I've got an idea! How about you first perform a complete physical examination to identify any scars or evidence of a traumatic injury - beginning with examination of every male's penis to see if he was circumcised. Circumcision is sexual torture and every circumcised male is a tortured soul, whether he remembers it or not.
The amount of passion you have for your field and to better help your patients is inspiring. Glad to see you expressing your frustrations about the system AND doing something about it by actively learning more yourself, ignoring what people say. You’re an amazing doctor.
I'm from Germany and over here all psychiatry residents have to rotate into neuro for 12 months and all neurology residents have to rotate into psychiatry for 12 months. I didn't know it was so different in other countries. Interesting
I'm a neurology resident and was honestly prepared to fight whatever you were about to say -- until I actually hit 'play'. You're such a refreshing and inspiring human!! Thank you for wanting to be a genuinely good doctor.
My son matched in psychiatry last week in NY and now I know why digs your videos so much. I hope , and I think he does, he shares your passion for wanting to improve mental health and for wanting to make positive contributions in the field of Psychiatry.
Yes!! Imagine if, instead of cardiologists, we had docs that only treated heart problems and docs that only treated vascular problems with minimal overlap in their training. This is a big reason why I want to either do neuro with a behavioral fellowship or psych with a neuropsych fellowship once I finish med school.
I'm really grateful that you discussed this issue a bit because I've been really frustrated with the separation of psychiatry and neurology despite so much overlap. I suffer with psychiatric illnesses as well as a brain cyst. Every time I ask a psychiatrist about options the response is along the lines of "I'm not a neurologist," but every time I ask a neurologist about options the response is "I'm not a psychiatrist." I am aware of neuropsychiatrists, but it feels like as a subspecialty it isn't as accessible to the large population of people with conditions that have these overlaps. I'm happy to see that doctors going into these fields, or at least you, are trying to get even a little more training to better serve your patients.
Good point. Oliver Sacks talked about how the abstract and concrete parts of the brain are both integral and this is a perfect real world example of that.
The best psych attending i worked with was a double boarded IM and psych. He was able to catch stuff that the primary team missed by banking on that extra IM training and bridging it wirh the psych training. It was super cool.
It's great to see this! As a neuro PGY-3 now, I work with a lot of psychiatry residents that don't care about the neuro rotation. Thanks for having this attitude.
Hey Preston, just wanted to say I really really enjoy your content, both the comedic and insightful. It's nice to see a Doctor so fully embracing their career, mocking the ridiculous but also unafraid to challenge the status quo. Sincerely, a fan ❤
Preston.... I love you! Neuro resident here who's going into FND! Guess what I'm doing this weekend. Attending a retreat on psychotherapy 😂 guess what I'm doing on a lot of my electives next year.... Yup Psych. I hope my screening for trauma is more than just "got drama, got trauma, got milk?" But tbh it very well might not be much more than that... YET. But I'm working on it! I'd like to think with the right motivation people like you and I can bridge the gap. 🥰 Thanks for another great video brother (in arms ☺️). Maybe I'll see you out there.
Haha aww thanks. ☺️ I'm actually doing my KAP training now. I've done a few psychotherapy trainings but I'm excited about the capacity of KAP to help with FND, Chronic Headache and pain, phantom limb. Obviously not a cure-all but an important tool. Anyway, I love your stuff. Love your appreciation for the intersection between psych and neuro. Would love to talk shop at some point if you're down. But obviously I know you're super busy with residency and being a star and all 😊 haha. Keep the videos coming!
Friend of mine did a full residency in neurology, decided he needed to know more about psychosomatic disorders, so he did another full residency in psychiatry, and is my go to for referring some of my FND patients (I'm neurologist). Also: when I had an active role teaching residents and students, the ever-shorter exposure of IM and psych to neurology was a perpetual source of frustration. You can tell from the quality of consult requests just how much less the hospitalists know about neurology than a couple decades ago. You're doing the right thing, and it will be a service to your patients!
