Psychologists do not go to medical school. They earn doctoral degrees in psychology, either a PhD (Doctor of Philosophy) or a PsyD (Doctor of Psychology), which typically takes four to six years of graduate study plus a one-year clinical internship. This is a completely different training path from psychiatrists, who are medical doctors and do attend medical school.
What Psychologists Study Instead
Psychology doctoral programs focus on human behavior, research methods, statistics, psychological testing, and structured therapeutic interventions like cognitive behavioral therapy. The coursework is built around understanding how people think, feel, and behave, and how to treat mental health conditions through talk therapy and behavioral strategies. There is no anatomy lab, no pharmacology sequence, and no hospital rotations of the kind medical students complete.
By contrast, psychiatrists spend four years in medical school learning the same foundational sciences as every other physician: anatomy, physiology, pharmacology, and clinical medicine. After earning an MD or DO, they complete four to six more years of residency training specifically in psychiatry. As Margaret Stuber, a vice chair for education in psychiatry at UCLA’s medical school, has put it: psychiatrists have more training in understanding the physical body because they’ve been through medical school, while psychologists are specifically trained in testing, structured interventions, and research methods.
The Psychology Training Timeline
Most people who become licensed psychologists follow a path that looks like this: four years of undergraduate study, four to six years in a doctoral program, a one-year predoctoral internship, and in many states, additional postdoctoral supervised hours before they can apply for a license. The internship alone requires a minimum of 1,500 to 2,000 hours of supervised clinical experience, with at least 25% of that time spent in direct contact with clients providing assessment and therapy.
After completing their degree and internship, psychologists must pass a national licensing exam called the EPPP (Examination for Professional Practice in Psychology), administered across all 66 licensing jurisdictions in the U.S. and Canada. The passing score is 500. Some jurisdictions also require a second part of the exam that tests clinical skills rather than just knowledge. Only after clearing these hurdles can a psychologist practice independently.
Can Psychologists Prescribe Medication?
In most of the United States, psychologists cannot prescribe medication. That’s one of the biggest practical differences between psychologists and psychiatrists. However, a small number of states have passed laws granting psychologists prescriptive authority if they complete substantial additional training. New Mexico was the first state to do so, and a handful of others have followed. The additional training is significant: 450 hours of coursework in neuroanatomy, physiology, pharmacology, and psychopharmacology, plus 400 hours of practical experience treating at least 100 patients under a physician’s supervision, followed by a national exam. Even after passing, psychologists in these states typically practice under a supervised license for two years before they can prescribe independently.
If you’re someone who needs therapy, a psychologist is often the first choice. If you need medication management for a mental health condition, you’ll generally see a psychiatrist or another prescribing provider.
Board Certification for Each Profession
Both professions have voluntary board certification systems that signal advanced competence in a specialty. For psychiatrists, the credentialing body is the American Board of Psychiatry and Neurology, which falls under the American Board of Medical Specialties. For psychologists, the equivalent is the American Board of Professional Psychology (ABPP), which oversees 15 specialty boards covering areas like clinical neuropsychology, forensic psychology, and child psychology. The ABPP examination process mirrors the medical model, including credentials review, a written exam, a practice sample evaluation, and an oral exam.
How the Costs Compare
The financial picture differs between the two paths, though neither is cheap. Clinical psychology doctoral students carry an average of $76,000 in student loan debt by the time they finish their programs. PhD students who receive research assistantships or teaching positions often pay less out of pocket than PsyD students, whose programs are more likely to charge full tuition. Medical school graduates, by comparison, typically carry significantly higher debt, often exceeding $200,000. However, psychiatrists generally earn higher salaries after training, which changes the long-term financial calculus.
Choosing Between the Two Paths
If you’re researching this question because you’re considering a career, the core distinction is straightforward. Psychology is the path if you’re drawn to understanding behavior, conducting therapy, and working with research. Psychiatry is the path if you’re fascinated by biology, the connection between brain and body, and want the ability to prescribe medication as part of treatment. Both require years of rigorous training, and both lead to careers treating mental health conditions, just from different angles.