Dr. Cannavo,
You know what you would rather be doing.  What is the likelihood of applying for a
residency in psychiatry?  Have you thought about neurology and neuroscience
research ?

Ed Modestino

No doubt about it, NYC has a relative surplus of psychiatrists (and
psychologists) compared to other regions, BUT there is always a certain
amount of turnover...

Psychiatry is notoriously labor-intensive (as is Pediatrics), so not as
lucrative as some other medical specialties--although there are those
who do "psychopharmacology" on an assembly-line basis...

The real question is, however, what makes your life worth living on a
day-to-day basis?  What would you be willing to do even if you were NOT
paid to do it?

Given a stronger hard-core medical background than many psychiatrists,
"consultation-liaison" psychiatry in a hospital setting might make
sense; i.e., you would have a good background to keep in mind and deal
with general medical aspects of your patient, AND (very important in
this setting) deal with your patients' primary physicians.

If you're interested in neuroscience aspects, take a look at my posting
on "Bilingual Brains", regarding a presentation at The New York Academy
of Sciences, the evenning of March 30.

Oh--I forgot: you're a resident.  EM resident, at that.  No doubt you
need any spare time you can get just to sleep!

F. Frank LeFever, Ph.D.
New York Neuropsychology Group

As a psychiatrist who loves the field,  I say go for it.   But be prepared for
the following:

1) shrinks are often not as cerebral or reflective as they have a reputation
for being.  Some are (I'm an intellectual geek, myself),  but don't always
expect sparkling philosphical conversations with your colleagues.  You get real
intellectuals sometimes,  but I was very disappointed to discover they're not
so common.

2)  You LIKE paperwork?   I mean REALLY like paperwork?   With the new Medicare
rules, you discover that the Federal Goverment really HATES the mentally ill,
and if they make the shrinks write 3 minutes for every minute spent  actually
seeing an inpatient,  the shrinks will go away and the mentally ill will then
stop bothering them.  I suppose it's getting that way in all fields,  but in
psychiatry it's ridiculous.

3)  I suppose you see the mentally ill at their worst in the ER,  so it
shouldn't be a surprise when you get a borderline trying to hold you hostage
with her threats of self-destruction.  Actually,  borderline treatment is
pretty good "sport" if you have the right approach.  (Like the cardiologist I
had as an intern  who told me during a code,  "Look at this:  good sport!
Choose your sport.")   So, choose your sport.   Psychiatry is sort of like a
nice game of pen-pal chess.  Unless you do borderlines,  which more resembles
the Cuban Missle Crisis.

Pay:  not going up right now...   $120-150K,  (more if you're a workaholic or
are unethical) in places that don't have too many shrinks per square inch.
Less in places that have a funky vibe   (SF,  New Mexico),  or exude power (DC,
NY),  or any big metro area.  $200K if you don't mind working in the prison
system (Ohio prisons,  anyway).

Workload?   you can do 40-48  hour work-weeks if you really make the necessary
choices.  Like any field,  there's always more work to do if you let it dictate
to you.

It can be hectic,  and empathy is hard to dole out on a production line,  but
if you really want to hear what your patients are saying,  they will know it.
Besides,  You should understand hectic.

Good luck,

-Bolt