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Any Psychologists/Psychiatrists? Thinking of a Career Change

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In a nutshell, Psychiatrists are physicians - we write prescriptions and are more focused on medical issues. Psychiatrists are on the lower end of the physician pay scale, but it's still in the pay scale range of what physicians make. This is why the pay scale is generally higher for Psychiatrists than Psychologists. The Psychologist I work with thought about medical school in college, but decided she wasn't a hard science person. I didn't ask the details, but I would guess she took some of the basic sciences and ran screaming in horror. She ended up studying Art History, did very well in that, and then went for her graduate degree in Psychology after that. In our program, she is much better at understanding the aesthetics of the reports and procedures we set up so that administrators can understand us, and patients like the program. I am better at understanding the technology underlying it, and figuring out the best way to set up the video monitors to communicate well with the computers, and how to get needed information quickly from one room to another room a hundred miles away.

To apply to medical school, you'd need to have completed the basic sciences in college: one year of physics, one year of biology, one year of general chemistry, one year organic chemistry, usually but not always, one year of calculus. For graduate school (Psychology doctorate) you'd take the GRE's as the entrance exam, for med school you'd take the MCAT's.

It was very selective to get into medical school when I entered in 1987, these days it's pretty insanely difficult. You can't really 'just decide' to go to medical school, unfortunately. There is an alternate path called Osteopathic School, which results in a D.O. degree. This is legally equivalent to an MD, and you can do anything an MD does. It's a bit easier to get into, and it focuses more on spine/muscle/whole patient (so they say). But if you're hoping to do research or get into the more selective residencies, the MDs have a leg up on the DO's. Some folks go to Medical Schools in other countries, where it is easier to get into. But coming back can be difficult, as once again, the American MD grads have a leg up on you.

If you get in, the first two years are generally basic science: biochemistry, anatomy, pharmacology etc ... you can look it up. Then it's 2 years of clinical rotations. The first year of clinical rotations (3rd year of med school) includes internal medicine, surgery, OB/Gyne, pediatrics, and psychiatry. This is the year you see in the TV shows/movies when the students run around the hospital getting trashed, feeling really stupid, and staying overnight wondering what the hell you got yourself into. The second year of clinicals (4th year of med school) is much kinder and gentler. Usually it's electives and catching up on things you may have missed in the first 3 years, plus allowing time off to interview for residency.

After finishing medical school you are officially an MD, but can't really do much of anything. You have to go to a residency in the specialty of your choice. This is when you choose to specialize in Surgery, Internal Medicine, Psychiatry, Pediatrics, Family Practice etc... Each residency has a different number of years, generally from 3 years to 5 years. Psychiatry is 4 years. Residency is what you see in the TV shows and movies when they show doctors in training getting trashed, staying up all night and really learning to become a physician. 'Scrubs' was about residents in training - I believe JD was an Internal Medicine resident and Turk was a surgical resident.

Comparing what I do as medical director of my program versus what my psychologist partner does as program manager: she tallies much more of the data - how many patients did we get referred to us? What diagnoses were they? How many clerical errors occurred and how can we minimize them? Are they satisfied with their care? Did they get better from our care? She writes reports on this and reports this at meetings. She attends meetings at the hospital and regional groups to obtain new information about programs that may affect ours and report our data. I make more decisions on the clinical flow of and medical issues related to the program. Is it reasonable that this degree of severity be seen in our program versus another? Is it medically appropriate to see a patient in this or that manner, or should they be referred to a different program? This type of treatment requires blood testing, so maybe they should do it this way, not that way. Because of my technical background, I do more of the figuring out what is possible or not, with the technology that we have.

Comparing what I do clinically as a Psychiatrist versus what my Psychologist partner does, I see a much greater volume of patients in shorter visits, focusing on their medications and guiding the overall plan. She sees the fewer patients for longer visits and much more frequently. If a patient gets a new prescription from her surgeon, she might call me to ask if it's ok to take it with the medicines I prescribe. If he gets anxious after being diagnosed with hyperthyroidism and noticing his heart is racing, he'd call me. If he gets anxious after seeing a car wreck that reminds him of being blown up by an IED while in the military, he'd call her (though he still might call me, as well). These are all generalizations, but it gives you an idea of the general differences.