It's not called psychosomatic any more. And for good reason. It contributes to the continuing huge stigma ( even amongst neurologists buy across the board) and the corresponding lack of care, resources, specialised clinics, knowledge and skill that stigmas throughout medical history have always been associated with. The consensus is functional neurological disorder now. Or functional disorder if it's in another body system. Its not conversion, it's not psychosomatic it's definitely not hysteria, factitious, hypochondria or any of those previous incorrect and dismissive terms. Thank you🙏
@belleheywood7109 I agree, and I use the term functional now. I also take care to explain to pts that they may be exposed to outdated concepts. I also continue to follow and treat my FND patients, even though i may be in the minority (many neurologists seem to believe their involvement ends with the dx). FND is way more complex than we had ever known. I used the term because, in the late 1980s when my friend was making this career choice, that conceptual framework was dominant and thus relevant. You are correct in pointing out that I was a bit too casual with an outdated term and I probably ought to have been more careful.
[Derived from the 'Introduction' to 'The Man Who Mistook His Wife for a Hat'] "...the mid-1980s...this has been a time when neurology has not only undergone an apparent revolution...but during which its partial agonist, psychology, seems to have ceded to much of its own fiefdom of understanding. But if we stand back from the claims of contemporary neuroscience to explain the human condition, we can see that substantively the picture hasn't altered one jot- or, rather, it's only to reinforce a 'soul-less neurology' and a 'bodiless psychology', one decoupled from any holistic consideration of the individual (i.e.; a philosophy of "empiricism")" All this only to imply that you're ABSOLUTELY right. There is a serious need for more overlap and training across related specialties, as you've succinctly put, "it's right there!" It's inspiring as a neurology residency applicant to know that a wave of upcoming physicians are truly dedicated to this field, despite all the hardships that come with it- we ARE a resilient generation of physicians guys 💪🏻💪🏻 Good luck with your future rotations Doc! I sincerely hope your efforts succeed in enhancing your knowledge and aiding you to provide the best possible care and get you ahead of the curve with efficient patient management! Your patients will be grateful :)
Dang bro i re-watched this and substituted ophthalmology with psychiatry and felt the same discontent with neuro training and ophtho training. the more our fields specialize, the further we become. Sometimes even the most BASIC of skills (checking vision one eye at a time, confirming bioncular vs monocular diplopia becomes challenging.. forget getting a good fundus exam. Our reliance on consulting other services, our concerns for medical-legal ramifications, the complexity of our fields, the system preventing us from training with one another, and partly our own fear from honing these valuable skills are all contributory. Lovely to see your passion in expanding your comfort, and I hope I can learn from this too.
Hey, I’m a 2nd year doctor in England and I’ve really been thinking about leaving medicine but your videos make me feel better about it ❤️ your enthusiasm is infectious (not in the ID way), thanks man x
Current MS2 (about to take step 1 in a few weeks 🙃) and while I’m not in residency, I feel that I can definitely relate to the sentiment. So far, medical school has felt so much like a ‘Jack of all trades, master of none’ situation where we learn enough information to meet whatever standards the NBME sets, but inevitably fall short of a more concrete or nuanced understanding of the specialty we’re covering for however many weeks. I’m sure going through rotations soon will ameliorate some of this, but I definitely can relate to the frustration of wanting to do more for a patient but being limited by how disconnected training in certain areas can be. I say this as someone wanting to go into pathology lol
Thank you! Thank you for being able to think and see how to help patients. Too many providers see black and white when it comes to where the treatment lines fall even when presented with evidence that it might be different.
Really cool to see you explore the neuro / psych boundary more, and thanks for coming back with this style of content! Your comedy was unparalleled but so are your insights:)
As a patient I appreciate a doctor who wants to learn more to better help their patients. I've had a PCP who decided to stop my 120 mg Cymbalta (on it for over ten years) cold turkey since I said I didn't think it was helping for pain. I begged for a taper down but he ignored me and refused. Within 3 weeks I ended up on involuntary psych hold from an attempt on my life. An obgyn told me any symptoms during a period besides just bleeding were psychosomatic and had to be dealt with psych. I said I know for a fact prostaglandin causes cramps due to uterus contractions and causes period poops and other things and it's not just all in my head its actual hormones causing actual physical responses. I'm sick of doctors who aren't well informed and pass the buck. Just this week neurology told me on Tuesday that my erythromelalgia needs to be treated by rheumatology and on Friday rheum said no it's neuro's problem. As a patient that drives me crazy (lol, making me now psych's problem due to medical trauma dealing with this crap system).
Props to you wanting to learn as much as possible to be the best doctor possible for your patient. Your charisma and whit is inspiring. Clinical practice is consuming.
