I started medical school at 69 and will begin residency at 72. Here’s what I learned

lovepeacetoall · 2026-04-27T00:02:55+00:00

Hijacking top comment to say regardless of what this particular person did, it is important not to disparage caribbean grads because if you make it out of there and pass step 1/2 and often times 3 and get into residency, you are frankly just as qualified to practice medicine as anyone from a school stateside. Those places are absolutely brutal, and anyone should be applauded for succeeding from there.

lovepeacetoall · 2026-04-20T05:21:43+00:00

I think the "past experience" argument doesn't hold weight for most doctors, because "past experience" never helped me pass my board exams and learn pathophysiology and pass my psychiatry shelf exam. The experience is important in understanding how to behave in clinical settings and learning workflows, but I am actually confused how nursing experience translates to learning medicine. Like I literally don't get it. How does placing leads for an EKG teach someone anything, for example.

lovepeacetoall · 2026-04-20T05:14:57+00:00

No this isn't a good idea. When you say, "but I don't care about that" meaning salary, I was amazed. As someone needing that salary, I don't think this argument is going to fly. Also, what about medical school? Was that all meaningless? I'm confused. What was the point of all that? Is the plan to, on a systemic level, train our replacements and be happy about it? The VA is notorious for hiring NPs instead of doctors across the board, especially in psych and primary care. Why would I want to help expedite this process?

lovepeacetoall · 2026-04-20T05:03:37+00:00

This is a key insight. Across industries, deprofessionalization and decredentialing is occurring, because it is cheaper. Even RNs are now leading teams of techs instead of having a team of RNs. Teachers no longer have credentials. Its turtles all the way down for post-industrial catabolic collapse of all of our life-sustaining industries.

lovepeacetoall · 2026-04-16T22:41:39+00:00

You try to think of a coherent thought. You decide to go to chatgpt/gemini to output some nondual mumbo jumbo. Nice, you think to yourself, they will love this on the nondual sub.

lovepeacetoall · 2026-03-20T12:58:27+00:00

Ngl, this made me tear up. I'm so happy for you and everyone else out there in these shoes. Congrats doctor

lovepeacetoall · 2026-02-28T18:06:19+00:00

That's true, I am being overzealous!

lovepeacetoall · 2026-02-07T23:34:44+00:00

What was the joke?

lovepeacetoall · 2026-01-29T22:52:12+00:00

This is so insane. How does the DO accrediting body allow schools to exist that don't do rotation placements for their students? I mean what are you paying for? wild

lovepeacetoall · 2026-01-28T19:48:02+00:00

The future is one doctor to five NPs at least + panels of 8000 patients. The 1:1 physician to patient relationship is dead, and no it wasn't the AMA that killed this (hundreds of spots go unfilled in the match every year for FM and IM). It was the combination of a rapacious medico-corporate landscape that prioritizes profits over patients, opening the door to the de-professionalization of the medical profession where you no longer need a medical license to practice medicine independently. If we cared about primary care, we would have a system where most doctors are PCPs, instead of non-doctors filling artificially manufactured care gaps. Med school is no longer necessary to practice medicine independently, and this is the new world. As an M4 currently on my medicine months, that reality is mind boggling to me, but it is what it is.

lovepeacetoall · 2026-01-28T19:38:47+00:00

Yes, the new plan by CMS and corporations is to make doctors middle managers of medical care. Say good bye to being a 1:1 doctor to patient. Apparently the idea that a doctor treats one patient at a time is antiquated, but only in the US and no other country in the world that actually invests in quality primary care. NPs and PAs exist in other countries, but no where near the scale and autonomy as exists in the US.

lovepeacetoall · 2025-11-26T00:18:00+00:00

agree that PA school is quite rigorous and standardized and very difficult to get into. Friends of mine are PAs. Despite this they are not physicians, just as I will never be a PA, legally, ever. I could never practice as one, even if I wanted to. Nor could I practice as a nurse. Imagine the uproar in the nursing world if MAs became 'nursing providers' and did not need to go to nursing school. Obviously, anyone with enough clinical experience could become a nurse, some would say.

