so do pretty much all psych applicants start out wanting to do child?

[Doctor Bagel]

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I've got all of zero interest in doing child or adolescent psychiatry, but it seems like a huge majority of people I've met on the trail want to do it. Is this a new thing, or has it always been this way? And why? The sad thing is that some of the people I've interviewed with who are not interested in child feel almost apologetic about not wanting to do it.

 

[GmailQueen]

I think that it's pretty typical for psych applicants to think "Hey, I like kids. I like psych. I bet I'd like child and adolescent psych." I've heard many change their minds after doing a rotation or two in child because it's too much to deal with - the kids are sick, they are often not "cute" like kids are on peds (think 16 y/o F who is likely going to get a borderline dx at 18, small child with ODD who will hit, punch, throw, scream, tear things up, etc, when they hear "no"), parents are a pain (children with psych problems often have parents with psych problems, which makes it even worse than regular peds; and then you have the parents who want you to "fix" the child with medications, even if it's not indicated or there is something else going on at home that the parent does not want to address).

 

[babel]

I was just talking to an Ophtho resident who commented that when she worked with some Psych interns on medicine during her intern year, that it seemed like they all wanted to do C&A, too. Does seem like it's the trend these days.......

 

[gaccboom]

I can't say much about others out there (though I have noticed an awful lot of folks on the interview trail are interested in child), but I've got no interest myself. I like kids alright, but I like 'em best when they're not in need of a psychiatrist.

Perhaps part of the reason that lots of people are interested now may be the desperate lack of C&A psychiatrists in some parts of the country? I'm in NYC at the moment, where there's plenty, but I hear that large parts of the US need more. That could be attractive in terms of employment opportunities, lots of places to choose from in the future.

 

[OldPsychDoc]

As MS3 I followed my psych rotation with a great Peds rotation and thought, "Hey, I don't know anything about child psych--I should check it out." Got myself into an elective and learned 2 things: 1) I wasn't as awful of a parent as I had suspected I was, and 2) I NEVER wanted to do child again!

 

[pingouin]

For me the interest comes from having lots of prior experience in child psych- including with the parents and the very non-cute adolescents.. and still loving it. I did child psych research this summer- liked it. Also got to shadow two child psychs in that program at their clinics- LOVED IT.

Find me another specialty where I can sit on the floor and play Battleship with my patients and I'll look into it.

 

[Doctor Bagel]

I didn't even think the kids on peds were cute, which probably contributes to my complete lack of interest. Maybe cat or dog psych would be fun. So were people really interested in child psych 5 years ago? I assume that the majority of people who state an interest won't wind up doing it except for people like pingouin who are basing their interest in strong past experience.

 

[pingumd]

I asked this same question to a chief resident and they said when they were interviewing it was the same thing...lots of people wanted to do child psych. But only a few actually end up wanting to follow through because fo the extra year involved (which you would think is not such a big deal but apparently sometimes people just want to get a practice started), or because dealing with parents was much harder than they expected.

So it seems like this was also an issue 4-5 years ago as well.

 

[OldPsychDoc]

...
So it seems like this was also an issue 4-5 years ago as well.

And 10 years ago...

 

[Doctor Bagel]

And 10 years ago...

Hmm, so I guess it's probably not so much related to media info about the shortage. Is it more socially acceptable to do child psych versus adult psych?.

 

[Anasazi23]

Is this a new thing, or has it always been this way? And why?

Because they haven't done child psych yet.

 

[masterofmonkeys]

9 out of 12 in my intern class lol.

In my defense, I've wanted to work with adolescents since I was an adolescent lol.

That said, if I was interested in being a generalist, I'd probably smash my face through a brick wall if I were to actually go that route. I'm interested in working with a very specific population (adjustment issues in kids with NMSK problems)

 

[gaccboom]

(adjustment issues in kids with NMSK problems)

NMSK

 

[Fermata]

NMSK

Neuromusculoskeletal.

In the past I believe that he's mentioned that he's a weightlifter as well.... although I'm sure what he has in mind goes beyond body dysmorphia.

