Triple Boards or Psychiatry

[Darkskies]

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Hi everyone,

I am a 3rd year medical student just finishing up the year. Unfortunately, I had Pediatrics as my first rotation and Medicine/Surgery last. I really liked the first two years of medical school while third year has not been as enjoyable. It seems like the job of being a doctor involves a lot of mundane aspects, bureaucracy, paperwork and following algorithms rather than all the basic science stuff we learn in the first two years. I really liked microbiology so I was thinking about doing Internal Medicine with a possible ID fellowship but everyone dissuaded me from doing that and I can't deny that I didn't really enjoy my IM rotation too much. It was all about following patients presenting with 10+ problems, AKI/dehydration, anemia, and following lab values and writing redundant notes in charts that you can't even read.. I also have a hard time remembering every little tedious fact(like whether PT was consulted, dietitian,etc.) about 20+ patients on a given census even though I didn't have trouble learning all the minutiae from the basic science years.. I imagine/hope this will improve with time..

I liked seeing the pediatric patients on my family medicine rotation because it was easier to know all about their medical history and track record as well as being able to focus on a single problem rather than 10+ chronic diseases. I am neutral towards children and feel uncomfortable about gushing over them like other people do.. Is that a negative? I also obviously liked Psychiatry. I can't deny that part of the reason I am considering triple boards is because I am not completely okay with losing the ability to know about and treat somatic diseases. Is it possible to work as a psychiatrist/child psychiatrist 3 days and then as a pediatrician 2 days a week? Do the logistics usually not work out such that people from these combined programs always end up just doing one specialty? Thank you for reading and I value your input.

 

[Bernardo_11]

Since you found the first 2 years of medical school to be quite enjoyable, have you thought about doing pathology? There are even ID type pathology fellowships available if you wanted to further pursue your interest in microbiology. Just a thought.

 

[Stitch]

I would find a pediatric psychiatrist at your hospital and see if you can shadow them for a little bit. It's worth seeing what types of patients you'd see on a daily basis, and learn what the job is like. Triple boarding is a long road. There is absolutely a need for more pediatric psychiatrists, so I'd think it would be relatively easy to get a job. Certainly having those skills and training would make you an excellent psychiatrist and pediatrician, but you have to ask if you are okay spending fairly long appointments with patients who are likely to have a number of behavioral issues in your role as a psychiatrist and then spending your other days doing more rapid visits seeing colds, doing vaccines and well child checks.

 

[hamstergang]

Is it possible to work as a psychiatrist/child psychiatrist 3 days and then as a pediatrician 2 days a week? Do the logistics usually not work out such that people from these combined programs always end up just doing one specialty? Thank you for reading and I value your input.

Sorry to be invading the Peds forum from the Psych world, but I know a little of the triple boards being in a child/adolescent psych fellowship. Pretty much no one works as a part time pediatrician and part time psychiatrist. It's enough work to keep up to date and be proficient in one field let alone two. Choosing a combined program to avoid making a decision seems like a way to set yourself up for issues in the future. I recommend figuring yourself out now.