To become a Psychologist, or a Psychiatrist?

[futureapppsy2]

I believe what was trying to be conveyed was that the example of neuropsychologists being used in a comparison when clinical psychologists (i.e. Clinical psychologists who are not neuropsychologists) was not a relevant comparison and not that neuropsychologists weren't clinical psychologists.

My point is the basic training neuropsychologists receive isn't hugely different from that received from people who don't go the neuropsych route, and those "basic" clinical skills and related education received in grad school are still a fundamental part of the training of clinical neuropsychologists. But, I'm sure the 5-6+ years of graduate education and clinical training neuropsychologists received prior to fellowship taught them nothing useful at all.

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[nitemagi]

This turf war is tiresome. Does either side recognize that there are gaps, and that they're not an expert in everything? Yes you could go on and get advanced training to do more, but out of the gate there's deficiencies on both sides. And even moreso philosophical differences in approach that can lead to problems.

 

[futureapppsy2]

This turf war is tiresome. Does either side recognize that there are gaps, and that they're not an expert in everything? Yes you could go on and get advanced training to do more, but out of the gate there's deficiencies on both sides.

Well said!

 

[st2205]

My point is the basic training neuropsychologists receive isn't hugely different from that received from people who don't go the neuropsych route, and those "basic" clinical skills and related education received in grad school are still a fundamental part of the training of clinical neuropsychologists. But, I'm sure the 5-6+ years of graduate education and clinical training neuropsychologists received prior to fellowship taught them nothing useful at all.

I'd take another look at what was being discussed. I don't think anyone has any disagreement with you here.

 

[nitemagi]

Nice post Jon.

I think there's a lot of truth in what you wrote. The standardized education for Ph.D. psychologists involves more statistical training than it does for MD's. Therefore you're more likely to always get a Ph.D. psychologist with decent stats training than an MD.

Agreeing with your statement about "scope of expertise" as related to assessment instruments, though I wouldn't necessarily generalize that to clinical interviews or all psychopathologies. Psychiatrists have at baseline much much more clinical hours of patient exposure, and exposure to more total hours within the required training period. Again, not that psychologists can't have equivalent exposure, but they would have to pursue it via fellowships. The flipside is that usually psychiatrists have less hours of continuity of therapy with an individual patient during residency. This leads to a schism IMO of differences in training of depth vs. breadth.

 

[Therapist4Chnge]

I'm in a similar position as Jon (though a couple years behind), and his post captured my feelings on the topic. $200k+ is possible for the top tier neuropsychologists, but it is far easier to attain in psychiatry.

 

[billypilgrim37]

Psychiatrists do a rotation (in psychiatry if they choose?) before residency and then 1 year internal medicine and then 3 years psychiatry? That's 6000 hours for psychiatry baseline versus around 5000 for psychology baseline.

3.5 years of psychiatry (not 3) x more like 60 hours a week (closer to 70-80 during first 1.5 years, probably closer to 50 the last 2) = 1100 hours. That doesn't even include the 2.5 years of patient time which we would say would be particularly relevant to our practice as psychiatrists, but which was not specifically directed at psychiatry. Add on a one year fellowship, and you're up to probably 14000 hours.

 

[nitemagi]

Not sure I understand this. Generally, psychologists have at least 1000 hours pre internship, 2000 hours internship (calculating hours as if 2000 = one year, your mileage may vary), 2000 hours postdoc. Then, there's the fellowship trained folks (additional time). Psychiatrists do a rotation (in psychiatry if they choose?) before residency and then 1 year internal medicine and then 3 years psychiatry? That's 6000 hours for psychiatry baseline versus around 5000 for psychology baseline.

I think it would be useful to involve both psychology and psychiatry in the diagnostic process before treatment is initiated. Of course, most people end up treated with drugs regardless of necessity or accuracy by their primary care physician or nurse.

Psychiatrists do 6 months of psychiatry during intern year, and you're right my math was off (I was basing my #'s on a full first year of psychiatry).
(Year 1) 6 months = 26 weeks (at 60-80 hours/week) = 1560 - 2080 hours in first year.
(Year 2) 52 weeks (at 40-80 hours/week) = 2080 - 4160 hours
(Year 3) 52 weeks (at 40-80 hours/week) = 2080 - 4160 hours
(Year 4) 52 weeks (at 40 hours/week) = 2080 hours

So during a 4 year residency, psychiatrists get a minimum of 7800 hours during residency alone, but up to 12,480 hours depending on the rigorousness of the residency. But you're right the type of assessment is different. Psychiatrists more often get exposure to consult, emergency, and inpatient situations, which gives us better training in the acute and severe situations, as well as having less time with individual patients, meaning we see a larger total number of patients and thus a wider breadth of pathology.

That's my perspective, at least.

 

[siked]

Of course, if you want to save a lot of time and money, you could always get your Masters, work at a school, and walk around and call yourself a "psychologist."

 

[LauraGS]

Hello all,

I'm a recent graduate of a prestigious school (liberal arts major) and I'm thinking about either going for a PhD and becoming a psychologist, or going for an MD and becoming a psychiatrist.

Now, according to the 2009 BLS report, a Psychiartist's median annual salary ($160,230) is more than twice as much as a Psychologist's median annual salary ($64,140); and the difference in length of education is only two years (for me at least, see below)...so it seems like Psychiatrist would be the obvious choice.

But, I'm not at all interested in conducting 15 minute medication management appointments, and I read in this 1998 WebMD article(http://www.webmd.com/mental-health/features/psychology-vs-psychiatry-which-is-better?page=2) that most health insurance plans won't even cover psychotherapy treatments from psychiatrists? Is that still true today? Is it going to be true post-health care reform?

I also read in the same WebMD article that psychiatrists only charge $5-$16 more for psychotherapy sessions (45-50 minutes) than psychologists. Is that still true today? Is it going to be true post-health care reform?

Thank you very much in advance for any help!

Best,

Jim



*Personal Education Paths:

Psychologist: masters (1-2 yrs), phd (6 yrs), licensing (1-2 yrs); total 8-10 yrs.

Psychiatrist: post-bacc (1-2 yrs), md (4 yrs), residency (4 yrs), fellowship (1-2 yrs); total 10-12 yrs.

Hi,

I know this was posted a while ago but I hoping for a response from the original forum poster. I find myself in the same exact predicament you are talking about in this post. Just wondering, what did you decide to do? And are you happy with your decision? Any and all feedback would be much appreciated. Thanks!

 

[OldPsychDoc]

I think he became the coach of the San Francisco 49ers.

 

[Chimed]

Hi,

I know this was posted a while ago but I hoping for a response from the original forum poster. I find myself in the same exact predicament you are talking about in this post. Just wondering, what did you decide to do? And are you happy with your decision? Any and all feedback would be much appreciated. Thanks!

You might want to try sending them a PM as they might not check this site, thread, or forum.