switch to psych

[mickee]

Hello,

I'm a PGY2 in radiology considering switching to psych. It seems like a strange switch but I've given rads a try but it's just not the field for me. I had a great psych rotation during med school and had briefly considered it at that point. Is it too late looking for open PGY2 spots that'd start in July 2015? How do I look for these open spots? Thanks in advance.

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[splik]

you need to apply through the match. PGY-2 spots are less competitive than PGY-1 spots as there are far fewer applicants, and as you were able to match in rads you are probably a competitive applicant as long as you don't have the personality of a slug. you will of course need a letter from your current program director, and ideally at least one LoR in psychiatry or from a psychiatrist. I have seen applicants with fairly limited psych LoRs match into very good psych residencies as PGY-2s. it is very much worthwhile to apply or inquire at programs you are interested in as they may have space or be willing to take you as a PGY-2. hurry though, the clock is ticking!

 

[SomeDoc]

Hello,

I'm a PGY2 in radiology considering switching to psych. It seems like a strange switch but I've given rads a try but it's just not the field for me. I had a great psych rotation during med school and had briefly considered it at that point. Is it too late looking for open PGY2 spots that'd start in July 2015? How do I look for these open spots? Thanks in advance.

Not a strange switch at all. I was in a similar position, and thank my lucky stars I went with psych- now planning on graduating residency in a few months, and going into fellowship with a bright outlook on the job market and on personal and professional satisfaction. Rads has seen its fair share of cuts, oversupply issues, and poor leadership; just head on over to auntminnie's general forum- its really a sad state of affairs.

 

[ZigPig]

I had done a transitional year, and decided to not go onto my my advanced position. Here is a link to a thread I had started at that time: Switching into Psychiatry. Your process will be a little different because it sounds like you have already started radiology residency. One way in which it will differ is that the psych residency where you match may have a year of less funding for you. There is also the residentswap which I don't know much about.

 

[ZigPig]

In the thread I had linked to, it looks like I was asking questions on December 6... and I think I had moved quickly after that. If you are going to make the switch, decide soon move fast! Doing this switch involves a slow moving process, so you need to get the ball rolling.

 

[OldPsychDoc]

PGY2 positions may now be filled outside of the Match, just FYI.

 

[ZigPig]

Oh, in addition to resident swap, open positions can also be found at: http://apps.psychiatry.org/clearinghouse/
and also on the http://forums.studentdoctor.net/forums/internship-residency-and-fellowship-positions.290/

 

[ZigPig]

I've gotten questions on my own situation, so I wanted to share it with anyone else who may be going through this situation.

There were opportunities for me to join as a PGY2, I chose not to go this route as location was important, specifically my wife wanted to go back to her home town. I was told I would be like a PGY1.5 - have some credits, but could not count as a whole year. I did not get this in writing, and so when it came to reality, I was not given any credits and had to start over as a PGY-1.

Yes, I was applying late in the season. Yes there are deadlines for some programs, so anyone going through this process would need to keep that in mind. I think if you email the coordinator/PD after the deadline and explain your situation, they may still accept your application. I only had two places in mind, both were aware of my situation, so I was fine.

As for the process of asking about which programs may have openings, it was my understanding according to NRMP, that I could not contact potential places until I already let my current match program no, and I had gone through the process of the NRMP letting my out of my residency position. Therefore the only way I knew about programs was the three ways I had listed above.

 

[mickee]

Thanks all for your replies.

I have just started contemplating the switch within the last week or two. I'm not sure if I can get an ERAS application ready with all the LoRs in time even for a late application (assuming that I can get an ERAS token and an exemption from NRMP to apply for 2014 ERAS because officially it's closed now).

Would it be a good idea to start emailing PDs at programs which I'd be interested in and requesting them to consider me if they should have any PGY2 opening? My understanding is that programs still can/do go outside of the match in certain situations like unexpected PGY2/3/4 openings. I just saw a PGY2 opening at Hawaii program on residentswap (sounds like a dream location but unfortunately i can't make it work).

In terms of LoRs, is it absolutely necessary to have a psych LoR? I don't have one from med school and I don't know if I can a meaningful letter this year during rads residency. Can good letters from my prelim medicine program (including from PD) be good enough (in addition to letter of good standing from my current PD). Can I use any of the med school letters?

Also, I've come across these types of articles condemning current practice of psychiatry. Is this mostly just propaganda or is there any validity to these? It'd be very disheartening if more and more people had this opinion of psychiatry.

http://www.madinamerica.com/2014/01/evidence-that-more-psychiatry-means-more-suicide/
http://healthland.time.com/2012/10/...the-field-is-committing-professional-suicide/

I apologize for this super long post. I'm feeling quite confused/clueless right now and am trying to figure out this important life decision I'm about to embark on.

 

[splik]

yes there are many criticisms against psychiatry that are valid, but these are mostly criticisms of the medical model in general. more psychiatry doesn't mean more suicide (except perhaps the evidence that short hospitalizations increase suicide rates) nothing we do one way or the other affects suicide rates on the population level. see here for a more realistic criticism of the problems with psychiatry and residency training.

