anyone else's family not supportive of decision to go into psychiatry?

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eastcoastdr

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**update in post 25!!**

I'm an MS3 who is planning on applying to psychiatry. I'm halfway through my clerkship year and I feel like I've made an educated decision on this. I've had Surgery, Medicine and Psych. Haaaated surgery and medicine. I passed out every time I was in an OR, I literally couldn't handle it! And medicine bored me to tears. But psych...it was like something CLICKED in me. I felt re-energized about medicine, and I actively want to study and read about psych. I woke up everyday happy and ready to go to the hospital, which was not the case for surgery and medicine. I'm very close to my parents and they do help finance my education and living expenses. They are Indian, grew up in India and they are NOT doctors. My dad is an engineer, and my mom is a home-maker.

They (my dad especially) say that:
- "psych isn't real medicine" (this is their BIG argument)
- "obamacare won't cover visits to the psychiatrist so you won't make any money"
- "no one respects psychiatrists"
- "why did i pay all this money for you to become a counselor"
- "all you will be doing is seeing bipolars and schizophrenics for the rest of your life"
- "in america everyone blames depression instead of just telling people to work through their issues"
- "all you do is write a few prescriptions and thats it"
-"psych clerkship was only 6 weeks, how can make such a decision in a short amount of time"

They even had me sit down and talk to their friends who are doctors in other specialties..again all Indians who went to school in India (where there is still a cultural stigma against mental illness). These doctors did give me helpful advice and they mostly said that I should be prepared to be disrespected by some doctors in other fields but at the end of the day I should do what makes me happy.

My parents keep telling me to consider other fields like neurology. They are literally begging me to pick something else. They say I'm being close-minded and not thinking this through carefully. Am I being close-minded? I don't understand how much longer my parents want me to weigh this decision, I have to start getting personal statements and LORs in order too! I mean..it's time for me to set up my 4th year electives, and ERAS opens up in just a few months... Please help. I don't know what to do. I want to be a psychiatrist, I don't care that some people don't see my profession as real. I want to do what makes me happy...but its hard to be happy when the people closest to you don't support your decisions.

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do what makes you happy. ultimately it's your life and your decision. having asian parents, im very familiar with the parental desire to steer away from psychiatry, much of which is based on stigma, as you've mentioned yourself. as long as you explain your rationale for choosing psych, and make them feel as though you've listened to their concerns, that should be enough... also the comment about the affordable care act not paying for MH visits is untrue, and the reality is basically the opposite. as I've done research on quality measures within the ACA, it's clear that MH is increasingly being recognized as and under-addressed issues in medicine.
 
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Thanks for your quick reply tishage.

I should add that I WILL apply for psych residency. I've made that decision and I'm gonna stick to it. I guess I should have edited my original post to say this..but I'd like some help in debunking some of these myths that my parents tell me about psychiatry. I've tried doing the best job I can by using my own experiences on the psych ward, but my parents just aren't buying it. If anyone had similar problems, what kind of things did you say to your parents to help them accept psychiatry?
 
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If your parents think being a neurologist is so awesome, they can certainly go to med school and choose to become neurologists. You're the one who has suffered through all this schooling, so I say you've earned the right to do what makes you happy.

When I look at stuff like Elyn Saks's story about living with psychotic illness, it helps me remember that our patients really do suffer (with their illnesses, and with inappropriate treatment) and that the work we do truly is very important even if others don't "get it".

Yes, there is a lot of stigma on mental illness (even in America). I have made a point of trying to combat that stigma, because stigma kills. So many people die of untreated mental illness because they couldn't admit they needed help. Just think of how hard it is for someone to admit they have a mental illness and need help. Really, compared to that stigma, the stigma of being a professional treating mental illness is insignificant. Being a physician of any type is a respected career and many laypeople do seem to find my job interesting. Other doctors may make anti-psychiatry comments when I'm not around, but other doctors tend to pick on other fields all the time anyway. It's not like I get spit on or anything. :)

I've noticed that as I've gotten older, other people's opinions of my choices matter less and less to me. I feel good about what I do and I know that I help people (yes, some psych patients really aren't happy to see you when you're the psychiatrist, but sometimes I have been surprised by how grateful some of my patients are).

