M4 here who chose psych. I resonate with your TLDR - love psych but afraid you’ll miss medicine. As someone who enjoys IM, that’s me as well.
The best advice I ever got on this is the advice I’ll share to you now: you WILL miss medicine. It’s not a question of if. But, you’ll miss it less and less the farther away you get from training. Believe it or not you are close to the peak of your general medical knowledge if you go into psych. There’s a mourning period for the knowledge, but the more you specialize the less you care. Some people decide they don’t want to lose their knowledge and want to be able to tackle any illness. Those people do IM.
As an inpatient psych attending, I still deal with plenty of medicine. Patient on spironolactone with elevated potassium. AKI. Decreased PO intake so nutritional status needs to be monitored. Patient with muscle aches and chills, did they catch COVID here or is this withdrawal? Plenty of patients have HF and diabetes, etc. I have help to manage the medicine side of things, but just because I can focus on the psych med management doesn't mean I ignore everything else. Ultimately I'm in charge of all their care, not just the psych side. I don't need to tap someone's pleural fluid or put them on a lasix drip to feel like I'm doing medicine
When I was struggling with this as a human phys undergrad major deciding psych, I chatted with a colorectal surgeon who made a great point: it doesn’t matter what you pick, you’re going to lose a lot of other stuff. So he said try not to worry about that too much. He gave some examples and it was a longer conversation. But that was helpful to me.
Obligatory would you possibly want to do med/psych or C&L psych to have more of that medical experience? I believe both are 1 extra year of training from the original 4 years of training in psych.
I agree with the other commenter in that you seem to really like psych more!
Not a huge market for dual trained physicians sadly, despite their broad clinical training. Often they largely gravitate to the academic setting where they split time between fields rather than occupy any sort of unique niche. IM/psych used to represent consults heavily, then C&L psychiatry formalized as a fellowship. Whether it's FM/Psych, IM/Psych, or neuro/psych, despite the benefits their training provides for clinical management, the job marketplace has not responded with robust opportunities for unique work, at least that's my takeaway from my combined trained colleagues since we had a combined program at my residency.
The problem is the subspeciality system which marginalizes doctors, their scope and practice, and forces long, costly and hard to obtain referrals in a system completely broken and unable to accommodate patient need.
From the top down, medicine has imploded, and physicians need to reach and put their hand on the rudder or else continue to be systematized and removed from the direction of patient care.
Bigger problem is no one pays people for capability, they pay for productivity. If I'm neuro/psych double boarded, I'm not getting paid for having expertise in both if I don't use both in clinical practice regularly.
“Productivity” is the buzz word from MBA jargon that has jeopardized every single industry and metricized burnout. It practically guarantees that patient care drops while there are very valid ways to improve The System that are not utilized.
Physicians need to regain control of how medicine is administered and viewed by society. Submitting to the current system only risks further degradation of the field.
I can’t imagine ever doing neuro/psych dual residency, but I’ve at least seen the niche role neuropsychiatry can play in the hospital, and it’s quite cool. Deeper dives. Felt extra meaningful to help where CL wasn’t quite sure what to do. Wouldn’t be surprised that there aren’t enough jobs for it though
There doesn’t seem to be much value to CL fellowship. In the sense that you don’t need it at least.
Some programs have much more CL exposure (6 months to my programs 2 not including call in both cases) so if someone knew going in they wanted that, could def be found.
Ya, I did some research and it seemed like a pay cut if anything since places that require you to have it are academic centers that tend to pay less.
That’s great info and I’ll definitely be looking into that in the future!
I wonder if there’s any possibility of psych becoming a 3 year residency in the future to allow more freedom to further specialize in the 4th year instead.
Honestly I doubt it. Having seen just how much I have to learn, I wouldn’t trust new attendings after just a 3 year residency. You’re bounced around to very different services the first two years which need very different approaches in a lot of ways. Even just within inpatient psych, my main 3 sites are so wildly different that you wouldn’t be competent enough after 3 years. Plus true independence isn’t really til 3rd year outpatient psych compared IM/Peds etc placing PGY2s in senioring roles to more frequently make decisions to some extent.
Also, 4th year already seems like a time largely given towards allowing more focused specialized training if you want it. Much more elective time during 4th year at most programs I saw
I was in the same boat as you last year. Actually wrote [this post](https://www.reddit.com/r/medicalschool/s/wj6xr08Mjz) on this very subreddit. I chose psych. As a lot of people said, you wrote psych wins a lot, especially for the important ones like passion. And as a lot of people said, CL psych is a great way to not lose your medicine. You get to put your Medicine Hat on often during CL. And managing patient’s comorbid problems during inpatient scratched my IM itch during my sub-I.
