Switching from ob/ gyn to psychiarty

Discussion in 'Psychiatry' started by Laughter lady, 01.14.14.

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  1. Laughter lady

    Laughter lady

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    I am currently an ob/ gyn attending with six years of practice. I am not yet board certified, long story. I want to switch to psychiatry. I have an interest in women health specifically in psychiatry! I was looking at psychiatry programs but I am told it is not an accredicted fellowship yet! I have licenses in ca, nv and il. I am looking at programs for 2015. I see my future as a community doctor . I need advice on potential programs that have this, I am aware I will start as pgy 2. I want to go to a place where I can learn the most and hopefully get a fellowship so it will cost me three years total. I am married with two kids! I am only 36 yrs old!
     
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  3. whopper

    whopper Former jolly good fellow 10+ Year Member

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    I don't what you mean by you are looking into psychiatry programs but are being told "it's not an accredicted fellowship."

    All psychiatry residencies are accreditted unless there's a program out there that I don't know about in operation that is not. They are not fellowships. Please clarify your question because I'm not sure what you're asking.

    You can still do some good work in the mental health field without going into psychiatry. For example, several Ob-Gyn clinics and primary care offices have a psychologist or psychaitrist there to assist the PCP in health issues for their patients.

    If you want to go into psychiatry and focus on mental health for women, there are programs with some attendings specializing in this such as NYU. There are specific areas where the ob-gyn aspects could affect mental health such as in late-onset schizophrenia and you could use your expertise in that field to advance the science.
     
  4. MacDonaldTriad

    MacDonaldTriad 2+ Year Member

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    Since you say you know you are going to have to start as a PGY-II, I assume that you intend to go into 3 years of a general adult psychiatry training. You are right, there isn’t a board certification in “Women’s psychiatry”, but there are PGY-V positions with some great mentors. Just look up Columbia, Brown, Brigham (Harvard), UNC. There probably will not be a new subspecialty created, but that can have some advantages as well.
     
  5. elftown

    elftown 7+ Year Member

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    I read it as women's health is not an accredited fellowship in psychiatry yet.

    How she plans to start psychiatry as a PGY-2 and do a fellowship all in 3 years is what I don't understand.
     
  6. touchpause13

    touchpause13 nolite te bastardes carborundorum 2+ Year Member

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    Do you guys think a women's health fellowship in psychiatry would be a possibility in the future?
     
  7. elftown

    elftown 7+ Year Member

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    I think so, but I remember reading on here that supposedly they don't want to create more fellowships in psychiatry. I think the reasoning was that after 4 years of training, you shouldn't need a fellowship to treat these various types of patients.
     
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  8. notdeadyet

    notdeadyet Still in California SDN Moderator 10+ Year Member

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    Doubt it.

    For all the pushes in psychiatry, I think a better option for most of them is to create tracks in psychiatry residencies themselves. Many programs do this for women's health psychiatry and you get ample exposure, targeted therapy cases, and clinics to pass along what's needed.
     
  9. Laughter lady

    Laughter lady

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    thanks for responding! I looking at the acgme website to see if there were accredited fellowships in women health. I emailed acgme and there are no psychiatry fellowship programs in women health like you do with forsenic etc. I was hoping to find programs that have this and apply there as I think that will be my path. You are an attending, what would you do if you were me? I want to do the psychiatry residency and hopefully women health fellowship and in cooperate at least contraception in my practice. I don't know anyone who has done this, was also hoping for done referrals of people who have done this or progra
    well i have read comments that you can do a fellowship your fourth year. but form you comment, I am guessing this is an option if you started from PGY 1.
     
  10. elftown

    elftown 7+ Year Member

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    I've only heard of fast tracking into child and adolescent during fourth year. If someone knows a program that lets you do this with other fellowships, please let me know. :)
     
  11. touchpause13

    touchpause13 nolite te bastardes carborundorum 2+ Year Member

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    Hey thanks for the replies! I'm interested in both women's health and psych so I was curious. :)
     
  12. Laughter lady

    Laughter lady

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    can anyone please comment, on the psychiatry programs in northern California? in terms of education, clinical practice, malignancy, life style. Thanks
     
  13. splik

    splik 7+ Year Member

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    it is sometimes possible to do non-ACGME accredited fellowships in 4th year if your 4th year is all elective. for example the public psychiatry fellowships at columbia and UCSD take 4th years. so theoretically this could be true for women's health, but it might be hard to do all the requirements in 3 years and thus much more difficult (though not necessarily impossible) for those entering psych as a PGY-2.
     