It's possible that in time your parents will come around. Even if they don't, though, I think life is too short to spend it trying to please everyone else.
 
I'm an MS3 who is planning on applying to psychiatry. I'm halfway through my clerkship year and I feel like I've made an educated decision on this. I've had Surgery, Medicine and Psych. Haaaated surgery and medicine. I passed out every time I was in an OR, I literally couldn't handle it! And medicine bored me to tears. But psych...it was like something CLICKED in me. I felt re-energized about medicine, and I actively want to study and read about psych. I woke up everyday happy and ready to go to the hospital, which was not the case for surgery and medicine. I'm very close to my parents and they do help finance my education and living expenses. They are Indian, grew up in India and they are NOT doctors. My dad is an engineer, and my mom is a home-maker.

They (my dad especially) say that:
- "psych isn't real medicine" (this is their BIG argument)
- "obamacare won't cover visits to the psychiatrist so you won't make any money"
- "no one respects psychiatrists"
- "why did i pay all this money for you to become a counselor"
- "all you will be doing is seeing bipolars and schizophrenics for the rest of your life"
- "in america everyone blames depression instead of just telling people to work through their issues"
- "all you do is write a few prescriptions and thats it"
-"psych clerkship was only 6 weeks, how can make such a decision in a short amount of time"

They even had me sit down and talk to their friends who are doctors in other specialties..again all Indians who went to school in India (where there is still a cultural stigma against mental illness). These doctors did give me helpful advice and they mostly said that I should be prepared to be disrespected by some doctors in other fields but at the end of the day I should do what makes me happy.

My parents keep telling me to consider other fields like neurology. They are literally begging me to pick something else. They say I'm being close-minded and not thinking this through carefully. Am I being close-minded? I don't understand how much longer my parents want me to weigh this decision, I have to start getting personal statements and LORs in order too! I mean..it's time for me to set up my 4th year electives, and ERAS opens up in just a few months... Please help. I don't know what to do. I want to be a psychiatrist, I don't care that some people don't see my profession as real. I want to do what makes me happy...but its hard to be happy when the people closest to you don't support your decisions.

Much of this sounds like a cultural issue that is creating a barriers, and in a good number of their assertions, frank misunderstanding and falsehoods.

You can choose to please others or to please yourself. I might suggest asking your parents whose happiness do they value more, theirs or yours?
 
Thanks for your quick reply tishage.

I should add that I WILL apply for psych residency. I've made that decision and I'm gonna stick to it. I guess I should have edited my original post to say this..but I'd like some help in debunking some of these myths that my parents tell me about psychiatry. I've tried doing the best job I can by using my own experiences on the psych ward, but my parents just aren't buying it. If anyone had similar problems, what kind of things did you say to your parents to help them accept psychiatry?

i think you should go for psych. if that is something you truly want, then do it. i have south asian parents and if they told me not to choose a field because they didn't think it was 'real' medicine, i obviously wouldn't listen to them. psychiatrists aren't disrespected in the medical community. maybe in india they are. but not here in america.

and i don't think your parents truly know what psychiatry, it is more than just seeing schizos and bipolar patients. i think you should explain to them what psychiatry is about. they may not know how the effect of the mind affects the body and vice versa. and you know you will have inpatient rotations during your residency so you still have the opportunity to practice what they consider 'real' medicine.
 
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You will spend the overwhelming majority of your professional life being called "Doctor" by your patients and the staff around you, far removed from other types of physicians. If you go into consult/liaison, then you will interact with other types of doctors, but they will be requesting your assistance and regardless of what they think of you, odds are good they will keep their mouths shut if they hold onto stigmas. Most of them will be appreciative of your help, and voice that. The only people who will have issues with your becoming a psychiatrist, are your parents and/or their friends (and Scientologists). There is the occasional attending who might try and dissuade you, but that's "their stuff" not yours. When you are a psychiatrist and/pr psych resident, you can tell your parents that your family visit was sponsored in part by the humane work hours of psychiatry. They will get over it in time, more likely than not. If they don't get over it, that is their problem, not yours.
 
