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Switching from FM to psych

Discussion in 'Psychiatry' started by scharnhorst, Aug 5, 2015.

  1. scharnhorst

    10+ Year Member

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    I'm an FM physician, out of residency and in practice for 5 yrs

    I was wondering if it would be still possible to get into a Psych residency program ? I did a fair amount of outpt psych for 3 yrs being an FP in a small town

    Has anyone done that ? please share your experience
    How long do I need to train ?
    Is it even possible considering I have completed one residency

    Thanks
     
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  3. MacDonaldTriad

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    This is possible, It will take 3 years, and the hardest part will be living on a resident's pay.
     
  4. scharnhorst

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    I live pretty frugally so that is not an issue
    I guess I will have to work with a psychiatrist before the application process starts.I'm thinking of shadowing a psychiatrist or 2 for a month , do you think that would help ?
    Will a psychiatrist allow me as another physician to shadow them ?
     
  5. Shikima

    Physician 10+ Year Member

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    You can do it, if you want. Just will be a hard 3 years. But you can moonlight doing ERs and UC with your time off.
     
  6. MacDonaldTriad

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    Shadowing may help, but probably isn't critical. It depends on how geographically mobile you are. If you need to get into one of two or three places, this could be hard. If almost anywhere will do, you will be fine. At my Hospital, you have to be a student or in training to see patients. A lot of places allow shadowing. In fact I'm sure most psychiatrists would love to have some family medicine input while managing their cases.
     
  7. smalltownpsych

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    Just out of curiosity, why are you thinking of switching? I, for one, think it is a great idea for many reasons. Foremost of which is the need for more good psychiatrists. Secondly, the solid experience of being a family doc will definitely give you a different perspective. My own experience has been that collaborating with family docs has often been more fruitful than collaborating with psychiatrists, mainly because psychologists and psychiatrists are often too closely aligned in our perspectives. It also could provide a more balanced or integrative view of the subtle or oftentimes glaringly obvious intersection between the psychological and the physical.
     
  8. Gavanshir

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    Why do you want to switch?

    Although not psychiatry, have you considered doing an addictions fellowship? I'm currently working with a FM doc who switched careers and is doing an addictions fellowship.
     
    #7 Gavanshir, Aug 5, 2015
    Last edited: Aug 5, 2015
  9. W19

    W19 Account on Hold
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    I worked with a DO doc in south FL that did a FM residency, but treat only psych patients in nursing homes and assisted living...
     
  10. scharnhorst

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    Thanks I will look into that !
    I was always more interested in Psych patients since my 2nd yr residency, and enjoyed treating them in my previous practice.But I feel like I need the training of a residency to handle the more challenging bipolars and schizophrenics
     
  11. scharnhorst

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    One more issue, I have ADHD ( I know a lot of you out there don't believe it exists) and so far I have not needed meds as I keep my workload light but I have used them ( legally ofcourse) in the past when workload was high or during exams. I do intend to take them before residency starts is it something that will cause problems ?
     
  12. scharnhorst

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    Thanks I still love FM don't get me wrong but I feel like too much is demanded of FM docs these days ! I will still try to work at my FM job one day a week to keep up my skills
     
  13. scharnhorst

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    Yes ! That's the plan
    However any tips on how to improve my application ( apart from shadowing a Psych) ? I have no research experience in PSych
    I had decent score 90 and 89 ( this was back in 2005) and step3 pass second attempt got 85
    I had no gaps in training and no other issues since graduation , board certified
     
  14. clausewitz2

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    Not in residency yet, but I can tell you the two digit percentile scores are no longer used for steps 1 and 2 in any serious way. What was the three digit?
     
  15. hamstergang

    hamstergang may or may not contain hamsters
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    You believe that a group of psychiatrists won't believe that ADHD exists? That seems so strange.
     
  16. heyjack70

    heyjack70 Junior Member
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    Becoming a psychiatrist is an awesome idea. You could probably moonlight in urgent cares on the weekends.
     
  17. splik

    splik Professional Cat at Large
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    does it?
     
  18. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Maybe over (or at least sloppily) diagnosed, but yes, I think most psychiatrists think it exists. If you have a diagnosis and a legitimate prescription, I don't think a stimulant prescription would be a problem. No one needs to know.
     
  19. shan564

    shan564 Below the fray
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    Your experience will make you a much stronger applicant than the average 4th-year medical student. I don't think you need to shadow a psychiatrist.
     
  20. MacDonaldTriad

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    “Not believing in ADHD” is a little like saying you don’t believe in UFOs. It is all semantics. Everyone has to believe that there are unidentified flying objects, but not everyone believes they are piloted by little green guys from another planet. (This analogy is working out better than I thought).


