Defending Psychiatry

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curve2002

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I am a 4th year US student applying in Psychiatry. I have had much struggle facing the medical and lay world about my decision. I have physicians, people who I have looked up to for years, telling me it's a waste of my education. I have one of the deans of my medical school very disappointed because I should be using my high board scores for something more "challenging."
I love psychiatry and know this is what I should be doing with my life, but I can't help but get pissed when people constantly put my decision down. Does anyone have any advise on how to deal with these people who think I'm wasting my life and I'm not going to be a "real doctor" (I love you Mom, but even if I just sat at home on my butt, I would still be a "real doctor")?
Thanks,
Mike

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As a non-psychiatrist I say get used to it, but get over it. Psychiatry is very much needed and respected, by those who bump into it. I bet if you ask docs who have had a family member with severe mental illness you would get a different opinion. People fear what they do not understand, and psych is fearful for alot of people.
 
I have had a few of those encounters as well. I usually get a very interesting response when I say psychiatrists treat the patients other doctors don't want to or know how to treat. When a patient is made into a Rx drug addict by other doctors and then turned away cuz they are "a drug seeker" who do they turn to? Or you could just say, "because psychiatry is awesome" and leave it at that. Good luck:)
 
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I am a 4th year US student applying in Psychiatry. I have had much struggle facing the medical and lay world about my decision. I have physicians, people who I have looked up to for years, telling me it's a waste of my education. I have one of the deans of my medical school very disappointed because I should be using my high board scores for something more "challenging."
I love psychiatry and know this is what I should be doing with my life, but I can't help but get pissed when people constantly put my decision down. Does anyone have any advise on how to deal with these people who think I'm wasting my life and I'm not going to be a "real doctor" (I love you Mom, but even if I just sat at home on my butt, I would still be a "real doctor")?
Thanks,
Mike

I always find it kind of surprising when I see posts like this. I can honestly say that I have received almost universal support from everyone regarding my decision to pursue psychiatry. I seriously considered surgery and other specialties to a lesser degree, and folks seemed just generally supportive.

In my hospital now (I'm a PGY-III), I have no one questioning my decision, but did have medical attendings ask me to stay on after I finished my medicine rotations. They would jokingly state that I'd make a better internist than a psychiatrist. I told them that the thought of dealing with cellulitis, DM, HTN, CHF, PNA and dehydration/electrolyte imbalances all day would make me crazy.

On the consult service, I would get about (excluding the ER) 4/5 of my consults from medicine floors, which included PM&R, Hospice, detox, and CCU/ICU. The remaining would come from surgery. They were all more than happy to have the expertise in handling a difficult patient, or provide some treatment guidelines for an obviously depressed or severely anxious/ocd/delusional/manic patient. Not once has someone told me I'm not a "real doctor."

I teach medical students every month on the inpatient unit. I teach them medicine, how to conduct physical exams, draw blood, catheterize, start IVs, perform detailed neurological exams, and of course, lots of psychiatry. Their response has also been positive, and is positive in their written feedback. Not infrequently, they tell me that there was a surprising amount of medicine on the rotation, and that they loved the interaction and interface between the two. No medical student (of course) ever told me I wasn't a "real doctor."

I have clinic outpatients, high-functioning inpatients, low-functioning inpatients, chronics, frequent flyers, and everything in between. Sometimes they hate me for what I make them do, or for the treatment they don't want. But they never say I'm not a "real doctor." When a geriatric depressed lady develops abdominal pain, vomits, and I get her a KUB and start fluids and an NG tube while I wait for a transfer to a medical floor (all of which are full), she doesn't say I'm not a "real doctor."

I have graduated from medical school like thousands before me. Not at the top, not at the bottom...somewhere in between. People who performed better than me went into family practice and peds. People who performed worse than me went into surgery and IM. Does this make me "not a real doctor?"

I will make more money than the average pediatrician or even internist, less money than the average cardiologist. Yet, they do similar things, and virtually no one asserts that they are not "medical doctors." By this virtue, money must not be the argument.