When I look at stuff like Elyn Saks's story about living with psychotic illness, it helps me remember that our patients really do suffer (with their illnesses, and with inappropriate treatment) and that the work we do truly is very important even if others don't "get it".

Hi,
Thanks for all your responses. And also special thanks to Peppy for posting the link to Elyn Saks' ted talk..I've been meaning to read her book! I found another great ted talk about mental illness by Vikram Patel...I'm gonna show these two videos to my parents in hopes of getting them to see why psychiatry is so important to me. Maybe they will take the word of a renowned professional seriously lol
 
I'll bet if you ask some of your psychiatric mentors if they experienced parental resistance to their decision, more than half would say yes. If you ask them if they made the right decision, almost all will say yes. Parents will not hold on to their disappointment very long. If they do, they will look silly explaining how their physician child let them down and you will have some great opportunities to utilize your most condescending eye rolling.
 
I'm an MS3 who is planning on applying to psychiatry.......... I want to do what makes me happy...but its hard to be happy when the people closest to you don't support your decisions.

I guess they would be really really unhappy with you if you ever had the temerity to end up with a diagnosis......just about no way back from that one I'd guess....:cool:
 
your dad doesn't have any misconceptions about psychiatry, there is a grain of truth in everything he has said, and you should save your breath trying to convince him because he just doesn't care. you cannot please everyone all of the time, this is a life lesson for you, but at the end of the day even if you won't be a real doctor, you still have a medical degree, will be vaguely respected, and make a decent crust. if your parents can't accept that's their problem. if they have paid for your education that is fine. they can always lie when people ask! i think some of my family members think i am a surgeon! ha!
 
What your Dad said aren't hard negatives. Psychiatry being light on medicine, focused on counseling and prescribing, and not being taken too seriously are aspects I really like about the field. I look at serious surgeons in training and laugh inside.

Like Splik said, you will be vaguely respected by most, earn an impressive hourly wage by many standards, and be able to help and treat a wide array of mental issues with thankful patients. That's hard to beat in a job with normal hours and low stress. Try it, I did. Most of America are stuck in jobs with pushy bosses, where you're only worth the quotas you meet and the bonuses you make. A piece of humble pie for your folks will put this all into perspective. I'm thankful every time I walk the wards as a psych resident because I lived that other life where you're a cog in some company wheel.
 
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Your folks will spend 0% of their time living your work life.

You will spend 100% of your time living your work life.

This is not about your obligation to them. The income will be there, and if you choose the specialty you want to do, the happiness as well.
 
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For situations like this, I'd recommend a fact-based approach. For example:

- Depression is one of the leading causes of lost productivity and morbidity as well. Show all the studies linking depression to worse medical outcomes, earlier death, etc.

- suicide is now a top 10 cause of death.

- psychiatry research is blossoming. We have the farthest to progress and the most to benefit. For example the new push to map the brain.

- We make as much (or more) per hour than other doctors. The low salary surveys are due to our aging psychiatric population, 75% of psychiatrists working part time (see Medscape 2012 salary survey), and not taking this into account.

- Get a little biological with them. Give them some evidence for the biological basis of psychiatric disorders if that's what they want.

- Do you want to do child? Tell them you do. People always feel bad for the children, and you make more $$$ generally. They'll like that.

Glad you made the right choice.
 
I might suggest asking your parents whose happiness do they value more, theirs or yours?

I'm Indian, and if I were to ask that question to my parents.....well the answer may not be what you're expecting. :laugh:

In any case, I'm thinking psychiatry too. But I've been paying for my own things since college, so it was more of me telling them what I'll be doing than asking them. I listen to them but I never make it out like it's something they have an input in. Maybe a change of approach to your parents would be better. If you phrase it like 'I'm thinking about psychiatry?', then they think there's a debate where they have input. I would phrase it like 'I'm going into psychiatry, I wonder where I'll match?'