    I do believe that not all ADHD children, “grow out of it”, and there can be some residual impairments that go on into adulthood and these may even benefit from stimulants. What I don’t believe is that there can be so many people who have adult ADHD that wasn’t diagnosed as children, and who cannot produce any parents or school records to support ADHD. I once attended a grand rounds by a well-known psychiatrist, and he was asked about the adult ADHD controversy and he said that all adults deserve a stimulant trial and if they do better, they should be continued on it. Ya right, that would be about everyone I think.
    :rolleyes:
     
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  21. clausewitz2

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    I am guessing a thread arguing for transhumanist-style cognitive enhancement would be even less productive than the presidential debate thread.
     
  22. milesed

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    It's easily doable. I trained under 2 psychiatrists who were previously in other fields- Anesthesia and Neurosurgery. I don't know details of how they switched.

    I don't recommend this, but a local pediatrician bills himself as an ADHD/Bipolar expert for all ages and has a booming practice. Of course, every patient who walks into his office is dx adhd and/or bipolar and takes the same 3-4 meds no matter what. He says he has attended various trainings to justify his claim to fame. I'm waiting for him to get sued or lose his license. Point is you can practice psyc w/o residency.
     
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  23. MacDonaldTriad

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    And you can practice psyc poorly even with a residency.
     
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  24. smalltownpsych

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    Most family medicine docs practice psychiatry to an extent, it's inevitable. Don't they prescribe the bulk of psychotropics? Of course, most are doing a better job than that quack and seek to refer when they feel it is beyond their scope, but I am thinking that the OP wants to learn how to do it better or he would be satisfied in the field of family medicine.
     
    #23 smalltownpsych, Aug 12, 2015
    Last edited: Aug 12, 2015
  25. scharnhorst

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    I see what you guys are saying but I think with proper training I can make a real difference , right now we hardly get any psych patients we have a big psych clinic next door at my new job

    Also I would like to train with more experienced psych docs so I figure out the art part of this field , the science is there but is not implemented right, in our EHR we have to do PHQ-9 and Bipolar screening now and if a patient waits 1 hr to see me then EVERY patient has a positive screen and the therapist then is on my a$$ for prescribing them meds !!!
     
  26. scharnhorst

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    I hope so, the LOR will all be from FM or IM docs then that's the problem

    Guess my question was if you are a Psych doc and hiring a new resident for a psych traning program
    what will you look for from a candidate like me to show interest in psych ?
    obviously if someone is willing to give up 3 yrs of their life as an attending to go back as a resident that should be a sufficient show of interest ? But that's just my biased view


    thanks for the encouragement though
     
    #25 scharnhorst, Aug 12, 2015
    Last edited: Aug 12, 2015
  27. scharnhorst

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    That's what Im hoping and do I need to report this if I file for a new state license or renew my present one ?
     
  28. scharnhorst

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    Im sorry Im still thinking that my audience is docs in general !
    But I try not to use my ADHD as a crutch
     
  29. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    My state asks something like has your ability to practice ever been affected by an illness, including mental illness. As far as I know, you're not expected to report well-controlled MH conditions like ADHD if you're stable on medications. It likely depends on your state. However, tons and tons of physicians are on stimulants for ADHD -- I doubt it's a big issue.
     
  30. shan564

    shan564 Below the fray
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    I think your biased view is correct from my less-biased perspective. But my perspective is also not the most experienced in the world, since I'm just a PGY3.
     
  31. milesed

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    My state asks about impairment from psyc issues, not just a dx.
     
  32. scharnhorst

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    SO should I go ahead and apply right away with ERAS for Psych as soon as it opens or wait until Nov or so when I have done a observership with a Psychiatrist and have an LOR from them ?

    Since I'm already in practice its very hard to follow a psychiatrist unless it is inpatient after hours, but without it I have no LOR from Psych

    ANy suggestions ?
     
  33. sunlioness

    sunlioness Fierce. Proud. Strong
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    More power to you. Seriously. I admire that. I couldn't be a resident again. I just couldn't.


    Sent from my iPhone using Tapatalk
     
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  34. shan564

    shan564 Below the fray
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    Apply now and then add the LOR later if you have it. If a program screened you out due to the lack of that LOR, you can contact them and ask them to fix that.
     
  35. splik

    splik Professional Cat at Large
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    november is too late for a letter and "observership". It is also unnecessary. as long as you don't have some ridiculous idea of what psychiatry is about, you will be fine applying without a psych letter. observerships are useless anyway. in short apply sep 15th with the 3 LORs you need. it will not be the kiss of death to not have a psychiatry letter though it would be helpful.

    PGY-2 spots are far, far less competitive than PGY-1 spots so it will be much easier to find a spot somewhere, and most are not in the match either
     
  36. scharnhorst

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    ^ Thanks guys for the advice
     
  37. scharnhorst

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    Thanks I know its not going to be easy but I want to be happy too !
     
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