I have a medical school diploma somewhere in my apartment, I can order tests, perform minor surgeries, write prescriptions for most any medication based on my own clinical interpretation of their clinical condition for whatever disease they may have. I can interpret x-rays, CT scans, MRIs, perform TMS, VNS, ECT, and draw blood and look at the smear under a slide if I so choose; I can tell a patient what to do and think, and they will most likely do what I say because I'm "the doctor." I do this not out of power or influence, but for the betterment of the patient - to alleviate their suffering.

I get thank-you cards, bottles of wine, homemade food, and baseball tickets from patients that insist I take them. They feel better, or their family member feels better, or is no longer sick. They seem to think I'm a "real doctor." I'll take call and see sick patients who can no longer cope. I might have to drive into a hospital in the middle of the night to take care of that patient. I'll also get a phone call from a patient while I'm relaxing on a beach next to my summer house. Either way, the patient will be helped.

Iatro in Greek means "physician."
Psyche in Greek means "principle of mind, soul, life."

Therefore I am a physician that specializes in the mind, the soul, of life. Who am I to argue with ancient Greeks?

In other words, I am a "real doctor."
 
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I always find it kind of surprising when I see posts like this. I can honestly say that I have received almost universal support from everyone regarding my decision to pursue psychiatry. I seriously considered surgery and other specialties to a lesser degree, and folks seemed just generally supportive.

In my hospital now (I'm a PGY-III), I have no one questioning my decision, but did have medical attendings ask me to stay on after I finished my medicine rotations. They would jokingly state that I'd make a better internist than a psychiatrist. I told them that the thought of dealing with cellulitis, DM, HTN, CHF, PNA and dehydration/electrolyte imbalances all day would make me crazy.

On the consult service, I would get about (excluding the ER) 4/5 of my consults from medicine floors, which included PM&R, Hospice, detox, and CCU/ICU. The remaining would come from surgery. They were all more than happy to have the expertise in handling a difficult patient, or provide some treatment guidelines for an obviously depressed or severely anxious/ocd/delusional/manic patient. Not once has someone told me I'm not a "real doctor."

I teach medical students every month on the inpatient unit. I teach them medicine, how to conduct physical exams, draw blood, catheterize, start IVs, perform detailed neurological exams, and of course, lots of psychiatry. Their response has also been positive, and is positive in their written feedback. Not infrequently, they tell me that there was a surprising amount of medicine on the rotation, and that they loved the interaction and interface between the two. No medical student (of course) ever told me I wasn't a "real doctor."

I have clinic outpatients, high-functioning inpatients, low-functioning inpatients, chronics, frequent flyers, and everything in between. Sometimes they hate me for what I make them do, or for the treatment they don't want. But they never say I'm not a "real doctor." When a geriatric depressed lady develops abdominal pain, vomits, and I get her a KUB and start fluids and an NG tube while I wait for a transfer to a medical floor (all of which are full), she doesn't say I'm not a "real doctor."

I have graduated from medical school like thousands before me. Not at the top, not at the bottom...somewhere in between. People who performed better than me went into family practice and peds. People who performed worse than me went into surgery and IM. Does this make me "not a real doctor?"

I will make more money than the average pediatrician, less money than the average cardiologist or even internist. Yet, they do similar things, and virtually no one asserts that they are not "medical doctors." By this virtue, money must not be the argument.

I have a medical school diploma somewhere in my apartment, I can order tests, perform minor surgeries, write prescriptions for most any medication based on my own clinical interpretation of their clinical condition for whatever disease they may have. I can interpret x-rays, CT scans, MRIs, perform TMS, VNS, ECT, and draw blood and look at the smear under a slide if I so choose; I can tell a patient what to do and think, and they will most likely do what I say because I'm "the doctor." I do this not out of power or influence, but for the betterment of the patient - to alleviate their suffering.

I get thank-you cards, bottles of wine, homemade food, and baseball tickets from patients that insist I take them. They feel better, or their family member feels better, or is no longer sick. They seem to think I'm a "real doctor." I'll take call and see sick patients who can no longer cope. I might have to drive into a hospital in the middle of the night to take care of that patient. I'll also get a phone call from a patient while I'm relaxing on a beach next to my summer house. Either way, the patient will be helped.