You'd be surprised how a minor change in focus results in a change in attitudes.
 
To the original poster, I understand your situation. I'm also Indian and when I expressed interest of going into psychiatry, my mom, who's a physician, wasn't too thrilled. And the reasons she gave were sort of similar to the reasons your dad gave you, primarily psychiatrists aren't real doctors...

But now I'm halfway through my psychiatry residency and my parents now are seeing how happy I am and how well I am doing. My mom couldn't be more proud of me and I know she's happy just to see me happy. She proudly tells her friends and collegues that I'm a psychiatrist. There is definitely a stigma in Indian society of how psychiatrists are not real docs, blah blah blah. I say follow your heart, because it's YOU that's going to end up working in whatever field you choose, for the rest of your life. Everything else will fall into place, and your parents will be happy just to see you happy and successful. But it might just take some time for them to accept your chosen field and you will need patience for that...
 
I'm an MS3 who is planning on applying to psychiatry. I'm halfway through my clerkship year and I feel like I've made an educated decision on this. I've had Surgery, Medicine and Psych. Haaaated surgery and medicine. I passed out every time I was in an OR, I literally couldn't handle it! And medicine bored me to tears. But psych...it was like something CLICKED in me. I felt re-energized about medicine, and I actively want to study and read about psych. I woke up everyday happy and ready to go to the hospital, which was not the case for surgery and medicine. I'm very close to my parents and they do help finance my education and living expenses. They are Indian, grew up in India and they are NOT doctors. My dad is an engineer, and my mom is a home-maker.

Wow, I could have written almost that entire paragraph, word-for-word. In fact, I had to scroll back up and look at the name/date on the post to make sure that it's not actually something that I did write a year ago. Except remove the sentence about parents financing your education, change "Indian" to "Pakistani", and change "homemaker" to "dietitian." And I didn't pass out in the OR.

Also, I'm lucky enough to have a direct family that is relatively well-educated when it comes to scientific principles, so they generally believe in psychiatry as a field. They also have a lot of Pakistani doctor friends, some of whom are psychiatrists, and never noticed a clear distinction in respect between different fields.


To address the individual points:
"psych isn't real medicine" (this is their BIG argument)
If psych wasn't real medicine, then we wouldn't require you to go to medical school and do a medical residency which includes a few months of internal medicine and entitles you to a license to prescribe medicine.

That said, there is some truth to their assertion. Psychiatry is definitely less "medical" than other fields, which is a huge selling point for many of us. But why does it matter if you're practicing "real medicine" or "not real medicine" as long as you have a medical degree, a medical license, a medical staff, medical job security, and a medical salary?

Also, tell any inpatient IM attending that there are no more psychiatrists at their hospital, and see their reaction. IM people hate dealing with psychiatric issues.

Also, the question of "what is real medicine?" cannot be answered by somebody who isn't a doctor. Is pathology "real medicine?" What about dermatology? Radiology? Genetics? Sleep medicine? Pill mill ology?



- "obamacare won't cover visits to the psychiatrist so you won't make any money"
That's just not true. If anything, the opposite is true. Many serious psych patients don't have insurance anyway, since it's hard to buy insurance when you're suffering from debilitating mental illness. Countries with public health systems (I have experience with Australia, but other countries are the same) do a much better job of covering mental health than we do here in the US.

There has never been any concern that Obamacare won't cover psychiatry. If my parents made an argument like this, I'd respond by saying something like "if you're going to start making up imaginary pseudo-facts, there's no point trying to have a rational discussion with you."
http://psychcentral.com/news/2012/0...nder-affordable-care-act-obamacare/41052.html
http://edwindearborn.com/psychiatrys-million-dollar-windfall-from-obamacare/


- "no one respects psychiatrists"
Psychiatrists do get less respect than other fields. If you care a lot about that, do some basic science research and call yourself a neuroscientist. Or do a fellowship in behavioral neurology or sleep medicine or pain medicine or addictions or C/L, and call yourself something other than a psychiatrist at parties.


