Psych vs FM

[Layla89]

Hi, 

I would really appreciate your help and advice. As the title suggests, I am having trouble ranking psych vs FM programs. So far my thoughts are:

Psych: Pros:  I really enjoy studying Psych and was fascinated during the few psych cases I saw on my primary care rotations. Love taking long detailed histories and having long interactions with patients. Can see myself loving Child and Adolescent psych. Cons: Because of COVID my placements were all virtual/ phone-based, so I did not get a realistic feel and committing to a 5-year program is scary. I am an IMG so I will need to do 5 years of residency PLUS 5 years ROS. Again as I am an IMG, had no exposure to psych in electives. 

FM: Pros: I found that though FM is very general, you still see a good amount of stable patients with mental health issues. 2 years is amazing! ROS will be shorter - year for year so I'll be done both my residency and ROS in 4 years. Cons: don't like the huge variety of cases, If I were to go into FM I want to mainly see patients with psych issues, idk how achievable that is.. Did an observership with 2 family physicians in Canada, they complained so much about unfair compensation from the government, paperwork, not having as much time with patients because of the paperwork, getting no respect from specialists, nurse practitioners etc. 

I am already considering things like location and program highlights/ electives. Are there any other factors I should think about before deciding how to rank them? Any advice will be appreciated! My understanding is that money wise both FM and Psych are very similar. Any insight on enhanced skills in Addictions/ or a fellowship in child and adolescent, on how they would affect lifestyle, salary, etc. would be appreciated. 

[Persephone]

I don't have a lot to add other than as someone who loves psychiatry, I found being an observing medical student on zoom calls with patients felt like torture, especially when my preceptor made it difficult to meaningfully participate. I now have a psychotherapy patient I see over zoom and I find it a lot better than in medical school. But in residency most things are in person, especially inpatient units. I find most aspects of psychiatry energizing, while I found only a few aspects of FM energizing, and not enough to win me over to that side.

As a FM doc you can bill for GP psychotherapy (at least in Ontario) and run a practice that is largely psychotherapy based if you wish. I know of a FM doc in Ontario who does that as his practice in combination with addictions medicine. So it's totally possible. He spent a small proportion of his time doing general medicine.

Does every IMG placement have a ROS attached to it? I was under the impression only some did, but I do not know the ins and outs of that at all!

[Findanus]

Sounds like you love psych. Just go for it, and remember to apply to the USA.

[unarmed walrus]

11 minutes ago, Findanus said:

don't remember to apply to the USA.

Care to expand? Psych applicant here, wondering if there's specific tea to which you are referring.

[Layla89]

On 3/15/2022 at 1:01 AM, Persephone said:

I don't have a lot to add other than as someone who loves psychiatry, I found being an observing medical student on zoom calls with patients felt like torture, especially when my preceptor made it difficult to meaningfully participate. I now have a psychotherapy patient I see over zoom and I find it a lot better than in medical school. But in residency most things are in person, especially inpatient units. I find most aspects of psychiatry energizing, while I found only a few aspects of FM energizing, and not enough to win me over to that side.

As a FM doc you can bill for GP psychotherapy (at least in Ontario) and run a practice that is largely psychotherapy based if you wish. I know of a FM doc in Ontario who does that as his practice in combination with addictions medicine. So it's totally possible. He spent a small proportion of his time doing general medicine.

Does every IMG placement have a ROS attached to it? I was under the impression only some did, but I do not know the ins and outs of that at all!

Thank you so much! It's good to know that if I match to FM I will be able to personalise it but I think I will just rank Psych programs higher. I do think a lot more about psychiatry excites me compared to FM so I relate to that. 

In terms of ROS, unfortunately all the programs I applied to do have a ROS contract. Sask and MB are 3 years max from my understanding and Ontario is 5 years. 

[Layla89]

On 3/15/2022 at 11:19 PM, Findanus said:

Sounds like you love psych. Just go for it, and remember to apply to the USA.

Thank you! I think I really needed to hear that haha

[Persephone]

On 3/18/2022 at 8:22 AM, Layla89 said:

Thank you so much! It's good to know that if I match to FM I will be able to personalise it but I think I will just rank Psych programs higher. I do think a lot more about psychiatry excites me compared to FM so I relate to that. 

In terms of ROS, unfortunately all the programs I applied to do have a ROS contract. Sask and MB are 3 years max from my understanding and Ontario is 5 years. 

Good luck with this cycle!