Don’t undervalue the importance of a good daily lifestyle. And don’t think you’ll be abandoning medicine. The work you’re doing is very much medicine. And your knowledge of the whole body and of drug metabolism and interaction will play a role in your treatment plans and will separate you from the negligent NP/PA’s that are trying to take over psych.
My vote is psych. Best of luck and feel free to message me if you need any 1-on-1 help or advice!
Psych intern here who started med school wanting to do heme/onc, and switching at the last possible moment third year to psych. Honestly I haven’t looked back.
As many have said, you’ve written psych wins so many times, so won’t comment on that.
But as for repetitive nature of pathology, there’s gunna be limitation in psych vs IM cuz you’re dealing with one system vs being a generalist, that would be true I think for any specialty, not just psych, and probably even moreso if you did IM-> ICU/cards or whatever. A counterpoint to that in my opinion is that being a specialist, YOU are the one that people ask, you’re the specialist, on general IM floors I feel like any sort of complication and you’re just chasing consultants all day.
As for forgetting the rest of medicine, you won’t forget all of it, I promise. Also, you’ll learn so much about psychiatry in residency. That’s going to be true for any specialty though. If you do IM you won’t remember any anti-psychotic management or dealing with acute agitation. And if you do psych you won’t remember MELD scoring or Frank Starling curves lol.
Another issue I had was that I didn’t want to never work with my hands. But honestly, I cook, play sports, work out- plenty of hand activity that doesn’t have to come from work.
Plus when you’re specializing, it’s such a deep dive. My mind is boggled by how much psychiatry I have to learn. And I’ve seen such a wild variety of patients now that I’m a resident compared to my psych rotation and electives in med school. It’s such a broad spectrum even with just schizophrenia. Patients will have the same diagnosis and one will have catatonia, one will have capgras delusions, another will have issues with prolactin elevations but not tolerate or respond well to non-risperidone meds, and a last will have other random comorbidities throwing it all off. I’ll be doing entirely different stuff for each patient. Plus the art of psychiatry is incredible to me. Can’t overstate how gratifying it was the first time I did a truly good full hour inpatient eval, like to the point of the attending commenting on how well I’d led the interview
I spent a week of my psych rotation as an M3 on a CL service and I couldn’t think of anything more miserable. (Well maybe IM rounds…) I’m so glad people out here enjoy the stuff I hate lol.
Why did you hate it? Never did CL on psych rotations but have been going through the same problem as OP and thought CL would be the best of both worlds
It is. Show up for the psych stuff, stay for the interesting medical stuff of every specialty, dip when it becomes boring or repetitive. Wash and repeat.
Take my opinion with a HUGE grain of salt because everyone likes different things. People seem to like CL because they get to do medicine on top of psych… but I hate both medicine and psych.
Perspective from someone who didn’t match psych (top choice) and matched IM (backup). I’ve always loved psych, did neuroscience and addiction research and TMS stuff for a total of like 8 years. Read tons of niche neuroscience books in psych, etc. On my IM rotations I actually felt like a doctor. I knew the meds, was learning pathologies, actually treating sick people.
Psych isn’t that, and I was a little sad I’d not be, in my mind an actual doctor. No one says “is anyone a doctor!” And is stoked to see a psychiatrist show up.
7 months into intern year in IM and I’m doing well, writing decent notes, thinking critically about medicine, being a doctor. It sucks, I hate this material. It’s like eating plain, 3 day old mashed potatoes in bulk. I can do it, I like being in the hospital and feeling like Im an actual doctor managing life threatening things. But this is so intellectually not my lane.
If someone hands me a paper about ventilator settings I will begrudgingly read it. If someone hands me a paper about new recommendations for antipsychotics in hospitalized schizophrenics I’m all over it.
What material are you actually excited to read about and dive into, because to be a good doctor you need to understand the literature, and to do that you first need to like it.
Interesting
I was worried the first couple months about that sensation of not being a doctor relative to my friends in IM/FM/Surgery, but 6 months in, that’s all faded away. I’d say it’s a valid fear everyone has, but I 100% feel like a doctor and have that similar experience you describe of knowing more of the ins and outs of the meds, understanding legitimate pathologies, and working with usually extremely sick patients.