- "why did i pay all this money for you to become a counselor"
Response: "If you think that psychiatrists are the same thing as counselors, then you clearly aren't knowledgeable enough to help me make this decision. That's like saying that I shouldn't become an ophthalmologist because you didn't pay all this money for me to become an optometrist. Or PM&R/physical therapist. Or pathologist/lab tech. Or radiologist/radiology tech."

Also, if they're concerned about their financial investment, then just show them salary surveys. Psychiatrists are more likely than other specialties to work part-time, but still earn more than many other specialties (although definitely not the richest of all doctors). So that's a pointless argument, since the financial investment will still pay off.


- "all you will be doing is seeing bipolars and schizophrenics for the rest of your life"
You could say the same thing about cardiology/CHF, pulmonology/COPD, endocrinology/diabetes, nephrology/CKD, rheumatology/osteoarthritis, neurology/dementia, etc. If you don't want to see patients with particular disorders, you can just refer them to somebody who does want to see them.


- "in america everyone blames depression instead of just telling people to work through their issues"
That's why we need psychiatrists to tell the difference between mental illness and "issues." Also, I thought that you'd just be seeing bipolars and schizophrenics? And I thought they said that there wasn't enough demand for psychiatrists?

When people say that depression isn't a real illness, I tell them to look at the evidence instead of just making things up based on their own limited experience. That's like saying "you should just eat less sugar instead of blaming diabetes for your issues." Sure, your sugar habits probably contributed to your diabetes, but as a South Asian, I'm sure you know plenty of skinny people with diabetes (I sure do). My uncle is a doctor with spectacular exercise habits and a body shape that I can only aspire to, but he still has type 2 diabetes. And I know plenty of people with a similar story about depression.


- "all you do is write a few prescriptions and thats it"
Argument: "I thought you said I was just a counselor? Counselors can't write prescriptions."
Also: "Most doctors just write prescriptions. The challenge is to know which prescriptions to write and what else to recommend in addition to that."

-"psych clerkship was only 6 weeks, how can make such a decision in a short amount of time"
You could say the same thing about any other clerkships/specialties.


They say I'm being close-minded and not thinking this through carefully.
Ironic. It seems to me that they're the ones who are being closed-minded and not thinking this through carefully. You were open-minded enough to consider every other specialty.




As I said before, this was much less of an uphill battle for me, but it was still slightly uphill. Here's how I did it:
"Hey guys, this psych clerkship is actually not as bad as I expected."
A few days later... "You know, psychiatrists actually earn more than I thought."
A few days later... "Ah man, residency is going to suck, unless I go into psych."
A few days later... "I was reading a salary survey the other day, and it turns out that 70% of psychiatrists work less than 40 hours a week."
A few days later... "Check out this cool neuroscience article... the psychiatry department is putting out some amazing research."
A few days later... "Look, they changed the billing codes so that psychiatrists will make more money now if they do comprehensive physical exams" (this is actually true).
A few days later... "You know, I like psych, but I'm not convinced that I should leave 'real medicine'... I'm thinking about applying to a combined med/psych program."
A few days later... "Those combined med/psych people get some great fellowships... you can make so much money as an interventional pain specialist, and they love to accept med/psych people."
A few days later... "You know, I'm finding out that you can get those interventional pain fellowships without doing the combined med/psych thing, since a general psych program allows more elective time to improve your CV for that fellowship."
A few days later... "Actually, I'm not sure if I even need to do pain medicine to make good money as a psychiatrist, since healthcare changes are generally increasing reimbursement for preventive psych and decreasing reimbursement for procedures."

and so on, and so forth.


At first, my mom was telling people that I'm planning to do a combined med/psych program, even though I was pretty set on psych (she still wanted me to do that). After a while, it sunk in that I'm doing general psych. As somebody else said earlier, she's now proud to say that I'm going to be a psychiatrist, especially since I matched at my top choice residency.


Yes, there are a lot of misconceptions about psychiatry. But in the end, if you want your family to accept what you're doing, all they need is time. In the meantime, you just need to tell them something that will make them happy without giving them false expectations. I even interviewed at a few med/psych programs because I wasn't convinced that I wanted to do general psych. Now I couldn't be happier with my decision.

