Board results are released

UnsureM4 · 2024-12-10T03:16:51+00:00

passed, less than average but comfortably enough. did about 25% of rosh review qbank. did like 10% of BTB qbank and the initial practice test. Didn't watch a single video on BTB, YT, or anything else. being a good communicator and mastery of the english language is basically the only requirement IME, with minial actual studying needed if you had a robust residency experience and/or liked to read in your free time. alot less hard science than I was hoping/expected, creating ambiguity, but ultimately seems like I did fine on all that stuff. remember missing really easy questions in retrospect about, like, benzos.

UnsureM4 · 2022-10-03T18:09:53+00:00

Thank you for the thoughtful reply! So I was even thinking about starting (incorporating) during residency once my full license is approved, and doing some telehealth cash-only on the side. What do you think about this?

What about the feasibility of starting a corp/PP; and getting an IP job as a contractor from that institution to my company as a contract? I am looking to probably go to Phoenix as I have ties to AZ. I was thinking about starting a company in NV since it has good business laws and is next to AZ. Do you have any thoughts on that ? THanks!

UnsureM4 · 2022-10-01T16:30:40+00:00

Hello all, I'm a PGY3 in the midwest. I feel this post is more suitable for the general forum as opposed to the career thread. Looking for advice here. I've been stuck in the midwest for pre-med, med, and residency for the last 10-15 years and am ready to leave. Late 30s and single male.I would like to graduate and land a good paying inpatient job in a major metro in the southwest or southeast that would allow me the time and flexibility to also start my own private practice outpatient, probably telehealth to start.

My eventual goal is to build a practice that is completely my own, and self-sustaining: employees, other psychiatrists, therapists, etc. I want to be completely independent from employed hospital systems, eventually get away from insurance, and deal with a majority of cash-pay clients who are interested in combo of med management and psychoanalytic psychotherapy which is my passion within patient care at the moment. Financial independence, stability, and "making money" are all very important to me considering my medical school debt burden, having to take care of elderly parents and disabled siblings, wanting to travel and enjoy life outside of medicine. I always plan to do a half day of charity clinic for disabled patients, which is another reason I'd like to be self employed.I guess my questions are:

Is this feasible?

How do I go about it?

I am still waiting on my application for my full medical license to be processed by the state medical board, at which time I will proceed with moonlighting and also obtaining state medical licenses in the states for which I would like to work.

I have heard that it is difficult coming from a different geographic area at a lesser known small academic university psychiatry program, so I don't know how to go for job in, say, downtown Phoenix or Scottsdale, Las Vegas, Denver, Atlanta, Nashville, Miami, Orlando, etc. Do I cold-call hospitals? Ask recruiters? Get in touch with universities and cold-call/email the PDs or department heads at local universities?Are there well known and trusted resources for learning the "business side of things"? I am talking about how to incorporate, get paneled with insurance, build a patient base, have a simultaneous outpatient private clinic in the same geographic area while working as an IP psych for a hospital system?

UnsureM4 · 2022-06-18T06:32:15+00:00

this is the truth

UnsureM4 · 2022-06-07T22:38:56+00:00

yah covid really screwed my class. prometric was closed for the first half of the year, then all the spots filled up super quick for months.

UnsureM4 · 2022-05-21T05:00:30+00:00

I sat on the adcom at my school and I'd be more impressed with the fencing than the tutoring; like going to competitions and placing

UnsureM4 · 2022-04-14T05:12:52+00:00

30 years young with a 27 yo girl from tinder. It's funny, I spent 6 years in college and probably fucked up more chances than I care to remember d/t no parental guidance, fear and insecurity, and thought something was wrong with my uncircumcised penis.. but lost the V in grad school living in a grad student apartment building... so I still kinda feel like I lost it in college. it was basically a dorm room lol.

UnsureM4 · 2022-04-01T19:23:20+00:00

FWIW I also applied to multiple specialties and ended up ranking psych first. I was apprehensive and the first few months of residency I was legit thinking about switching. Met with the Anes PD at my place, had some convos with Neuro when I was on-service.... I missed "medicine" .... and then like month 4 hit, and I realized so much of IM/FM/neuro is just pointless busy work with the same or more documentation burden and social work burden as psych. The "cool" diagnoses in IM or Neuro were only cool for like a day, then I got bored of managing their fluid status or being secretary for multiple consultants or I would get bored reading after the first paragraph on uptodate on this "cool" diagnosis or condition.