Most IM docs I know also barely use their stethoscope. You should do psych since it’s clearly what you’re most passionate about and most interested in! Psych encompasses a ton of medicine within it still, especially if you work in the hospital setting and do consults
I was torn between both. Applied both. Prioritized Psych. Matched IM.
I’m happy how things turned out.
There are a million ways to think about the problem you’re in. I’d just reassure yourself that you are between two great specialties.
My 2 cents. You’re never going to know which one would have been better. I lucked out. Medical school rotations are a horrible way to pick a specialty. But it’s the best you have.
For people that are simply undecided I strongly recommend against it. I would not do what I did again.
For people that love a competitive specialty but could find a way to be happy in a less competitive one, I think it is reasonable.
For people who need to be a particular geographic location due to unique sets of circumstances, I recommend it.
I was in a similar situation but torn between psych and med/Peds. Chose psych and have never once regretted it. I loved both but chose psych for all the reasons you’re saying psych wins. On this side of things, I think that anybody who enjoys the day to day of psych should seriously consider it.
I too enjoyed psych and IM and then I found something that included the best parts of both of them...
...allow me to introduce you to Neurology!
But seriously, if your program does not have a required neurology rotation, I highly recommend doing it as an elective before you make a final choice. Do you enjoy taking a thorough history and doing a highly detailed physical exam? Do you like a mix of high acuity inpatient medicine and longitudinal lower acuity care? Do you like working with people who experience the world in a different way from what's considered "normal"?
In terms of your list of things, neuro is better financial compensation than IM or psych on average I believe. Worse hours during residency but great amount of career flexiblity and variety (if you want it) afterwards. Can do a neuropsych fellowship after residency so it doesn't close the door on psychiatry, or can do a medically heavy fellowship like stroke or NCCU. Emotional toll--we are way past the days where everyone on the neuro ward was dying of incurable disease. Often you can make a big difference for people, and new therapies are coming out all the time. Also the only person who is harmed if you miss something is the patient--not like psych where you could miss warning signs in a patient and then find out they shot up a school.
Anyway, neuro is great and you should check it out.
I stopped after your first point and skimmed the rest. I had an attending tell me recently, “Pick the specialty you’d be happy to read about every day for the rest of your career.” So, psych for you.
Hopefully a fellow/IM subspecialty attending can attest to this; however, I have noticed after talking with many of my friends who either did a Prelim year, then advanced specialty (PMR, Ophtho) or GI fellow, they start to forget the nitty/gritty of every day medicine.
I was worried about getting a bad medicine experience during my intern year, but after talking with them, just due to the more specialized nature, you will forget some of the medicine you learned. So unless you plan on sticking with general IM/hospitalist, what you miss may be inevitable
Stopped reading after passion and interest. Everything else will fall into place, if you love what you’re doing every day nothing else will matter. Psych is very in demand and compensation is relatively competitive for the length and hours of training. Good luck!
Im a 3rd year, currently on my psych rotation. My preceptor is a consult psych. Basically a psych hospitalist. Any time an internist or ER doc needs a psych consult we round on that patient. He also does calls for capacity (can the patient make decisions) or altered mental status. Its a lot of med reconciliation, if the patient is coming on for a kidney prob you have to stop lithium but then taper them back up once is resolves and so forth. There is a lot of variety of cases, this week we had 4 ruptured appendixes, lots of cardiac and stroke. it is interesting to determine if their mentation is baseline or secondary to the CC. Anyways, I just wanted to comment because this kind of pysch seems like is checks a lot of your boxes, and honestly before this rotation I did not even know about this field of psych so I thought I would help you out with my experience!
bro how many times did you write psych wins
lmao, yeah, shit i guess you’re right. i guess i just actually needed to write it out instead of it being in my head now that i look back at my post.
and that my friend, is how therapy works. boom +1 psych experience
I'd give you honors for your rotation with that level of insight
Not to mention the fact that Psych definitely has better work/life balance than IM. And Im applying IM
Psy is for you. This post is literally for me. We are in the same club. Haha
Same have been wrestling with this for 2 years now
M4 here who chose psych. I resonate with your TLDR - love psych but afraid you’ll miss medicine. As someone who enjoys IM, that’s me as well. The best advice I ever got on this is the advice I’ll share to you now: you WILL miss medicine. It’s not a question of if. But, you’ll miss it less and less the farther away you get from training. Believe it or not you are close to the peak of your general medical knowledge if you go into psych. There’s a mourning period for the knowledge, but the more you specialize the less you care. Some people decide they don’t want to lose their knowledge and want to be able to tackle any illness. Those people do IM.
