

 

[clausewitz2]

Yeah, back in my old hospital job, they didn't even a doctoral level therapy provider in the entire OP clinic at one hospital, there was an OP mgr who was a PhD, but they were at an entirely different site.

A few years ago, the psych hospital I trained at used to have one PsyD/PhD/DPsych level person as the unit director for each unit, so about 35 beds of varying levels of acuity and speciality. I believe this job was about 0.7 FTE. Then, one day, all the unit directors were fired and invited to reapply to their jobs. The catch was, now, instead of getting 0.7 FTE for being a director for one unit, they could get 1.0 FTE for being director of 3 units and part-time unit director positions were no longer on the table. As you might expect, there were not 15 unit directors still standing at the end of this process.

It's when they don't even pretend to care that Leviathan really p*sses me off.

 

[WisNeuro]

A few years ago, the psych hospital I trained at used to have one PsyD/PhD/DPsych level person as the unit director for each unit, so about 35 beds of varying levels of acuity and speciality. I believe this job was about 0.7 FTE. Then, one day, all the unit directors were fired and invited to reapply to their jobs. The catch was, now, instead of getting 0.7 FTE for being a director for one unit, they could get 1.0 FTE for being director of 3 units and part-time unit director positions were no longer on the table. As you might expect, there were not 15 unit directors still standing at the end of this process.

It's when they don't even pretend to care that Leviathan really p*sses me off.

Yeah, this is how things are going. At that old job, they wanted people to take over positions that also had training duties (prac studemts, interns) but with no admin offset. Sweet, and extra 10-15 hours a week with zero compensation for it! Where do I sign up?

Also, I'm having a difficulty time remembering the Leviathan reference.

 

[clausewitz2]

Yeah, this is how things are going. At that old job, they wanted people to take over positions that also had training duties (prac studemts, interns) but with no admin offset. Sweet, and extra 10-15 hours a week with zero compensation for it! Where do I sign up?

Also, I'm having a difficulty time remembering the Leviathan reference.

I mean, the goodness of your heart should be incentive enough, obviously. Unless you don't care about your patients or training the next generation of psychologists. You're not a monster, are you? Only a monster would make this about something so crass as money.

Leviathan (Hobbes book) - Wikipedia

 

[WisNeuro]

I mean, the goodness of your heart should be incentive enough, obviously. Unless you don't care about your patients or training the next generation of psychologists. You're not a monster, are you? Only a monster would make this about something so crass as money.

Leviathan (Hobbes book) - Wikipedia

Ah, that makes sense, I wasn't thinking about that Leviathan. I assumed it was a more modern pop culture reference. I immediately thought of the company in Better off Ted, but that was Veridian.

 

[mmiller1998]

I mean I guess overall I truly want to help people with mental illness.. having the option to prescribe and do therapy would be awesome regardless of what my title is.. my heart is in it for the right reasons for sure. Any opinions are much appreciated. I’ve tried to decide for 2 years in regards to either psychiatry or psychology.

 

[Indiana_Jane]

I mean I guess overall I truly want to help people with mental illness.. having the option to prescribe and do therapy would be awesome regardless of what my title is.. my heart is in it for the right reasons for sure. Any opinions are much appreciated. I’ve tried to decide for 2 years in regards to either psychiatry or psychology.

Apologies if you’ve said this already, but have you shadowed a psychiatrist or psychologist to see what the day to day looks like? I recognize this can be difficult, and there is much variability, but it is something to consider.

I took two years off after undergrad to work in an inpatient facility so I could see both side of things, and this helped me choose between the two. Granted, as others have stated, you may not see a psychologist in every setting, facility, etc.

 

[mmiller1998]

I personal

Apologies if you’ve said this already, but have you shadowed a psychiatrist or psychologist to see what the day to day looks like? I recognize this can be difficult, and there is much variability, but it is something to consider.

I took two years off after undergrad to work in an inpatient facility so I could see both side of things, and this helped me choose between the two. Granted, as others have stated, you may not see a psychologist in every setting, facility, etc

Apologies if you’ve said this already, but have you shadowed a psychiatrist or psychologist to see what the day to day looks like? I recognize this can be difficult, and there is much variability, but it is something to consider.

