psychologist/psychiatrist2B

[sasevan]

Hi everyone,

Recently discovered SDNF.

Currently I'm completing my post-doc fellowship in clinical psychology and have begun taking pre-req courses for medical school.

I'm planning to go to medical school in a couple of years and to eventually practice psychiatry.

Just wondering if there are any other psychology professionals out here with similar plans.

Peace.

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[Sanman]

Out of curiousity, what made you decide to go to medical school after finishing your PhD?

 

[bella_dottoressa]

That's my question too. Not a psych professional, just a major btw.

 

[sasevan]

Hi,
Sorry for not getting back to you sooner...fellowship...just like internship...keeps me pretty busy.
Thank you both for your responses.
When I started psychology 5 years ago I never considered psychiatry because I didn't want to do premed (i.e., math) nor med (i.e., surgery). I also didn't fully realize the limits in scope of practice and lifestyle that come with clinical psychology. However, I don't regret the road that I took though I am now facing 2 years of pre-med, 4 of med, and 4 of residency...at least. Psychology is an awesome discipline that has taught me how to think in a scientific way, how to understand human cognitive, affective, and bahavioral dimensions, and most of all to better comprehend myself. In fact, I hesitated for a long time in making the decision to try to become a psychiatrist because I didn't want to lose my identity as a psychologist. Thanks to talking to a number of psychologists/psychiatrists in the med. school/dept. of psychiatry that I'm affiliated with, I was able to put to rest the issue of professional identity as all of these clinicians reassured me that they consider themselves psychologists as much, if not more, than psychiatrists.
Once that issue was settled the rest was easy...sort of...LOL
As psychology has recognized, there is a significant biological dimension to much of mental illness. That dimension requires psychopharmacological inteventions that psychologists (for the most part) are not able to provide. As I learned at the APA convention in Toronto this year, psychology is committed to advancing prescription privileges for psychologists so that we no longer find ourselves limited in our ability to help our patients. Many state psych assoc are working either through the legislature or the judiciary to permit psychologists prescriptive authority. Some psychologists are individually pursuing prescription privileges by becoming nurse practitioners. In fact, I intended to follow that route before changing plans and deciding to go to med as opposed to nursing school.
I realized that np, while enjoying some measure of prescriptive authority, do not have in many states access to full psychotropic formularies (e.g, stimulants like Ritalin or sedative-hypnotics like the benzos) nor to independent practice (e.g., a collaborative agreement with a physician is required).
I believe (hope?) that psychologists will one day have prescription privileges but just like for np it will be a very, very, very long road with the situation being significantly different from state to state. I don't want to wait for that.
Psychologists and psychiatrists also enjoy very different lifestyles. According to the U.S. Dept of Labor psychologists' mean salary is $50,000 while psychiatrists' is $135,000. After doing all sorts of calculations I realized that despite the added debt that I will incur by pursuing the path to psychiatry I will pay off my combined psychologist/psychiatrist student debt sooner based on a psychiatrist's salary than I would pay off my curent loans based on a psychologist's earning potential.
Anyway, that's it for now. Best to you both.
Peace.

 

[bella_dottoressa]

Wow sasevan, that is really impressive and admirable. honestly. I've often thought about going the clinical psych route but am now pretty set on med. I really wish you all the best though...when are you planning on taking the mcat? keep me posted on how you're doing! again, i really am inspired by your determination in pursuit of med

 

[Sanman]

Wow, thats really interesting sasevan. It's funny because I am coming from the other direction. I used to be pre-med until recently, when I realized I was more into psychological testing and non-pharmacological solutions to things like dyslexia and ADD, so I decided to head towards psychology as a career.

 

[sasevan]

Hi,
Crystal18mc I wish you the very best in med. and Sanman I wish you the same in psych.
Ultimately I believe that both psych and med have much to contribute to keeping people alive and healthy, improving their quality of life, and reducing their experience of pain, either physical or psychological.
I am equally committed to both non-pharm and pharm/surgical solutions; whatever really works for that particular patient and his or her presenting problem. I'm excited about being able to intervene with behavioral methods and to assess with the personality, intellectual, achievement, etc. measures that psych has at its disposal; I fully intend to remain a practicing psychologist (btw, I plan on taking the mcat next Fall as I'll be taking the psych licensing exam in the Spring/Summer). However, I've become very committed to the biopsychosocial paradigm in both evaluation and treatment and this has led me to want to become a psychiatrist.
Again, best to you both. Maybe one day we'll see each other at the APA and/or the AMA.
Peace.

 

[MacGyver]

Why should psychologists have prescription rights? That makes no sense at all.

If people want to practice medicine, then they go into PA/NP/MD/DO programs.

There are already 4 pathways to prescription rights. We dont need any more.

People who want to be medical doctors need to go to medical school and quit looking for shortcuts.

 

[raspberry swirl]

i am a first year med student who plans on persuing psychiatry, and i also hope to get my PhD in clincial psych at some point shortly after (although it is a long way off, so we'll see). i do not think that clinical psychologists have a true need to prescribe-- i think it would change the focus of the work that they do in a negative way. however, i do feel that psychiatrists should have a better foundation and understanding of clinical psychology in order to appropriately treat their patients.
i wish you the best of luck saseven!

 

[sasevan]

Hi raspberry swirl,
Thanks for the positive wishes. I agree with you; both psychology and psychiatry have much to learn from each other. I work at a major med ctr where both disciplines are very integrated; maybe its because the chairperson of the dept is both a psyciatrist and a psychologist. Actually, there are a few MD/DO-PhD/PsyD in the dept; hopefully one day I'll join them; maybe you will also. Best of luck to you in your own journey as well.
Peace.
P.S. Besides the positions of the two professional guilds, there are a lot of different perspectives among PhD/PsyD and MD/DO about psychologists having RxP. I can recommend a very informative and interesting book on the subject: Sammons, Levant, & Paige (2003). Prescriptive Authority for Psychologists: A History and Guide.

 

[Sanman]

Hey, there hasn't been a post here in a while so I thought I'd say whats up. By the way, are there any progressive clinical grad schools out there that emphasize teaching psychopharm?

 

[PublicHealth]

Hey, Sanman.

Great to see some action in this forum!

In response to your question, there are some clinical psychology graduate programs that emphasize psychopharmacology, but unfortunately only one or two states (New Mexico is one, some other states are pending) actually have laws permitting clinical psychologists to prescribe psychotropic medications. In order to get prescription privileges, psychologists have to complete a postdoctoral M.Sc. degree in clinical psychopharmacology. Here's a description of such a program: http://fduinfo.com/gradbull/ucp-postdocms-psychpharm.php
These programs prepare psychologists to sit for the Psychopharmacology Examination for Psychologists or PEP. Here's info on that: http://rxpsychology.com/PEP.htm and http://rxpsychology.com/ Make sure to check out the links on those pages.