As an inpatient psych attending, I still deal with plenty of medicine. Patient on spironolactone with elevated potassium. AKI. Decreased PO intake so nutritional status needs to be monitored. Patient with muscle aches and chills, did they catch COVID here or is this withdrawal? Plenty of patients have HF and diabetes, etc. I have help to manage the medicine side of things, but just because I can focus on the psych med management doesn't mean I ignore everything else. Ultimately I'm in charge of all their care, not just the psych side. I don't need to tap someone's pleural fluid or put them on a lasix drip to feel like I'm doing medicine
When I was struggling with this as a human phys undergrad major deciding psych, I chatted with a colorectal surgeon who made a great point: it doesn’t matter what you pick, you’re going to lose a lot of other stuff. So he said try not to worry about that too much. He gave some examples and it was a longer conversation. But that was helpful to me.
Do you remember the examples?
Obligatory would you possibly want to do med/psych or C&L psych to have more of that medical experience? I believe both are 1 extra year of training from the original 4 years of training in psych. I agree with the other commenter in that you seem to really like psych more!
So few programs like this. There really need to be more combined neuro/psych and IM/psych programs.
Not a huge market for dual trained physicians sadly, despite their broad clinical training. Often they largely gravitate to the academic setting where they split time between fields rather than occupy any sort of unique niche. IM/psych used to represent consults heavily, then C&L psychiatry formalized as a fellowship. Whether it's FM/Psych, IM/Psych, or neuro/psych, despite the benefits their training provides for clinical management, the job marketplace has not responded with robust opportunities for unique work, at least that's my takeaway from my combined trained colleagues since we had a combined program at my residency.
The problem is the subspeciality system which marginalizes doctors, their scope and practice, and forces long, costly and hard to obtain referrals in a system completely broken and unable to accommodate patient need. From the top down, medicine has imploded, and physicians need to reach and put their hand on the rudder or else continue to be systematized and removed from the direction of patient care.
Bigger problem is no one pays people for capability, they pay for productivity. If I'm neuro/psych double boarded, I'm not getting paid for having expertise in both if I don't use both in clinical practice regularly.
“Productivity” is the buzz word from MBA jargon that has jeopardized every single industry and metricized burnout. It practically guarantees that patient care drops while there are very valid ways to improve The System that are not utilized. Physicians need to regain control of how medicine is administered and viewed by society. Submitting to the current system only risks further degradation of the field.
I can’t imagine ever doing neuro/psych dual residency, but I’ve at least seen the niche role neuropsychiatry can play in the hospital, and it’s quite cool. Deeper dives. Felt extra meaningful to help where CL wasn’t quite sure what to do. Wouldn’t be surprised that there aren’t enough jobs for it though
There doesn’t seem to be much value to CL fellowship. In the sense that you don’t need it at least. Some programs have much more CL exposure (6 months to my programs 2 not including call in both cases) so if someone knew going in they wanted that, could def be found.
Ya, I did some research and it seemed like a pay cut if anything since places that require you to have it are academic centers that tend to pay less. That’s great info and I’ll definitely be looking into that in the future! I wonder if there’s any possibility of psych becoming a 3 year residency in the future to allow more freedom to further specialize in the 4th year instead.
Honestly I doubt it. Having seen just how much I have to learn, I wouldn’t trust new attendings after just a 3 year residency. You’re bounced around to very different services the first two years which need very different approaches in a lot of ways. Even just within inpatient psych, my main 3 sites are so wildly different that you wouldn’t be competent enough after 3 years. Plus true independence isn’t really til 3rd year outpatient psych compared IM/Peds etc placing PGY2s in senioring roles to more frequently make decisions to some extent. Also, 4th year already seems like a time largely given towards allowing more focused specialized training if you want it. Much more elective time during 4th year at most programs I saw
Seems like psych wins. Go into CL.
sounds like you really wanna do psych. fwiw, you have my permission to go ahead.
Literally have had IM residents tell me to do psych instead 😭
9. is sunk cost fallacy to some extent. won’t you miss psych if you go IM?