Iatro in Greek means "physician."
Psyche in Greek means "principle of mind, soul, life."

Therefore I am a physician that specializes in the mind, the soul, of life. Who am I to argue with ancient Greeks?

In other words, I am a "real doctor."

You da man.
 
anasazi, that was beautiful!
and the people who knock on psych may not have the depth or knowledge to appreciate the potential that the mind holds not just on our emotions and behavior but also on almost every physical aspect of our lives!
 
anasazi, that was beautiful!
Amen. I am applying for Psych this yr and that post was truly encouraging. You (Anasazi) should write a book about this. :cool:
 
to the OP, i get the same responses you do. everytime someone asks me what im applying for, i hesitate before replying, because im getting sick of the raised eyebrows, the quizzical looks, and the people saying "you're crazy!" (and then they laugh because they think they are the first one to come up with this pun).

the attending i am with this month did the same thing. he asked me what i was applying for, and after i told him, he said "ughh, i could never understand why anyone would ever want to go into psych". (he actually apologized to me the next day out of nowhere, which i thought was sort of nice. he then said he thought psych was one of the most difficult fields and he gives me a lot of credit. but that was after he had ruined my entire day the day before...). i feel your pain. it sucks.

luckily for me, my family and the people i am closest to support my decision and have told me they think i will be great at it. so i try an ignore the nay-sayers, but i agree, some days it can be harder than others to brush the comments off.
 
First off lets hear it for Anasazi!

it happened to me just yesterday..went with my husband to his doctor who, on hearing that i was going thru the match this year, asked me what specialty im applying for..then came the usual raised eyebrows and the incredulous "Why PSYCHIATRY?" followed by an unconvincing "well..there IS a need for it.." not to put down any other specialty but i thought that was interesting considering hes a gastroenterologist and earns his living looking up patients' u know what :laugh:

not to mention the various relatives (i have a lot of doctors in my family) calling in to suggest i rethink my decision (all with my BEST interests in mind im sure) for fear that i might internalize so much that it will take me from being a psych doctor to a psych patient!

BUT its what i WANT to do! I dont think I could see myself in any other field. And since im the one who's going to be in the hospital 60 hours a week (which i might add is a plus compared to the hours an IM or surgery intern is putting in for the same pay), I think Ill stick with what I like. So call me crazy but psychiatry is definitely for me. :)
 
I think there is no need to defend it, the life style is excellent as an attending (hopefully it stays the same when I graduate), and that by itself is sufficient reason. But if you are shaky to start with..might reconsider your decision as it is going to be a recurrent phenomenon. Lot of people look down on Psych, if you search on salary.com you will see Psychiatrist as separate profession as compared to other specialities which all come under 'Physician'. Make sure you are able to answer 'Why Psychiatry?' during your Psych Interviews. Hopefully you will make an informed decision. All the best.
 
Just a side note here, during my 3rd year I considered doing, peds, fp, er, OB and Gen surg. Here is the typical response for a stated interest in each of those fields
peds-"don't you want to make money? I hate kids/parents"
fp-"Oh, thats...nice, I know some Fp's who are really smart, hey, good hours though"
er-"nice lifestlye"
OB-(guys going interested in OB get some pretty unquotable remarks)
Surg-"Don't want to see your kids huh?"
No matter what field you go into, people have some sort of opinion and will probably be irritating. Everyone thinks their field is the best. We're just right.:laugh:
 
I am a 4th year US student applying in Psychiatry. I have had much struggle facing the medical and lay world about my decision. I have physicians, people who I have looked up to for years, telling me it's a waste of my education. I have one of the deans of my medical school very disappointed because I should be using my high board scores for something more "challenging."
I love psychiatry and know this is what I should be doing with my life, but I can't help but get pissed when people constantly put my decision down. Does anyone have any advise on how to deal with these people who think I'm wasting my life and I'm not going to be a "real doctor" (I love you Mom, but even if I just sat at home on my butt, I would still be a "real doctor")?
Thanks,
Mike

You can't please everyone. Live YOUR life.
Good luck in psychiatry. :thumbup:
 