Please also be aware of the fact that having an M.Sc. in clinical psychopharmacology does NOT entitle you to prescribe in every state. The idea is that having the degree will enhance your credentials, and allow you to prescribe ONLY IF your state approves legislation to allow psychologists to prescribe. Understandably, this could take 5, 10, 25 years, or may never happen at all in some states.

In short, if you want to know psychopharmacology, go to medical school. Nowadays, an M.D. or D.O. could easily land a reputable psychiatry residency. In fact, a good percentage of psych residency slots are filled by FMGs. Plus, the pay is MUCH better.

 

[sasevan]

Hi PublicHealth,

I just got your PM from 9/4/03 yesterday! Didn't know there was PM here until then.

I thought I'd reply here as it might be helpful to others considering psych or med school. Keep in mind that I'm speaking primarily from personal experience and consequently caution should be exercised in generalizing from my impressions.

First of all, I don't believe that psychology/neuropsychology (psych/neuropsych) is a dead-end in healthcare. NOT AT ALL. I believe that there are no better trained behavioral scientists and practitioners than psych/neuropsych clinicians.

Clinical psychology, and especially its specialty fields of health, forensic, and child and adolescent psych, are well representated in many med centers and integrated into many dept of psychiatry and behavioral med.

Neuropsychology even more so. Oftentimes physicians and psychiatrists seek the consult of neuropsych because they need assistance on a matter that ONLY neuropsych has knowledge and skill about. (Unlike psych, where consults come in more for therapy which psychiatrist and others such as social workers may often believe that they could do just as well but don't because they are too busy doing what only they can do, i.e., med or social work).

A forensic neuropsych is especially in high demand and regard.

Nevertheless, I believe that psych/neuropsych are and will most likely always be second class citizens in med ctrs and even in beh med. I guess it ultimately comes down to the fact that it's about med and physicians are the primary providers in that field.

Consider the discrepancy between psych/neuropsych residents and med residents in the med ctr where I'm at: stipends for psych are 18k while for med are 40k; cafeteria and parking reduced rates are in effect for med only; free lab coats and their cleaning for med only, etc.

Psychiatry residents tell me that even before the year they finish residency they are constantly getting all kinds of job offers. This is not the case for psychology THOUGH it may be for neuropsychology.

After completing residency, psych/neuropsych continue to be at a disadvantage in comparison to med when it comes to staff privileges in med ctrs, admitting/discharging pts from those ctrs,
etc., including pay discrepancy where on average psych only makes about 1/2 of what psychiatry earns and neuropsych about 2/3 of that.

(To be continued)

 

[sasevan]

Hey,

Basically, I believe that while psych/neuropsych are not dead-ends in health care they are not, and will most likely not be, on an equal footing with med.

What can be done? I'm sure there are many options. I entertained several such as getting more involved in research and teaching at a med school or at a psych one; leaving the med ctr for a comm mental health clinic or a primary care clinic; going into private practice, etc. All of these still hold some attraction for me but I believe that psych was ultimately going to be a dead-end for ME.

I want to be able to help mentally ill pts with all of the tools that are available including psychological testing, psychotherapy, and psychiatric medications. I like working in med ctrs but don't want to feel as a second class citizen there. I want to be able to enjoy greater financial security after all the years of education, training, sacrifices, and student debt that psych/neuropsych requires but that it can't adequately compensate for.

A PhD/PsyD takes 4 yrs of psych school, 2 yrs of residency (1 yr pre-doc internship; 1 yr post-doc fellowship), and a doctoral dissertation!!! (BTW, its 3 yrs of residency for neuropsych). It also often takes 100k in student debt. The result is an awesome educational and training experience in beh med but one that still leaves the clinician with limited scope of practice and second class status. Again, it might be different for neuropsych.

For me that wasn't enough. I cconsidered other options such as the nurse practitioner (NP) or physician assistant (PA) route but that would only give me a little more scope of practice and financial security but not complete or independent scope and even less status. (This is NOT to say that NP or PA, or Phd/PsyD for that matter, are inferior to MD/DO....NOT AT ALL...but, in the hierarchy that is healthcare in general and med ctrs in particular physicians DO have a higher status, and the accompanying privileges that come with that).

So, after I complete this last year of psych residency and take my psych licensing exam I intend to go to med school to eventually become a psychiatrist. Of course I don't regret having gone to psych school and I fully intend to remain in psychology practice but I believe that I need to complement that with med school and a psychiatry practice. I DON'T recommend 14 yrs of post-bacc schooling as a way to become a mental health practitioner but that is my journey and choices.

Wish you the best with yours.

Peace.

 

[Sanman]

You do make good points sasevan. I'm curious know what you think is the best way to have a complete scope of practice. Personally, I have struggled with the same thing. I am interested in treating children with ADD, LD, aphasia, etc. and I would also like a complete scope of practice, but it doesn't really seem possible as behavioral medicine presently stands. I think the closest I could get is practicing as a child psych/ ped. neuropsych. I have seen centers run by neuropsychs (Mt. Sinai) and others run by developmenta peds, behavioral neuros, child psychiatrists, etc. Anyway it's becoming an interesting decision for me. By the way, what are the hours worked for psychologists and psychiatrists. FYI, mean income for neuropsychs was 120,000 in 2000, though it was around 100,000 after removing outliers. About 70,000-80,000 for those in institutions. Though that number is down from 136,000 in 1993

 

[PublicHealth]

Originally posted by Sanman
You do make good points sasevan. I'm curious know what you think is the best way to have a complete scope of practice. Personally, I have struggled with the same thing. I am interested in treating children with ADD, LD, aphasia, etc. and I would also like a complete scope of practice, but it doesn't really seem possible as behavioral medicine presently stands. I think the closest I could get is practicing as a child psych/ ped. neuropsych. I have seen centers run by neuropsychs (Mt. Sinai) and others run by developmenta peds, behavioral neuros, child psychiatrists, etc. Anyway it's becoming an interesting decision for me. By the way, what are the hours worked for psychologists and psychiatrists. FYI, mean income for neuropsychs was 120,000 in 2000, though it was around 100,000 after removing outliers. About 70,000-80,000 for those in institutions. Though that number is down from 136,000 in 1993

Hi, Sanman.

You cited some salary figures for clinical neuropsychologists in this post. Where did you obtain this information? I have been trying to locate such information for a while, and seem to only be able to find salary figures for clinical psychologists.

The downward trend in salaries has been plaguing ALL behavioral healthcare practitioners for the past ten years. Psychiatrists working in academic health centers, for example, may sometimes start at $90,000 - $100,000. I learned this from a salaried academic neurologist who worked at an academic health center. Hopefully he didn't cite such a low figure simply to bash psychiatrists!