I took two years off after undergrad to work in an inpatient facility so I could see both side of things, and this helped me choose between the two. Granted, as others have stated, you may not see a psychologist in every setting, facility, etc.

I sent you a message on here! I have not shadowed a psychiatrist or psychologist. I have a general idea of what they do but have not seen them do their work personally.

 

[AcronymAllergy]

I mean I guess overall I truly want to help people with mental illness.. having the option to prescribe and do therapy would be awesome regardless of what my title is.. my heart is in it for the right reasons for sure. Any opinions are much appreciated. I’ve tried to decide for 2 years in regards to either psychiatry or psychology.

If you know going into it that prescribing is a strongly preferred option, psychiatry is your best bet. It would probably end up taking less time to complete med school + psychiatry residency than it would to pursue prescription privileges as a psychologist (although the latter may be cheaper), and your prescribing scope would be broader.

 

[TexasPhysician]

This is my opinion alone:

Most psychiatrists are not well trained in therapy. Most that want to focus on therapy will need to do extra training to get there after years of medical school and residency that lacks that aspect. I mostly do “therapy lite” on select patients that are there for mostly medication. I recommend that they do regular intensive therapy elsewhere.

Psychologists have no role in prescribing. I get that there are RxP states, but the training is terrible. I would never recommend it. If I worked in those states, I would recommend patients not use a RxP for even therapy as the likelihood of them crossing over and making inappropriate recommendations is high.

With you mentioning a preference for therapy, I’d argue that you should strongly consider the psychologist route. That is with me really enjoying my profession.

 

[Splenda88]

It comes down to this:

Do you want to make 100k/yr with less flexibility vs. do you want to make 300k/yr with more flexibility and prestige? 😛

 

[mmiller1998]

It comes down to this:

Do you want to make 100k/yr with less flexibility vs. do you want to make 300k/yr with more flexibility and prestige? 😛

I would never go into career for the money.. I just want to be comfortable and happy doing what I’m doing. But some people look at it differently! I appreciate your opinion. Thanks for the reply 😊

 

[WisNeuro]

It comes down to this:

Do you want to make 100k/yr with less flexibility vs. do you want to make 300k/yr with more flexibility and prestige? 😛

Just throw in IME work, make money, have great flexibility, and do whatever you want with the other half of your time.

 

[mmiller1998]

Just throw in IME work, make money, have great flexibility, and do whatever you want with the other half of your time.

Within which career?

 

[WisNeuro]

Within which career?

Either.

 

[medium rare]

If I had to help a family member choose between a new graduate of an online ARNP program and a prescribing Psychologist, I would recommend my family members see the ARNP every time.

I'm curious to see how @medium rare feels about the two.

It varies considerably. With APRNs, you can have a seasoned nurse who has practiced as a RN for years and then went on to train as a PMHNP or you can have someone with a bachelor’s degree in Spanish who completes a 2-year, accelerated BSN/MSN program as a PMHNP and both end up with the same scope of practice, privileges and income potential but significantly varied expertise. This is a problem for advanced practice nursing as there are clearly NPs out there with inadequate training and others who are excellent.

Prescribing psychologists are few in number and it is difficult to get a sense of their prescribing expertise as a group because of their scarcity. The prescribing psychologists that were part of the DoD demonstration project were heavily scrutinized and found to be competent by their psychiatrist colleagues as reported in the federal GAO report put out several years ago but there were only 10 prescribing psychologists in the project. Several of them continue to practice and prescribe in the military.

The few (3) prescribing psychologists I know in New Mexico seem competent via the conversations I have had with them at various psychopharmacology conferences where we have jointly attended and I know they are well-respected in their various home communities.

The RxP training program at New Mexico State University is generally viewed as reputable and is administered in conjunction with the Family Medicine Residency Program.
The RxP training programs at other schools/institutions are more variable and the ones administered by for-profit schools have poorer reputations.

Until there are greater numbers of RxP psychologists, not much is going to change there, IMO. There have been some psychologists who have moved to RxP states to train and then prescribe but not nearly enough to consider it a movement and there are not a lot of psychologists going into RxP training now. I think many clinical psychologists, by the time they complete the 5-7 years required to earn a doctorate, have little desire to go back for 2 more years of training - particularly since RxP opportunities are very geographically limited.

