A question from a PD to me

[barzan]

Dear All;

I have been asked a couple of days ago a great question by a program director and I thought I would share it with you all,

What is the single most important question you want to answer by doing psychiatry?

this question made me really ponder and ruminate on what is it the that truly motivates me to do psych and by doing it what do I really want to achieve.


I would love to read your responses.

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[erg923]

Dear All;

I have been asked a couple of days ago a great question by a program director and I thought I would share it with you all,

What is the single most important question you want to answer by doing psychiatry?

this question made me really ponder and ruminate on what is it the that truly motivates me to do psych and by doing it what do I really want to achieve.


I would love to read your responses.

While the nebulous and possible philosophical nature of the question is interesting, I am not sure it would be predictive of...anything. And Isnt that what you are trying to do in a job interview.

 

[MacDonaldTriad]

The question would give an example of a candidate’s ability to think, and think abstractly potentially. It might also reveal some potential problems. “I’m going into psychiatry so I don’t disappoint my parents.” Or more likely, “I’m going into psychiatry because it is going to make my parents climb up the walls.” And then the layperson stereotype belief, “I’m going into psychiatry to try and better understand my own pathology.” Any of these would prompt further exploration.

 

[Chimed]

I think the question speaks more about the biases of the person asking the question rather then whether or not someone can given an answer that they would consider "meaningful." We're not applying to join a religious order or cult, unless the PD is trying to make sure you don't respond with something that sounds psychotic. In that case, I guess it would a good screening question for pathology.

 

[slappy]

That's a great question.

 

[vistaril]

Dear All;

I have been asked a couple of days ago a great question by a program director and I thought I would share it with you all,

What is the single most important question you want to answer by doing psychiatry?

I'd tell him/her that it is a stupid question and to please ask the question in another way that is at least sensible(such as what is the single most important thing you want to get from a career in psychiatry)

 

[vistaril]

The question would give an example of a candidate’s ability to think, and think abstractly potentially. It might also reveal some potential problems. “I’m going into psychiatry so I don’t disappoint my parents.” Or more likely, “I’m going into psychiatry because it is going to make my parents climb up the walls.” .

And yet none of those things would really go towards directly answering the person's question. "I'm going into psychiatry to see if ticking off my parents will cause their love for me to decrease" would be an answer along those same lines which would at least attempt to answer the horrible question.....

 

[MacDonaldTriad]

I would say "the meaning of life the universe and everything", but of course we know that this is 42. (Douglas Adams, a hitchhiker's guide to the universe)

 

[slappy]

"Perhaps you didn't ask the right question."

Having the urge to watch the movie now just to hear Marvin speak. Alan Rickman was a case of perfect casting.

 

[MacDonaldTriad]

"Perhaps you didn't ask the right question."

Having the urge to watch the movie now just to hear Marvin speak. Alan Rickman was a case of perfect casting.

Could you imagine a “cluster B” patient with a “point of view gun”. Talk about validating projections.

 

[shan564]

I would say "the meaning of life the universe and everything", but of course we know that this is 42. (Douglas Adams, a hitchhiker's guide to the universe)

42 isn't the meaning of life, the universe, and everything... it's the answer to life, the universe, and everything. You can't learn the meaning until you figure out the question:

 

[slappy]

I call BS. Twice. That's 42 too.

 

[whopper]

My honest answer is there is no single answer I can think of that is the greatest it can answer. It's not an end. It's an ongoing process that is always improving if we as a field continue to practice and research it in a scientific and ethical manner, just as one could never expect to 100% rid a society of crime, invent a 100% efficient machine, or find an equation that solves everything, but what's more important is we keep our ideals to always go in those directions. Whenever we figure out the next step and how to make it, we'll find ourselves with our next set of problems. I'm more interested in being part of the never-ending endeavor.

From that, the most important question for myself is how will I deal with this given the complexities of life and balancing it with the hope of being a happy and whole person?

And then the layperson stereotype belief, “I’m going into psychiatry to try and better understand my own pathology.”

I've seen actually several people go into this field for that reason. Students tend to pick the field that treated a specific disorder they or someone they loved suffered from in a manner that significantly affected that person.

I don't think this will make for a bad resident. I do believe this may even further embolden several to fuel their passion to help others and make them more sensitive in regards to empathy.

