Psychology to Psychiatry - AMA

When you started your BSc what career path did you have in mind?

My path was a little convoluted if I’m honest. I was never on the typical “medical pathway” in terms of A levels etc. I took a gap year and never initially planned to go to university at all, but eventually fell in to psychology as a Bsc having studied it at A level.

Once at university I gained an interest in neuroscience, psychopharmacology psychopathology and discovered graduate entry medicine; the rest is history really! I always went in to medicine with the realistation that I would probably want to pursue psychiatry longer term, but I did consider general practice quite seriously as well.

Did you ever consider clinical psych? What made you choose psychiatry over it?

I definitely did consider clinical psychology as most psychology graduates invariably do. For me personally, I preferred the medical model/approach and always liked the ideal of being medically trained. I was also aware of how competitive it was to get on to a DClinPsych course and whilst medical school is equally as competitive, once you’re in medicine then psychiatry is a very uncompetitive field.

Arguably I was drawn to the better career prospects are as well. There are more options for varied work (e.g. tribunals, court work, second opinion doctor work, Section 12 work, medical management, pharmaceutical work, as well as private practice, research and medical education) and the pay scales are more favourable for medics as well.

I really think these are important points that are often overlooked. Clinical Psychology is competitive to get into, and quite competitive to move up the ladder once you qualify, whereas there is an acute shortage of medical graduates going into psychiatry. There are also options to become a medical psychotherapist with a medical degree, if people are that way inclined. Plus, I am sure the extra pay is attractive.

Personally, being a clinical psychologist who was involved in medical education in the past, and works to support medics through supervision and training, I am a huge advocate for grad entry medics coming from psychology undergraduate degrees. I find they value clinical psychologists (compared to some of the old school psychiatrist who think we are a nuisance), and are open to collaboration and new ways of working. II think its a great option for those that are talented and skilled, with the balance of academic and personal attributes that make for good clinicians, and recommend it to psychology graduates highly as something to consider.

For me I think my biggest reservation is more about the culture between medical school and DClinPsy. Medical school in my experience treats its students quite brutally, and there are hierarchies, snobberies (e.g. surgery is better than psychiatry) and subtle bullying at all levels (at least until you become consultant). This is based on observations in my academic work, but also my current clinical practice where I have treated my fair share of medical students for anxiety, depression and self harm.

However, on clinical psychology training, I would go as far to say its the opposite. Once you are on training it is intense, but you are hugely supported by a range of tutors, have lots of 1-on-1 training from your clinical supervisor and have tiny class sizes (I was one of 20) which are reminiscent of seminars rather than lectures at university. We had access to therapy, reflective practice and time reserved for research, and we were on a Band 6 salary and everyone is rooting for you to graduate. I was on first name terms with the staff and there was very little rank pulling, and as a supervisor I hugely value my current trainees and endevour not to treat them as disposable commodities, because they are you future peers and collaborators, not competitors or rivals. It was a very different mindset from what I observed.

What is your opinion on vortioxetine, clozapine, aripiprazol and lamotrigine and potentially lithium???

Is it healthy to take all of these? I’m really worried it’s going to mess my brain up as no one knows of the long term health risks to meds as they haven’t been around long enough.

I’m doing a joint honours in bio & psych, would that be accepted for graduate level medicine?
How is psychology bsc accepted?

How did you find the degree in psychology? Was there anything in the degree that you disliked?

Unfortunately it wouldn’t be professional, or appropriate, for me to give specific advice to people in this context. I would however encourage you to talk to your psychiatrist if you have specific concerns and would stress the importance of never suddenly stopping or amending medication unless under the direct supervision of a psychiatrist.

Many of these medications have been around for many years (lithium since 1947 for example) and it is always a balance between the risks of medication and the risk of the underlying health condition.

That’s ok, I guess I just have to ask my psychiatrist.

Are you ever scared on the ward or have been assaulted?

Hey, I did BSc Psychology (graduating this year) with a place on a grad entry med course. I'm really interested in psychiatry as a specialty (although open to everything at the moment), partly because of the work-life balance it allows you to have, which I know is definitely not the case with every specialty. The thing that puts me off is how long the specialty training is. How is it being in training for so long, with continuous assessments etc.? I also wonder what the pay's like throughout those years, are you still on a 'junior' salary throughout all that training? Thanks in advance

Congratulations on your place in medical school; you must be very excited to get started!

Training is long, but the way I look at it is that you in essence get a guaranteed promotion and pay rise every year; not many other jobs offer you that kind of career progression.

Medicine is very much based on lifetime learning so you will have to constantly be engaging in ongoing professional development throughout your entire career.

Being in a training post has benefits as you do get protected time for teaching opportunities and it is nice to have the variation rather than just be doing clinical work 40-50 hours per week.

Pay wise, you will progress relatively quickly up the pay scales. In F1 you will be on £30,000-£35,000 depending on various factors. By the time you reach your fifth year post qualification (CT3) you will be on £60,000-£65,000. They have also now introduced a new pay point at ST6 meaning that most ST6’s will be on nearly £70,000 a year.

Whilst it isn’t as good as a consultant’s pay, its a reasonable salary to be on whilst you’re still relatively young.

Hi there, you writing about your experiences has made quite reflective on my new choices in regards to Medicine and Psychology. Unfortunately, last year I was unsuccessful in securing a place at med school, and I decided to take up Psychology at Trinity College Dublin. Then last October, I realised I wasn't ready to give up and thank God I was able to secure a place for medicine this year at Imperial. The truth is I liked psychology, and if I decide to leave Trinity for Imperial, I fear that it may permanently shut the door to Psychology. Surgery has always been a primary focus of mine, but the more I learn about medical careers, the more confused I become. Although I do not have to figure out which path to take now, my question is that if I go down the medical school line first, would it more challenging to become a psychiatrist?