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Just a side note here, during my 3rd year I considered doing, peds, fp, er, OB and Gen surg. Here is the typical response for a stated interest in each of those fields
peds-"don't you want to make money? I hate kids/parents"
fp-"Oh, thats...nice, I know some Fp's who are really smart, hey, good hours though"
er-"nice lifestlye"
OB-(guys going interested in OB get some pretty unquotable remarks)
Surg-"Don't want to see your kids huh?"
No matter what field you go into, people have some sort of opinion and will probably be irritating. Everyone thinks their field is the best. We're just right.:laugh:

Yeah, what is it with all those self centered boneheads? ;)
What I like to tell my (close) friends who are going into surgery is that they are my future patients. (usually in response to some jab about me going into psychiatry) They always kind of chuckle, but then go away with an annoyed look.
Which brings up a funny story. There is a "riddle" that is supposed to be some kind of indicator of possible psychosis. It goes:

A woman goes to her mothers funeral, and she meets a guy she really, really likes. The next day she kills her sister, why?

I don't know the sensitivity or specificity or if it even has any basis in reality, but supposedly a high percentage of psychotic patients answer it correctly. Back in my first year of medical school, I asked it of one of my friends who is now a die-hard surgery hopeful and she responded, "Oh that's easy. She wanted the guy to come to her sister's funeral too so she could see him again." (that's the "correct" answer by the way). Her expression made me laugh so hard after I told her what it was supposed to mean.
 
I get a mixed bag of responses but as soon as you tell them Call is Q 8 and ends after 2 years (at the program I am probably going to) and then tell them you can have a completely cash pay business and work40 hours when your done residency-that usually shuts them up and they look embarrased.

Other poeple I get tell me that is really cool and interesting. Everyone seems to have an inherent"interest" in psychiatry patients-with movies like silence of the lambs and many other high profile killers etc in the world-I think everyone has an inherent intrigue in the field-anyway I get a mixed bag of replies-go figure! I like it mostly because you can have a GREAT lifestyle with ZERO call,zero weekends etc-now THAT is the life esepcially as an MD, or DO
 
Yeah, what is it with all those self centered boneheads? ;)
What I like to tell my (close) friends who are going into surgery is that they are my future patients. (usually in response to some jab about me going into psychiatry) They always kind of chuckle, but then go away with an annoyed look.
Which brings up a funny story. There is a "riddle" that is supposed to be some kind of indicator of possible psychosis. It goes:



I don't know the sensitivity or specificity or if it even has any basis in reality, but supposedly a high percentage of psychotic patients answer it correctly. Back in my first year of medical school, I asked it of one of my friends who is now a die-hard surgery hopeful and she responded, "Oh that's easy. She wanted the guy to come to her sister's funeral too so she could see him again." (that's the "correct" answer by the way). Her expression made me laugh so hard after I told her what it was supposed to mean.
What's the correct response to the riddle? I'm thinking the man is her sister's husband? Am I right?
Oh, and by the way Anasazi, You Go Boy/Girl!!! That what beautiful.:love:
 
i'm not a psychiatrist, but am in radiology. i used to get some of the same lines "you should be a real doctor" but you know what, unless you actually do a certain field, you really can't understand how important it is. i've come to realize just having had interactions as an intern and now as a radiology resident that every single field is just as important as any other. those ppl who want to put down other fields either have no clue what they're talking about or have a huge chip on their shoulder (but you guys would be a better judge of that, hehe)
 
Sazi's post still gets me every time. Gotta put that stuff on a poster, or something.
 
Nicely said Anasazi!

As Type A personalities, we're driven to varying extents by the pursuit of prestige. The take home point is that a vast number of physicians get their egos bruised in some way or another.

I'm glad we had the Rads resident chime in. Unfortunately, a large portion of the American public is unaware that there are specialized physicians trained to interpret imaging studies; they think a Radiologist is a Radiological Technician.

Beyond Rads, my best friend is an Anesthesiologist and he takes flak that a CRNA can do his job. Internists are often confused with interns! FPs are knocked as glorified PAs. ER docs get dogged as being triage nurses. A good portion of the public confuses Ophthalmologists and Optometrists--the spelling of the discipline is even an interview question at some Ophtho residency programs!