Personally, it was much more practical and beneficial for me to go the PMHNP route especially given the more established training and foundational nursing background.

 

[Splenda88]

It varies considerably. With APRNs, you can have a seasoned nurse who has practiced as a RN for years and then went on to train as a PMHNP or you can have someone with a bachelor’s degree in Spanish who completes a 2-year, accelerated BSN/MSN program as a PMHNP and both end up with the same scope of practice, privileges and income potential but significantly varied expertise. This is a problem for advanced practice nursing as there are clearly NPs out there with inadequate training and others who are excellent.

Prescribing psychologists are few in number and it is difficult to get a sense of their prescribing expertise as a group because of their scarcity. The prescribing psychologists that were part of the DoD demonstration project were heavily scrutinized and found to be competent by their psychiatrist colleagues as reported in the federal GAO report put out several years ago but there were only 10 prescribing psychologists in the project. Several of them continue to practice and prescribe in the military.

The few (3) prescribing psychologists I know in New Mexico seem competent via the conversations I have had with them at various psychopharmacology conferences where we have jointly attended and I know they are well-respected in their various home communities.

The RxP training program at New Mexico State University is generally viewed as reputable and is administered in conjunction with the Family Medicine Residency Program.
The RxP training programs at other schools/institutions are more variable and the ones administered by for-profit schools have poorer reputations.

Until there are greater numbers of RxP psychologists, not much is going to change there, IMO. There have been some psychologists who have moved to RxP states to train and then prescribe but not nearly enough to consider it a movement and there are not a lot of psychologists going into RxP training now. I think many clinical psychologists, by the time they complete the 5-7 years required to earn a doctorate, have little desire to go back for 2 more years of training - particularly since RxP opportunities are very geographically limited.

Personally, it was much more practical and beneficial for me to go the PMHNP route especially given the more established training and foundational nursing background.

As someone who was a RN (albeit not a psych RN), and now a physician interacting with RN on a daily basis, I have found that there is very little overlap between the two professions.

 

[PikminOC]

Op, can you get into med school? And then thru, along with residency and board certs?

 

[WisNeuro]

Until there are greater numbers of RxP psychologists, not much is going to change there, IMO. There have been some psychologists who have moved to RxP states to train and then prescribe but not nearly enough to consider it a movement and there are not a lot of psychologists going into RxP training now. I think many clinical psychologists, by the time they complete the 5-7 years required to earn a doctorate, have little desire to go back for 2 more years of training - particularly since RxP opportunities are very geographically limited.

Personally, it was much more practical and beneficial for me to go the PMHNP route especially given the more established training and foundational nursing background.

Just had our annual meeting with other state association heads, along with some follow-ups in a related listserv, especially in some of the newer states, it looks like recent students are going through the process in decent numbers, so we'll likely start to see what this trend looks like in 5-10 years.

 

[90sportsfan]

I don’t have much more to add than what’s already been stated. But after my Psych rotation, it reminds me that as a Psychiatrist (as people have stated) you are first and foremost a physician. You will get training in the full scope of medicine, so you will be treating the patient within the scope of medicine.

You’ve mentioned the desire to “prescribe” a few times, but to do that you will have to understand the breadth and depth of the patient’s full health history, which again goes back to why Psychiatrists are physicians.

So I would say if that interests you, then medicine may be the route. Although med school/residency is an investment in time and money, so if Psychology interests you more and the only thing drawing you to Psychiatry is prescribing, med school may not be the best route. I’d follow your interests.

I will also mention that I think Psychiatry will provide you the broadest scope and most opportunities. Psychology will limit what you are able to do (i.e. prescribing and other things).

 

[WisNeuro]

I don’t have much more to add than what’s already been stated. But after my Psych rotation, it reminds me that as a Psychiatrist (as people have stated) you are first and foremost a physician. You will get training in the full scope of medicine, so you will be treating the patient within the scope of medicine.

You’ve mentioned the desire to “prescribe” a few times, but to do that you will have to understand the breadth and depth of the patient’s full health history, which again goes back to why Psychiatrists are physicians.