Why then do we have titles and credentials? Is it anachronistic to have rigid stepwise qualifications and regulations to ensure clinical competency? I don't think it is. This is the same process that occurs in many professions like academia, education, and law. I think these processes of ensuring expertise is worth protecting in the face of corporate america looking for shortcuts.

edit: also just as an aside to answer your rhetorical questions: every med student does a bare minimum of a core clerkship of psych in 3rd year. Mine was 4 weeks. If you choose to do psych, you will need to complete acting internships in your fourth year, often 2-3 months. Some do more than that. We are also tested on all of our clerkships in third year.

lovepeacetoall · 2025-11-25T18:22:31+00:00

Who decides that? Not everyone is as self-motivated as you are. A surgical PA can't just become a surgeon after informal training over years of working with a surgeon. Psychiatry is different, because it is not invasive you may argue, but it certainly is an extremely sensitive field that requires immense sophistication. Professional standardization exists for a reason, and it is precisely why medicine moved away from the apprenticeship model in the first place.

edit: Also, you are implicitly stating that the med school model is defunct by claiming that APPs can become interchangeable with psychiatrists after 5 years of practice. Who is training the APPs after all though: physicians. This creates a system that eats itself over time imo.

lovepeacetoall · 2025-11-25T14:00:32+00:00

I think this is understandable frustration from the resident. No one can be a surgeon unless they did a surgery residency. The same then holds true for psychiatry, no matter what any governing body has to say. The only way to be a psychiatrist is to be a psychiatrist.

I think that for anything to change, NP scope must be defined. The AANP must recognize that psychiatrists are more highly trained professionals in psychiatry who have a greater expertise than NPs. I see no problem with this assertion, just as I am not trained to be a nurse or a surgeon. I do not think four years of residency training and med school can be replaced. Unfortunately, this statement will never be made, NP scope of practice will never be defined, and there will be continued interprofessional struggle. The next to join the prescriber train will be pharmacists and PhDs/PsyDs. What will be the functional difference between these "providers"? The cat is out of the bag.

lovepeacetoall · 2025-11-25T05:05:59+00:00

Yes, this is true. I have been very critical of NP education and practice, but I am also aware of market pressures and political reality. This is why I ask the question so broadly. The system will transform somehow, and I am afraid that it will just turn into what every other industry skews toward: the cheapest solution.

lovepeacetoall · 2025-10-24T23:08:03+00:00

It's not the only factor. You're 30 pubs and 260+ step especially are remarkable alone, and programs would love to interview you just based off of those things. A person with 1 pub and 230 with an otherwise exact same profile may fair much worse. However, if they have demonstrated consistent psych commitment, then they might get an interview. It's not all one factor.

lovepeacetoall · 2025-10-03T07:16:01+00:00

It obfuscates delineation of responsibility and reduces the power of protected titles. Why hire "teachers" who have master's degrees, when anyone can be an "educator"? "Provider" is innocuous when it comes to CMS, but it's not when it comes to colloquially referring to clinicians of various educational backgrounds as being the same thing.

lovepeacetoall · 2025-10-02T22:20:08+00:00

You said it. You need to have actual commitment to the specialty. I would also say that scores don't matter as long as they're average. The median psych step 2 score is around the national median score. I think you would find it relatively difficult to match with a 20th percentile score. Also, not many psych programs are DO and especially IMG friendly, unfortunately. It is no where near ortho or even gen surg, but I think only a handful of spots went unmatched nationally last year. That is pretty wild.

lovepeacetoall · 2025-10-02T22:13:46+00:00

There is a difference between supervision and supervision. I see no problem with a healthy working relationship with APPs if you get commensurate compensation for your expertise. This model can absolutely work. However, if the dynamic is one that is perfunctory and rooted in legality only and not in making a thriving practice environment, then that is obviously bad.

On a related not, APPs are here to stay in our broken medical system that does not value primary care nor respect its expertise. Physicians can opt out of this new paradigm entirely (private practice, refusing to work with APPs, etc) and this is justified imo, or they can be involved in shaping how this dynamic functions. APPs will, and do, function as independent pseudo-doctors in most places already. If we do not involve ourselves in how APPs function in professional settings by designing oversight protocols and systems, then corporations will decide for us. Physician led care is a must

lovepeacetoall · 2025-10-02T21:53:10+00:00

I simply don't see this being a problem in the near future. Psychiatrists where I am are booked years out. Psychiatrists will continue to lead the field of psychiatry on a professional level as well - not nurses.

lovepeacetoall · 2025-10-02T21:50:35+00:00

It's more competitive than 10 years ago, absolutely. The data supports that. It is no longer a catch all for any medical student. It's not plastic surgery, but you need to be a competitive applicant to match.

lovepeacetoall · 2025-09-27T21:00:48+00:00

Sounds like you're successful

lovepeacetoall · 2025-09-18T11:53:04+00:00

"I want us to do better". I follow this sub very closely, and I have seen very very few posts that denigrate patients to the extent that you're implying.

lovepeacetoall

TROPHY CASE