Any links to salary info for clinical neuropsychologists would be greatly appreciated! As you know, I am strongly considering this field, and do not want to spend 7+ in training only to make $50,000/year. I can make that right now as an M.P.H.!

sasevan, you make some excellent points. Interestingly, you did not mention research in your post. Did you consider a career in clinical research or are you strictly set on clinical practice? I would ultimately like to conduct clinical research and function as a clinician, preferably 70% and 30% of my time, respectively. For this reason, I think I would be better off with a Ph.D., as I could work in a plethora of settings, including academic health centers, hospitals, colleges, schools, government, private industry, etc.

Any thoughts?

Cheers,

PH

 

[Sanman]

I got it from the Archives of Clinical Neuropsychology:

National Academy of Neuropsychology/Division 40 of the American Psychological Association Practice Survey of Clinical Neuropsychology in the United States: Part II: Reimbursement experiences, practice economics, billing practices, and incomes, Archives of Clinical Neuropsychology, Volume 18, Issue 6, August 2003, Pages 557-582
Jerry J. Sweet, Edward A. Peck, III , Carolyn Abramowitz and Sharon Etzweiler


If you are looking to go into academia, it looks like $60,000 - $80,000 is the max. At the moment those numbers look at the majority of neuropsychs, who are pretty much doing neuropsych testing full time. Also, It is a very variable pay scale in private practice, but most make between $60,000 and $120,000. I know that is a big difference. There are very large standard deviations, so it seems it is what you make it. If you do mostly forensic and self-pay testing for things like LD, which isn't covered by insurance, you are pretty much garuanteed a good income. Going rate for full neuropsych like $500-$1000 per battery or $125- $250 per hour depending on location. If you do more medicare, it can be much lower. The study seems to show incomes going down, but whose income isn't in medicine, especially meantal health. As far as I know, Neuropsych is the best paying psych field after I/O and human factors psych. The other factor of this is obviously which program you go to and how much debt you incur. As far as I am concerned I don't know if med school is worth it for such low incomes either. Especially for a person like me, who doesn't like to prescribe meds until other med/ behavioral sources are exhausted. It seems you can only make decent incomes in psychiatry by prescribing to everyone and sending them elsewhere for other aspects of treatment. Thats the opinion I have gotten anyway.

 

[Sanman]

By the way public, how would you like to split your time bet. clinical work, research, teaching, etc? For me, I'm interested in primarily clinical work for kids with ADD/LD and there seems to be a large self-pay market for people treating these disorders, so that complicates the decision for me because, I could potentially make more than most psychiatrists/ neurologists with less hours this way and have a more fulfilling practice. On the other hand, if things change, income could change drastically.

 

[sasevan]

Hi Sanman and PublicHealth,

Here are my impressions:

Because Mental Health is fragmented with psychology/neuropsychology primarily doing testing, psychiatry doing medicating, and everyone doing therapy I believe that you have to really look into yourself and see where your priority lies (tests vs. meds)-unless of course you're like me and you really, REALLY, want to do both in which case you must be willing to train for 14 years and go into debt for 250k and be crazy...LOL

From what has been written I get the impression that Sanman really wants primarily to treat children and adolescents through the use of neuropsychological instruments and psychological interventions and that PublicHealth really wants primarily to do research and secondarily clinical work.

Please correct my summations if mistaken.

If not mistaken, then I believe that clinical psychology is the most advisable route for both of you to go on. Compared to me, neither of you seem as interested in psychopharmacological therapy to warrant the 8 years of med school that that requires. I believe that while you both have some interest in psychopharm your priorities lie elsewhere. In any case, you can always do psychopharm therapy without becoming a psychiatrist. In some states nurse practitioners can prescribe most if not all psychotropic meds. Additionally, psychologists may one day be able to do so as well under their own PhD/PsyD license.

Sanman, I totally agree that neuropsychs earn more than psychs and I would encourage you to pursue that, especially forensic neuropsychs. Very, very challenging specialization but the rewards will be great if that is your passion. But beware.

By far the most challenging rotation around during my pre-doc internship was neuropsych, whether pedi or adult. While most psych interns did 60 hrs a week, neuropsych interns were doing 80-90. It was too much and it was cut down but its still not equivalent. Psych post-doc fellowship is 1 yr while neuropsych is 2 and neuropsych attendings where I work are very busy. This is all a double edge sword, yes neuropsych is very busy because it is in such high demand by med but it is very, VERY busy.
So, beware.

As far as lifestyle, the money will be good not great but again it all depends on what lifestyle you want. You can make more in psychiatry but usually only about 1/3 more. Is it worth it to forfeit a passion for that?

As far as status, like you said, some units are run by neuropsychs though I suspect that if they are in a med ctr while the CLINICAL director of the unit may be a psych/neuropsych the MEDICAL director, who must be a physician-either a psychiatrist or a pediatrician-would oversee the other clinician and ultimately have the authority-and responsibility-for treatment. Then again, like the Scripture reading said in the Mass this past Sunday: seek not status but to serve.

PublicHealth, I did consider the option of going more into research but my passion lies in clinical practice. I can see myself doing research as I believe that psychologists should ideally strive to be researchers, teachers, and clinicians but for me that would not be anywhere equally divided. As a result of that I did not pursue a PhD degree and instead attained a PsyD one. The irony of all of this is that I did not like research because of all the stats, etc and now I find myself having to take all levels of mathematics in order to attain the MD/DO degree. The irony!!! Actually, I'm starting to like algebra...LOL

However, if you do like research AND stats you may be in a very, very good position. One of the things that academicians-including PhD, PsyD, AND MD/DO-have to do is research and publishing. This is very important in both psych or med school. A lot of academicians don't like to do research and/or stats; if someone can come in and offer assistance with that that person will be in high regard. People like to see their names in journals; to publish they need to do research; whomever helps with that research will be very valuable.

I have a friend of mine who is a PhD student intending to do primarily research, hopefully for a pharmaceutical company.
I know of a neuropsych who is heavily into doing research and helping others with theirs, very, VERY highly valued. Enough said

So, yes there are many ways to be a successful psychologist without becoming a psychiatrist or a nurse practioner; to enjoy a good lifestyle, be in a leadership position, etc.

Hope my rambling helps.

Peace.

 

[Sanman]

hey sasevan,
You're pretty dead on about me. I personally am against prescribing meds unless they are really called for and would hate to be forced to do that in order to make decent money, however medicine has always interested me, I simply prefer a more holistic approach. Additionally, I would like to be in a position where I can tailor treatment where I see fit and would hate to be put in a position where I was simply used as a consult for a psychiatrist, neurologist, peds, etc. Also, I had no idea that neuropsych post-docs were so labor intensive, though it still beats med. school residencies. Anyway, good luck with med school. I think I'd have to hurt somebody if I had to go to school for that long.