Many lay people have difficulty distinguishing an MD, DO, PhD, OD, DC, and DPM. To them, they're all "Doctors".

People who understand the health care system recognize the vital role that Psychiatrists play. It's only a matter of time before mental health benefits are put on an equal footing with "medical" benefits. It's very clear that the tide is turning toward destigmatization. While I'm not a regular viewer, Oprah has done a tremendous amount for mental health by educating the lay public about many psychiatric conditions. As recognition and treatment improve, a Psychiatrist's role will be that much more vital.

Keep your head up and don't let the haters get you down.
 
While I'm not a regular viewer, Oprah has done a tremendous amount for mental health by educating the lay public about many psychiatric conditions.

Yeah, she highlighted a bunch of them when she had Tom Cruise jumping on her couch.
 
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Hi, I start my Psychiatry residency in June and I wanted to chime in. I considered almost every other field but I did not see myself doing any of them for the rest of my life. I liked and performed well in Surgery, Sports Med, EM, Neurology. Whenever I spoke to someone about going into one of those fields, I would almost always find a negative response.

Now that I chose Psych, I get alot of positive responses. Actually, one attending (infectious diseases) today told me, "I really appreciate you going into Psychiatry." It was really nice. I would say that out of 10 responses, 8 are positive.The other 2 are usually confused or they have a chip on their shoulder. I have gotten the "waste of time" response but she seemed crazy herself. For awhile, I was geting alot of confused or negative responses followed by a story. Like, Their uncle who went crazy, Or their son who commited suicide. Or their child who has emotional problems.

I think for the people that respond negatively, it is usullay fear because it arouses something in them that really scares them. That is the way of humans. Every once in a while, I have this strange fear that people will think that I am weird for picking it.

I admit that I get alot of fear myself but I am sticking with it. I feels like it is going to be really, really hard.

My reasons for doing it relate to how the mind affects the body. I find this fascinating and rewarding. I also feel like I am working with the patient and empowering them.
 
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What's the correct response to the riddle? I'm thinking the man is her sister's husband? Am I right?
Oh, and by the way Anasazi, You Go Boy/Girl!!! That what beautiful.:love:

I mentioned the answer in my post, but here it is again. The woman killed her sister because she figured that someone who came to her mother's funeral would also come to her sister's funeral. Since she wanted to see the guy again, she killed her sister in the hopes that he would come to her sister's funeral as well. Sorry about the delay in response time...;)
 
I have physicians, people who I have looked up to for years, telling me it's a waste of my education.

Something of a rant on my part but does it seem to me that medical schools in general and premed advisors, and several residency programs are often times out of line with this type of bull?

Several people I know during interviews get some really out there questions like, "Oh you're Indian, so your parents must be proud that you're applying to medical school because they're Indian" .. (No I'm not Indian, but I've gotten similar stuff).

I got a "you've fulfilled your parents mandate" comment during an interview that was compeltely racially motivated.

And it seems to me that this really happens a lot with my friends who were premed and in medschool.

I remember when I was premed, the premed office at my school, the advisors were often times rude, telling people to give up on going to medschool because one grade was out of place. I noticed this trend in Rutgers (my premed school) and several big "public ivy" universities on both coasts where they try to weed out students. I transferred to RU from Syracuse, where the premed office wasn't trying to weed out people and they were always supportive but also realistic. They'd tell people to drop out if their grades really were bad, but they'd do so nicely.

Hardly heard of that type of rudeness with my non-medical friends when they had interviews.

Sounds to me like the same type of idiocy.

There seems to be a subculture in medicine where its alright to demean/pimp those under you. Yeah, no matter the field, there's always some egocentric loser, but just seems so prevalent in medicine. This is the only field I know of where they use the word "pimping", other than actual prostitution.
 
Some articles I read such as "Should psychiatry be your specialty? Eleven Questions" by Maurice Rappaport, MD, PhD; "Why psychiatry? Part 1" by Mary Ann Barnovitz, MD, helped me in my decision. You should check it out, but what Anasazi23 summarizes it all.