Here's a blog post I wrote recently. I hope it can help you:
http://encephalotomy.com/2013/02/6-common-misconceptions-about-psychiatry/
 
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But psych...it was like something CLICKED in me. I felt re-energized about medicine, and I actively want to study and read about psych.
.

I'm glad for your interest in psych, but make sure that you enjoy actually seeing psych pts rather than just reading about them/neurosciene. I encourage you to do a psych elective early 4th year, with some outpt exposure if possible.
 
tell your family to go climb a tree
 
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As the OP, I just wanted to update on this situation! I matched into psychiatry and my parents are actually very happy and excited for me. So for anyone in a similar situation, there is HOPE!

After months of arguing with my parents, I just went ahead and applied psych. After I applied and the interview invites started rolling in, my parents became a little more positive about the situation. My parents continued to talk to some more health professionals they knew and they actually got in touch with an Indian psychiatrist attending who's son is also a psych resident. They talked to both of them and I think after hearing about how successful their work is and whatnot, they really started to change their minds. No one in my immediate family is a doctor, but my uncle is a clinical pharmacist and he talked about how awesome the psychiatrists at his hospital are. I have a distant cousin in internal medicine, and even she said she liked working with the C/L attendings a lot. I think it really helped that my parents heard the other side of the story from people they trust in the health professionals field. Kind of sucked that my parents didn't take me seriously but in my culture, parents like to think that the adults/elders are the ones that know best.

So for anyone that is in a similar situation...Chin up!! Go ahead and apply to whatever you want. Show your parents that you are 100% serious about your decision. And encourage them to reach out to health professionals (not just doctors....nurses/pharm/SW/whatever too!) within their community to get a better sense of what your chosen field is like. The turning point was definitely when my pharmacist uncle talked about how he really respects the work psychiatrists do. It helped for my parents to hear that other people take psychiatrists seriously, because their big argument was "psychiatrists aren't real doctors", "therapy is B.S." etc.

Anyways I'm so thankful to have matched, and that my family is supportive of me. For anyone that is still struggling with this issue please feel free to PM me :)
 
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Thanks for coming back to update! I wish people did that more often, it's useful to those struggling with the same issues.
 
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Thanks for posting. I'm in a similar situation. It's nice to hear the positive stories for a change ;)
 
While I am certain it varies from family to family, and am happy for the OP's persistence in winning them over, I don't think psychiatry is viewed positively by that many people in general. So that, many of them comprising our families, seems inevitable.

It's a noncompetitive specialty with good pay and lifestyle for a reason.
 
We have a terrible PR problem in general. Sometimes it comes from above more than from the general public. Other specialty attendings make jokes about us, or they tease medical students who dare admit they are aiming at psychiatry. My school had an advisor who told one of my classmates that her grades were too good to go into psychiatry. It seems that she would be “wasting her medical knowledge.” I suppose this could be construed as a compliment, but medical school still isn’t the milieu in which we support student’s interest in psychiatry. It didn’t take me a second analysis to resolve any insecurity complex. I have been very happy with my decision for 30 years and good for you for sticking to your guns.
 
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eastcoastdr- I'm so glad your family has been coming around. You don't need your family's approval when you choose your specialty, but it sure makes it easier on folks.

I agree that psych's PR program is multi-factorial. We get it from within medicine and from the general public. Some of it is stereotyping and ignorance but we also have to own some of it ourselves.

The downside to being one of the least competitive specialties is that we attract a lot of bottom feeders. Folks who barely made it through medical school and/or lack clinical judgment or professionalism that couldn't match into much of anything often find their way into psych because there are many programs that will take pretty much anything this side of a warm body. There are a lot of criminally bad psychiatrists out there, way more than I've seen in other specialties. We need to do a better job of policing ourselves. It's hard to champion your specialty when there are a frightening number of folks that realistically shouldn't be practicing.