 

[PublicHealth]

You rock, sasevan! Great post.

I think your assessment of my career direction is dead on -- it helps to have someone else sum it up once in a while as I'm always changing my mind! However, I must admit that I do have an interest in psychopharmacology, although I am still in the process of determining if this interest outweighs my desire to pursue a career in research.

Can you shed some more light on what life is like for a clinical neuropsychologist? As mentioned above, I am interested in pursuing a career in clinical research, neuropsych assessment, and teaching. Do you think it's possible to combine these three interests and do each of them well?

Also, how much do neuropsychs make down in Florida? What is lifestyle like once residency is completed? I know of two neuropsychs in Connecticut and several in Massachusetts, but have not gotten around to asking them about lifestyle issues such as salary and day-to-day life. What confuses matters is that some psychologists call themselves neuropsychologists even though they do not have any clinical training -- experimental neuropsychologists, behavioral neuroscientists, etc. Scientists in these fields are more likely to be found conducting research and teaching in academia and medical centers.

While I have not ruled out medicine (I have taken all the prerequisites and MCAT), I think clinical psychology, and after a post-doc, clinical neuropsychology, would be an appropriate track for me. I enjoy research, have published a few papers, and tend to gravitate toward the psychology more than medicine. Still, many of my colleagues are constantly encouraging me to pursue medicine. Ah, the decisions!

I welcome any feedback.

Sanman, did you check out Hofstra's program in Clinical and School Psychology? It's a unique program in that it combines training in clinical and school psychology, and prepares you for licensing in BOTH fields. Here's the link: http://www.hofstra.edu/Academics/Graduate/Programs/GP_PSY/index_GP_PSY.cfm

Thank you, Sanman and sasevan for being such tremendous resources, and all-around nice guys. I appreciate your taking the time to reply to my posts. It's reassuring to know that there are like-minded people out there.

Cheers,

PH

 

[Sanman]

Hey public,
Thanks for the link. I have seen a few other programs that combine the two specialties. However, I fear that it might hinder me from being competitive fo a neuropsych. fellowship, as compared to finding a program that leaves time for more of a concentration in neuropsych during grad. school. Ah, all the decisions that must be made. Also, I think I'm leaning more towards a Psy. D degree due to the concentration in clinical aspects. I definitely understand about people encouraging you about med. school. Personally, I think I lean more towards psychology too, but I still flip flop. Personally, One of the big turn offs for me about medicine is the lengthier education and the hours worked. Also, having to be attached to a medical center to do the work is not that appealing to me, I like to be able to have a choice. But then again nothing in life is perfect, and no matter how much we try to plan it, life always seems to take its own course. All we can do is be true to ourselves, so lets see where we all end up

 

[PublicHealth]

Originally posted by Sanman
Hey public,
Thanks for the link. I have seen a few other programs that combine the two specialties. However, I fear that it might hinder me from being competitive fo a neuropsych. fellowship, as compared to finding a program that leaves time for more of a concentration in neuropsych during grad. school. Ah, all the decisions that must be made. Also, I think I'm leaning more towards a Psy. D degree due to the concentration in clinical aspects. I definitely understand about people encouraging you about med. school. Personally, I think I lean more towards psychology too, but I still flip flop. Personally, One of the big turn offs for me about medicine is the lengthier education and the hours worked. Also, having to be attached to a medical center to do the work is not that appealing to me, I like to be able to have a choice. But then again nothing in life is perfect, and no matter how much we try to plan it, life always seems to take its own course. All we can do is be true to ourselves, so lets see where we all end up

We must share a brain! I feel EXACTLY the same way as you do. I, too, would prefer to have the option of working in a variety of settings, and do not want to spent the better part of my adult years sleeping in a hospital! Being a clinical psychologist -- neuro or otherwise -- offers a range of opportunities with respect to setting, research, teaching, clinical work, etc. Of course, this type of flexibility may not be for everyone, and some prefer the six- figure salaries of psychiatry.

Which Psy.D. programs are you considering? I'm sure sasevan should be able to help you out with choosing a program. There are some good programs out there, but they're often tough to track down. Moreover, faculty members are not always responsive, especially this time of year when they're being bombarded with applications.

Have you taken the GRE yet? I'm preparing for it now, and plan to take both the General and Psychology Subject Tests in November. If you took the exam, how do you recommend preparing for it?

Thank you!

PH

 

[Sanman]

Hey Public,
Yeah I definitely want the options whether its w/ neuropsych or otherwise, I think I might like to teach as an adjuct on the side. I have also considered clinical sleep psychology which is also quite interesting. As far as Psy.D programs, there is a combined school/clinical at Yeshiva University (w/ clinical sites affiliated Albert Einstein hospitals) and the program at Nova Southeastern has several different tracks including a neuropsych. track. There are others, but those seem to stand out in my mind. Sorry, haven't taken the GRE's yet, but I'm going to take it in june or closer to the end of my school year. I'm taking both the general and psych. subject tests too. Hopefully we'll both do well. I wonder what books are good since they recently changed the exam.

 

[PublicHealth]

Hi, Sanman,

The programs at Yeshiva and Nova sound great. Sasevan should know more about the program at Nova, as he's from Florida.

Regarding the GREs, I have been using books from Kaplan and Barron's to prep for the General Test, and a psychology textbook (Gray) and Barron's book on the psychology subject test. The most recent editions of the GRE prep books contain information regarding the Analytical Writing sample, which is analogous to the MCAT Writing Sample except you are allowed to word process your essays on the GRE. The material is pretty straightforward, but a thorough review of vocabulary, basic math skills, and basic psych concepts is in order for anyone sitting for the General and Subject Tests. Of course, clinical psych programs expect applicants to score quite highly on both tests (600+ on verbal, quantitative, 5.5 to 6 on analytical writing, 650-700+ on the psych subject test). Back to studying!