Almost forgot to ask: Does the VA welcome people who would like to volunteer their time in some capacity? Seattle has a large VA presence and I would like to do more to help.
 
Since you went to grad school, I am guessing you have already taken the GRE and it sounds like you did really well in both! Therefore, you could probably pretty much apply to Psychology grad school pretty quickly, or maybe even right now, esp if you've already taken a number of Psych courses in college. Grad school for Psychology probably parallels what you did for your grad school degree, but focused, of course, around Psychology.

Med school would be a pretty significant turn onto a different road. The biggest thing right now would be taking the prerequisite basic sciences, which you'd need before even applying. It sounds like you're plenty smart enough, but having not taken the hard sciences, do you do well in that type of class? Hard to know. I suspect if you took one or two of the basic science classes, you would know very quickly. Sign up for or audit a college level general chemistry class - that's the typical 'weed out' class for pre-meds. (I should say though, that I couldn't pass a gen chem test right now, if my life depended on it!) The majority of people in that one class decided immediately that medical school was or was not in their future. If you either like it, or at least don't absolutely hate it, and get at least a B+, preferably an A- or A, that would answer a lot of questions right there. There are a lot of very bright people I know for whom this just wasn't for them, and they went on to really great careers elsewhere. I also know people who found their calling later in life, and went on to become fantastic physicians, having seen what the 'real world' is like before committing themselves to medicine. They were the much more mature medical students - not just in age, but also in life experience. There's a lot to be said for the medical student who did something in life already, and didn't just shoot through college getting really good grades and being an asshole.

Most hospitals, and definitely our VA have volunteer departments. I did a summer internship in Biomedical Engineering in a hospital (The Cleveland Clinic), and was drawn very much to what the physicians were doing. That was when I decided to go to medical school for sure. Now I had already completed all the basic sciences, so I had an inkling that I might want to go, all through college, but wasn't sure until I did the internship at the hospital.

Now I should warn you that the volunteer department is filled mostly with older retirees who are looking to get out of the house and kill time to keep from driving their spouse crazy at home. But that's ok, at least you'd be hanging out in a hospital and getting to know healthcare providers of all sorts!
 
Just getting too old for porn. It is hard on the hips and knees.

My understanding is that in gay porn that the ass really takes a pounding and you just cant even sit without pain after 10 years of doing films.

Is this true?

I am asking for a friend btw.
 
My understanding is that in gay porn that the ass really takes a pounding and you just cant even sit without pain after 10 years of doing films.

Is this true?

I am asking for a friend btw.

I'm not the expert. I only do Estonian Dothraki/Khaleesi fetish porn (sometimes moonlight doing Icelandic widow elbow window/fire escape stuck porn).

@The Oi is the man you want.
 
I'm not the expert. I only do Estonian Dothraki/Khaleesi fetish porn (sometimes moonlight doing Icelandic widow elbow window/fire escape stuck porn).

@The Oi is the man you want.

Sorry. I only specialize in producing Brazilian fart porn and acting in current Matt Damon lookalike sex scene reenactment porn. You'd be shocked how many movies he doesn't have sex scenes in that we are able to crowbar these into as "behind the scenes footage."

If you're looking for gay porn, you're actually looking for @Bill Walton. who also specializes in a rare type of porn called shower running porn, which he can describe to you in more detail.
 
Sorry. I only specialize in producing Brazilian fart porn and acting in current Matt Damon lookalike sex scene reenactment porn. You'd be shocked how many movies he doesn't have sex scenes in that we are able to crowbar these into as "behind the scenes footage."

If you're looking for gay porn, you're actually looking for @Bill Walton. who also specializes in a rare type of porn called shower running porn, which he can describe to you in more detail.

@Lee the ass takes a beating for sure. Sitting is something that comes back over time. The first few days are the hardest and you really embrace the left cheek right cheek "leaning" approach especially when it comes to stubborn wooden chairs. Desk chairs, couches, chases are defiantly the ideal partner for relaxation during this time.

The bigger problem is the number the pounding does to fecal production. The poops you take the next few days are almost certainly bloody and form a square box like shape. Luckily the pounding is a blessing disguise because passing the "boxes" becomes easier due to the sheer size of your anus during recovery.