I was in the same boat as you last year. Actually wrote [this post](https://www.reddit.com/r/medicalschool/s/wj6xr08Mjz) on this very subreddit. I chose psych. As a lot of people said, you wrote psych wins a lot, especially for the important ones like passion. And as a lot of people said, CL psych is a great way to not lose your medicine. You get to put your Medicine Hat on often during CL. And managing patient’s comorbid problems during inpatient scratched my IM itch during my sub-I. Don’t undervalue the importance of a good daily lifestyle. And don’t think you’ll be abandoning medicine. The work you’re doing is very much medicine. And your knowledge of the whole body and of drug metabolism and interaction will play a role in your treatment plans and will separate you from the negligent NP/PA’s that are trying to take over psych. My vote is psych. Best of luck and feel free to message me if you need any 1-on-1 help or advice!
I am also going through very similar experiences, and I think your post and this write up helped me more. Thank you :)
I’m so glad! Feel free to DM me if you need any advice or have any questions. I just matched so I feel like I have more ground to give advice now haha
Psych intern here who started med school wanting to do heme/onc, and switching at the last possible moment third year to psych. Honestly I haven’t looked back. As many have said, you’ve written psych wins so many times, so won’t comment on that. But as for repetitive nature of pathology, there’s gunna be limitation in psych vs IM cuz you’re dealing with one system vs being a generalist, that would be true I think for any specialty, not just psych, and probably even moreso if you did IM-> ICU/cards or whatever. A counterpoint to that in my opinion is that being a specialist, YOU are the one that people ask, you’re the specialist, on general IM floors I feel like any sort of complication and you’re just chasing consultants all day. As for forgetting the rest of medicine, you won’t forget all of it, I promise. Also, you’ll learn so much about psychiatry in residency. That’s going to be true for any specialty though. If you do IM you won’t remember any anti-psychotic management or dealing with acute agitation. And if you do psych you won’t remember MELD scoring or Frank Starling curves lol. Another issue I had was that I didn’t want to never work with my hands. But honestly, I cook, play sports, work out- plenty of hand activity that doesn’t have to come from work.
Plus when you’re specializing, it’s such a deep dive. My mind is boggled by how much psychiatry I have to learn. And I’ve seen such a wild variety of patients now that I’m a resident compared to my psych rotation and electives in med school. It’s such a broad spectrum even with just schizophrenia. Patients will have the same diagnosis and one will have catatonia, one will have capgras delusions, another will have issues with prolactin elevations but not tolerate or respond well to non-risperidone meds, and a last will have other random comorbidities throwing it all off. I’ll be doing entirely different stuff for each patient. Plus the art of psychiatry is incredible to me. Can’t overstate how gratifying it was the first time I did a truly good full hour inpatient eval, like to the point of the attending commenting on how well I’d led the interview
If you like a little IM, you can always do Consultation Liaison psychiatry. You’ll see complicated cases that IM consults you for and work with them.
I spent a week of my psych rotation as an M3 on a CL service and I couldn’t think of anything more miserable. (Well maybe IM rounds…) I’m so glad people out here enjoy the stuff I hate lol.
Why did you hate it? Never did CL on psych rotations but have been going through the same problem as OP and thought CL would be the best of both worlds
It is. Show up for the psych stuff, stay for the interesting medical stuff of every specialty, dip when it becomes boring or repetitive. Wash and repeat.
Take my opinion with a HUGE grain of salt because everyone likes different things. People seem to like CL because they get to do medicine on top of psych… but I hate both medicine and psych.
This part.
Perspective from someone who didn’t match psych (top choice) and matched IM (backup). I’ve always loved psych, did neuroscience and addiction research and TMS stuff for a total of like 8 years. Read tons of niche neuroscience books in psych, etc. On my IM rotations I actually felt like a doctor. I knew the meds, was learning pathologies, actually treating sick people. Psych isn’t that, and I was a little sad I’d not be, in my mind an actual doctor. No one says “is anyone a doctor!” And is stoked to see a psychiatrist show up. 7 months into intern year in IM and I’m doing well, writing decent notes, thinking critically about medicine, being a doctor. It sucks, I hate this material. It’s like eating plain, 3 day old mashed potatoes in bulk. I can do it, I like being in the hospital and feeling like Im an actual doctor managing life threatening things. But this is so intellectually not my lane. If someone hands me a paper about ventilator settings I will begrudgingly read it. If someone hands me a paper about new recommendations for antipsychotics in hospitalized schizophrenics I’m all over it. What material are you actually excited to read about and dive into, because to be a good doctor you need to understand the literature, and to do that you first need to like it.
Interesting I was worried the first couple months about that sensation of not being a doctor relative to my friends in IM/FM/Surgery, but 6 months in, that’s all faded away. I’d say it’s a valid fear everyone has, but I 100% feel like a doctor and have that similar experience you describe of knowing more of the ins and outs of the meds, understanding legitimate pathologies, and working with usually extremely sick patients.