PH

 

[sasevan]

Hi PublicHealth and Sanman,

A few more impressions:

A know a few neuropsychs at the med ctr I'm at as well as in the community.
Their lifestyle appears to me to be along the norm as far as amount of work, i.e. a lot of work. One of these is exclusively involved in clinical practice at the med ctr, another is very involved, VERY, involved in research and in generating grants to subsidize that research and is also involved in clinical work and in teaching. Still another is heavily involved in academic work, both instructive and administrative while another, who is also a physician but works exclusively as a neuropsychologist, has a private practice where he is primary involved in assessment and in supervision of other clinicians who do interventions.
I'm inclined to believe that all of them work at least 60 hrs a week but most are in committed relationships and half have children. In other words, they have very busy professional lives but also have time to maintain and develop personal relationships.
Their lifestyle appears to me to be significantly above the norm as far as income is concerned, both in terms of other psychologists and even other neuropsychologists. I would guess that their mean income would be about 175k.
So, neuropsych may, while exacting a busy prof schedule, still leave time for a personal life and provide the financial rewards to afford an above average quality of life.
Again, these are just my impressions...they have not been validated

As far as programs, if you really want to do research I suggest that you strive for a PhD as opposed to a PsyD program. Though there are a lot of similarities between both models there are some significant differences and these are primarily in the area of research. PhD students are trained to be primarily PRODUCERS of research while PsyD students are taught to be primarily CONSUMERS of that research, i.e., applying the findings in clinical practice. If you really want to teach (and not be generally limited to prof schools of psych) again I suggest that you seek to become a PhD. Yes, there are exceptions and some PsyD do teach in med schools and in univ psych dept as well as in prof psych schools but these are usually the exceptions.

I think that because both of you are really interested in neuropsych, research, and teaching you may want to consider looking first at PhD programs. Additionally, while these programs are EXTREMELY competitive (e.g., much harder to get into than med school) they often provide an education without tuition and even a stipend for those students who are either research or teaching assistants. I had a friend in a clinical psych PhD program in FL where he did not have to pay tuition and got about a 1k a month stipend. However, the program only takes 6 (that's 6!!!) students a year.

I believe University of FL (UF) has a great PhD program as does Univ of Miami (UM). Nova Southeastern Univ (NSU) has both great PhD and PsyD programs. UM provides the most financial incentives; UF is expensive except for FL residents; NSU is expensive period.

Schools that I've heard have great neuropsych programs include UF, NSU, St. John in NY, and Wright State.

Anyway, I think I'm rambling on now. Hope some of this helps and remember to, as every good scientist does, to check for reliability and validity.

Peace

 

[sasevan]

Hi again,

Below is a link to neuropsych post doc fellowships. I thought you might find that interesting and useful.

Peace


http://www.appcn.org/programs/

 

[Sanman]

Hey Sasevan,
Thanks for all the info. Their mean income is 175K a year WOW!! Anyway, as far a my career aspirations are concerned, I would like a largely clinical practice while teaching the occasional course at a college. As far as research, I'm not very interested in being involved hevily with research, with the exception of the occasional case study. Thats why I'm interested in the Psy.D programs. I should check out the program at U of M. Thanks again for all the info.

 

[sasevan]

Hey Sanman,

There's no PsyD program at either UF or UM; however, there is a great PsyD program at NSU.

Peace.

 

[PublicHealth]

Thank you, sasevan! Your posts are incredibly informative.

Wow, $175K/year sounds like a lot for clinical neuropsychologists! However, the three examples you described sound like outliers. Based on what I have read, and from what practicing clinical neuropsychologists have told me, mean income is around $60-80K/year. Of course, forensic neuropsychs could probably pull that into the six-figure range. This probably explains the disparate salary figures published in the Archives of Clinical Neuropsychology article that Sanman mentioned above.

Regarding competition for seats in clinical psych PhD programs, I have read that the key is to have high numbers (GPA/GRE), significant research experience (pubs are good), some clinical exposure, and strong letters. In other words, EVERYTHING has to be glowing! I am applying to several of these programs right now for admission in 2004, so I will describe the process once I am in the thick of it. For now, it's all about soliciting letters, getting transcripts, and the like.

Any tips or suggestions would be great!

The title of this forum should be changed to "The Sanman, Sasevan, and PublicHealth Forum"

Cheers,

PH

 

[Sanman]

Hey Sasevan,
My mistake, I misread your post thanks for clearing that up.

As far as salary is concerned, I think the reason for so many different figures is that neuropsychologists can be in so many different positions and do change prices depending on market. I have heard that neuropsychologists can charge anywhere from $500-1000 for the same battery of tests. Depending where you are on that scale, you could go from making $60,000 to $120,000 a year. Also, some take insurance and some don't and that makes a big difference. The third factor is the forensics, which you mentioned public. I'd bet that people in ritzier areas make more than others, even accounting for cost of living because they can charge at the higher end and not accept insurance. As for grad school, I've heard that while grades and GRE scores are important, being published can make for weaker numbers. Also, I've heard that clinical experience is much more important for Psy.D programs.

 

[Sanman]

Oh and you're right public, the name of the thread should be changed

 

[Sanman]

Out of curiosity, does anyone know what would be considered a bread and butter case for a clinical neuropsychologist in private practice or academia? How about peds. neuropsych?

 

[Sanman]

 

[PublicHealth]

Wake up Sanman!

Sorry I have been idle for a while. Here are some of my thoughts regarding your question:

A "bread-and-butter" case for a clinical neuropsychologist may be any of a variety of neurobehavioral syndromes.

Here's some info I found on-line (http://psychiatry.uchc.edu/patients/neuropsych.php)

Neuropsychological consultation has a major role in diagnosis, treatment, rehabilitation, educational, and vocational planning. It is especially valuable as an objective measure of pre- and post-treatment assessment. Patients who would benefit include adults and adolescents with the following conditions or needs:

Acquired brain injury (i.e., stroke, traumatic brain injury, central nervous system infection, toxic encephalopathy, brain tumor, or hypoxia)

Degenerative disease (i.e., Alzheimer's Disease, Parkinson's Disease, Huntington's Disease, Multiple Sclerosis)

Medical conditions affecting central nervous system function (i.e., cardiovascular, renal, liver, respiratory disorders, and Lyme disease)

Attention-Deficit/Hyperactivity Disorder, Learning Disorders, and other behavioral, academic, and vocational problems

Psychiatric conditions with a high index of risk for organic involvement (i.e., chronic alcoholism, schizophrenia)

Memory, attention, or language problems that impair functioning, but for which the causes are unknown

Identification and description of cognitive abilities in preparation for neurosurgery, including post-surgical testing

Assessment of cognitive abilities for psychoeducational planning or determination of giftedness


COMMON NEUROPSYCHOLOGY REFERRAL QUESTIONS

To determine the presence, nature, and severity of cognitive dysfunction related to illness or injury of the brain

To determine cognitive capacity for work, school, and independent living

To provide baseline information to track cognitive impairments over time

To aid in differential diagnosis of complex patient presentations suspected of having neuropsychiatric components

To examine cognitive functioning for the purposes of Independent Medical Examinations or other forensic evaluation purposes

To identify psychological factors such as depression that either falsely appear as disorders of brain function or contribute to cognitive dysfunction

To provide diagnostic information needed prior to neurosurgical procedures

To provide treatment recommendations for cognitive disorders and psychological adjustment


HOPE THIS HELPS! I think it's a nice summary of the types of neurobehavioral syndromes that clinical neuropsychologists typically assess and treat.