Getting into the shower porn, it's defiantly something you have to try before you judge. Most showering running porn takes place in the shower. The pure ecstasy of the noises the shower produces during sex actually creates a higher level of orgasm that many in the industry are calling "mega-climax". The idea was adopted in a project @Deezus oddly enough was working on while pleasuring middle aged sex transplant patients in Prague during 2000s. (Which he would be able to describe more in detail) But basically the subconscious creates a more detailed orgasm which actually causes the male nipples to excrete small doses of sperm during climax. Anyways there's truly a high demand of pornographic material in this field right now because the market is so thin. Basically most directors don't feel the juice is worth the squeeze because of the outrageous water bills that have come as a result of this porn. It's actually a really good topic and I'd be willing to talk about it anytime via PM.
@The Oi @Maximus
 
@Lee the ass takes a beating for sure. Sitting is something that comes back over time. The first few days are the hardest and you really embrace the left cheek right cheek "leaning" approach especially when it comes to stubborn wooden chairs. Desk chairs, couches, chases are defiantly the ideal partner for relaxation during this time.

The bigger problem is the number the pounding does to fecal production. The poops you take the next few days are almost certainly bloody and form a square box like shape. Luckily the pounding is a blessing disguise because passing the "boxes" becomes easier due to the sheer size of your anus during recovery.

Getting into the shower porn, it's defiantly something you have to try before you judge. Most showering running porn takes place in the shower. The pure ecstasy of the noises the shower produces during sex actually creates a higher level of orgasm that many in the industry are calling "mega-climax". The idea was adopted in a project @Deezus oddly enough was working on while pleasuring middle aged sex transplant patients in Prague during 2000s. (Which he would be able to describe more in detail) But basically the subconscious creates a more detailed orgasm which actually causes the male nipples to excrete small doses of sperm during climax. Anyways there's truly a high demand of pornographic material in this field right now because the market is so thin. Basically most directors don't feel the juice is worth the squeeze because of the outrageous water bills that have come as a result of this porn. It's actually a really good topic and I'd be willing to talk about it anytime via PM.
@The Oi @Maximus

With water rationing in CA the past few years I imagine those films are pretty short. Which is fine. Who ever makes it all the way through anyway?

Who can hold their nut in when someone is so obviously shooting loads out their nipples while drenched in conditioner?
 
@jvlgato, could you describe how the matching thing worked for you and how your residency went?

On top of working for the VA, do you also moonlight in private practice?
 
I have been ruminating on my life and I am considering a career change. I have very strong feeling about helping veterans with PTSD and am considering earning a PhD in Psychology.

I have varying impulses on whether to practice clinical psychology (probably military Psychology for personal reasons) or possibly Institutional and Organizational Psychology (pays better). My graduate work is in poll-sci so Political Psychology is also a possibility (well-paying niche I can fill). Going back to the Army after the PhD is also on the table. Or I could earn a PhD and a I and O Masters to accompany it.

Any advice or guidance people would like to offer?

I think if you want to do something and have the means to do it, you should go for it. If you think you'll be happier in your new career, then that's reason enough imo.
 
I think if you want to do something and have the means to do it, you should go for it. If you think you'll be happier in your new career, then that's reason enough imo.

Yeah, I think I am going to do it. Once I wrapped my head around accepting that a total hard-science reboot would be challenging, but conquerable, it seems obtainable. Do well in post-Bacc science/bio courses, study like a fiend for the MCAT and then see what happens. Thankfully, the significant other is very supportive of my plans and is just now graduating law school and has a very good job with a top firm starting in the fall.

The GI Bill will mean I won't pay much to go to medical school so at this point it is a matter of application, discipline and focusing on the end state (helping people and making a damn good living while doing it). Perhaps I will have my own radio show in Seattle and live a life of wacky, yet sophisticated hijinks.

That and I will be able to indulge @The Oi with lurid stories of serial killers with truly horrific, yet oddly boner inducing, fetishes.
 
@jvlgato, could you describe how the matching thing worked for you and how your residency went?

On top of working for the VA, do you also moonlight in private practice?

When you finish med school, you apply to residency in your specialty of choice. There are residencies for psychiatry in most major universities which have medical schools, along with a fair number of smaller community programs. So geographic preference is the next big factor. I loved Chicago and knew I wanted to return to the area (while keeping my Cleveland sports loyalties :) ). So I applied to most of the Chicago area residencies. You can read about residency training philosophies/school of thought and talk to people also, and may choose to not apply to some because you don't agree with their school of thought, for example.