I’m a radiology resident and while I’m really happy with where I’m at, your videos do make me miss the clinical days. Rad is pretty isolated from other specialties and generally self-sufficient, so it’s cool to be reminded of the clinical crossover between specialties like Neuro/Psych and how much their respective clinical assessments affect the same patient’s health.
@@itspresro It's healthygamergg, it's a big channel. I'll try and find the specific episode. I think he had a lot of patients referred to him with addictions and got good results dealing with the underlying trauma. Your general reasoning in your video seems to resonate his thinking. Sounds like you are the type of health professional we need more of, good luck on your journey.
My neurologist is also a psychiatrist. Dual board certified. I have a neurological disease and he said it’s incredibly comorbid with psych issues (mine is anxiety). Which DUH. Obviously. That makes no sense that you don’t get more time in Neuro n
As a parent to two adopted boys with developmental trauma, attachment issues, an alphabet soup of diagnoses that may or may not be accurate, including possible FASD…. Let me know where you’re practicing psychiatry when you’re done with training and I will fly my children to see you. 😂🎉 thank you for caring!
I love that you started aggro but increasingly talked yourself into being more solution oriented. I wish a more comprehensive approach to complex issues was the norm in health care.
Oh no the patients is pregnant What should we do?!?! Just call ob gyne doesn't matter what disease she has just throw it at ob gyne Sub specialty is great for quality care the problem is what if the patient has a problem that requires multiple specialty? Now what Have family medicine lead everyone in a multideciplanry approach?
“MVC vs ped pt s/p hemicraniectomy due to subdural hemorrhage. Seen stiffening on seen concern for seizure given versed and loaded with 2g keppra for post traumatic sz prophylaxis. Neuro consult for EEG interpretation, seizure rule out and AED recs.” Has consistently been my only interaction with neurosurgery
Pretty sure I heard at one point about some folks pushing for psychiatry and neurology being lumped together into a single residency. Would you be down?
Hi! I would LOVE to hear your thoughts on combined training. Specifically what your thoughts were before residency and now. Im a 4th year applying combined FM/Psych and psych and would love to hear your take. Thanks!!!!! 🙏
Having just finished psych residency, you will definitely learn enough neurology through your 4 years. You dont need to waste several months doing neuro scut work; youll learn the aspects that are relevant to our job best by doing our job.
Please let us know what your program director says! I feel like this is the case for a number of medical disciplines and if you have the motivation and option to do it, that should totally be accessible. Thanks for sharing homie 🙂
I am sure you already know but this is why combined neurology/psychiatry residencies exist!! This is exactly the sort of thought that lead to those programs!
Thank goodness there’s someone who cares out there! I feel like neurology completely cuts off the head. I tried to see one once because ADHD is one of those borderline disorders just to see if there was anything I missed because I was having trouble finding the right treatment and meds, and he was so mean and abrasive I went back to my psychiatrist who happens to be on the board of neurology as well as psychiatry. My psychiatrist is good, but it feels like it’s really throwing darts in the dark. I have treatment resistant bipolar disorder and anxiety. I’m also gifted. Could it just be none of any of those and I could be autistic? Well isn’t that just a can of worms? 😂 I’m not totally sure, as ADHD and being a sensitive smart person have overlapping symptoms. Is it really depression if I’m just overly aware of the vastness of space and our finite existence plus I have perimenopause so I cry a lot? Anyhoo, yeah, psychiatrists have people skills. It’s on a sliding scale. The less drugs a mental health professional can throw at it, the better the people skills. Psychologists, therapists and social workers are nicest. ❤
Can you give advice for a US medical student who Who fail to match psychiatry this cycle? Definitely not a strong applicant academically, but my whole application was psychiatry focused with no red flag. Honestly I cannot see myself doing anything other than psych
Man thats so cool how you have that kind of flexibility with your education/training. Would you, in an ideal world, envision a combo neuro/psych speciality?
In an ideal world I want 3-6 months of IM and a full year of neuro broken up over residency. The psych fourth year has a lot of flexibility and BS (a lot of people think it isn’t needed). So I would that extra space to fill with important extra training imo
You are dead right. I have FND..After 35 years involvement with the mental health profession with everything it having done making things worse to the point whereby it turned my life into a living hell I found out what I have from a lead from the media.