Have you decided on the schools to which you would like to apply?

PH

 

[Sanman]

Hey Public,
Thanks for the reply. It was helpful, but I guess I was looking for a more clear cut answer as far as what the number one complaint is, i.e. neurologists mostly see headaches, peds mostly cold, flu, ear infections, etc. It seems like there aren't many simple answers when it comes to neuropsychology. As far as which programs to apply to, I'm still deciding. Mostly the question becomes whether I would be better off going to a program w/ a neuropsychology track vs. a solid program with a accredited post-doc fellowship in clinical neuropsych. The financial discrepencies bet. programs makes it even harder. So many decisions, so little time. You decide on anything yet?

 

[PublicHealth]

Hi, Sanman.

Clinical neuropsychology is a unique discipline in that there really isn't a "bread and butter" case. This explains why clinical neuropsychologists may be found in departments of psychiatry, neurology, psychology, rehabilitation medicine, as well as in educational and vocational settings. There probably are "number one" complaints within each of these departments. In my experience, Alzheimer's, Huntington's, and pre- and post- neurosurgical assessments are big in neurology, organic-based syndromes like substance abuse and schizophrenia are common in psychiatry, and a whole lot of TBI is seen in rehabilitation settings. Peds neuropsych likely sees a lot of ADHD and learning disabilities.

Medical specializations, as you know, are very well defined. This explains why the training is so extensive. Clinical neuropsychology also requires extensive training, but emphasizes the development of skills needed to assess, diagnose, and treat a wide variety of neurobehavioral syndromes that are not specifically relegated to a particular subdiscipline of medicine. Many students find this feature particularly appealing because of the wide variety of settings in which they may potentially work once they have completed training.

I'm still preparing for the GRE. I plan to take the General Test and Psychology Subject Test in November. My personal statement is slowly beginning to come together. I plan to apply to Yale, Michigan, UCLA, UConn, BU, and Harvard (non-clinical program in experimental psychopathology).

PH

 

[Sanman]

Hey,
I figured you were going to say as much public. I have looked at the Yale program and do like it, but I'll wait till I've taken the GRE's before I settle on my list of schools, good luck with the GRE's.

 

[PublicHealth]

Yale's program is #1 for clinical psychology, and rightfully so, has exceedingly high GRE averages. I must note, however, that they do not have any faculty members who specialize in clinical neuropsychology. The program tends to be have a focus on social and cognitive psychology, although Pete Salovey and Kelly Brownell conduct research in health psychology.

Here's their applicant data: http://www.yale.edu/psychology/clinical_perfdata.html

The 5 acceptances out of 247 applicants seems a bit daunting.

Some clinical psychology programs such as UConn (Ph.D.) and Nova (Psy.D.) have developed clinical neuropsychology specialization tracks. Whether other clinical psychology Ph.D. programs follow suit remains to be determined.

This is probably a reiteration of what you already know.

Back to those darn index cards...(grandiloquent, loquacious, sententious, vituperative...). Darn GRE words!

Have a good one!

 

[Anasazi23]

Hi folks...

I quit my Ph.D. in clinical neuropsychology after my second year to pursue medical school. I graduate from medical school this May, and am currently being recruited for psychiatry residencies. I can certainly offer a lot of information on the similarities and differences between the two professions.

In short, I completed a post-bac program to finish my science requirements in order to apply, and as stated, am graduating osteopathic medical school this May.

I had always been interested in psychopharmacology, and made the decision to become a physician in order to best help patients that require psychotropic interventions. As you'll realize when your experiences mature, talk therapy is simply not enough. As for the neuro/psychological testing - I simply fell out of love with it after a few hundred administrations while in graduate school. I couldn't envision myself testing people for hours on end for the rest of my life.

I've found that the research and publications I obtained while in graduate school help me tremendously in my recruitment from residency programs. I have a bunch more residency interviews coming up - some of which are considered some of the best psychiatric institutions in the country. God willing, I'll get one of them that is a good fit for me.

A quick note on psychologists desiring prescription privilages:
Please, please be wary. Without proper medical training (which will not be obtained in a nursing or psych prescribing program) you WILL kill someone. The complexities of the medications and their interactions with non-psych meds cannot be taught in a half-hearted program like those mentioned. This blanket-statement applies to all types of psychotropic medications, including SSRIs. While your patient may not drop dead from taking Lexapro, the interaction between that and one of their heart medications may indeed cause subclinical changes that you are not qualified to assess or recognize, or ameliorate.

I'd be happy to answer any questions anyone may have regarding the interface between the two disciplines.

Forgive the disjointed writing please, I was on call last night and am sort of tired.

 

[Sanman]

Hey Anasazi23,
I was wondering what you thought the biggest differences were in the types of training (hours, difficulty, exposure to patients, etc.). Also, did you do a PhD in clinical or neuropsychology or was it a concentration in neuropsych? Out curiosity, what kind of pathologies are you interested in treating?

 

[sasevan]

Congratulations Anasazi23
Almost at the end of med school...awesome.
Like you I started in psychology and intend to finish in psychiatry.
I've already obtained my Psy.D. in Clinical Psychology (concentration: Forensic; specialization: Health) and am now completing my post-doc fellowship while beginning to take pre-med classes. After the end of the fellowship I intend to work as a psychologist in a clinical and/or research site for a couple of years, complete my pre-med courses, and hopefully start med school in the Fall of 2006. However, I will remain a psychologist after I become a psychiatrist as I am excited about being able to provide the full scope of practice: therapy, testing, and meds that currently neither PhD/PsyD or MD/DO are able to do because of the split in mental health care.
Because I agree with you that therapy is at times not sufficient I've committed myself to have prescriptive authority in order to be able to provide medication when necessary. However, medication alone is almost always not sufficient. Necessary yes but sufficient no. Therapy is almost always required in order to motivate patients to adhere to their medication regimen as well as to identify and address psychological issues that may be contributing to their biological disorder. I believe that it is this awareness of both the biological and psychological dimensions of mental illness that has moved the APA (psychology) to seek prescriptive authority for psychologists. Some PhD/PsyD are seeking this RxP by advocating for legal and/or judicial mandate that would allow them to prescribe meds after completing a 2-3 year post-doc masters program in psychopharm. Others are seeking that RxP by becoming NP or MD/DO. I know that the ApA (psychiatry) is opposed to the first route but not to the second. So, I was surprised to see that in your post you asserted that PhD/PsyD who become NP would be risking killing their patients.
Additionally, there are currently prescribing psychologists in the US armed forces with stellar clinical record. One of these, Dr. Debra Lina Dunivin, not only has full and independent scope of practice but also supervises residents in their own psych therapy/meds training. I got to meet Dr. Dunivin at the recent APA convention in Toronto; very informative about the reality of RxP. I recommend the book Prescriptive Authority for Psychologists: A History and Guide edited by Sammons, Levant, and Paige wherein Dunivin wrote a chapter. Anyway, just some thoughts that I wanted to propose for your consideration.
Peace.