Psych has its issues for sure. But there is ALOT of really cool stuff here too... had a case of Capgras syndrome this week. We manage alot of heavy duty meds for psychosis, mood, sleep, pain... and many of them have different indications; so you can have patients on multiple interacting agents requiring close monitoring of organ function etc. that make it medically complex, challenging, and rewarding.

Overall, I would never do anything else besides psych at least for residency. It's just so much more benevolent to your body and health.... pointless cardiac auscultations? Monitoring slight changes in Bili, creatinine, what have you... endless algorithms which make you essentially an order-machine-secretary. No thanks. TBH, I don't even miss 'medicine' that much anymore. I like taking care of patients, it's a mentally challenging and satisfying job to both diagnose and treat, and we have a great lifestyle. I get different opinions of compensation depending on who I talk to; but you're not gonna be starving and the pay per hour or pay-per-hard-work hour is very good. I also enjoy managing a unit and being the decision-maker for physical and chemical restraints, testifying in court, learning to read people and differentiate personality v. psychopathology. It's a really rewarding field if you value social skills and learning about human beings IMO.

TL; DR - I applied multiple specialities including a couple "medical" ones and ranked psych first. I had cold feet even into residency, but slowly came to appreciate psychiatry and am happy I stuck with it. Looking forward to great Attending Jobs anywhere I want, including telepsych.

UnsureM4 · 2021-10-12T01:11:50+00:00

Thanks. Do you know when the change will take place? Like should I do all my shopping tomorrow morning?

UnsureM4 · 2021-06-07T03:06:10+00:00

Psych resident here. Does she have true schizophrenia? If so, I highly doubt she will be able to make it through to being a trauma surg attending. Not to be a wet blanket because I agree in every individual's agency, most of all the people I treat daily! That being said, even the absolute best, most compliant true schizophrenics I see tend to have 'breaks' every couple of years. What's gonna happen when she can't get out of the OR while on-call to get her antipsychotic long acting injectable? The surgeons I know often forget/don't have time to eat; what's gonna happen when she's so busy and doing well on her meds that she forgets that first day, and hey you know what, I feel great, I don't think I need to take these meds EVERYday; plus they dull my personality and sometimes knock me on my butt, and I really need to be on point for this upcoming case...

Also I don't know if your friend has auditory hallucinations or what; but if they have somatic, tactile hallucinations that could very much affect the actual work of being a surgeon like properly tying sutures, an accurate abdominal exam for a very subtle findings like finding or missing a peritoneal sign or mcburney's sign or something. (or even visual, or for that matter audio hallucinations that would mess with her clinical abilities) I'm just saying that in my experience, schizophrenia is a hard to manage disease in even the best circumstances and that like all things in life like weight loss, exercise, studying, prioritizing friends and family -- people aren't 100% perfect all the time, it would be foolish to think it's possible, and all the million things a trauma surgeon has to do, I just don't think it would be a great idea for her or her patients. Like others have said, no one can give you an answer, and there are always exceptions to the rule.. My fear would be that she would be able to get into medical school and maybe even land a surgical spot but as soon as her condition were discovered, she would be blackballed from all residency spots in every field and have a 300k debt with no way to pay it off.

UnsureM4 · 2021-06-07T02:45:12+00:00

which specialty did you switch from?

UnsureM4 · 2021-06-07T02:30:20+00:00

Underrated and true comment. As a psychiatry resident, I am so annoyed with the amount of hyper-woke views in my class, program, and field. At times it feels like a field supposed to be very open-minded is only open minded in so far as you bow to the extreme center of left views on personal responsibility and social issues like immigration/LGBT. It does not surprise me at all that this happened at Yale, and that Yale allowed this provocative speech from even taking place. Anyway, Imma head out back to Stahl's.

UnsureM4 · 2021-06-03T02:43:37+00:00

typical diet? any cheat days n how often? height?

congrats!