Hahaha I really appreciate it but I mostly just want to feel competent. We’ve have so many complex neuro cases with insane psych overlap this week and I just keep thinking “I need to know more neuro dude”
I have waited years to hear this and been saying it for years. In my experience psychiatrists are dropout doctors and psychologists and unintelligent ineffective people getting to call themselves doctors.
Thank you. Awesome! And, IF ONLY all doctors HAD to do extensive trauma-informed study. Do you feel medicine treats any hint of trauma with dismissiveness pure and simple, or based on this that you share here in this video, do you feel it actually comes from ignorance and lack of training ...? If you can help doctors in other fields in any way in regard to trauma then you are definitely doing a great service to patients.🙏
Dont worry. They are teaching neurology residents to diagnose every neurological condition as "migraines" so youre not missing much. Neurologists are going to refer all their stroke patients its "all in their head" and refer right over to you anyways. The vast majority of practicing neurologists act like they never went to medical school.
just go practice in some backwoods rural area, you'll be the only doctor for hundreds of miles, you'll be the OBGYN, you'll be the pediatrician, you'll be the drug counselor, you'll be the therapist, you'll be the oncologist who mixes the chemo and gives the patient a seven-hour infusion of drugs while they're watching Animal Planet on your living room couch
The overlap in patients with epilepsy and PNES has always made me want to understand neuro better.. I think asking to do neuro rotations during psych residency is a good idea maybe I’ll ask too 😅
And you can’t undersell the overlap between bipolar and epilepsy. Not to mention managing either with depakote, lamictal, possibly oxcarb like at the very least getting better at prescribing neuro meds the way neurologists do
@@itspresro Yes. Also.. I don't want to become the psychiatrist who awkwardly does nothing while waiting for Neuro to arrive during a code stroke on inpatient [eek] Idk about you but I had some difficulty picking between Neuro and Psych for residency
Not exactly sure how rotating on the neuro service solves the problem your complaining about... did you watch your this video again after you posted it?
Do you have liaison psychiatry in the US? It pretty much covers the interface you have alluded to. Also you seem kind of hyper and slightly destabilised right now
As a neuro resident, my reaction was the same as those in your program.
As a chemistry major seeking a PhD in pharmacology, my reaction was one of surprise.
I've got an idea! How about you first perform a complete physical examination to identify any scars or evidence of a traumatic injury - beginning with examination of every male's penis to see if he was circumcised.
Circumcision is sexual torture and every circumcised male is a tortured soul, whether he remembers it or not.
The amount of passion you have for your field and to better help your patients is inspiring. Glad to see you expressing your frustrations about the system AND doing something about it by actively learning more yourself, ignoring what people say. You’re an amazing doctor.
I'm from Germany and over here all psychiatry residents have to rotate into neuro for 12 months and all neurology residents have to rotate into psychiatry for 12 months. I didn't know it was so different in other countries. Interesting
Wow, that is great!
That is incredible. It just makes sense! Wow good to know!
In Brazil they have 1 month and in Argentina there’s no rotation into neuro at all
I'm a neurology resident and was honestly prepared to fight whatever you were about to say -- until I actually hit 'play'. You're such a refreshing and inspiring human!! Thank you for wanting to be a genuinely good doctor.
As a neuro resident i feel the same as you about my psych rotations
My son matched in psychiatry last week in NY and now I know why digs your videos so much. I hope , and I think he does, he shares your passion for wanting to improve mental health and for wanting to make positive contributions in the field of Psychiatry.
Yes!! Imagine if, instead of cardiologists, we had docs that only treated heart problems and docs that only treated vascular problems with minimal overlap in their training. This is a big reason why I want to either do neuro with a behavioral fellowship or psych with a neuropsych fellowship once I finish med school.
This exists. Vascular surgery and cardiology
what?
I'm really grateful that you discussed this issue a bit because I've been really frustrated with the separation of psychiatry and neurology despite so much overlap. I suffer with psychiatric illnesses as well as a brain cyst. Every time I ask a psychiatrist about options the response is along the lines of "I'm not a neurologist," but every time I ask a neurologist about options the response is "I'm not a psychiatrist." I am aware of neuropsychiatrists, but it feels like as a subspecialty it isn't as accessible to the large population of people with conditions that have these overlaps. I'm happy to see that doctors going into these fields, or at least you, are trying to get even a little more training to better serve your patients.