The application process is fairly standardized across specialities. There's a standard form you fill, and they all get your med school grades and medical boards scores (of which you have now completed 2 out of the 3) and usually an essay, typically 'Why I want to be a shrink' kind of stuff. That form gets sent to all the residencies you apply to. Depending on specialty and how hard it is to get in, most people apply to at least 4-5. Psychiatry has traditionally been easier to get into, but getting harder lately. For the more difficult specialties, people might apply to as many as 15-20. After reviewing your application, the residency may choose to invite you to an interview if they wish to pursue you. You drive to the residency on that date, go through several intense interviews in which a bunch of residents and attendings (an 'attending' doctor is one who is all done and now practicing in his/her field) put you through the grinder and see how you act during stressful times. Yes, they ask you questions about all kinds of things, including 'Why do you want to be a shrink', but really, they want to see how you deal with stress. And if you say stupid shit or act like an asshole to your co-applicants and future teammates. Kind of like how job interviews are. They also introduce you to their residents, show you around the place, and try to convince you how awesome they are.

After this is 'The Match'. After the interviews, you rank the residency programs in order of preference, and they rank all applicants in order of their preference. There's a big computer with a mysterious algorithm which no one really knows how it works, and using this mysterious algorithm, it cranks out which residency you ranked highest which also matches with the residency's highest ranking. There's a big celebration/mourning at all med schools throughout the country on match day, and everyone finds out on the same day which residency they matched with. Or sadly, if you didn't match (rare). If you didn't match, you scramble and call places on the list of residencies which didn't fill all their spots. That's pretty rare, though, unless you're trying to get into a rare surgical subspecialty like Neurosurgery or Ophthalmology.

I should tell you that there is a mild to moderate degree of discrimination against psychiatry in most med schools. It's just such a different specialty from most medical fields, and even as doctors, people think it's fun to make fun of mental illness. No one admits to it openly, but it's there, believe me. For me, I just wanted to work in something I enjoyed and was good at, and that's what's important. But you should know about that going in.

Residency for me was much better than med school. It is still a lot of hours and lots of overnighters and hard work, and still difficult people to deal with. But at least you're mostly doing what you want to eventually do, and hopefully you're good at it. Also, psychiatry residency is known to be easier than most other residencies in terms of hours and lifestyle.

When I finished my residency, I took on the VA job half time and started a solo private practice half+ time (20-35 hrs per wk, changed through the years, depending on interest and need). I planned to ditch the VA job when my practice was established. I never did, because I liked the VA despite its frustrations. I ran my solo practice for just under 20 years and really enjoyed it. I saw outpatients in my own office, went to nursing homes, worked in community mental health, did hospital consults, hospital inpatient work, all to varying degrees through the years. I closed it 2 1/2 years ago because my wife's job was really good and stable (though she quit it 1 year later) and the kids were getting to an age that I wanted to be around more, and I just didn't need to have two+ jobs any more. Plus, my VA salary caught up to my private practice salary after 15 years (at least for a set 42.5 hour work week - VA/Federal salaries start low and increase very slowly so that through a 30+ year career, in the beginning you are underpaid, in the middle you are paid fairly, and when you retire you are slightly overpaid). I didn't want/need to work more than a regular work week any more. Also, you sick of running the health care business and the constant fight with insurance and health care policy. Plus I was offered the medical director position for Telemental Health. So I closed my pvt practice and went full time at the VA. I miss the pvt practice a bit - I miss the autonomy and being my own boss. I miss the variety of patients. But I love the regular hours of the VA and the very easy call schedule which is the result of sharing call with 40 other psychiatrists. In my solo practice, I covered my own patients 24/7/365, and if I had to leave town, I had to get someone else to be available for my patients, which wasn't always so easy.