So I would say if that interests you, then medicine may be the route. Although med school/residency is an investment in time and money, so if Psychology interests you more and the only thing drawing you to Psychiatry is prescribing, med school may not be the best route. I’d follow your interests.

I will also mention that I think Psychiatry will provide you the broadest scope and most opportunities. Psychology will limit what you are able to do (i.e. prescribing and other things).

Well, they can prescribe in at least 5 jurisdictions currently, so it's still an option within certain parameters. What are the other things we can't do?

 

[90sportsfan]

Well, they can prescribe in at least 5 jurisdictions currently, so it's still an option within certain parameters. What are the other things we can't do?

I would say the main limitation is not being able to prescribe, but the bigger limitation is not being able to practice medicine (which prescribing is a part of). There are also fellowship opportunities that would not be available as a Psychologist, and I'm guessing it could be harder to get privilege's in certain settings as a Psychologist.

So as a Psychiatrist, since you are a physician and have the ability to practice medicine and prescribe, I feel like your potential scope of practice options is broader and there are greater opportunities for subspecialties, etc.

This isn't to say that either profession is better than the other. I just think that because Psychiatry provides 4 years of medical training (+ Internship) and expertise in practicing medicine in addition to the Psychiatry residency training, that its scope is broader and it offers more potential opportunities, including sub-specialization.

If someone knows they what to provide more behavioral-based care and is less interested in the biophysiological aspects , the extra time and cost of medical school would not be worth it, and Psychology would be the better career choice.

 

[WisNeuro]

I would say the main limitation is not being able to prescribe, but the bigger limitation is not being able to practice medicine (which prescribing is a part of). There are also fellowship opportunities that would not be available as a Psychologist, and I'm guessing it could be harder to get privilege's in certain settings as a Psychologist.

So as a Psychiatrist, since you are a physician and have the ability to practice medicine and prescribe, I feel like your potential scope of practice options is broader and there are greater opportunities for subspecialties, etc.

This isn't to say that either profession is better than the other. I just think that because Psychiatry provides 4 years of medical training (+ Internship) and expertise in practicing medicine in addition to the Psychiatry residency training, that its scope is broader and it offers more potential opportunities, including sub-specialization.

If someone knows they what to provide more behavioral-based care and is less interested in the biophysiological aspects , the extra time and cost of medical school would not be worth it, and Psychology would be the better career choice.

In terms of practicing medicine, I would agree. As for the OPs stated desires, and the subspecialization part, I'd say that's debatable. Many different fellowship specialties, many academic paths, legal work, applied research, program development, corporate consultation, etc. Both are pretty flexible even outside of the modal path.

 

[parametric]

@mmiller45, you’ve posted multiple threads over the past ~9 months, asking this same question. I’m wondering whether more responses from SDN are really what would be most useful, or whether the barrier(s) to deciding what you want to do with your life might require a different strategy at this point? 🙂 SDN certainly has no shortage of opinions to share, but it doesn’t seem like more of our opinions are helping you get closer to finding your answer.

 

[psyguru]

Many med school grads will end up going into a different field than they intended. I have seen residents leave psychiatry or come into psychiatry from other fields (oddly several from surgery). Similarly, you may end up switching from private practice to another setting. For example, although I had a hunch I wanted to go into psychiatry from the first year of med school, I had no idea I had an interest in forensic psychiatry at the end of my third year. Now 50% of my time is doing forensic expert witness work and I work in a neuro-rehab treating those with TBI and SCI (which I became interested in several years ago). It is almost as if I have a bucket list and state hospital, eating disorders, and addictions are other interests. There is no shortage of interesting settings. I enjoy variety and I would get bored with one setting 40 hours a week. Expert witness work always keeps things interesting. My advice is to expose yourself to as many settings as possible. Mental health has a lot of variety. I worked on Death Row, a state-supported IDD/ Autism facility ("state school"; where half the residents are non-verbal), a forensic competency restoration unit, and private practice.

I prefer being a psychiatrist to a psychologist. As a psychiatrist, you can always learn psychotherapy (they even have psychotherapy fellowships) and you can work in a medical hospital as a consultant and do ECT. As a psychologist, even if you are in a state where you can prescribe meds, it is likely it would not be at the same level as the psychiatrist doing psychotherapy.