Unfortunately, however, I have seen some residents with some very significant pathology to the degree where it could not be excused. One particular resident I saw make recurrent and false allegations that several other residents and attendings raped her, and it seemed to be due to histrionic PD because when asked if she wanted the police involved, she always insisted no (among several other things such as one day showing up to work wearing a see-through shirt you expect someone to wear if they wanted to give out hook-up signal at a club). After the third false accusation, and several several practice errors (E.g. she kept over-medicating patients without informing the attending including Depakote to a pregnant woman) the program I was in kicked her out.

I later found out she got into another program, happened to get into a discussion with the chief there, and that chief found out what program I was in, told me the path of destruction that same resident did there, again claiming she was raped and blaming several attendings of both sexes of doing that.

 

[michaelrack]

What is the single most important question you want to answer by doing psychiatry?

.

How to safely and effectively treat mental illness.

A better question would by "why" rather than "what"- Why do you want to be a psychiatrist, learn psychiatry, treat the mentally ill, etc?

 

[heyjack70]

What is the single most important question you want to answer by doing psychiatry?

What are the Scientologists so up in arms about?

 

[wolfvgang22]

How to safely and effectively treat mental illness.

A better question would by "why" rather than "what"- Why do you want to be a psychiatrist, learn psychiatry, treat the mentally ill, etc?

I thought a similar thing: "How can I best serve people with mental illness in my community every day as a psychiatrist?". The interviewer will then either say, "Ok" and move on, or ask a follow up question like "How would you go about that, then?". So many good answers to that. Here's one: "Well, I plan on getting the most I can out of residency training as a start." Then ask your own follow up question about the program with genuine interest.

If asked "Why do you want to be a psychiatrist" there are sooo many good answers one can mix and match, depending on the situation and how you read your interviewer's personality and intent. Not only am I answering the question, I'm building rapport with the interviewer, just like I do with patients. How you say things is as important as what you say. I'll sometimes answer these basic kinds of questions starting with "I get asked that question a lot on the interview trail. <smile, chuckle, you are in this interview process together, after all> I was just telling Dr. Jones downstairs earlier this morning that...:

1. Nearly everyone knows someone who has been affected by mental illness. As a physician in training, I think treating mental illness is just as important, maybe more important than treating something like diabetes. If a person has untreated mental illness, they are less likely to take care of their physical health, which further impacts our society.
2. I really enjoyed working with the psychiatrists during medical school. The collegiality, professionalism, and compassion of my attendings really impressed me, and I felt I could do a lot worse than follow their examples. (Be ready to give an example or two.)
3. Psychiatry is a fascinating field, with new information coming out everyday, such as <enthusiastically insert interesting article you carefully reviewed and reflected upon yesterday that the interviewer may not have had a chance to read yet here. Be prepared to summarize and discuss just like a journal club. Be humble and admit what you don't know. Show you are gonna be a cool colleague.>​

Fortune favors the prepared. If I ever get an actual off-the wall, inappropriate, or truly unexpected question I'll often say "That's the first time I've been asked that particular question in an interview, lets see..." and thoughtfully answer. If the interviewer does not like my sincere effort in providing a professional sounding answer, I don't want to be around that person for four years.

 

[birchswing]

Outsider's point of view:

To the question, "What is the single most important question you want to answer by doing psychiatry?"

I would answer, "How can we alleviate human suffering safely and effectively?"

 

[Salpingo]

I'd tell him/her that it is a stupid question and to please ask the question in another way that is at least sensible(such as what is the single most important thing you want to get from a career in psychiatry)

This is a great question, for just this reason. It delineates those who see residency as a career path versus those who see it as an academic endeavor. Of course, if you see it as vocational training, giving you the necessary credentials to prescribe meds and pile through evals, its a stupid question. And those are the people that are going to chronically be looking over their shoulders, paranoid about NPs or prescribing psychologists who can essentially do the same task for half the fee. As an MD, we have to carve a niche for ourselves, push the field forward, and do something more than mid-level work.

Anyway, some of my answers:
The psychotherapist in me wonders why people do the same thing when they know the result will be negative.
The pseudoscientist in me wonders where the brain ends and the mind begins.
The community physician has me wondering how to integrate psychiatry into primary care.
The physician in me wonders if this is all possible in one lifetime/career.

 

[slappy]

And that's a great answer.