 

[sasevan]

Hi again Anasazi23,
Moving away from the whole RxP debate for a moment.
I was intrigued about the possibility of you having done med school in Long Island; if you did was that at NYCOM?
I'm open to either MD or DO programs. Of the latter I'm most interested in the ones in FL, NY, and NJ.
If you did go to NYCOM how did you like it? Where are you interviewing for residency?
My dream residency would be in UM (FL), Yale, NYU or Columbia.
I interviewed at all four for my internship and got my number one choice with which I have been very happy but it was a difficult choice and I still like all of those four programs very much.
Peace.

 

[PublicHealth]

Hi sasevan,

I just wanted to note that NYCOM is probably the best osteopathic medical school for someone interested in psychiatry. NYCOM is affiliated with two of the best psychiatry departments in the U.S. -- Long Island Jewish and Maimonides -- and several graduates have placed into well-respected residency programs in psychiatry, although I do not recall seeing UM, Yale, NYU, or Columbia on any of the lists.

http://www.lij.edu/hil/psychiatry/

http://www.maimonidesmed.org/GMEresidency/Psychiatry.htm

I'm interviewing at NYCOM in a couple weeks, so I'll post some more info as I learn it!

PH

 

[Anasazi23]

Hi Sanman,

The differences in training between Psychology and psychiatry are vastly different. Psychiatry is a specialty of medicine. As such, the majority of your background is medical. Because of this and the nature of general medical training, the hours are much longer, the patient exposure is more brief but more intense, and the difficulty is certainly much more difficult.

You asked about my previous background in psychology. I was in a clinical PhD program for psychology with Div. 40 approved specialty in clinical neuropsychology.

As for what I'm interested in treating...I've always been very interested in psychopharmacology, and enjoy seeing outpatients in that capacity. Although inpatient psych certainly can be rewarding. If I have the energy when I finish my general psychiatry residency, I'll complete a forensic fellowship, since that is where my biggest interest lies.

Hope this helps.

 

[Anasazi23]

Hi Sasevan,

Thanks for the congratulations on my almost ending medical school. Although I'll feel a lot better when I finally know where my residency will be....only a few more months.

To address the issue of psychologists with prescription privilages, and Dr. Debra Lina Dunivin...Yes there is a good track record THUS FAR with psychologists prescribing in the military, but I must caution you.

In general and for a person with no medical comorbidities, simple psychiatric pharmacology is often safe. However, without a proper medical background, I wouldn't want to be in your shoes in court when you fail to recognize the early signs of a neuroleptic malignant syndrome, or weren't privy to the fact that person with certain medical conditions (not addressed in any pharmacology class) have relative or even absolute contraindications for a variety of medications. Without understanding the differences a fluctuating blood glucose level may have on a psychotropic medication, or how autonomic instabilites may be due to the effects of things like a serotonin syndrome, you will hurt people unwittingly.

I see on a daily basis the damage done by primary care physicians making decisions on peoples' psychiatric medications. These doctors even have medical training. Psychiatry is a medical specialty for a reason. Trust me, the details cannot simply be garnered from data on non-comorbid patients prescribing SSRIs.

Thanks for the congratulations again. Let me know what you think of my thoughts.

 

[Anasazi23]

Hi again Sasevan,

I did indeed go to NYCOM. As luck would have it, I have interviews at all those places you mentioned except Yale and NYU, although I haven't actually heard from NYU yet. I also have an interview at Univ. of FLorida, which I hear is a really nice program. I'll be in Miami and Gainsville in January, I think.

NYCOM was okay I guess. They've made a lot of changes the last two years that have really, really improved the place. They even renovated the campus. It looks much nicer now.

I have other interviews at UCLA, UCSF, Univ. of Arizona, Georgetown, Univ Miami, Univ. of FLorida, St. Lukes - Columbia, Long Island Jewish, North Shore Manhassett, Cabrini, Creedmore, and a few others I'm not going to.

Hope this helps.

 

[sasevan]

Hey,
Wouldn't it be weird if we all ended up being NYCOM alumni...

Thanks PH for the links. As med school goes I'm open to just about any MD or DO program that's in the right geopgraphical area for me (i.e., FL and NY-and those places around it such as CT and NJ). Didn't know about the connection between NYCOM and psych. Good to know. NY has an incredible amount of great clinical sites not to mention the energy of The City so NYCOM has just jumped to the top of my list. Are you interviewing at NSUCOM or UMDNJ-COM?? Are you interested in any MD programs???

Good luck Anasazi23 with the interview at UM. That is a very DO friendly program. I know of at least a few DO psych residents there. UF, from what I hear, is a great program; same for USF (Tampa). Did you apply there?

Again, good luck to both of you on your respective interviews and thanks for all the info.

Peace

P.S. Anasazi23, the APA does NOT support RxP for psychologists unless and until PhD/PsyD receive the necessary and sufficient training (both academic and practical) to prescribe safely and effectively. No one wants to risk patients health or life, though the current shortage of properly trained psychopharmacologists is risking just that either by limiting access to psych meds to those who most need them or by having those with RxP but without sufficient training in psychopharm providing the meds
(as you yourself pointed out). At the APA convention in Toronto a PhD-JD warned his listeners that if and when PhD/PsyD get RxP they will come under the same legal scrutiny as MD/DO. Heeding
that warning the APA is proceeding with its advocacy for RxP
by developing training programs that will produce competent and ethical psychopharmacologists that will not only know neuroscience but also anatomy and physiology. These specially trained PhD/PsyD will know when, what, and how to prescribe including for patients with dual dx and comorbidities. They will also know when to refer to the ultimate psychiatric specialists, MD/DO. Partially due to the limited ambition on the part of the APA in this regard I have chosen to become a psychiatrist since even when PhD/PsyD get RxP they will not be intending for the most part to work with those most severely mentally ill who require inpatient tx and I want to be a part of that. Below is a link to NSU post-doc masters program in psychopharm's curriculum. They also have a 200 hours/50 patients minimum practicum under the supervision of an MD/DO. PhD/PsyD just want to join MD/DO and NP in providing psychopharm care. Back in the 1950s psychiatrists said that psychologists could not and should not be clinicians because academicians weren't trained to dx and tx (with psychotherapy) med patients. Now the argument is that non-med clinician cannot and should not be allowed to provide psychopharm tx. We proved that we could be diagnosticians and therapists. We've proven in the Armed Forces experiment and subsequently that we can be psychopharmacologists. We'll prove it again State by State. Of course, I could feel differently after med school ...but that would probably be for economic reasons more than for clinical ones

http://cps.nova.edu/

 

[Anasazi23]

Hi Sasevan,

You are right about one thing for sure...you WILL feel differently about psychologists' prescribing psychotropic medications after medical school. I bet my life on it. a 200 hour practicum with 50 patients is no less than a joke. You'll see that as well.

