Psychiatrist vs. Psychologist: What’s the Difference?
The demand for mental health services is on the rise throughout America, but alongside this increase comes a significant deficit of providers. A 2018 report from the U.S. Department of Health and Human Services found that demand exceeds supply for both psychiatrists and psychologists in all regions. Because of this, regardless of whether you choose to pursue a career in psychiatry or psychology, you will be filling an incredibly important role.
While psychiatry and psychology are equally rewarding careers, the paths to get there are quite different. This page will provide resources and information to help you decide which is the best path for you. Learn the differences between psychology and psychiatry, information about salaries and job growth, options for specializations, and educational requirements.
Approaches to Treatment
The ultimate goal for both psychologists and psychiatrists is to improve their patients’ mental health. Because of that, there are some overlaps in the type of work they perform, but the approach can be very different—mainly due to the training and education involved.
Psychologists take an academic path into the mental health field, earning a doctoral degree. This approach takes a holistic perspective on mental health, focusing on patterns of behavior and emotional and personality development. The field of psychology is also quite broad, with many opportunities for specializations. While many psychologists work directly with patients in psychotherapy sessions, others might work from a more focused vantage point, such as those who specialize in business, international, or industrial-organizational psychology. Those in specializations often conduct research to understand consumer or workplace psychology and how it might affect a company’s processes rather than working one-on-one with patients.
Psychiatrists, on the other hand, are trained medical doctors who specialize in the mental health field. Like any medical doctor, they work directly with patients—in this case, evaluating and treating mental health disorders. Because psychiatrists have earned an M.D. or D.O. (Doctor of Osteopathic Medicine), they also can prescribe the medications used alongside psychotherapy, such as antidepressants, mood stabilizers, and stimulants. They may also refer patients to other mental health treatments, such as deep brain stimulation (DBS) or electroconvulsive therapy (ECT).
For patients seeking mental health intervention, their first referral will likely be to a psychologist. Through regular counseling sessions, a psychologist can provide patients with the tools needed for behavioral interventions. However, in many cases, they might also find that a patient needs medical intervention, usually through prescriptions. Most psychologists do not have prescribing authority. However, some states are beginning to allow psychologists to prescribe mental health medication with additional education and training. Their scope is still not as wide as a psychiatrist’s, though, and in most cases, if a psychologist deems a medical intervention is necessary, they will refer them to a psychiatrist for assessment.
Salaries and Job Growth
Psychologists earn a median annual salary of $79,010 (BLS, 2018), with job opportunities predicted to grow 14% between 2018-2028. Your chosen work environment will also affect your salary potential. For instance, psychologists working for the government earn a median salary of $96,410, but those who work in elementary and secondary schools earn a lower median salary of $75,890. Additionally, the type of work undertaken makes a difference. For example, industrial-organizational psychologists earn a median annual salary of $97,260 while clinical, counseling, and school psychologists make $76,990.
Psychiatrists earn a median annual salary of over $208,000 per year (BLS, 2018), which is consistent with the length and difficulty of schooling. Growth potential is also quite high—it is predicted to be between 10-14% from 2016-2026. Like psychologists, the environment a psychiatrist works in also makes a difference to their salary. Those working with local governments (excluding work in schools or hospitals) make a median annual salary of $253,140, outpatient care center psychiatrists make $241,820, and those in physicians’ offices make $220,010.
Psychologists and psychiatrists have very different educational paths. The following is an overview of the education requirements for each field.
Psychologist Education Requirements
Psychologists take the academic path to their profession by earning a doctorate in psychology, usually either a Psy.D. or a Ph.D. Anyone wanting to enter a doctoral program in psychology must first have a bachelor’s degree. You might also need a master’s degree in the field, but many doctorate programs include a master’s degree. In fact, many schools with psychology graduate programs don’t offer terminal master’s degrees at all. However, each program is different, so it’s best to look closely at your desired program’s stipulations. Additional entry requirements include strong GRE scores, a statement of purpose, and letters of recommendation.
The curricula for doctoral programs in psychology are rigorous and highly academic. Coursework focuses heavily on research in the field of psychology and includes courses in research methodologies and psychological theory. Other foundational courses can consist of psychopathology, ethics, statistics, and affective science. While the most common degree programs are in clinical psychology, there are a variety of other specialties to choose from and some programs offer the opportunity to concentrate on those through your coursework. Specialization examples include counseling, industrial-organizational, school, business, and international psychology.
Most psychology programs require 70-80 credit hours of coursework, completion of a dissertation or doctoral thesis, and the passing of a comprehensive exam to graduate. Dissertations are extensive research studies that must be approved prior to conducting the research and defended in front of a panel of faculty upon completion. Many programs also include pre-graduation internships or clinical hour requirements as a part of the coursework. Upon completion of the degree, you must also complete around 2,000 post-graduation direct clinical hours (although the hour requirements depend on your state) and achieve a passing score on the Examination for Professional Practice in Psychology (EPPP).
Psychiatrist Education Requirements
Psychiatrists are medical doctors, so upon completion of a bachelor’s degree, the long path to your career begins with medical school. While students can also earn a Doctor of Osteopathic Medicine (D.O.), traditional medical school will focus on the more common M.D. programs (though the requirements are similar).