My instinctual response was something along those lines but I didn't give it enough thought to build it up as much as you did. So, great job!

 

[wolfvgang22]

I'd tell him/her that it is a stupid question and to please ask the question in another way that is at least sensible(such as what is the single most important thing you want to get from a career in psychiatry)

I could be wrong, but I feel that telling any interviewer that anything they asked is "stupid" may not be the optimal way to succeed in an interview. It could indicate a lack of tact and an inability to redirect a conversation when faced with stupidity.
Anyway, I don't think I'd be above asking a stupid question occasionally, or frequently, as an interviewer.

 

[bashir]

I feel like the question relies on the premise that a good psychiatrist is an academic first and foremost, which I reject and kind of resent. There are some great responses in this thread that at the same time answer the question and reframe it, politely and subtly rejecting this premise.

 

[slappy]

Well, the PD may have such a bias/premise, but not the question itself.

It's just a good open-ended question that would likely throw more light on the applicant's biases and priorities than the PD's.

 

[bashir]

Well, the PD may have such a bias/premise, but not the question itself.
""
It's just a good open-ended question that would likely throw more light on the applicant's biases and priorities than the PD's.

I respectfully disagree. My goal in practicing psychiatry is not to "answer a question". My goal in practicing psychiatry is to relieve suffering and restore function. The question implies that that's not enough, that one should be driven by intellectual curiosity about a certain topic, in other words, that one should be an academic.

 

[Salpingo]

I respectfully disagree. My goal in practicing psychiatry is not to "answer a question". My goal in practicing psychiatry is to relieve suffering and restore function. The question implies that that's not enough, that one should be driven by intellectual curiosity about a certain topic, in other words, that one should be an academic.

I think you're going to find that its hard to practice psychiatry without a little intellectual curiosity. There are some other specialties where you can relieve a lot of suffering by cutting, clipping or cauterizing, then punching out. But I can't think of a very satisfying equivalent with psychiatry. Anyone can prescribe an SSRI, march through the TMAP or run through SIG E CAPS, but I wouldn't want to make a career out of it, and I'm sure a program director wouldn't want to graduate a class full of those people.

For the record, and for the future applicants out there, PDs are well aware that roughly a third of their class will end up in academics (although a greater percentage for the Columbia's and MGH's). But a little intellectualism makes the interview much easier, and certainly makes the class more interesting.

 

[OldPsychDoc]

I respectfully disagree. My goal in practicing psychiatry is not to "answer a question". My goal in practicing psychiatry is to relieve suffering and restore function. The question implies that that's not enough, that one should be driven by intellectual curiosity about a certain topic, in other words, that one should be an academic.

I see your point--but hopefully choosing to not be an "academic" in the classical sense, you still might be able to answer the question with respect to your own desires to "relieve suffering and restore function", or even reflect on your own individual role in that enterprise. Remember "doctor"="teacher". Even if your students are primarly patients or the public at large.

 

[Nasrudin]

I've been thinking a lot about this question and what psychiatry training is going to mean to me. What I want out of it. Which is exactly why I like the question. Or any other open ended question that inspires this kind of self-reflection.

Upon reflection in anticipation of beginning internship, I think I realized I have an over-riding cautiousness related to age and debt that has the potential to stunt my growth and blunt my curiosity and ability to learn.

I started thinking about people I admire here and elsewhere and what draws me to them. These turned out to be people committed in some way to deriving a different sort of satisfaction from their work in psychiatry. Whether it was OPD's commitment to teaching residents and giving them (and us) guidance or whopper's quest for constantly learning from the top minds he can. Or many others--(NDY, MacDonaldTriad, etc)--who always seem to point to deriving deeper satisfaction from the work.

So I think I figured out my preliminary answer to the question...I want to answer the question--What can I contribute to it?

 

[jakeislove]

If it was possible to give a sincere answer, without penalty: "What is the airspeed velocity of an ulnaden swallow?"

Everything I needed to know about a program would be contained in that question.

There's no point trying to explain. Only someone who gets it could understand why that program would be ranked 1st.

 

[Nasrudin]

Monty Python and the Holy Grail!

I agree. That's a superb question. One that should determine your rank list for sure.

 

[jakeislove]

Monty Python and the Holy Grail!

I agree. That's a superb question. One that should determine your rank list for sure.