Good point. Oliver Sacks talked about how the abstract and concrete parts of the brain are both integral and this is a perfect real world example of that.
The best psych attending i worked with was a double boarded IM and psych. He was able to catch stuff that the primary team missed by banking on that extra IM training and bridging it wirh the psych training. It was super cool.
Do you have any specific examples regarding this? Very interesting tho
It's great to see this! As a neuro PGY-3 now, I work with a lot of psychiatry residents that don't care about the neuro rotation. Thanks for having this attitude.
Hey Preston, just wanted to say I really really enjoy your content, both the comedic and insightful. It's nice to see a Doctor so fully embracing their career, mocking the ridiculous but also unafraid to challenge the status quo. Sincerely, a fan ❤
Preston.... I love you! Neuro resident here who's going into FND! Guess what I'm doing this weekend. Attending a retreat on psychotherapy 😂 guess what I'm doing on a lot of my electives next year.... Yup Psych. I hope my screening for trauma is more than just "got drama, got trauma, got milk?" But tbh it very well might not be much more than that... YET. But I'm working on it! I'd like to think with the right motivation people like you and I can bridge the gap. 🥰 Thanks for another great video brother (in arms ☺️). Maybe I'll see you out there.
Hahaha I’m sure your interview skills are top tier if you’re attending a psychotherapy retreat! That’s above and beyond even for a psych resident
Haha aww thanks. ☺️ I'm actually doing my KAP training now. I've done a few psychotherapy trainings but I'm excited about the capacity of KAP to help with FND, Chronic Headache and pain, phantom limb. Obviously not a cure-all but an important tool.
Anyway, I love your stuff. Love your appreciation for the intersection between psych and neuro.
Would love to talk shop at some point if you're down. But obviously I know you're super busy with residency and being a star and all 😊 haha.
Keep the videos coming!
Friend of mine did a full residency in neurology, decided he needed to know more about psychosomatic disorders, so he did another full residency in psychiatry, and is my go to for referring some of my FND patients (I'm neurologist).
Also: when I had an active role teaching residents and students, the ever-shorter exposure of IM and psych to neurology was a perpetual source of frustration. You can tell from the quality of consult requests just how much less the hospitalists know about neurology than a couple decades ago.
You're doing the right thing, and it will be a service to your patients!
It's not called psychosomatic any more. And for good reason. It contributes to the continuing huge stigma ( even amongst neurologists buy across the board) and the corresponding lack of care, resources, specialised clinics, knowledge and skill that stigmas throughout medical history have always been associated with. The consensus is functional neurological disorder now. Or functional disorder if it's in another body system.
Its not conversion, it's not psychosomatic it's definitely not hysteria, factitious, hypochondria or any of those previous incorrect and dismissive terms.
Thank you🙏
@belleheywood7109 I agree, and I use the term functional now. I also take care to explain to pts that they may be exposed to outdated concepts. I also continue to follow and treat my FND patients, even though i may be in the minority (many neurologists seem to believe their involvement ends with the dx). FND is way more complex than we had ever known.
I used the term because, in the late 1980s when my friend was making this career choice, that conceptual framework was dominant and thus relevant. You are correct in pointing out that I was a bit too casual with an outdated term and I probably ought to have been more careful.
[Derived from the 'Introduction' to 'The Man Who Mistook His Wife for a Hat']
"...the mid-1980s...this has been a time when neurology has not only undergone an apparent revolution...but during which its partial agonist, psychology, seems to have ceded to much of its own fiefdom of understanding. But if we stand back from the claims of contemporary neuroscience to explain the human condition, we can see that substantively the picture hasn't altered one jot- or, rather, it's only to reinforce a 'soul-less neurology' and a 'bodiless psychology', one decoupled from any holistic consideration of the individual (i.e.; a philosophy of "empiricism")"
All this only to imply that you're ABSOLUTELY right. There is a serious need for more overlap and training across related specialties, as you've succinctly put, "it's right there!"
