Medical Education US

As a quick summary:

First, you will have to do well in high school in order to get accepted to a decent college.

You will most likely go to college for 4 years and take the necessary pre-med courses, which includes 1 year of biology, 1 year of chemistry, 1 year of organic chemistry, and 1 year of physics. Around the end of your 3rd year of college, you will take the MCAT exam (like the SAT but for medical school). You will have to apply for medical schools, and acceptance will be based mostly on your grades in college and your MCAT scores.

Medical school then is an additional 4 years. The first 2 years are basic science classes - anatomy, biochemistry, pathology, histology, pharmacology, and more. The last 2 years are clinical rotations where you work with doctors and resident doctors rotating through all of the major areas of medicine - surgery, internal medicine, Ob-Gyn, pediatrics, psychiatry, neurology, and some electives. During your last year of medical school, you apply for a residency program in your field of interest - in your case psychiatry. You then go on interviews and the different programs. You rank the programs of interest to you, and the programs rank the applicants. It all goes into a computer, and around Mid-march you find out where you are doing your residency.

Residency in psychiatry is then a 4 year experience. You spend 4 months doing general medicine rotations either in pediatrics, family medicine, or internal medicine. You spend 2 months doing neurology rotations. The remainder of the residency is in a variety of areas of psychiatry plus electives. Essentially, you spend around 1 year doing inpatient psychiatry, 1 year doing outpatient psychiatry, and the remainder of the time is spent doing subspecialties of psychiatry - consultation liaison psychiatry (now called psychosomatic medicine), addiction psychiatry, child psychiatry, geriatric psychiatry, forensic psychiatry, and a few others, plus electives.

At the end of those 4 years, you are a board eligible psychiatrist.

hey,
i still don't understand. What classes do you take in high school to become a psychologyst then what do you do in college to get your degree... im very confused and would like a little better understanding to fullfil my dream. please help..
thank you

In HS, take college prep courses.

In college, take whatever major you like, but make sure that you take the pre-medical science courses to prepare you for the MCAT exam.

Then, apply to medical school, and after you finish that you can become a psychiatrist by completing residency training in that specialty.

That's the Cliff Notes version...

Good luck!

hi there..i'm a junior n high school also and i want 2 become a psychiatrist. What all do you need to know because i know ALOT of stuff about psychiatry. hmm lets see. a psychiatrist basically diagnoses and treats patients who are mentally ill, they can use either therapy or prescribe them a medication. They can work independently or with a company.(i plan on working independently). In order to become a licensed psychiatrist you must complete high school. get your bachelors degree in college.have experience working in a medical setting, and take a couple tests to become certified or licensed in your state.(its 2 tests here in texas i think).when you're in school you can decide whether 2 specialize in pediatric,geriatric or adult psychology.i figure i'll be done with all my school and training by the time i'm 30. the average income for a psychiatrist in the united states is 160,000per year.i'm not sure if u live in the u.s. or not.i started reading about psychology when i was in 9th grade and i found that Half Price Books stores carry ALOT of psychological books.you might also want to read about sociology.its about the behaviors of humans and stuff like that.i hope i helped u

Junior in HS,

You did provide some accurate information there, but it's not quite complete. I think it's great that you already have an idea of what you want to do with your life, but I would suggest keeping an open mind throughout college and medical school - you might be surprised to find something even more interesting to you than psychiatry.

The other thing to realize is that while you said after college you need to get some experience working in a medical setting, you are accurate - but not complete. You actually need to do well enough in college with your grades and MCAT test scores to get into medical school - which is very competitive. Med school is 4 VERY challenging years.

During your last year of medical school, you apply for residency. Psychiatry residency programs are generally not that competitive, but the top programs are. The residency program is 4 years, during which time you do clinical work under the supervision of other physicians. Parts of psychiatry residency are very hard work with little sleep and long hours. At some programs, the entire residency may be that way. At many psychiatry residencies, you do get a little bit less work the last 2 years - but it is still a lot of time at most programs.

You obviously pay for college. You have to pay for medical school, but most people can get educational loans (lots of them) for medical school. Residency pays around $35k-$40k, which doesn't sound too bad, but based on an hourly rate is probably close to minimum wage. Most people defer their loans throughout that time, but some will start paying them off near the end of residency. With somewhat less work the last two years, some programs will allow residents to do moonlighting work. This type of work can vary a lot, but can pay fairly well. Some very motivated residents have made a decent living, but they were VERY busy.

Once done with residency, you are "board eligible" which means you can work as a psychiatrist at most places. There is then a two step certification exam that takes about 1 year to complete if you are lucky and pass everything your first try. There is first a written exam - multiple choice, typical type of exam, that I believe has around an 80% pass rate. It has a lot of very tough questions as 1/3 of it is neurology and 2/3 are psychiatry. From what I recall, the neurology questions were VERY hard. You have to get a certain percent right on each part to pass. So, if you ace the psychiatry part, you can still fail the exam if you don't get enough right on the neurology part.

The second part of the exam is the more controversial. Once you've passed the written exam, you will get scheduled for an oral exam. The oral exam consists of 2 parts - a video portion and a live patient. For the video portion, you watch a 30 minute video of part of an interview, and then you meet with 2 examiners (I heard it may now go to 1 examiner plus a floating examiner who comes in and out of the various rooms) for a 30 minute test. You are expected to present the patient and then answer questions from the examiners.