 

[masterofmonkeys]

Neuromusculoskeletal.

In the past I believe that he's mentioned that he's a weightlifter as well.... although I'm sure what he has in mind goes beyond body dysmorphia.

Yeah. I'm an aspiring powerlifter. My pre-weighlifting weight was pretty much the same as it is now. Really interested in male body dysmorphia because as a larger guy in a gym who doesn't care about size I see a fair amount of it.

But more interested in the psychiatric consequences of NMSK dysfunction. Take sympathetically-mediated pain for example. Excitement, good or bad=more pain. Imagine being on your first date at 16 because you were a very late bloomer with an outrageously hot girl. You're rather confused and disoriented because you're not actually sure why she likes you and what you can do to keep it that way. Butterflies in your stomach and your somatic discomfort growing worse, you gasp as she leans into you it hurts so bad. And then, socking up your courage and biting your bottom lip against the steadily mounting pain, you slowly, agnozingly, put your shaking hand around her. And when she holds your hand with her own, you actually have to stifle a whimper, run into the bathroom, stuff a paper towel into your mouth and scream until you feel better.

Just thinking about the cognitive-behavioral and psychodynamic implications of that makes my head spin.

Also really interested in the positive psychology side of this. I happen to think that genetic and early developmentally-determined resilience plays a huge role here, but parent/caregiver interactions as well as personal narrative are likely important as well.

 

[Fermata]

One of the things that is increasingly drawing me towards psychiatry is how you can seemingly conduct research in just about anything.

At the very least, you've given me some food for thought.

As far as power lifting goes, as long as you aren't one of those guys in the ridiculous bench shirts that does all the work I applaud you.

 

[clement]

From a med student perspective and from personal experience having worked with various psychiatrists in big cities on both coasts:
1. Pretty much every psychiatrist I've ever met in my life has at some point or another said, "There's really no money in it" (without me ever asking if there was). Ironically, these psychiatrists were all located in cities where psychiatrists supposedly have the highest incomes within the U.S. I guess you could argue big city materialism if what they meant was "less than $200K per year" (I'm still not certain).
2. A lot of medical students interested in psych and capable of tolerating children and adolescents (if in fact they're not "kid people"), are under the impression the only way to make money in psychiatry is to go for child and adolescent psych.

My two.

 

[Sneezing]

I agree. I think a lot of the kid fever is centered around $.

I won't touch it with a 10ft pole.

 

[billypilgrim37]

All psychiatry is child psychiatry. Just some of you all are seeing them after it's already too late.

 

[trophyhusband]

Actually, basically the reason my wife chose to pursue psychiatry was because of her experience with child inpatient. She loved that portion of her rotation. She's loved all of her subsequent experiences with it as well. Seems like it's one of those things you either love or hate.

Oh and she definitely didn't choose it for the money, she'd work for free if I would let her. Bleeding heart and all that...

 

[bullpup777]

I would never dream of doing child and adolescent psychiatry (SHUDDER)

 

[gdbaby]

Not I McFly. Adult psychotic people, all the way.

 

[clement]

...I'm going to throw in another theory and speculate that some people on the fence about psych may have an initial interest in child/adolescent for safety reasons, i.e. "cute little kids could never be physically threatening."

 

[Fermata]

...I'm going to throw in another theory and speculate that some people on the fence about psych may have an initial interest in child/adolescent for safety reasons, i.e. "cute little kids could never be physically threatening."

But their parents wouldn't be?

 

[psychattending]

I've got all of zero interest in doing child or adolescent psychiatry, but it seems like a huge majority of people I've met on the trail want to do it. Is this a new thing, or has it always been this way? And why? The sad thing is that some of the people I've interviewed with who are not interested in child feel almost apologetic about not wanting to do it.

My impression is that somewhere between 40-50% of people are saying that they want to do child this year. This is possibly up from last year (my guess is that last year it was 40%). In the end, though, not everyone who initially thought they want to do child does a child fellowship. In my program, typically 20-30% of my residents end up doing child.