  14. Leo Aquarius

    Leo Aquarius Anxiety.org Schizophrenia.com DepressionHealth.net 2+ Year Member

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    Congratulations on your decision to switch into psychiatry. Every specialty has its benefits, and psychiatry sure has many of them.

    If community emphasis is what you are looking for, then in California I can recommend UCSF and UCLA-Harbor. Both offer excellent community psychiatry training, arguably some of the best in the nation. UCSF offers community psychiatrists that are top notch, as well as psychiatrists who specialize in women's health. UCLA-Harbor IS a community psychiatry program, one of the best, and their residents have access to psychiatrists who specialize in peri-partum and post-partum patients. Half of your final year at UCLA-Harbor is elective, which you can tailor to women's mental health if you like. In terms of lifestyle, UCSF will be more rigorous than UCLA-Harbor.

    Stanford has exposure to "community" psychiatry, but it's VA heavy. Last time I checked there are many many more men than women in the VA system. Not ideal for your goals.

    UC Davis is also worth looking at. They offer flexibility in your 4th year as well, and encourage community psychiatry. But it's great strength is in forensic psychiatry.

    None of these programs are malignant, not in the general surgery sense. In fact, I don't think any program in CA is malignant. CA is competitive, both for residents and faculty.

    Clinical practice is what you make of it. There's such a shortage of psychiatrists (as evidenced by several markers which I can talk about elsewhere) that you can create your own practice style.

    Good luck!! and welcome!
     
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  15. whopper

    whopper Former jolly good fellow 10+ Year Member

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    There is a vast amount of literature on women's health and encompasses a wide area not just in psychiatry but in related fields that would impact psychiatric care such as in psychology and legal/forensic.

    Got a female patient with an abusive boyfriend? You are supposed to factor in the possibility the boyfriend may kill the patient, especially if there's a breakup. I don't see a lot of psychiatrists doing that.

    This, IMHO, is an untapped vein or low-hanging fruit. A psychiatrist could study these correlated areas and incorporate them into psychiatry and advance their academic standing by publishing articles on it. It could also go hand-in-hand with DBT since several DBT groups are populated with women with several social problems.
     
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  16. MacDonaldTriad

    MacDonaldTriad 2+ Year Member

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    I mentioned some advantages to being in a non-ACGME/board certified fellowship. The difference is that you can do some “fellowships” as a PGY-IV, only they are part of your general adult training and you are a transfer student. If this is in the same program, then it is very much akin to just doing a lot of elective time in a specialty clinic. Board certified fellowship training currently requires you to finish adult training before entering. This may change, but so far it hasn’t. Either way, women’s psychiatry is unlikely to have a board certification in the foreseeable future.

    In your situation, you can come in as a PGY-II and be board eligible in three years. This would mean 4 months of medicine, 2 months of neuro, 6 months of inpatient (one year), 12 months of continuous outpatient (two years), and then you need 2 months of child, 2 months of C&L, one month of Geri, one month of addiction, forensics, community psychiatry, and emergency psychiatry. In other words, you will not have much elective time to spend in a women’s clinic. You could do this and then spend a PGY-V year doing women’s psychiatry, or (and similarly) you could enter as a PGY-I and take the same 4 years with elective time. There would be some difference in pay.

    My analogy would be buying a new set of Calloway golf clubs. You could buy a used set, have them sharpened, repainted, and re-gripped, and the outcome would be about the same. After you get out there and play a while, no one would be able to tell the difference. How well you play would have more to do with how you practice and how much mentoring you get from whom.

    Since you mention California, http://www.semel.ucla.edu/mood/womens-life

    Good luck.
     
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  17. splik

    splik 7+ Year Member

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    she wouldn't need to do 4months of medicine as a PGY-2 entrant!
     
  18. MacDonaldTriad

    MacDonaldTriad 2+ Year Member

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    Depends on what her OB/GYN gave her credit for.
     
  19. splik

    splik 7+ Year Member

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    how would she be able to start as a PGY-2 applicant if she didn't have credit? she has finished a whole residentcy apparently. If you start as a PGY-2 This assumes you have been given credit for whatever. OB/GYN counts (as does surgery) in lieu of medicine as has been discussed in previous threads. The ACGME requirement is just IM, FM, peds OR a specialty which involves "continuous patient care" - i.e. any intership counts.
     