For the live patient part of the test, you have a real patient you've never seen before come in the room, and you have 30 minutes to interview that patient. You then have a 30 minute test where you present the case to 2 (now maybe 1?) examiner and then answer questions.

While the American Board of Psychiatry and Neurology has tried to make this an objective exam. Personally, I think it is an awful test. Not only is it very anxiety provoking which effects some candidates much more than others, but there are many many random factors. The particular patient, the particular examiners, what questions you might get asked and whether they fit in with your knowledge areas or not. Of course, the entire interview is an artificial situation.

I'm not sure there is a better way to test candidates, though - as the ability to interview patients is a vital part of psychiatry. And the field of psychiatry is trying to maintain credibility of the profession - so it is important to make sure board certified candidates are able to effectively talk with patients. Of course, I think this is important for almost all fields of medicine - yet very few other fields require an oral exam. Most of the abilities to interview, present, and understand patients are observed during residency, but I suppose completion of residency does not necessarily mean you are competent. My thought is that just passing the exam doesn't mean you are competent either.

And did I mention that the oral exam has around a 50% pass rate? This is for people who have done well enough in college to get into med school. Have completed med school and matched in a residency. Have completed a residency and passed a challenging written exam.

Your target age for finishing training is probably about right.

Complete High School around age 18, complete college around age 22, complete medical school around age 26, and complete residency around age 30. That's if you go straight through.

More and more people are taking extra time in college (5 years instead of 4), having a career before going back to med school and taking time off during med school (to do things like research or pursue a second degree).

In my case, I happily went straight through the whole process - actually cut one year off of college but added an extra year of residency to do a combined internal medicine / psychiatry residency program. I am very glad to be done with the training aspect of things.

I probably should have broken my answer down into several different threads, but maybe eventually I'll put together one thread of frequently asked questions or something like that.

Thanks for your comments!

Hi- I started to medical school in Tennessee when I was 40 after entering college as a mother of two at age 34.My kids are grown now and I am now a 55 year old practicing gero-psychiatrist and I really love working with my patients. Certainly you are not too old to pursue your dream. It can be hard to complete a medical education as a young mother but not impossible with good support in place.

Thank You so much for your inspiring response. I am a 34 yr. old single mom with a 3 year old daughter. I am currently at a junior college and planning to transfer. I was just becoming discouraged about pursuing psychiatry until I read what you said. Thanks again..you have touched me.

I am a junior in high school and i have to write a career search paper as well. Psychiatry has always been my dream, and i just want to thank all of the people on this site for providing such copious and accurate information on the subject. You have saved my life with this paper!!! THANK YOU!!!

I deeply appreciate your information here. It's most informative. I'm currently in college and hope as well to push into med school and eventually become a psychiatrist. I did have one question though that still lingers. Is there a doctoral thesis involved in the graduation process from med school?

no

I'm a senior in HS gettin ready for the whole college scene and my goal has always been to become a psychiatrist. Although i have at many times become discouraged because of all the people that say it is a very hard career because of med school being able to get accepted to one and then the residency and every thing like that. Is it really as hard as it seems to become a psychiatrist and is it worth going through all this hardwork?

[ Edited by Admin on 2006/2/10 18:14 ]

I am another future psychiatrist with no clue where to start. I served in the military for five years as an air traffic controller. I am currently working in Ecuador now as an air traffic controller. I have researched some colleges online but didn't know what exactly to look for. Do I go for a BS in psychology? What would your opinion be concerning online colleges? Would Med School look at it as a bad thing? I think an online college would be my only option right now since I am not in the states. What do you recommend?

You can major in any field as long as you complete all your pre-med classes. I can not imagine there is any online college that would be adequate to get accepted into medical school.

Hey I'm a junior thinking about it too. Not sure I want to spend so much time in school though if I get the chance. Is there any easier way? haha I hope so. I take psychology right now and love the class. I've always been interested in those TV scenes involving therapy even though those aren't 100% accurate. If only it was a lot easier and quicker then this would be an easy decision for me.

Guest wrote:Hey I'm a junior thinking about it too. Not sure I want to spend so much time in school though if I get the chance. Is there any easier way? haha I hope so. I take psychology right now and love the class. I've always been interested in those TV scenes involving therapy even though those aren't 100% accurate. If only it was a lot easier and quicker then this would be an easy decision for me.

As a Junior in high school, it is really too early to know exactly what you want to do for a career. Unfortunately, there are not many ways to shorten the path to becoming a psychiatrist. You could do one of the BA/MD programs that may allow you to combine medical school and college into 6 or 7 years, but you give up a lot in the process - you miss out on the college experience and never really fit in with the medical school class. This process is definitely not easier but is quicker.

You mention enjoying the TV scenes involving therapy - in general that type of therapy is now more likely to be provided by a psychologist than a psychiatrist. In my opinion, the path to becoming a psychologist is significantly less difficult than the path to become a psychiatrist.

If you are really considering the psychiatrist route, I'd suggest you take the required pre-med classes as well as all of the other college courses that you find interesting. Give yourself time, as it is still very early to be locking yourself into a career choice. You'll have just as many options even if you decide not to pursue medical school / psychiatry.