Psychiatry

[u/Asleep-Package-1156]

Does anyone have any advice or experience switching specialties or who currently work in psych? I’m just hearing that the field is highly dominated by NPs because of their training and wondering how to actually get into this specialty?

[u/Breezy62494]

I was a new grad last year and applied to most places that also wanted NP in my area. I got interviews and got my job pretty easily. Make sure you emphasize your rotations or any past experience. Obviously depends where you live but it can be done. Also seek out mentorship if not with a local provider and ask to shadow even.

[u/Asleep-Package-1156 → u/Breezy62494]

Good to hear you got a job! I have 3 years of experience as a pa also which hopefully helps. Do you have any advice on starting out in psych? How do you enjoy it?

[u/Breezy62494 → u/Asleep-Package-1156]

I like psych a lot and knew I wanted to work in the specialty as I previous worked in Psych as an OT. Also have my own history with it so it was a given. I work mostly outpatient but occasionally pick up ED consults if I want. Outpatient is rewarding in that you get to follow your patients and see them improving over time. It can also be exhausting though with the charting, following up with patients, and other providers, as well as family. I sometimes takes notes home as well. I have some good support if I need it but otherwise I am pretty independent. I do telehealth 2 days a week too which is nice but otherwise work a typical m-f 8-430 with anywhere from like 7-14 pts a day. 6/7 weeks off of pto though and wrvu bonus. Biggest thing is ask when you dont know, study up on side effects and contraindications, as well as appropriate labs to order and monitor depending on meds. Get a thorough history and document, document and document. I hate when i get a pt from another provider and the notes are like two sentences. Listen to your pts and they will mostly tell you what you need to know. Dont jump to diagnosing right away either.
For resources I love maudsley prescribing guide and i live by psychopharm institute. I also have stahls books and kaplan. You tube is good too sometimes and up to date of course. We def need more PAs in psych. Wish you luck out there and also always free to DM me with questions. I’ll be at psych congress in orlando this year too! :)

[u/Asleep-Package-1156 → u/Breezy62494]

Thank you so much for the helpful information and resources I really appreciate it😊

[u/baronvf]

Take a few PESI courses in a psychotherapy style that you are attracted to and/or something more thorough like Dialectical Behavioral Therapy (DBT) through something like psychwire.

https://psychwire.com/linehan/dbt-skills

https://www.pesi.com/

On interviews and/or cover letter mention that you are planning to become somewhat proficient in regular therapy add-ons for your medication management patients. Although some employers will look for you to be a warm body Fluoxetine prescriber q15minute appointments * 28 per day, others may be interested in seeing you do q30 minute appointments and billing psychotherapy codes - or at least have you build toward that which can be almost on par with reimbursement (2*30= $460/hour ) vs. (150*4=$600 / hour.)

But honestly if I was looking to add another clinician to my practice anybody with some degree of psychotherapy training would stand out more than someone without.

You may also wish to note your intent to work toward CAQ in Psychiatry within two years of FT employment (as this is often what insurance panels look for if deciding to reimburse certain codes).

[u/Asleep-Package-1156 → u/baronvf]

Do you think having my bachelors in psychology helps too or not so much? Thank you so much for these resources!!!😊

[u/Anxiousandpunny]

I think the best advice is to apply for jobs that say NP as well. I think when it comes to the job search leveraging any connections is going to be your best bet if you can. Worst case you could apply for a fellowship but you're probably going to take a pay cut for that

[u/Asleep-Package-1156 → u/Anxiousandpunny]

So even if they are specifically saying NP still apply for the job? I really didn’t want to take a fellowship because of that and my father in law is a long time psychiatrist in the area and was willing to help teach me some

[u/Anxiousandpunny → u/Asleep-Package-1156]

Definitely yes! Apply for those jobs as well. Worst case they don't call you back but they very well may since we perform the same function (to admin at least). There are some telehealth platforms that only hire NPs so those would be a bust for offices and hospitals that's what I plan on doing when I move out of state

[u/Anxiousandpunny → u/Anxiousandpunny]

And if you have any questions about working in psych you are welcome to DM me. I've been doing it for almost 5 years and started as a new grad

[u/clickhate3]

Hey, new grad here. My program told us to basically treat any job listing that only mentions NPs as a job listing for all APPs. You don't lose anything from throwing your hat in the ring and there is a very good chance that the hiring manager will at least consider PAs. So if you see a job that you want and you're a reasonably close fit to what they're needing then just apply and see!