I think it's awesome that you still want to pursue this! I'll also say you're a little crazy. It's a really long road, longer than you can know. But for sure, take your basic sciences - you'll at least have a better idea how realistic the goal is. Not to discourage you, but I know that for me, despite being a pretty smart guy, and having done well in high school across the board, if I took a polysci course in a competitive university, I definitely would not get an A. Not saying you won't; just saying that you don't know until you're in it. There's just a really wide range of abilities if you expand the upper 90th to to 99.999th percentile of the bell curve. On the other hand, I never thought I'd be a psychiatrist, and never took a psychology course in high school or college, but discovered a hidden talent in the middle of medical school, and it turned out really well! So I hope it turns out great, and you discover your hidden talent! I have doctor friends who did it as a second career through a similar path you are taking, and they did great! One was a librarian, another was a housewife. They went back and took their basic sciences, did just great, and loved it. They became great doctors and loved what they did their whole career (albeit with some bumps in the road that everyone has in life). I know other very smart people who took their basic sciences and just hated it or couldn't get more than a B-. They changed careers and did really well in something else. I know some who did well, hated it, but kept trying to convince themselves that they would love it some day, because they wanted the prestige of a title and a nice salary. Definitely don't do that - those people remain miserable their whole lives. There are other ways for a smart guy to make money.

Either way, congrats on your decision! Let me know how things progress, and if you have any other questions.
 
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Yeah, I think I am going to do it. Once I wrapped my head around accepting that a total hard-science reboot would be challenging, but conquerable, it seems obtainable. Do well in post-Bacc science/bio courses, study like a fiend for the MCAT and then see what happens. Thankfully, the significant other is very supportive of my plans and is just now graduating law school and has a very good job with a top firm starting in the fall.

The GI Bill will mean I won't pay much to go to medical school so at this point it is a matter of application, discipline and focusing on the end state (helping people and making a damn good living while doing it). Perhaps I will have my own radio show in Seattle and live a life of wacky, yet sophisticated hijinks.

That and I will be able to indulge @The Oi with lurid stories of serial killers with truly horrific, yet oddly boner inducing, fetishes.

How old are you? You always struck me as being not completely over the hill like @Maximus, but maybe early 40s.
 
@jvlgato So I am laying preliminary ground work for all this. Looking at volunteering at the VA or other clinical settings.

But, I have another question. I have no desire to drop the $30K it would cost to take the 15 or so courses needed for my hard sciences. That is three semesters worth either at UW, Stanford or Cal (may be moving to Palo Alto in the fall).

As a non-traditional student, would med schools look askance at Community College credits for the post-Bacc stuff if I slay the MCAT? I have all my other schooling behind me, including a masters (was in the PhD program but hated it), so I'd rather not drop that cash for catch-up courses.
 
Tough call. You mentioned before that you had Veteran funding, in which case that's an easy call... go to the 4 year college. I guess if you crush the MCAT, they could convince themselves you're equal to anyone else who went to the 4 year school. But as you've seen with some folks , it's so competitive, there may be 10 other people like you who crush the MCAT but did the 4 year school. Plus, could you really crush the MCATs if you studied the sciences at the community colleges versus a big time 4 year school? Possible, but I'd say it's like the NFL drafting the receiver from Akron with a 4.3 40 instead of the OSU guy with the 4.6 40. Sure, it happens, but it's pretty rare, rare enough to be newsworthy.

On the plus side, you'd be unique as a polysci major with the military experience who did great in the sciences also, which is rare, and you'd be competing against a smaller pool. In my year, the majors who had the highest acceptance rate were English majors. I have never met a single one of them in real life; most people I know majored in one of the sciences, but again, if you can do great in English and still do great in the sciences, thats pretty unique, and you'd be competing against other English majors, if which there are few. I had a classmate at Northwestern who majored in music, piano performance specifically. She also killed all the premed classes, the MCATs, and was on the varsity tennis team. I studied with her a few times, and she was just a helluva a lot smarter than I was. It was very obvious. She went to NU medical school (chosen over me) and is now a cardiothoracic surgeon. But then she killed her sciences at Northwestern, alongside all the other science geeks.

So, I'd say yes, they could potentially hold it against you. When I speak to the medical students who rotate through with us, they're all unbelievably impressive. Great at everything, great grades and test scores, plus went to Africa to feed babies and volunteer in a medical community, blah blah blah. It makes you want to just strangle them. I did have one med student in the last few years who took a few years to get a Master's in a health science before getting in. But she was a minority student, and fair or not, there are fewer minorities to compete with. And that's another controversial topic that could be a whole thread unto itself.

You'd be unique because of your military experience and polysci major, as well. But again, you'd be leaving a bit of a hole in your education if you did the community college thing. Not a mortal wound, by any means, but it'd be a question mark for sure.
 

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