Medical Education US

hi! great site..my first time here. i am a fmg who has recently been torn whether to pursue a residency in medicine or psychiatry..i have off the charts scores in usmle(i am being truthful) and am recently been interviewing in psych programs and medpsych programs.i have 2 questions and would really appreciate someone experienced in medpsych answering them
1.what are the prospects of medpsych in a third world country which has no concept of this combined field. if one ends up there eventually with a medpsych residency on his cv he would end up either practicing psych or else medicine..in which case one of his degree kind of becomes professionally redundant.
2.this is a question of an immediate nature:) how would a residency program director feel when itell him the truth that i am still double in my head about my residency plans. if he asks me a question as why you want to do medpsych..well that is tough one to answer without sounding vague. i believe solidity in answer comes from personal conviction:)

any advice will go a long way.thanks

Good questions.

First, USMLE scores aren't everything. They do tend to act as an initial filter for IMG's, but that alone isn't enough to match (from what I've heard). Nonetheless, it's great that you'll easily make it past that first filter.

Second, practicing any form of medicine in a third world country would be a pretty unique sort of practice. I do know some people a few years back went into med-psych and they were interested in "international psychiatry" or "cross-cultural psychiatry". In a third world country, I doubt that people care too much what your area of expertise is - they are probably happy just to have access to a doctor. Doctors there probably don't have the same board eligibility issues, etc. If I were going to practice in a third world area, I'd want to do my residency in an area that will help me most for what I'm going to be dealing with. I'd probably be more interested in family medicine, as it'd give me experience in ob/gyn, peds, medicine, and surgery.

3. As to your question on how a residency director would feel if you are ambivalent as to what you want to practice and why - I have a few thoughts. First, you should be honest during your intervews. If you are undecided, you should not tell people you know exactly what you want to do, but you don't have to advertise that you are undecided either. I would try to better clarify what it is you want to do before you interview, or at least what questions you want answered to help you decide what you want to do. When I interviewed, I was pretty sure why I was interested in doing med-psych (and peds-psych-child psych which I also interviewed for). The irony is, what I thought I was interested in then is different than what I wound up interested in after residency. The general topics are still just as interesting, but what I had invisioned as my type of practice is not what I'm doing - at least not at this time.

Basically, your comment is right - solidity in answering comes from conviction. This comes mostly from honesty. But you should certainly be prepared to answer the common questions about why you are interested in what you are interviewing for, and what you plan on doing with that training.

Best of luck!

thanks a lot for the answer. its going to go a long way:)