It's inspiring as a neurology residency applicant to know that a wave of upcoming physicians are truly dedicated to this field, despite all the hardships that come with it- we ARE a resilient generation of physicians guys 💪🏻💪🏻
Good luck with your future rotations Doc! I sincerely hope your efforts succeed in enhancing your knowledge and aiding you to provide the best possible care and get you ahead of the curve with efficient patient management! Your patients will be grateful :)
good luck, you're an inspiration man
I have such mad respect and appreciation for the compassion and enthusiasm you have for psyc/mental health/anything related to the brain. Thank you
Me with sometimes non-corresponding MS symptoms and a boatload of trauma: *chuckles* I'm in danger
Dang bro i re-watched this and substituted ophthalmology with psychiatry and felt the same discontent with neuro training and ophtho training. the more our fields specialize, the further we become. Sometimes even the most BASIC of skills (checking vision one eye at a time, confirming bioncular vs monocular diplopia becomes challenging.. forget getting a good fundus exam. Our reliance on consulting other services, our concerns for medical-legal ramifications, the complexity of our fields, the system preventing us from training with one another, and partly our own fear from honing these valuable skills are all contributory. Lovely to see your passion in expanding your comfort, and I hope I can learn from this too.
This is so true. There's so much institutional inertia keeping these 2 obviously linked specialties apart for no good reason.
Hey, I’m a 2nd year doctor in England and I’ve really been thinking about leaving medicine but your videos make me feel better about it ❤️ your enthusiasm is infectious (not in the ID way), thanks man x
Solution: combined neuro psych residency that’s 8 years long
Current MS2 (about to take step 1 in a few weeks 🙃) and while I’m not in residency, I feel that I can definitely relate to the sentiment. So far, medical school has felt so much like a ‘Jack of all trades, master of none’ situation where we learn enough information to meet whatever standards the NBME sets, but inevitably fall short of a more concrete or nuanced understanding of the specialty we’re covering for however many weeks. I’m sure going through rotations soon will ameliorate some of this, but I definitely can relate to the frustration of wanting to do more for a patient but being limited by how disconnected training in certain areas can be.
I say this as someone wanting to go into pathology lol
Thank you! Thank you for being able to think and see how to help patients. Too many providers see black and white when it comes to where the treatment lines fall even when presented with evidence that it might be different.
Really cool to see you explore the neuro / psych boundary more, and thanks for coming back with this style of content! Your comedy was unparalleled but so are your insights:)
As a patient I appreciate a doctor who wants to learn more to better help their patients.
I've had a PCP who decided to stop my 120 mg Cymbalta (on it for over ten years) cold turkey since I said I didn't think it was helping for pain. I begged for a taper down but he ignored me and refused. Within 3 weeks I ended up on involuntary psych hold from an attempt on my life.
An obgyn told me any symptoms during a period besides just bleeding were psychosomatic and had to be dealt with psych. I said I know for a fact prostaglandin causes cramps due to uterus contractions and causes period poops and other things and it's not just all in my head its actual hormones causing actual physical responses.
I'm sick of doctors who aren't well informed and pass the buck. Just this week neurology told me on Tuesday that my erythromelalgia needs to be treated by rheumatology and on Friday rheum said no it's neuro's problem. As a patient that drives me crazy (lol, making me now psych's problem due to medical trauma dealing with this crap system).
Props to you wanting to learn as much as possible to be the best doctor possible for your patient. Your charisma and whit is inspiring. Clinical practice is consuming.
You seriously deserve a bigger following than you have. Enjoying the content, Prestion, keep it up!
I’m a radiology resident and while I’m really happy with where I’m at, your videos do make me miss the clinical days. Rad is pretty isolated from other specialties and generally self-sufficient, so it’s cool to be reminded of the clinical crossover between specialties like Neuro/Psych and how much their respective clinical assessments affect the same patient’s health.
I'm really appreciating more of these more personal videos you've been putting out. Keep it coming.
Your friendly neighborhood EM/CCM nerd :)
I remember the psychiatrist with the healthy gamer channel discussed this, not a lot of joined up thinking across medical specialisation.
What’s his channel?
@@itspresro It's healthygamergg, it's a big channel. I'll try and find the specific episode. I think he had a lot of patients referred to him with addictions and got good results dealing with the underlying trauma. Your general reasoning in your video seems to resonate his thinking. Sounds like you are the type of health professional we need more of, good luck on your journey.