Unfortunately, we earned some (but not all) of the bad reputation we have in the community and in medicine. When I hear someone at a party tell me some horror story of an experience they had with a psychiatrist, I don't dismiss it as exaggeration. And when I hear a medical practitioner talk about a bad clinical run-in they had with a psychiatrist, I also can't dismiss it. I'm not sure what the solution to this is, other than improved applicant pool and improved training programs. There are a lot of amazing psychiatrists out there and some incredibly innovative high quality training programs, but like anything, the bad apples really spoil it for the rest of us.
 
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I wonder if we'll see a more competent group of new psychiatrists in the coming years as the residency position crunch continues. Although there are many other issues with not increasing the number of residency positions, one side effect could be better residents in the less competitive specialties as the bottom of the applicant pool is edged out.
 
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I wonder if we'll see a more competent group of new psychiatrists in the coming years as the residency position crunch continues. Although there are many other issues with not increasing the number of residency positions, one side effect could be better residents in the less competitive specialties as the bottom of the applicant pool is edged out.
Interesting question. Right now, about half of psych residents are IMGs. Programs tend to be fairly black and white on their “friendliness” towards IMGs. The mix of IMGs and US grads is fairly polarized in that there are a lot of programs with zero or maybe a couple of IMGs, and there are a lot of programs with close to 100% IMGs. If this were an absolute polarization, half of programs would be US grads only and half would be IMG only. I would guess this is roughly 1/3, 2/3rds now. As the pool of US grads grows, more programs will have the “no IMGs club” within their reach. We all know that the low end US grads are much lower on the desirability list than an average IMG, but then there is a perception factor that is driven by applicant behavior as much as training director bias. Many competitive US grads do look askance at programs with IMGs. I’m not saying this is right or fair, it just is true.

My prediction is that it will get harder for IMGs and US grads with red flags will not be hurt as much as might be predicted.
 
Interesting question. Right now, about half of psych residents are IMGs. Programs tend to be fairly black and white on their “friendliness” towards IMGs. The mix of IMGs and US grads is fairly polarized in that there are a lot of programs with zero or maybe a couple of IMGs, and there are a lot of programs with close to 100% IMGs. If this were an absolute polarization, half of programs would be US grads only and half would be IMG only. I would guess this is roughly 1/3, 2/3rds now. As the pool of US grads grows, more programs will have the “no IMGs club” within their reach. We all know that the low end US grads are much lower on the desirability list than an average IMG, but then there is a perception factor that is driven by applicant behavior as much as training director bias. Many competitive US grads do look askance at programs with IMGs. I’m not saying this is right or fair, it just is true.

My prediction is that it will get harder for IMGs and US grads with red flags will not be hurt as much as might be predicted.

Yeah, we've discussed this before, and US grads already do get a significant advantage JUST for graduating from US schools. This difference will only get steeper, and bad US grads will not be hurt as much as middle of the pack IMGs. Anyways, those generalizations over IMGs are really silly. We're talking about a group of people that comes from tens of countries, with equally heterogeneous medical school quality. It's like lumping out Harvard with Touro (no offense, not saying it's bad).

IMO the bad reputation for psych comes mostly from perception of the mentally ill. Despite how common mental illness is, people don't empathize with them. In fact, they want to get rid of them. They will empathize with the cancer or diabetic patient, but not with the bipolar, the schizophrenic, the borderline or the suicidal. And if people don't care about the mentally ill, they will not look up to their providers. Psychiatrists are the estranged black sheep of doctors just like psych patients are estranged from society. Some of the stigma within the medical community is justified. Diagnosis in psychiatry is still not where you want it to be. It's still a group of heterogeneous disorders that we have close to no understanding about.
 
I think this is one of those things that will require a generational change. And I don't think that our current generation will be the one to make the change. I had plenty of friends in med school who said things like "you're too smart to go into psychiatry" or "you shouldn't just take the easy way out and go into psychiatry"...
 
I think this is one of those things that will require a generational change. And I don't think that our current generation will be the one to make the change. I had plenty of friends in med school who said things like "you're too smart to go into psychiatry" or "you shouldn't just take the easy way out and go into psychiatry"...

