Additionally, while psychologists are technically the only ones who can do psych assessment, that is slowly changing, as social workers recently won the right to purchase IQ assessment instruments. Also, the Rorschach can technically be used by psychiatrists (or anyone) who has gone through psychoanalytic training at a psychoanalytic institute, which is completely separate from earning either a PhD or MD. However, psychoanalytic training is not very common outside of NY and CA nowadays, so most psychiatrists don’t learn the Rorschach (which is of limited diagnostic value anyway).

Also, as MD’s, psychiatrists can admit and discharge a patient from a hospital. PhD’s, even if working at a hospital, cannot. Thus, if a PhD has a private patient who is suicidal, they still need to have an MD at the hospital admit them.

I’m not sure where he ended up. I think he was going for Family Practice, but the last I heard (years ago), he didn’t Match and had to scramble for a residency spot.

On the other hand, if you decide to go into private practice, you aren’t board-certified, so you’ll get paid a lot less, and as you pointed out, malpractice is much higher.

These days, technically once you complete an internship (aka the first year of residency, aka the first year after graduation from med school) and pass the final step of the USMLE (step 3, the first two coming during medical school), you can become licensed. If you want to become trained in a specialty — any specialty, including the primary care specialties of internal medicine, pediatrics, and family medicine — you have to do your residency in that specialty. People used to joke during residency about leaving clinical medicine to go work for a company in a capacity as medical doctors, which I believe you could do after your internship. You wouldn’t see any patients, but people would pay you for your “expertise” as a doctor. People used to say if you wanted to, you could “hang up a shingle” and start seeing patients as someone who only finished an internship… I don’t know about this whole idea… it could be an urban legend. If it does really happen, I imagine malpractice insurance would be crazy expensive (and rightly so, as this hypothetical person who never did a residency would be under-trained).

Alberto, I guess I can’t categorically say that only psychologists can administer and interpret the Rorschach; possibly there is some specialized training that non-psychologists can get for that. But the test has been developed, studied, and administered primarily by psychologists. I have never heard of a psychiatrist (or anyone besides a psychologist) giving a Rorschach test as this is traditionally the psychologist’s bailiwick. In the setting of criminal justice, the person administering the test would generally be a forensic psychologist.

One thing I left off my original comment but should be in there for completeness’ sake: advanced practice nurses with specialized training can also provide mental health care, including medications, but also psychotherapy (joining the group of psychiatrists, psychologists, social workers, and the rare EdD that provide psychotherapy).

That reminds me of Dr. Malcolm Long, Rorschach’s shrink in prison… As I recall it, I always thought he was a psychiatrist. But I might be wrong.

Does someone have Watchmen at hand to take a look and see how Alan Moore refers to him?

At the time this comic came out (when was that, by the way?) was it necessary (as it seems to be now) to go through an internship and residency? Along the lines of BPK’s suggestion, maybe Brother Vodoo has a PhD in Psychology and a simple MD (graduated from medical school). Would that qualify him to give medications? Perhaps after getting his MD he decided that he preferred research to practice. To run one’s own research it is necessary to get a PhD. Or if he went through the residency who’s to say that it was in psychiatry? Another question might be whether in Haiti at the time of the comic, it was possible to get one’s hands on medication whether or not one is an MD.

In vet med it is still rather uncommon to go through internships and residencies. Most vets are practicing having just had the 4 years of vet school. Would anyone care to comment on when it became obligatory and common to go through an internship and residency after getting the MD? I’m really curious.

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