Unfortunately, we do have what I call psychologists with an MD in our field and they are the ones that sometimes give other specialties a bad impression of psychiatrists. You may encounter some of them in your training. They don't even touch their patients, or bother to carry a stethoscope. But it will be your choice to be one of them or to be a real physician. I am a physician and will never give up my medical skills because mental health patients have medical problems along with their mental illness and/or their medical problems may be the cause of their mental instability; to neglect medicine is like being a handicapped psychiatrist like Freud. No offence since he did contributed to psychiatry in one way but I call it the dark age of psychiatry. We went backwards and completely neglected what Kraepelin already had theorized in the beginning of the 20th century - that there were a biological and genetic components to psychiatric diseases. I do believe therapy is important, but you can't forget we are carbon made.

Anyways, Just don't be discouraged if you enter a residency program and do not find any residents like Anasazi23; if you do have the same passion for medicine in general. I can garantee you they are few. Most psych residents don't want to touch their patients, don't want to draw blood, put NG tubes, IV lines - they usually call the nurse or consult IM/Surgery. I have seen some of them call a consult to Neuro in how to manage a headache bc they don't want to deal with it. I had to get a mentor in order not to quit bc I got to a point I thought all psychiatrists were like that and felt isolated. So make sure you find a program where the residents think the same as you, and get a mentor that has the same kind of enthusiasm in what you think is important in psychiatry to keep you going. But in my opinion to be a true and successful psychiatrist you have to be half Kraepelin and half Freud; you can't neglect one or the other.
 
My reasons for doing it relate to how the mind affects the body. I find this fascinating and rewarding. I also feel like I am working with the patient and empowering them.

I just finshed reading "Coyote Wisdom." You might like it.
 
Most psych residents don't want to touch their patients, don't want to draw blood, put NG tubes, IV lines - they usually call the nurse or consult IM/Surgery.

I have yet to see a resident of any field put in a peripheral IV or draw blood. The only time I've ever seen a resident draw blood is in trauma, and that's from a femoral stick.
 
St. Mike's in Newark, the residents do most of this stuff. ITs not that the residents are supposed to do this, its that the nurses pretend to do it, but really don't. If the nurse can't find a vein after 3 attempts for example, they're supposed to ask the resident to do it. They of course in reality don't even make the attempt and then just call the resident.

If you're a resident and you complain, well the attending then yells at you because the attending just wants the thing done. They don't care that its unfair and the nurses are taking advantage of the resident.

Nope--not my program. If you're in that program you waste about 2 hrs a day doing work nurses are supposed to be doing. Well at least when I was a medstudent there-3 years ago.
 
I had to place peripheral IVs for patients bc the nurses could not get it (or are not as persistent as we are to get it) as well as draw blood and do ABGs (only physicians can draw them and in some hospitals respiratory therapists). Also Inpatient psychiatric facilities, not psych medical floors, don't have stat labs or phlebotomists in the weekends. I had two patients on clozaril that needed labs in the weekend. Otherwise pharmacy would not give them their next dose. I guess attendings can get away with not doing these things, but if you are resident it is your responsibility to make sure the patient gets the treatment they need.
 
My standard response: "Psychiatry is my calling. Anything else would have been just a job." Works every time. ;)
 
My standard response: "Psychiatry is my calling. Anything else would have been just a job." Works every time. ;)

"I like the crazy people". And "medicine is pretty boring without a little psychosis /neurosis". That's what I say.:D

I'm in it for the stories. And the art too-- I keep getting really cool pieces of art from my Axis II patients on the medicine and neurology floors. I just got a bizarrely cool drawing from the patient with Guillain Barre that I described in the "do you have to like neuro" section... It's no. 1378/3000 in his series on the Birth of the Universe in black and white... the other thing I received was from an x-IV drug user with chronic SBP, who sent me a fire-red business card holder, wrought from sheet metal, and shaped in the form of Beelzebub.