1:15 and I’m paraphrasing here, ever been traumatized?! 😹😹😹
My neurologist is also a psychiatrist. Dual board certified. I have a neurological disease and he said it’s incredibly comorbid with psych issues (mine is anxiety). Which DUH. Obviously. That makes no sense that you don’t get more time in Neuro n
As a parent to two adopted boys with developmental trauma, attachment issues, an alphabet soup of diagnoses that may or may not be accurate, including possible FASD…. Let me know where you’re practicing psychiatry when you’re done with training and I will fly my children to see you. 😂🎉 thank you for caring!
Really cool and good idea! Just be careful you don’t suffer subject burnout
**Neuropsychiatry sweating between the two**
I love that you started aggro but increasingly talked yourself into being more solution oriented. I wish a more comprehensive approach to complex issues was the norm in health care.
Do a fellowship in behavioral neurology and neuropsychiatry
Thank you.
Keeping being You.
Oh no the patients is pregnant
What should we do?!?!
Just call ob gyne doesn't matter what disease she has just throw it at ob gyne
Sub specialty is great for quality care the problem is what if the patient has a problem that requires multiple specialty? Now what
Have family medicine lead everyone in a multideciplanry approach?
Neuropediatric resident here, I have the same exact feeling.
I have functional Neurological disorder. Please do this!! Please. The mind body disconnection is awful to navigate.
Psychiatrist here. I feel the same about Internal Medicine rotations. Why only two months? It should be two months per year!
neurologist here. Mad respect to you. But its a life long learning commitment theres lots of great psych electives to do as well
This is why I enjoy geriatric psychiatry so much, have to keep the neurology and medicine hats on while still getting to be a psychiatrist.
"always neurology and never neurology" - my career in neurosurgery.
“MVC vs ped pt s/p hemicraniectomy due to subdural hemorrhage. Seen stiffening on seen concern for seizure given versed and loaded with 2g keppra for post traumatic sz prophylaxis. Neuro consult for EEG interpretation, seizure rule out and AED recs.” Has consistently been my only interaction with neurosurgery
Pretty sure I heard at one point about some folks pushing for psychiatry and neurology being lumped together into a single residency. Would you be down?
Yeah honestly. I think we should spend the first 2 years together and then track out
@@itspresrothis is a very interesting idea
Hi! I would LOVE to hear your thoughts on combined training. Specifically what your thoughts were before residency and now. Im a 4th year applying combined FM/Psych and psych and would love to hear your take. Thanks!!!!! 🙏
Sounds like a neuropsychiarrist in the making! 😉😉
Yeah honestly I could see it
Having just finished psych residency, you will definitely learn enough neurology through your 4 years. You dont need to waste several months doing neuro scut work; youll learn the aspects that are relevant to our job best by doing our job.
Yeah.... you nailed it.
Please let us know what your program director says! I feel like this is the case for a number of medical disciplines and if you have the motivation and option to do it, that should totally be accessible. Thanks for sharing homie 🙂
I am sure you already know but this is why combined neurology/psychiatry residencies exist!! This is exactly the sort of thought that lead to those programs!
Thank goodness there’s someone who cares out there! I feel like neurology completely cuts off the head. I tried to see one once because ADHD is one of those borderline disorders just to see if there was anything I missed because I was having trouble finding the right treatment and meds, and he was so mean and abrasive I went back to my psychiatrist who happens to be on the board of neurology as well as psychiatry.
My psychiatrist is good, but it feels like it’s really throwing darts in the dark. I have treatment resistant bipolar disorder and anxiety. I’m also gifted. Could it just be none of any of those and I could be autistic? Well isn’t that just a can of worms? 😂
I’m not totally sure, as ADHD and being a sensitive smart person have overlapping symptoms. Is it really depression if I’m just overly aware of the vastness of space and our finite existence plus I have perimenopause so I cry a lot?
Anyhoo, yeah, psychiatrists have people skills. It’s on a sliding scale. The less drugs a mental health professional can throw at it, the better the people skills. Psychologists, therapists and social workers are nicest. ❤
Wow this explains a lot
Can you give advice for a US medical student who Who fail to match psychiatry this cycle? Definitely not a strong applicant academically, but my whole application was psychiatry focused with no red flag. Honestly I cannot see myself doing anything other than psych
It’s the bulging neck veins from anger for me.
Would love to connect as an art psychotherapist that is currently in practicum with a focus on neurological function disorder
Hey! Reach out to askpresro@gmail.com
As a med student applying psych, would you recommend searching for residencies that have more Neuro exposure?