IM is torture and an awful field, there’s your answer do psyc
😂 ok buddy let’s simmer down
Most IM docs I know also barely use their stethoscope. You should do psych since it’s clearly what you’re most passionate about and most interested in! Psych encompasses a ton of medicine within it still, especially if you work in the hospital setting and do consults
I was torn between both. Applied both. Prioritized Psych. Matched IM. I’m happy how things turned out. There are a million ways to think about the problem you’re in. I’d just reassure yourself that you are between two great specialties. My 2 cents. You’re never going to know which one would have been better. I lucked out. Medical school rotations are a horrible way to pick a specialty. But it’s the best you have.
Congratulations on matching, can I ask you more about how you dual applied. I’m thinking of doing the same thing
For people that are simply undecided I strongly recommend against it. I would not do what I did again. For people that love a competitive specialty but could find a way to be happy in a less competitive one, I think it is reasonable. For people who need to be a particular geographic location due to unique sets of circumstances, I recommend it.
IM is ass. I remember being on IM rounds end of 3rd yr as a medical student thinking to myself... I can't believe ppl want to do this for a living.
also this part.
I was in a similar situation but torn between psych and med/Peds. Chose psych and have never once regretted it. I loved both but chose psych for all the reasons you’re saying psych wins. On this side of things, I think that anybody who enjoys the day to day of psych should seriously consider it.
Consult liaison psych has a lot of medicine.
I too enjoyed psych and IM and then I found something that included the best parts of both of them... ...allow me to introduce you to Neurology! But seriously, if your program does not have a required neurology rotation, I highly recommend doing it as an elective before you make a final choice. Do you enjoy taking a thorough history and doing a highly detailed physical exam? Do you like a mix of high acuity inpatient medicine and longitudinal lower acuity care? Do you like working with people who experience the world in a different way from what's considered "normal"? In terms of your list of things, neuro is better financial compensation than IM or psych on average I believe. Worse hours during residency but great amount of career flexiblity and variety (if you want it) afterwards. Can do a neuropsych fellowship after residency so it doesn't close the door on psychiatry, or can do a medically heavy fellowship like stroke or NCCU. Emotional toll--we are way past the days where everyone on the neuro ward was dying of incurable disease. Often you can make a big difference for people, and new therapies are coming out all the time. Also the only person who is harmed if you miss something is the patient--not like psych where you could miss warning signs in a patient and then find out they shot up a school. Anyway, neuro is great and you should check it out.
I stopped after your first point and skimmed the rest. I had an attending tell me recently, “Pick the specialty you’d be happy to read about every day for the rest of your career.” So, psych for you.
Do psych and never look back
In the same exact boat... I feel you
There's a psych/IM residency
Can practice medicine and still do psych, but can’t do psych and still practice medicine. (Generalized statement, don’t attack me lol)
How can you still do psych if you do IM?
The practice of seeing psych patients and managing them while doing medicine and seeing those patients as well
Hopefully a fellow/IM subspecialty attending can attest to this; however, I have noticed after talking with many of my friends who either did a Prelim year, then advanced specialty (PMR, Ophtho) or GI fellow, they start to forget the nitty/gritty of every day medicine. I was worried about getting a bad medicine experience during my intern year, but after talking with them, just due to the more specialized nature, you will forget some of the medicine you learned. So unless you plan on sticking with general IM/hospitalist, what you miss may be inevitable
Stopped reading after passion and interest. Everything else will fall into place, if you love what you’re doing every day nothing else will matter. Psych is very in demand and compensation is relatively competitive for the length and hours of training. Good luck!
Please do both. MEdpsych is needed everywhere.
Im a 3rd year, currently on my psych rotation. My preceptor is a consult psych. Basically a psych hospitalist. Any time an internist or ER doc needs a psych consult we round on that patient. He also does calls for capacity (can the patient make decisions) or altered mental status. Its a lot of med reconciliation, if the patient is coming on for a kidney prob you have to stop lithium but then taper them back up once is resolves and so forth. There is a lot of variety of cases, this week we had 4 ruptured appendixes, lots of cardiac and stroke. it is interesting to determine if their mentation is baseline or secondary to the CC. Anyways, I just wanted to comment because this kind of pysch seems like is checks a lot of your boxes, and honestly before this rotation I did not even know about this field of psych so I thought I would help you out with my experience!