Have a look at UW, Hopkins, UMN, maryland, yale, as programs that often have specific PGY-2 spots that are generally for people transferring from other specialties. And just inquire anywhere you're interested in.

I have never seen an applicant who didn't have a psych letter so I would strongly suggest one even if you have barely known them. People transferring from other programs often have a letter "yeah I know this guy, we like him and think he would good" and leave at that, and they still match at top programs. Try and do an elective, or attend psych meetings/grand rounds, observe rounds etc. But I would just go ahead any apply without it and send in the letter as soon as you can. don't waste anytime.

If you are perturbed by people riling against the specialty, you won't last very long. Yes there are many, many people who are critical of psychiatry with good reason. But part of that is because there are alot of angry people with mental illness who displace some of that onto psychiatry, who re-experienced abuses within treatment, because psychiatry is an easy target for criticism, and because it has greater visibility. No one complains about radiology because they don't know what it is or what radiologists do. There are people who are anti-medicine, peds, obstetrics, surgery, vaccination etc etc. There is still a growing demand for psychiatrists because so few psychiatrists wish to work with the mentally ill and are so geographically unevenly distributed. No one wants to do the work of psychiatrists (working with high risk patients with complex medical, psychiatric and substance use comorbidities), not psychologists, not NPs, not PAs. We're not going anywhere.

 

[PistolPete]

What haven't you liked about radiology, and why switch to psych specifically?

 

[mickee]

Mostly sitting in a dark room for hours churning the list without any patient contact. Seeing patients for procedures in IR is not the same thing.

I loved my psych rotation in med school but it never crossed my mind to make it my career (other people going into psych were frequently told that their grades were too high to waste on psych). I like the fact that in psych, physicians rely mainly on history and observation (exam) and not like ordering a gazillion tests and imaging hoping to come to a diagnosis (which I feel like I did during prelim medicine).

 

[dl2dp2]

...other people going into psych were frequently told that their grades were too high to waste on psych...

Here's the irony--if you have the grades to get into rads, you can probably make more on a per hour basis in psych than in radiology in private practice. And the lifestyle IMHO is way better.

 

[slappy]

 

[kitsens]

Hello,

I'm a PGY2 in radiology considering switching to psych. It seems like a strange switch but I've given rads a try but it's just not the field for me. I had a great psych rotation during med school and had briefly considered it at that point. Is it too late looking for open PGY2 spots that'd start in July 2015? How do I look for these open spots? Thanks in advance.

felt I had to throw my support out there. I switched from rads ... finished up in July. so if you want to do it it s not unreasonable and you won t be the first guy. psych has potential which may or may not be realized in the next decade or two depending on neuroscience / genetic / imaging advances. as is it s a good field with lots of autonomy and flexibility -- the verdict is out on how much patients improve and the safety of most of our interventions. the income is ok.

rads is obviously a cool field in which you acquire very comprehensive knowledge of pathology and anatomy through sophisticated technology and high income -- you ll have to decide for yourself the merits and demerits of the current practice environment of the field and your capacity to enjoy the work day to day

 

[vistaril]

Here's the irony--if you have the grades to get into rads, you can probably make more on a per hour basis in psych than in radiology in private practice. And the lifestyle IMHO is way better.

I actually wouldn't be surprised if, in psych, there isn't an overall slightly inverse relationship between the quality of people entering residency(by metrics like their med school, img/amg status, etc) and income. I say that because if you look at the top 3% of all psych earners in the country, the vast majority of those are going to be people doing insane volumes of community psych work(especially inpatient) and not this high dollar cash pay analysis in manhattan. Yeah, there are some of those, but there are more > 375k all across the country who make their >375k through volume than cash pay.

The highest paying psych I know went to med school in Pakistan and probably earns 450k annually.

 

[Armadillos]

I actually wouldn't be surprised if, in psych, there isn't an overall slightly inverse relationship between the quality of people entering residency(by metrics like their med school, img/amg status, etc) and income. I say that because if you look at the top 3% of all psych earners in the country, the vast majority of those are going to be people doing insane volumes of community psych work(especially inpatient) and not this high dollar cash pay analysis in manhattan. Yeah, there are some of those, but there are more > 375k all across the country who make their >375k through volume than cash pay.

The highest paying psych I know went to med school in Pakistan and probably earns 450k annually.

Definitely agree, especially seeing as academics takes a pay cut. I would expect MGH residents for example on average make significantly less over their careers compared to podunk-U graduates b/c of the % of each class going into academics.

 

[MLT2MT2DO]

Definitely agree, especially seeing as academics takes a pay cut. I would expect MGH residents for example on average make significantly less over their careers compared to podunk-U graduates b/c of the % of each class going into academics.

I actually wouldn't be surprised if, in psych, there isn't an overall slightly inverse relationship between the quality of people entering residency(by metrics like their med school, img/amg status, etc) and income. I say that because if you look at the top 3% of all psych earners in the country, the vast majority of those are going to be people doing insane volumes of community psych work(especially inpatient) and not this high dollar cash pay analysis in manhattan. Yeah, there are some of those, but there are more > 375k all across the country who make their >375k through volume than cash pay.

The highest paying psych I know went to med school in Pakistan and probably earns 450k annually.

Can't this be said of nearly all specialties?