  20. MacDonaldTriad

    MacDonaldTriad 2+ Year Member

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    This is scrutinized by both the ACGME and the ABPN and they don’t always see things the same. To make it even more difficult, the ACGME is interpreting requirements put forth by the psychiatry RRC. They have lots of different RRCs to contend with so when asked about what does and doesn’t count, the answers can be inconsistent. The acid test is taking the letter from the OB/GYN PD describing the rotations and asking the ACGME and ABPN what they think. Despite what has been discussed here, answers can vary.
     
  21. peppy

    peppy Senior Member 10+ Year Member

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    The main reason I would not expect a separate women's health fellowship to be recognized is that, in my experience, this can easily fall under the umbrella of Psychosomatic Medicine already. If you are willing to join the APM, you might want to try to join their special interest group for women's health: http://www.apm.org/sigs/index.shtml
     
  22. Wednesday

    Wednesday Senior Member 10+ Year Member

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    Hi,

    This is what I do. I completed my internship in ob/gyn and then switched to psychiatry as a PGY2 (no problem getting it to count, as you know ob/gyn is a very medicine heavy specialty, most people don't realize that). Did three years of general psychiatry residency and now I work at a non-academic (mostly) hospital officially as a consult-liason psychiatrist. I did not do a fellowship. I see exclusively women who are either pregnant, postpartum or thinking about getting pregnant and have mental illness. A lot of postpartum and antepartum depression and anxiety but also some women with previous diagnoses of bipolar and psychotic disorders. We have an addiction recovery program for pregnant women in my hospital (run by Family Med addictions specialists) and we consult on those patients as well. Most of my practice is outpatient (which I prefer) although we see some inpatient antepartum and postpartum patients. We are located in the ob/gyn clinics associated with our various campuses and at a new postpartum clinic they opened this year. We do not do any therapy because we would be too full. The priority is to be available to see patients the obs refer to us as soon as possible since this is such a critical time. We follow patients for med management during pregnancy and up to a year postpartum and refer out for therapy (although we are working on getting a therapist in our clinic). There is a huge demand. I realized this in ob/gyn residency because the psychiatrists were afraid of prescribing in pregnancy and the obs didn't know anything about the drugs psychiatrists use. I'm not as interested in menopause and the myriad of mental health problems than can crop up then, but we constantly turn patients away who are seeking this sort of care as well. I did my residency at the University of Washington where I was able to tailor my clinical experiences to get some women's health experience. I had a great mentor. And then I just read (and continue to read) a lot. I absolutely love my job. In psychiatry, more than in other fields, I think it's possible to tailor your job to what interests you. Good luck!
     
  23. Laughter lady

    Laughter lady

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    Thank you all for your encouragement! Just a little worried about if there will be pgy 2 positions open in ca area for family and spouse job reasons. Hoping for guidance from God and Universe! Thank you all!
     
  24. Laughter lady

    Laughter lady

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    Thank you all! I got in and I am having the best time of my life! Found my passion!
     
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  25. MacDonaldTriad

    MacDonaldTriad 2+ Year Member

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    Congratulations and good for you!
     
  26. Leo Aquarius

    Leo Aquarius Anxiety.org Schizophrenia.com DepressionHealth.net 2+ Year Member

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    Congrats and welcome!
     
  27. liquidshadow22

    liquidshadow22 Junior Member 7+ Year Member

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    sorry, if this was answered bc i didnt read the entire thread...but here's my q: because the OP has finished a residency previously, how will her salary get paid for this second residency? will her program get acgme funding for havinig her?
     
  28. vistaril

    vistaril 2+ Year Member

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    I couldn't imagine doing an obgyn residency and then going back to do a psych residency. If this story is true that's gotta be a unique situation.
     
  29. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Moderator Emeritus SDN Advisor 10+ Year Member

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    The program's going to have to pick up the tab. Some hospitals have the ability to do this. Most don't. None would for every resident, >80% of residency funding comes via CMS, =Medicare, the federal government. (Not ACGME, as implied above.)*

    *(That's OK--it's hard for us to keep all our alphabetical oversight straight, too.)
     
  30. koc123

    koc123 A person 2+ Year Member

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    I am another Ob/gyn (having completed residency+ board certification) to psychiatry convert. So, it's not unique or un-doable. Before I applied three years ago, I too thought that the funding issue would be a problem. But I received invitations for interviews from a range of programs (from high-caliber ones like Columbia to community programs such as Albert Einstein in Philadelphia). In fact, I will be doing a fellowship next year.
     

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