Hmm--makes me wonder why my friends and colleagues all said "you really should go into psychiatry"!
:eyebrow:
 
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Tell your parents that the SDN told you to tell them that WE ARE NOT IN KANSAS...AHEM...INDIA ANYMORE!

FOLLOW YOUR HEART!

Best Luck!
 
So if we're the black sheep of doctors, why are we doing this? Why not go into neurology, critical care, or pediatrics?
 
So if we're the black sheep of doctors, why are we doing this? Why not go into neurology, critical care, or pediatrics?

Mostly because I don't like neurology, critical care, or pediatrics.

Oh, Old Psych Doc, maybe psychiatry is like sexual orientation. If someone suggests that you would make a good psychiatrist and you take great offense, then psychiatry is not in your inherent make up, or you are overcompensating and your psychiatrophobia gives away your closet psychiatry tendancies.
 
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Say it loud: I'm Black and I'm proud!

That's funny cause I feel that telling all my family and friends that I want to be a psychiatrist is like coming out. My med school friends have no problem with it, but everyone else will be quick to judge. I already got a hysterical reaction from my uncle, who's a nurse. I'm still in the closet and not yet prepared to break the news. I might leave it to the point when I get married (I match).
 
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That's funny cause I feel that telling all my family and friends that I want to be a psychiatrist is like coming out. My med school friends have no problem with it, but everyone else will be quick to judge. I already got a hysterical reaction from my uncle, who's a nurse. I'm still in the closet and not yet prepared to break the news. I might leave it to the point when I get married (I match).

So are we black or gay?

Also regarding your uncle nurse....should a male nurse be the first at casting stones?
 
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That's funny cause I feel that telling all my family and friends that I want to be a psychiatrist is like coming out.
There's definitely that element. Up to and including friends saying how much they personally couldn't do psych, with a quick look to me and comments comparable with "... not that there's anything wrong with it..."
 
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"I'm OK with psychiatry. Some of my best friends are psychiatrists.... Of course I would never go into it.."
 
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I've always gotten mixed responses from the medical community. Most are like "wow, you are gonna have such a great lifestyle, enjoy". Some even say its brave that I would choose to work with difficult issues such as suicide, trauma, etc. and that they respect my decision. Like Shan and others have said, I have also gotten the "you are too smart for psychiatry" line. I've even had a couple attendings look at me with an expression that basically suggests "Oh well you will be useless on this rotation since your only going into psych". I just got off a cardiology rotation and the attending said "Surprised you signed up for this rotation after match day, it's not like you need to know any of this information for residency". Which is funny because over half of our referrals were chest pain/palpitations due to anxiety and panic attacks!
 
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So if we're the black sheep of doctors, why are we doing this? Why not go into neurology, critical care, or pediatrics?

once you go black, you never go back

just wait until the old generation of indian attendings die out and people won't have a problem with psych or DOs
 
once you go black, you never go back

just wait until the old generation of indian attendings die out and people won't have a problem with psych or DOs

:laugh:.

Once you go gay....you... Uh... Are kinda gay from then on...or bi...damn.

Anyway, I can't speak to the immigrant transition or how it alters the spectrum of psych opinion by generation. But I think there are many emerging fronts in our PR situation. The alternative health scene. Hippies. White separatists and black nationalists. Anti-Semites. Perhaps those who suffered under regimes that used oppressive forms of social psychology. The Scientologists. Some religious groups. And not least--the untold number of patients we've f'd over in the infancy our understanding. And their families.

I don't have the sense these groups are fading. Some are growing in my opinion.
 
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I feel like the "you're too smart to be a psychiatrist" is the "you're too pretty to be a lesbian" of medical backhanded compliments

So if I'm queer and am interested in psych does that mean I'm just totally screwed? Lolol.
 
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I feel like the "you're too smart to be a psychiatrist" is the "you're too pretty to be a lesbian" of medical backhanded compliments

So if I'm queer and am interested in psych does that mean I'm just totally screwed? Lolol.

:). It means you'll fit right in with us.
 
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