It's also the question I'd most like to ask.

It's just doubtful the interview process is ready for such thoughtful, revealing, and deeply personal questions. I guess we're obligated to ask/answer what's expected.

Not joking, though. That question would lock in the number one spot. In a nutshell: It's my opinion that those helping the mentally ill need a healthy sense of humor.

 

[Evidence Based]

If it was possible to give a sincere answer, without penalty: "What is the airspeed velocity of an ulnaden swallow?"

African or European?

 

[jakeislove]

The question

African or European?

"Huh? I... I don't know that."

 

[deleted432032]

"How do you know so much about swallows?"

 

[slappy]

African or European?

"How do you know so much about swallows?"

Well, you have to know these things when you're an applicant, you know.

 

[OldPsychDoc]

It's also the question I'd most like to ask.

It's just doubtful the interview process is ready for such thoughtful, revealing, and deeply personal questions. I guess we're obligated to ask/answer what's expected.

Not joking, though. That question would lock in the number one spot. In a nutshell: It's my opinion that those helping the mentally ill need a healthy sense of humor.

I, for one, would love to fill my program with light-hearted geeks.

 

[MacDonaldTriad]

I, for one, would love to fill my program with light-hearted geeks.

Wouldn’t we all. However, if our mission is to maintain the fragile population of self-congratulatory uber egoed, patronizing academic types, we will have to let a few in that have Prima Donna tendencies. Like the amazing bacteria thriving in hydrothermal sulfur vents at the bottom of the Atlantic, they have to start out a little annoying if they are going to make it in a university setting.

 

[wolfvgang22]

Just don't ask me what my favorite color is.

 

[jakeislove]

Just don't ask me what my favorite color is.

"Pink, it reminds me of my first love." should work.

 

[OldPsychDoc]

Still waiting for the magical moment when an applicant asks if our ECT stimulator goes to 11.

 

[jakeislove]

Still waiting for the magical moment when an applicant asks if our ECT stimulator goes to 11.

Nigel Tufnel is one of the few people I'd allow to sign my LP.

 

[Nasrudin]

Still waiting for the magical moment when an applicant asks if our ECT stimulator goes to 11.

. Let me cue that amazing moment in film up for you.

 

[jakeislove]

It goes to infinity now.

 

[Evidence Based]

As an incoming medical student, this thread (along with everything else in this forum) make for an excellent advertisement for psych. Things to think about in a few years... Maybe I'll bookmark this thread and come back summer 2017 when I'm deciding about the Match

 

[jakeislove]

As an incoming medical student, this thread (along with everything else in this forum) make for an excellent advertisement for psych. Things to think about in a few years... Maybe I'll bookmark this thread and come back summer 2017 when I'm deciding about the Match

I'm kind of a goof.

Refraining from using any of my responses would be a good idea.

 

[MacDonaldTriad]

As an incoming medical student, this thread (along with everything else in this forum) make for an excellent advertisement for psych. Things to think about in a few years... Maybe I'll bookmark this thread and come back summer 2017 when I'm deciding about the Match

You have a lot of time to sample and taste before drinking our Kool Aid. When you see (and I didn’t say “if”) your mentors and classmates teasing psychiatry, understand there is an element of envy and discomfort behind their need to do this. Good luck and have fun.

 

[jakeislove]

You have a lot of time to sample and taste before drinking our Kool Aid. When you see (and I didn’t say “if”) your mentors and classmates teasing psychiatry, understand there is an element of envy and discomfort behind their need to do this. Good luck and have fun.

It's probably a deep-seated fear of their pathology being exposed.

 

[MacDonaldTriad]

It's probably a deep-seated fear of their pathology being exposed.

We could test your theory by threatening to do a Vulcan mind meld as a prolonged exposure exorcise.

 

[OldPsychDoc]

We could test your theory by threatening to do a Vulcan mind meld as a prolonged exposure exorcise.

I see what you did there...

 

[MacDonaldTriad]

I see what you did there...

I’m obviously using a Freudian spell checker program.

 

[slappy]

This thread would find itself at home on the SA forums.

 

[jakeislove]

We could test your theory by threatening to do a Vulcan mind meld as a prolonged exposure exorcise.

Touching a someone while saying "My mind to your mind" would almost be amusing enough to suffer the ramifications. I'd be giggling about it on my deathbed.