underserved communities

[Symmetry11]

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What pathway does a psychiatrist have to take in order to serve minority communities? Say for example working two days a week as a CA psychiatrist in an under served high school and the rest as a PP or inpatient psychiatrist? Is something like this where much of your work is dedicated towards helping the under insuredetc while not totally sacrificing your lifestyle?

 

[Shikima]

Be a NHSC scholar.

 

[sunlioness]

It doesn't take too much effort to get a job at a CMHC. Be careful though. I don't think they're really set up to actually do much good.

As a patient yesterday said, "I been coming here for five years and ain't nobody helped me yet!"

And I didn't either.


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[thoffen]

There are lots of jobs (academic or not) for the underserved. If this is your passion, you can make a good living at it. You won't make nearly as much as you could in private practice, but you also won't be poor. I think things like lack of administrative support and poor access to other needed areas of care (e.g. therapy, case management, medical care) interfere with these career choices as often as salary. There are other options such as doing part time work for the underserved balanced with a more lucrative practice, akin to what you describe.

Not sure about NHSC scholarship. One of my med school instructors did this (primary care) and regretted it. Didn't make good financial sense right out of college. She was fluent in Spanish and had connections to a local underserved community, thinking that they would match her interests somewhat. Nope. Shipped off to Appalachia I think. Especially if you want to build an academic career, that practice setting and lack of access to a community of smart docs would turn me off. From a service aspect, I would do it, and the financial incentive is more than enough. It wasn't an option for me due to lack of personal flexibility.

 

[milesed]

I did both CMHC and NHSC loan repayment program. I started with exposure during residency. Our outpt VAMC had a community outreach program and I worked at 2 different CMHC's during my last 3 years of training.

 

[WingedOx]

It doesn't take too much effort to get a job at a CMHC. Be careful though. I don't think they're really set up to actually do much good.

As a patient yesterday said, "I been coming here for five years and ain't nobody helped me yet!"

And I didn't either.


Sent from my iPad using Tapatalk

I guess that beats the "actively conspiring to hurt me" that we're apparently guilty of at my VA.

/Not me though, I'm the "one good doctor in this f.cing place who isn't an idiot".

 

[WingedOx]

Honestly if working with the underserved is your thing, start out in a residency which primarily serves poor communities as part of your training so you can learn to deal with the more unique issues while you still have supervision and mentors to learn from. Jumping from learning to practice psychiatry with suburban Lexus drivers into a full time gig with poverty stricken populations would burn out any psychiatrist quickly.

 

[smalltownpsych]

Go to med school, complete your residency, pass your boards, then take the job at a CMHC in a community that has minorities. As far as working at a high school, I have not heard of a psychiatrist doing that. The kids will usually come to your office, but I don't see any reason why you couldn't go to them.

 

[clausewitz2]

Honestly if working with the underserved is your thing, start out in a residency which primarily serves poor communities as part of your training so you can learn to deal with the more unique issues while you still have supervision and mentors to learn from. Jumping from learning to practice psychiatry with suburban Lexus drivers into a full time gig with poverty stricken populations would burn out any psychiatrist quickly.

This was sort of my thought process in deciding where and how to rank, so I am glad to hear an experienced voice affirming that particular decision.

 

[milesed]

Go to med school, complete your residency, pass your boards, then take the job at a CMHC in a community that has minorities. As far as working at a high school, I have not heard of a psychiatrist doing that. The kids will usually come to your office, but I don't see any reason why you couldn't go to them.

We were asked to do this by a local high school, but it is an impossibility for me. I ALWAYS see kids with an adult present- preferably one who is the caregiver. 99.9% of the time, the kids just lie about what is going on- the adults give the rest of the story that is actually useful. I also would be concerned about any allegations they may make about what was said or done while you are with them. About 5 kids a year I see have made false abuse allegations in the past. Another adult in the room pretty much prevents any of that crap. We do have therapists who see kids at school w/o parents present, but they also have to set at least half of the appts with a parent to get the full story.

 

[hamstergang]

An institution I do a lot of training in has been contracted to work with several school districts in my area. Typically, this involves having a social worker placed in the high school (or middle school? I'm not sure) to do some therapy and help with case management. In addition, psychiatrists go to these schools part of the time. In the school I was in, our appointments did require that the parents come in to the school.

The advantages of this included:
1) It was paid for by some grant and I believe the school district to some degree. So for the kids that were otherwise having trouble getting a psychiatrist, we were there for free.
2) We could much more easily collaborate with the school (teachers, counselors, etc).
3) The kids were already coming to school, so we only needed to get the parents in. This was slightly easier than getting them all to come to an outpatient appointment while they were busy doing other things. Or at least that's what I hoped. We had a high no-show rate, but this population may have had a high no-show rate anywhere.