Man thats so cool how you have that kind of flexibility with your education/training. Would you, in an ideal world, envision a combo neuro/psych speciality?
In an ideal world I want 3-6 months of IM and a full year of neuro broken up over residency. The psych fourth year has a lot of flexibility and BS (a lot of people think it isn’t needed). So I would that extra space to fill with important extra training imo
EVER HAD ANY TRAUMA????
Same board why not?
Preach Preston
I’m proud of you man
Love this
Is there an endocrinology rotation in your psychiatry residency?
Curious because of how endocrine issues can have psychiatric manifestations
ITS RIGHT THERE!!!!
You are dead right. I have FND..After 35 years involvement with the mental health profession with everything it having done making things worse to the point whereby it turned my life into a living hell I found out what I have from a lead from the media.
UH burns us all out! Lol
It’s hard out here
You're incredible, what the heck :)
Hahaha I really appreciate it but I mostly just want to feel competent. We’ve have so many complex neuro cases with insane psych overlap this week and I just keep thinking “I need to know more neuro dude”
I laughed my ass off at 1:20 thank you
if you don't have a patagonia vest were you really a resident?
Nope!
It's one semester of the psychiatry training in Germany I believe.
Are these
After your shifts
Before your shifts
In the midst of your shift?
This one was after
I have waited years to hear this and been saying it for years. In my experience psychiatrists are dropout doctors and psychologists and unintelligent ineffective people getting to call themselves doctors.
Psychiatry should be a fellowship after neurology residency.
The first time I had the use of my hands and when the brain fog lifted was when I got drunk. Diabolical parenting was the cause
Wise man
There will be quite a few portions you'll be surprised how little it's coveted.
PTSD and ADHD most definitely should be neurology based
sometimes an SLP's perspective can help!!
Look into proper
Methods: brainspotting, Deep Brain Reorienting, Internal Family Systems, LENS or EEGer neurofeedback
PSSD? Protracted whitrawal?
Neuropsychiatry for the win!
Wait until you find out how much neuro we get in FM
In my FM program we had 4 weeks
Are you accepting patients
Feel that way except with trauma icu
Psychiatry should be merged into Neurology in the future.
Thank you. Awesome! And, IF ONLY all doctors HAD to do extensive trauma-informed study.
Do you feel medicine treats any hint of trauma with dismissiveness pure and simple, or based on this that you share here in this video, do you feel it actually comes from ignorance and lack of training ...? If you can help doctors in other fields in any way in regard to trauma then you are definitely doing a great service to patients.🙏
ROCK AND ROLL
Holy shit does psychiatry training in the US take 4 years, wild.
Accurate
Dont worry. They are teaching neurology residents to diagnose every neurological condition as "migraines" so youre not missing much. Neurologists are going to refer all their stroke patients its "all in their head" and refer right over to you anyways. The vast majority of practicing neurologists act like they never went to medical school.
👏👏👏👏👏👏👏👏
just go practice in some backwoods rural area, you'll be the only doctor for hundreds of miles, you'll be the OBGYN, you'll be the pediatrician, you'll be the drug counselor, you'll be the therapist, you'll be the oncologist who mixes the chemo and gives the patient a seven-hour infusion of drugs while they're watching Animal Planet on your living room couch
how does this guy get through his days being outraged at every tiny little inconsistency or inefficiency. chill dude 80% rule brudda
You may be the person to bring about change. Look for a document called the Power Threat Meaning Framework.
The overlap in patients with epilepsy and PNES has always made me want to understand neuro better.. I think asking to do neuro rotations during psych residency is a good idea maybe I’ll ask too 😅
And you can’t undersell the overlap between bipolar and epilepsy. Not to mention managing either with depakote, lamictal, possibly oxcarb like at the very least getting better at prescribing neuro meds the way neurologists do
@@itspresro Yes. Also.. I don't want to become the psychiatrist who awkwardly does nothing while waiting for Neuro to arrive during a code stroke on inpatient [eek] Idk about you but I had some difficulty picking between Neuro and Psych for residency
Not exactly sure how rotating on the neuro service solves the problem your complaining about... did you watch your this video again after you posted it?
What’s the problem I’m complaining about?
❤
Do you have liaison psychiatry in the US? It pretty much covers the interface you have alluded to. Also you seem kind of hyper and slightly destabilised right now
Just finished a 6 day 75 hour week im running on empty lol