Are you saying that military shrinks don't see tons of patients with personality disorders?
I think he's saying that treating someone with PTS is more fulfilling than treating a cluster B.
I'm thinking about taking the Army HPSP scholarship and hopefully matching into a psychiatry residency. Could anyone tell me more about:
- where psychiatrists could be when they're deployed (like work environment)
- dangers that psychiatrists/physicians face while deployed
- what your experience with BOLC was like
- difficulties of military psychiatry/advice
Thank you so much.
I'm not a psychiatrist. One of my closest friends is an Army psychiatrist, so I can respond to your questions based on my impressions of his thoughts and experiences. Please note that these are not his answers but my impressions of his thoughts based on our numerous conversations--there is no substitute for speaking directly with a psychiatrist.
1. Psychiatrists go wherever the Army is deployed. Most psychiatrists are stationed in embedded behavioral health teams which are brigade and higher assets that deal with all the behavioral health aspects of a unit or AOR. These teams also conatin psychologists and enlisted behavioral health specialists. Some psychiatrists are attached to CSHs where they will generally serve a C&L role. On my friend's last deployment he was assigned to the detainee prison in Bagram and funcioned as one of the "prison psychiatrists".
2. Psychiatrists face the same dangers as other docs not assigned to a role 1 (which is to say generally low). Rocket/mortar attacks happen occasionally. If you travel in a convoy or fly in a chopper there is a risk of being attacked. I believe that a psychiatrist/pschologist is at greater risk of being fragged due to the inherent patient poulation (but again this is a relatively rare phenomenon with only 2 instances that I can recall offhand).
3. BOLC (OBC when I did it) is relatively painless. If you can engage your frontal lobe, pass your PT test, and be where you're supposed to be when you're supposed to be there you'll pass with a minimum of difficulty. You could compete with the gunners for honor graduate, but why? You'll meet some genuinely good people, get paid as an AD officer, and get to hang out in San Antonio. I enjoyed BOLC/OBC.
4.
The Residency Bubble: In residency you treat acute psychosis, manage long-term psychiatric disease, perform C&L psychiatry in large hospitals with complex pathology, learn CBT and lead small group CBT sessions for PTS and the personality disorders, see addiction clinic, perform TBI research, do some adolescent psych, and dabble in the legal aspects of forensic psychiatry (i.e. the things that most psychiatrists like to do). If you stay at one of the major medical centers, you'll get to do pretty much the same thing. If you go out to the line the vast majority of your duties involve serving as a risk management consultant for commanders of "high risk" soldiers with SI and enrolled in ASAP and chaptering soldiers out for psych issues that are incompatible with service.
Smartest and the Dumbest: Some very intelligent people go into psychiatry. It is also a haven for people who barely passed through medical school or were bounced by other specialties. As in the civilian world, a specialty that deals with mental/behavioral issues attracts many practitioners with their own behavioral/mental issues.
Malingerers: There are scammer-shammer douchebags in the military. Psychiatrists deal with a disproprotionate amount of these individuals.
Psychiatry and the Military in General: There is an obvious, fundamental tension/distrust between Servicemembers and the practitioners of mental/behavioral health. It's why Marines refer to psychiatrists as "wizards".
