Switching from Neuro to Psych

[Neurotopsych]

I am currently an intern in a reputable categorical neurology program but am having some serious thought about switching to psych after my intern year. I really enjoy both fields and the overlap. I came really close to applying to both psych and neuro but ultimately decided to go for neurology. I always thought of myself more as a concrete thinker hence my decision. However, I am finding myself dwelling on the social aspect of things more often than the medical issues on my medicine wards rotations. On top of that, I see all the of psych residents/attendings always happy while the neuro residents/attendings exhausted. Residency is also killing my family life and my wife consistently feels alone. I don't think doing the q5 overnight calls will help either when I start neuro. For me, I view medicine more as a job, not a lifestyle. I can see myself working as either one happily but if one tends to require more hours per week or overnight call, then I don't know if I will be happy doing it.

I wanted to ask how difficult is it to switch after intern year? Should I address this with my PD and see if there will be vacant psych spots in my program? Or is this all just residency blues? Thanks all!

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[Leo Aquarius]

Taking a moment to pause in my intern year, I have to admit yes, we are pretty happy as residents in my psych program. Yesterday I was done by 3pm and took my wife to the aquarium. Most days, though, it's 8pm to 5pm for me.

 

[michaelrack]

. Most days, though, it's 8pm to 5pm for me.

21 hour days- that's hardcore even by neurosurgery standards

 

[peppy]

Well, hey, Freud was a neurologist, so it seems like a logical transition doesn't it?

If you're sure you want to switch you would probably be able to do so pretty easily. I am pretty sure your internship in Neurology would be considered equivalent to a PGY-1 in psych and you could probably start as a PGY-2 psych resident. (ABPN requirements for internship: "A broad-based clinical year of ACGME-accredited training in internal medicine, family medicine, or pediatrics; or an ACGME-accredited transitional year program that included a minimum of four months of primary care med- ical; or an ACGME-accredited residency in a clinical specialty requiring comprehensive and continuous patient care" )

Residency is hard at times in any specialty. In Psych, usually the hours aren't very long (depending on the residency) but the nature of the work can be stressful. For me, the hardest part was the psychotherapy year because I found it emotionally taxing and didn't really enjoy doing therapy myself even though I think it is valuable. You also have to be prepared for some of the stigma that psychiatrists face (although my experience is that doctors in general don't get respect like they used to, so I don't care that many people don't really respect/understand what I do).

Overall, I do think that the atmosphere in psych is more benign and family-friendly than it is in many other specialties, though individual residencies will vary some on this and you should try to investigate the residency you're considering joining. Most days, I get to see/talk about some interesting things and then get to go home in time for dinner, so I would say that my job is pretty good.

 

[BobA]

My impression is that it's very easy to switch after intern year and you'll probably be able to pre-match at a decent program if you're not too picky about location.

 

[Leo Aquarius]

21 hour days- that's hardcore even by neurosurgery standards

Hahaha wow I didn't even notice the type-o..... or is it !!

 

[Neurotopsych]

Thanks everyone for the replies!!

In terms of searching for open programs, when does one start looking for vacant spots? I suppose talking to my PD would be the first step. If anyone knows of any programs with openings for PGY2 starting 2013, particular on the west coast, any info would help. Thanks!

 

[peppy]

Sometimes spots are actually posted on the APA website, but many of them are filled through "word of mouth" (programs often don't want the hassle of getting a deluge of applications and can find someone they want without doing an entire formal application season) so it would probably be a good idea to actually contact any programs in locations where you'd be willing to live to see if they expect to have a PGY-2 opening.
You will need your program director's support to get a new spot, so definitely talk to your program director before you actually apply anywhere else. It would look bad if the PD found out you were leaving from another PD calling to ask about you (they do things like that do sometimes).
There are some programs that routinely hold open a spot so they can take good people switching out of other specialties as PGY-2s. I believe that Medical College of Wisconsin, University of Maryland, Johns Hopkins, Yale, and University of Washington have routinely done that in the past. I'm not sure if the new Match procedures (the all-in/no prematch thing for PGY-1 spots at least) have changed how they do that, though, so I'd suggest contacting those programs to see if they plan to continue to do things that way.