I guess you could argue that I got the art from patients not on psych floors, but it was my attention to "non-medical" issues (which actually happen/ed to be vital to the medical treatment of these patients) that has landed me the artwork. And I think that it's really the stories and the connection behind the art that really brings the art alive. You don't have time for that in virtually any other field. The fields that do have the time, don't have the patients.

And, because sarcasm is hard to project over cyberspace, I think I should explain that I'm not really that cavalier, but I think it's fun to respond to the lumpers that sterotypically disrespect the field of psychiatry in a manner equally farcical (i.e. "I like the crazy people")-- but with a smile.
 
they hate me for what I make them do, or for the treatment they don't want. But they never say I'm not a "real doctor." When a geriatric depressed lady develops abdominal pain, vomits, and I get her a KUB and start fluids and an NG tube while I wait for a transfer to a medical floor (all of which are full), she doesn't say I'm not a "real doctor."

I've never seen a psychiatrist do ABG's, place NG tubes, etc at this institution.
 
Anesthesiarocks just reminded me of something Jetproppilot once wrote in the Anesthesiology forums about choosing a specialty. The entire thread can be found at http://forums.studentdoctor.net/showthread.php?t=285125

From Jetproppilot:

Try and look beyond all the artificial, meaningless, competition/hype/this-specialty-is-better-than-that-specialty/ bull s h i t that goes along with the specialty-selection-period in medical school.

This is a CRITICAL decision for med students. And yet many times one's decision is not heartfelt....what I mean by that is you have to be honest with yourself. So here's a list of non-politically correct questions you should be asking yourself when you're trying to pick a specialty (being politically correct isnt a forte/desire of mine anyway...I'll tell you how I see it...sometimes to my demise):

1) Did you do a rotation that REALLY IMPACTED you? That really grabbed your attention? Got you so excited that you were waking up before the alarm clock with anticipation? Can you honestly say to yourself that no matter what happens to the specialty (reimbursement changes for example) and no matter what the hours are, you still HAVE to be a heart surgeon/pediatrician/neurosurgeon/geriatric physician etc etc??
Congratulations. You are one of the lucky ones. Go with this specialty because this is your life calling.
The percentage of med students fulfilling this mindset I'd say is less than 20%. This 20% can stop reading this post NOW. For the rest of you, read on.

2) OK, so you're in the 80% that are on the fence with 3 or 4 specialties. Maybe you're lucky and you've got it down to 1 or 2 specialties. Please take my advice since I think you'll thank me later....like in year 2016:

Think LONG TERM here. Try and look beyond all the alleged prestige, guts, glamour, and adrenaline rush you feel from your narrowed-down specialties.

Don't let your buddies opinions of your selected specialty impact you.

Please believe me that you, and your life will be totally different once you finish your training and you are 5-10 years into your private practice life.. Your priorities will most likely change.


Why is this SO important? Because remember that decision you made late in your third year of med school....I wanna be a (you fill in the blank here)? This decision affects you FOREVER. Yeah, that sounds dramatic, but, well, it IS dramatic.

Pick the wrong specialty for the wrong reasons and ten years from now you probably wont be happy with your life.

3) Be honest with yourself. You fell in love with heart surgery but the hours are intimidating to you. Dont go into heart surgery. You really loved internal medicine but you hate clinic. Dont go into internal medicine. You really love family medicine but the most important thing to you is money. Don't go into family medicine.

Thinking ahead, no matter what your buddies say, to what you perceive will make you happy 10 years from now concerning the right mix of medicine/lifestyle/money, should be the number one concern of yours. Not what is making you happy RIGHT NOW during your academic rotations.

4) Seek opinions of doctors outside academia when selecting a specialty. Call them. Talk with the dudes in private practice, since most likely this is where you will end up. Many times a specialty is viewed differently by docs outside academia.

There it is in a nutshell. Look ahead.

Good luck.
 
Anesthesiarocks just reminded me of something Jetproppilot once wrote in the Anesthesiology forums about choosing a specialty. The entire thread can be found at http://forums.studentdoctor.net/showthread.php?t=285125

From Jetproppilot:

Try and look beyond all the artificial, meaningless, competition/hype/this-specialty-is-better-than-that-specialty/ bull s h i t that goes along with the specialty-selection-period in medical school.