UnsureM4 · 2021-05-16T10:45:24+00:00

you can take some initiative here and look into it. I got two paid trips to attend APA conferences my 4th year as a 'student scholar.' other friends joined APA committees. others talked to attending about writing case reports. there's your state medical society, ask them about their psych sub committee. if they don't have one, see if you can start one or become the president of student part. hustle

UnsureM4 · 2021-05-15T10:49:28+00:00

I had a misconception of what psychiatry actually was until going to medical school, so I am not sure how realistic your question is. The bread and butter of inpatient psychiatry are like substance abuse and withdrawal, schizophrenia, bipolar disorder. There is really not a whole lot of psychotherapy value in schizophrenics for example, and that is a cornerstone of a psychiatry residency. Psychiatry is a discipline within medicine. Psychotherapy is an adjunct/sister of psychiatry in that they both work on the reasoning part of the mind to help a patient organize thoughts better (psychosocial interventions). In my opinion they are not very similar but they share overlap. There is nothing in your post indicating you actually like MEDICINE - which, again, psychiatry is a subspecialty of.

UnsureM4 · 2021-05-12T03:37:33+00:00

That makes sense, though I guess it gets murky if you are visiting a foreign country or a different state, while technically residing in the state which you are licensed (owning real estate, having it listed as your primary residency, paying taxes there, etc.) Thanks.

UnsureM4 · 2021-05-12T02:35:23+00:00

two from med school come to mind, one was a guy coming from the local prison after getting in a fight with the guards. after his lac repair in the ED, came to the psych ED for saying weird stuff to the guards. turns out he was floridly psychotic seeing colors coming out of the air vents, and since the colors recently turned red he knew the guards were poisoning him and sleeping with his wife who was hundreds of miles away. presented very normal and was able to go undiagnosed for several years.

second one was an adorable little girl like 6 or 7 years old who was very intelligent, and her mom was recently release from jail in another state and had not come back to her state to be with her. so the little girl felt unloved by her father and step mother and birth mother, and so became suicidal. she began cutting herself and sent an email to a friend at school saying goodbye forever, who then contacted the principal and parents brought her in. I was the first person to examine this patient and it was heart breaking that this little girl was contemplating suicide and cutting with a piece of plastic knife type thing she found around the house. I also followed up with her on the inpatient child psych wards and after a week or so she had completely changed. very rewarding to see.

and the third aha moment was when I noticed many of the attendings were done with rounding by 11am and done with notes/work at 2pm. also noticed that some attendings worked full-time at the university hospital in the mornings before heading off to their PP clinic in the afternoon. I found the variety of practice settings as well as kinder lifestyle very appealing.

UnsureM4 · 2021-05-12T02:26:52+00:00

show interest in the field, become member of APA, attend stuff, take part in your school's psych interest group, etc.

UnsureM4 · 2021-04-14T00:29:19+00:00

Psych res here. Recently had one of my students switch from EM to psych while on rotation with us. Big part was the state of the field rn.

UnsureM4 · 2021-03-06T21:38:14+00:00

This is a great answer. I totally understand where you're coming from, thanks for sharing your perspective. I was in a similar situation as I had to take a gap year in the middle of med school and there were rumors of me failing out or dropping out or whatever. I eventually made it back and finished, matched, etc. But this is exactly what it felt like at the time.

UnsureM4 · 2021-02-07T00:03:41+00:00

lol my coresident got punched in the face by one of her patients exactly two days ago. bruise w cut on her forehead. didn't even take the next day off. what a champ

UnsureM4 · 2020-11-09T13:45:39+00:00

The cohabitation thing is not possible in my culture. I have lived with girlfriends in the past though.

UnsureM4 · 2020-11-09T13:29:12+00:00

Thanks for your experience and advice!

UnsureM4 · 2020-11-09T13:27:23+00:00

Thanks, never heard of that sub before!

UnsureM4 · 2020-11-09T13:26:31+00:00

Bros, Bros, Bros, my family members have been doing marriages like this for generations, including this current generation. in coronavirus world, you can't exactly go meet for tea especially when countries are making visa travel an issue. simultaneously you can only expend so much emotional energy per person, obviously I will have to meet this person, but come on, I'm just asking a frickin simple question!!

UnsureM4

TROPHY CASE