It takes hundreds to thousands of patients for even the most seasoned psychopharmacologists to learn the subtleties of the science and art, something a half-baked "training course" will never be able to provide. Like I said, God help the first psychologist who makes a blunder and winds up seriously damaging a patient. As you mentioned, pleading ignorance will do this person no good. Their license very well may be suspended or revoked.

What do I think is the appropriate amount of training and experience? Certainly a solid knowledge of biochemistry, anatomy, and physics is essential. This, coupled with at least a rudimentary understanding of pulmonology, cardiology, certainly nephrology, neuroscience, musculoskeletal pathology, basic dermatology, critical care, emergency medicine and of course psychiatry is required.

In other words--medical school.

Isolated military programs cannot and will not cut it. At best, they will become poor prescribers of psychotropic medication, given their innate lack of scientific physiological knowledge. At worst, they will reduce the quality of care for psychiatric patients nationwide, and in many cases, either conspicuously or more unconspicuously, kill people.

Give it time, I guarantee you'll change your mind.

Best of luck in the application process.

 

[boards032003]

It is interesting to hear some of the issues that always seem to come up in discussions about psychiatrists and psychologists. I am about enter a psychiatry residency but I remember a few years ago when I spent a very long time deciding between medical school and clinical psychology - the psychologists would say coming out of medical school, you have little to no training in psychotherapy, and the psychiatrists would say we can prescribe and do psychotherapy. It was easy to see the biases coming in to play. I don't know if this will be helpful but I will state some of the issues that came up in my decision making process and my opinions on certain matters.

Psychology is an amazing subject. For anyone who is interested in it and wanting to go to medical school (not just for psychiatry), I highly recommend it. You will need understanding of people, behavior, communication skills, and basic psychotherapy techniques for almost all fields of medicine. That being said, if you are interested in the biological aspects and medication aspects of mental health (you don't have to be only interested in those aspects), I truly think the route to take is to go to medical school and then into psychiatry. If you do it correctly and pay attention to what you need to, you will have a base in psychology, learn medicine, then learn some more psychology and psychiatry and eventually synthesize it all. How do you separate someone's mind from his/her brain and/or body? You can't. It's all interwoven and continuous. That is one reason to synthesize it all. Another is that throughout medical school, you will see illnesses and how they affects lives, not just in psychiatry. You will also see extreme ranges of the human condition, from prenatal to birth to development to palliative care and death. All of this will help you more understand people and be a better therapist, if that is what you want. Just keep your eyes, ears, and heart open. While some psychiatrists focus on the biological aspects only, I think the consensus is that people are trying to follow the bio-psycho-social model nowadays and even people that want to mainly practice psychopharm have to learn psychotherapies and developmental aspects. Remember some parts of psychology are to psychiatry as physiology is to pathophysiology. And most people feel that learning things like psychodynamic therapies helps them in the their psychopharm too e.g. motivations for poor medication adherence. The psychiatrist that does not learn his/her psychology is foolish, indeed. In terms of job security and financial considerations, psychiatry is also stronger. And although I ultimately did not stray from what I was set on then, I was mature enough to realize that I was immature enough to possibly change. Here, going to medical school gave more options than just psychiatry. On a purely practical level, getting into medical school, I think, is easier than getting into some of the clinical psychology programs because of the number of spots. Also, if you do want to go into psychiatry, it is a relatively less competitive specialty to enter. And psychiatrists can prescribe medications and can have more independence and flexibility in their practices. These are some of the reasons I went the route that I have and I can tell you, now, as I stand on the edge of jumping into psychiatry, I have no regrets at all. I do not want anyone to think that I am belittling psychology - nothing is further from the truth. Psychology is where it all started for me and I picked places to apply to based on their emphasis on it. Psychologists have training that you will not get in a standard psychiatric route unless you especially sought it out. For example, most psychologists have had more training in research methodology and psychometric testing. Relative to some psychiatry programs, psychologists probably have more psychotherapy training, but this is not always the case, and sometimes is reversed. And this attempt at many to find sides and pick at the other is really a waste of time. With the issues of stigma, prejudice, and shortages affecting mental health, all the players on the team should be working together and thankfully, at many places, it is like this. It's the type of question that many ask in medical school - what is the best specialty? The answer is all of them. It's the same for psychiatry and psychology. I recommend you to look at your own personal reasons for wanting to go one route or the other and examine what is important to you in the long run.

That being said, I do not feel rights to prescribe medications should be given lightly. I agree with what was written last. I used to think it was no big deal until I came to medical school. Remember, in medical school, you are taught to think medically and learn medicine. There are many different conditions of the body, let alone other non-psychotropic medications that interact. Trying to shortcut and prescribe by taking some pharmacology classes misses the point, causing sub-optimal care and can lead to some very dangerous situations. Take for example, a person who you think needs a tricyclic antidepressant. Say this person has poorly controlled diabetes, heart problems, and acid reflux. If anyone thinks this sounds like a more complicated case than common practice, it is actually even more basic than what you will see day in and day out. So you go ahead and give the TCA. Did you get a baseline EKG? Do you know how to read it confidently? If not, you may have killed the person by exacerbating an arrythmia. Did you check out the interactions with this person's reflux drug? The blood levels of your TCA may be higher than what you expect. Do you know how to diagnose the side effects of the drug versus a disease process? Is the gastrointestinal upset from the reflux, a side effect of the TCA, diabetic gastroparesis, or mesenteric ischemia? What about this person's kidney's? The long standing diabetes totally screwed them and/or the person has a bad liver from any number of causes - now your drug is not metabolised and/or excreted the way you would expect. And I'm not even mentioning other aspects like what if this person is also on some anti-arrythmic drugs. My point is that, prescribing medications is not just giving a drug and looking for a checklist of side effects. Among other things, you need to fully understand many lab tests and what they indicate, other medications, non-psychiatric diseases, and know what you are looking for. And that doesn't even mention that what if you diagnosis of a psychiatric disorder is secondary to some undiagnosed condition such as a thyroid disorder.

Hope some of that input sparks some thought on the subject. I am not trying to be rude or malicious so if you completely disagree with me, then write back some we can rationally discuss in this thread.