To get into medical school, you’ll need a bachelor’s degree in a life or biological science with a strong GPA, especially for the science coursework. Some universities offer pre-med programs that guide you through the steps necessary to be accepted to medical school. If you didn’t major in a life science, you will likely have to complete post-baccalaureate coursework in subjects such as chemistry, biology, physics, and genetics.
Upon the completion of your bachelor’s degree, you will need to take the Medical College Admission Test (MCAT). As with any post-graduate study, you will also need to submit a statement of purpose and various letters of recommendation.
Medical school takes four years of full-time coursework to complete, with each year having a specific focus. The first and second years typically involve foundational classroom and lab-based coursework in life sciences such as anatomy, microbiology, pharmacology, pathology, and biochemistry. After the completion of year two, you’ll take the United States Medical Licensing Exam (USMLE) step one, which assesses your comprehension of the basic sciences.
Years three and four of medical school primarily consist of clinical and hospital rotations to introduce students to the various specializations and practices in the field. In year four, you’ll have more choice in your rotations, which is where you will expose yourself to different areas of the psychiatric field. Also, during the fourth year, you must pass step two of the USMLE, which will assess your medical knowledge and diagnostic and clinical skills.
In your last year of medical school, you will begin the path to the next major step in your psychiatry career: residency training. It involves a rigorous application process that includes interviews and high-level matching. Psychiatry residency programs take four years to complete. As a resident, you will learn about and develop the skills necessary to be an independently practicing psychiatrist. The first year of residency is typically called “the intern year” because you are still learning the necessary skills to practice in the field. It consists of foundational work and a higher level of supervision by psychiatric instructors.
During your psychiatric residency, you will complete step three of the USMLE (usually between the second and third years) as one of the major requirements to receive a medical license. Once you are a licensed physician, you will need to be board certified and take the American Board of Psychiatry and Neurology (ABPN) exam. Note that each state also has specific licenses to practice in their state. So, while these requirements are standardized across the country, there may be other state-specific licensing requirements as well.
While not required for generalists, to further your training in a subspecialty of psychiatry, you may opt for a fellowship. At this point, you’re a fully qualified psychiatrist, but you can choose to expand your scope of practice.
The fields of psychology and psychiatry are wide-ranging. While many practitioners can pursue a more generalized path, there are a variety of specialization options to choose from.
Specialties in psychology include the following:
- Clinical psychologist: work directly with patients to assess and treat mental illness and can work in a variety of settings, including hospitals, community-based organizations, and private practice.
- Child psychologist: specialize in understanding psychological development in children and adolescents who, because of their developing brains, process and respond to the world differently than adults.
- Sports psychologist: work with athletes to ensure they perform their best by helping them navigate the challenges related to training and injury recovery.
- Industrial and Organizational psychologist: specialize in workplace psychology to help companies and organizations maximize employee productivity by improving workplace culture.
- School psychologist: work in the school setting to help students overcome barriers to learning, such as learning disabilities, cultural and language differences, and heightened emotional stress.
Sub-specialties in psychiatry include the following:
- Forensic psychiatrist: work where the law meets mental health by conducting legal research or providing expertise in legal cases. Examples of evaluations they would make include deciding whether someone is mentally capable of standing trial and evaluating parental competency.
- Geriatric psychiatrist: work with older patients to help them cope with stress, life changes, and general mental health challenges.
- Addiction psychiatrist: work with people battling addictions by providing treatments and counseling to develop healthy coping practices.
- Community psychiatrist: conduct their practice for the public good by utilizing a public health approach, typically working with community-based organizations, the nonprofit sector, and community mental health agencies.
- Military psychiatrist: work in the military or with military personnel or veterans by applying their expertise to help advance research and assist people with the unique experience of having served as a soldier.
Psychology vs. Psychiatry: Which is Right for You?
While the fields have many similarities, there are enough differences— especially in deciding which career path to take— that it’s important to consider your options carefully. The following factors should be researched when making your decision:
- Length of time to complete your education: A doctoral degree in psychology typically takes around five years of education, plus at least one year of a post-graduate internship. However, the path to psychiatry can take at least eight years (four for med school, four for residency)—more if you want to specialize.
- The cost of your education: A longer path to earning a full-time salary as a licensed professional also means there will be more debt accrued. You’ll want to look at your educational funding options and weigh the earning potential with the potential debt from student loans.
- Your age or where you’re at in your career: Because of the length of time it takes to complete an M.D., many medical students are younger and very recently out of undergrad education. If you’re mid-career or completed your undergraduate degree later in life, this may be an important factor.
- Your interest in the sciences: Psychiatry education is primarily centered on biological sciences and it’s essential to excel in those areas in order to get into medical school. Psychology might have some focus on science but is much more about theory and psychological development.
- Interest in medication management or holistic therapy: Because psychiatrists are medical doctors and have the appropriate training in pharmacology, they often focus on medication management. Psychologists, on the other hand, look at mental health more holistically and more broadly in terms of patterns, trends, and behaviors. They will initially focus on behavioral interventions when working directly with patients.
- Specializations or sub-specialties of interest: There are many overlaps in the specializations in both fields, but the specific type of work differs, so research those specific duties carefully.
- Environment you want to work in: Psychiatrists most often work in medical environments such as hospitals, clinics, and private practices. The work environments for psychologists can be more varied and include schools, private companies, and community organizations.