This is a CRITICAL decision for med students. And yet many times one's decision is not heartfelt....what I mean by that is you have to be honest with yourself. So here's a list of non-politically correct questions you should be asking yourself when you're trying to pick a specialty (being politically correct isnt a forte/desire of mine anyway...I'll tell you how I see it...sometimes to my demise):

1) Did you do a rotation that REALLY IMPACTED you? That really grabbed your attention? Got you so excited that you were waking up before the alarm clock with anticipation? Can you honestly say to yourself that no matter what happens to the specialty (reimbursement changes for example) and no matter what the hours are, you still HAVE to be a heart surgeon/pediatrician/neurosurgeon/geriatric physician etc etc??
Congratulations. You are one of the lucky ones. Go with this specialty because this is your life calling.
The percentage of med students fulfilling this mindset I'd say is less than 20%. This 20% can stop reading this post NOW. For the rest of you, read on.

2) OK, so you're in the 80% that are on the fence with 3 or 4 specialties. Maybe you're lucky and you've got it down to 1 or 2 specialties. Please take my advice since I think you'll thank me later....like in year 2016:

Think LONG TERM here. Try and look beyond all the alleged prestige, guts, glamour, and adrenaline rush you feel from your narrowed-down specialties.

Don't let your buddies opinions of your selected specialty impact you.

Please believe me that you, and your life will be totally different once you finish your training and you are 5-10 years into your private practice life.. Your priorities will most likely change.


Why is this SO important? Because remember that decision you made late in your third year of med school....I wanna be a (you fill in the blank here)? This decision affects you FOREVER. Yeah, that sounds dramatic, but, well, it IS dramatic.

Pick the wrong specialty for the wrong reasons and ten years from now you probably wont be happy with your life.

3) Be honest with yourself. You fell in love with heart surgery but the hours are intimidating to you. Dont go into heart surgery. You really loved internal medicine but you hate clinic. Dont go into internal medicine. You really love family medicine but the most important thing to you is money. Don't go into family medicine.

Thinking ahead, no matter what your buddies say, to what you perceive will make you happy 10 years from now concerning the right mix of medicine/lifestyle/money, should be the number one concern of yours. Not what is making you happy RIGHT NOW during your academic rotations.

4) Seek opinions of doctors outside academia when selecting a specialty. Call them. Talk with the dudes in private practice, since most likely this is where you will end up. Many times a specialty is viewed differently by docs outside academia.

There it is in a nutshell. Look ahead.

Good luck.

I think this is some great advice that would be helpful to most any medical student. As an addendum I might add that people should strongly consider doing at LEAST 2 rotations in their chosen field at different institutions. One great example is a third year I met on rotations that decided he wanted to be an OB/GYN on his second month of rotations (during OB/GYN). This in and of itself was fine except for the fact that the place he rotated had him working 30 hours a week or so with no call. So many experiences are institution dependent. You also really want to get a feel for what your life will be like as an intern/resident/attending, not just as a medical student.
 
Another random bump for Sazi's amazing post.
 
When people ask why do I want to go into psych, is it ok to say that I think crazy people are funny? Not all of them obviously, and I don't ever laugh at them, but manics and such are so entertaining.
 
I think that's something that many of us in the field would quietly acknowledge- there's something in our personalities that enables us to work better with the mentally ill, and humor can definitely be a mechanism that allows for this. I think ER docs have something similar, too. A black sense of humor goes a long way to defusing the reality of our jobs, work that might otherwise really take a toll _every day_. We're human too. Gotta cope somehow.
 
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I think that's something that many of us in the field would quietly acknowledge- there's something in our personalities that enables us to work better with the mentally ill, and humor can definitely be a mechanism that allows for this. I think ER docs have something similar, too. A black sense of humor goes a long way to defusing the reality of our jobs, work that might otherwise really take a toll _every day_. We're human too. Gotta cope somehow.

That is why people invented golf and the NFL. ;)

-t
 
Hey now. Some of us 'refined types' prefer our gin. Straight. :)
 
Another bump for a still beautiful post.
 
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