Another way to look at it is as a psychiatrist you can work part-time (with a salary comparable to a full-time psychologist) and have time to learn psychotherapy. However, you also have to have an interest in being a physician as 4 years of med school without any interest in medicine would be challenging to say the least.

 

[mmiller1998]

Many med school grads will end up going into a different field than they intended. I have seen residents leave psychiatry or come into psychiatry from other fields (oddly several from surgery). Similarly, you may end up switching from private practice to another setting. For example, although I had a hunch I wanted to go into psychiatry from the first year of med school, I had no idea I had an interest in forensic psychiatry at the end of my third year. Now 50% of my time is doing forensic expert witness work and I work in a neuro-rehab treating those with TBI and SCI (which I became interested in several years ago). It is almost as if I have a bucket list and state hospital, eating disorders, and addictions are other interests. There is no shortage of interesting settings. I enjoy variety and I would get bored with one setting 40 hours a week. Expert witness work always keeps things interesting. My advice is to expose yourself to as many settings as possible. Mental health has a lot of variety. I worked on Death Row, a state-supported IDD/ Autism facility ("state school"; where half the residents are non-verbal), a forensic competency restoration unit, and private practice.

I prefer being a psychiatrist to a psychologist. As a psychiatrist, you can always learn psychotherapy (they even have psychotherapy fellowships) and you can work in a medical hospital as a consultant and do ECT. As a psychologist, even if you are in a state where you can prescribe meds, it is likely it would not be at the same level as the psychiatrist doing psychotherapy.

Another way to look at it is as a psychiatrist you can work part-time (with a salary comparable to a full-time psychologist) and have time to learn psychotherapy. However, you also have to have an interest in being a physician as 4 years of med school without any interest in medicine would be challenging to say the least.

For some reason psychiatry always comes back to me... I have heard people have the feeling in their blood of wanting to do something so I’m not sure why I have such a passion about it. I feel stuck I guess. I’m glad you have a variety in the field. I will DM you to talk more about this if you don’t mind. Thanks

 

[futuredo32]

Do you want to be a physician? You have to prescribe medications and manage side effects. If not, psychiatry is not for you Medical school and residency are difficult and demanding Are you willing to make the sacrifice, financially physically and emotionally for the longer route?. I LOVE doing psychotherapy. I chose a therapy heavy residency program and saw as many therapy patients as I could. I went through a psychodynamic course during my last year of residency. Psychotherapy doesn't pay well. I get my psychotherapy fix by having a micro private practice. If you want to do private practice with a lot of therapy, you won't likely make as much as other psychiatrists unless you do cash only. Most positions for psychiatrists are for medication management and evaluations, not therapy. I was offered a position with a fee split and they were willing to let me do psychotherapy, and that is the only position I have ever been offered that would let me do psychotherapy. I am in psychoanalysis with a psychiatrist and he has a 70/30 split where he works and sees a lot of therapy patients but doesn't earn as much as he would if he did exclusively or more med management appointments.

 

[WisNeuro]

Do you want to be a physician? You have to prescribe medications and manage side effects. If not, psychiatry is not for you Medical school and residency are difficult and demanding Are you willing to make the sacrifice, financially physically and emotionally for the longer route?. I LOVE doing psychotherapy. I chose a therapy heavy residency program and saw as many therapy patients as I could. I went through a psychodynamic course during my last year of residency. Psychotherapy doesn't pay well. I get my psychotherapy fix by having a micro private practice. If you want to do private practice with a lot of therapy, you won't likely make as much as other psychiatrists unless you do cash only. Most positions for psychiatrists are for medication management and evaluations, not therapy. I was offered a position with a fee split and they were willing to let me do psychotherapy, and that is the only position I have ever been offered that would let me do psychotherapy. I am in psychoanalysis with a psychiatrist and he has a 70/30 split where he works and sees a lot of therapy patients but doesn't earn as much as he would if he did exclusively or more med management appointments.

Is it longer? For some of our specialties it's an eight year course post bachelors. Wouldn't that be the same as med school and psychiatry residency?