What kind of training does a psychiatrist have?
All psychiatrists are Medical Doctors (MD). This means that one has at least an undergraduate degree (minimum 3-4 years), a 4-year medical degree and then a residency (minimum 5 years). Thus, most psychiatrists have had 13 years of post-secondary training (if not more) before being certified as a psychiatrist.
Furthermore, examinations that a Psychiatrist has to pass before obtaining certification includes:
- General Medical Exams: one set written, one set oral (LMCC Part I and II)
- Royal College of Physicians and Surgeons Psychiatry Exam (two sets of oral exams at the University level, one written exam at the National level, and one oral exam at the National level)
Finally, Child and Adolescent Psychiatrists have also then completed the Royal College of Physicians and Surgeons Subspecialty Child and Adolescent Exam (one set of written exam). Please note that this exam has only been implemented since 2013, and thus not all qualified psychiatrists have written it.
Dr. Leung has completed all the training and examinations as indicated above.
What is the difference between a psychiatrist, psychologist
and social worker?
Psychiatrist training is as indicated above. Psychiatrists are medical doctors, and thus have been trained to assess and treat psychiatric conditions. Treatments provided by psychiatrist can include medications and/or therapy.
Psychologists have completed their PhD in psychology, after having obtained their Masters Degree. This is an extensive and rigorous training program that allows psychologists to assess and treat different psychiatric conditions. Treatment provided by psychologists is via therapy only, as they are not licensed to prescribe medications. Psychologists are also trained in providing psychoeducational and learning assessments, which psychiatristshave not been trained to do.
Social workers have a Masters of Social Work. Their training consists of an undergraduate degree (4 years) and then a master’s degree (2 years). Social workers cannot diagnosis psychiatric conditions. However, there are social workers that have focused their practice on providing psychotherapy treatment.
How much does it cost to see a Psychiatrist, Psychologist
or Social Worker?
In person visits to see a psychiatrist are covered by OHIP, as long as a patient’s health care coverage is active. If OHIP coverage is not active, then one can expect to pay a fee to see any physician, including a psychiatrist.
Costs that are not covered by OHIP, and will be charged to the patient includes missed/late cancellation of appointments. Forms/Letters that are requested by the patient may also incur a charge, as OHIP does not pay for these services. Any form of contact between the patient and psychiatrist that is not in person (ex telephone/email) can also incur a charge, as OHIP will not pay for this service.
Most psychologists are in private practice, which means a patient has to pay to receive therapy. However, most insurance plans cover the cost of psychology visits. The majority of school boards also have a psychologist on staff, who can complete psychoeducational/learning assessments. Very rarely will the school board psychologist provide ongoing therapy given the demands on their time.
Social workers may open a private practice, where like psychologists, a patient has to pay to see them. Usually, a social worker has lower fees than a psychologist. Some insurance plans may cover the costs of seeing a social worker. Social workers are also usually the providers of therapy in government funded mental health programs.
How do I find a psychiatrist?
The College of Physicians and Surgeons must register all physicians in Ontario. To find a physician, go to:
www.cpso.on.ca
Complete a doctor search filling in the criteria that meets your needs.
If a psychiatrist can provide therapy, why does my psychiatrist only prescribe medications only, or say that I need a separate counselor/therapist?
Psychiatrists are underserviced in almost all locations. With the demands on their time, many do not have the availability to provide ongoing therapy for patients (as one therapy patient takes 45-60min/week on an ongoing basis). If a psychiatrist were to only provide therapy, one would only be able to hold a roster of about 30-50
patients. (There are a handful of psychiatrists who provide mainly or mostly therapy, and these psychiatrists are generally located downtown Toronto, in a non-hospital setting.)
With the hundreds to thousands of patients requiring assessment and treatment, it is not feasible for most psychiatrists to only provide therapy given the demands of the system. Hence, most psychiatrists provide general medical/psychiatric follow up that may take 20-60 min once every few weeks/months, and have the therapy completed by other qualified individuals like psychologists or social workers. In this manner, a psychiatrist may have hundreds of patients on their roster and help to address the demands of the system.
Dr. Leung’s practice involves mostly assessments and general psychiatric follow up. However, for certain cases where therapy may not be readily accessible or appropriate elsewhere, , Dr. Leung may take on these patients for therapy depending on availability. Acceptance of a patient for therapy is reviewed on a case-by-case basis.
What is the difference between the psychiatrist and my family
physician prescribing the medication?
Most family physicians refer to a child psychiatrist for a clarification of diagnosis and treatment recommendations. Some family physicians do not feel comfortable prescribing medications to children or adolescents given the nature of complexity of treating mental illness in this population. However, once an assessment and treatment recommendation is made, many family physicians then feel comfortable initiating medications based on the recommendations.
Some families elect to continue to see a psychiatrist for their ongoing medication management. This can be for a number of reasons, including patients that are high risk/too complex for a family physician to provide care. For these cases, it may be preferable to see a psychiatrist in order to stabilize the patient’s symptoms, before going back to see a family physician for ongoing care.
Another reason to see a psychiatrist for medication management is that using medications in children and adolescents may not always be straightforward. Should one encounter side effects/difficulties/lack of response to a medication, a psychiatrist then can alter the treatment plan immediately, while family physicians may not be experienced or know what the next steps to take are.
However, many patients do elect to see their family physician for their medication management as it may be easier to get an appointment with the family physician and most psychiatrists work in a hospital setting, which generally requires parking costs.
Whether one chooses to see a family physician or psychiatrist for medication management is an individual choice based on one’s own circumstances and is acceptable either way.
At times, patients may have seen a psychiatrist for an assessment and has not been offered follow up. How physicians practice is varied, but even if a patient is offered only an assessment, they can generally always be referred back to the psychiatrist should more issues/questions present themselves.
How do I know if my child or I need to see a psychiatrist?
If you are asking yourself this question, then you likely have some concern/issue that is bothersome. Given this, it is always better to be prudent and have an assessment completed. However, you should speak to your family physician to see about whether it is appropriate to be referred to a psychiatrist.