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What the title says. What made you want to be a psychiatrist above all other medical specialties?
What was the moment that made you fall in love with psychiatry?
- Thread starter Anotherwin
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Capgras, state hospital, on forensic unit.
Recognition that helping quality of life was more fulfilling than quantity of life. I.e. Hospital based medicine with lines and lines and ions and dialysis and CHF and patients etc, etc. No thanks.
Recognition that helping quality of life was more fulfilling than quantity of life. I.e. Hospital based medicine with lines and lines and ions and dialysis and CHF and patients etc, etc. No thanks.
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Worked as a mental health caseworker for a couple of years. Saw that psychiatry offered a decent lifestyle with way more pay, same patients I already enjoyed helping.
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I think I set the record for the number of psychiatrists in my family, so this is hard to answer. The best I can say is the moment I took my first breath. No regrets ever since.
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I was in a very good mood on a Monday night. I started wondering why.
I had my psych rotation every Tuesday morning. I didn't hate med school but I was never happy to go classes or rotation, except for this one.
So that was it
I had my psych rotation every Tuesday morning. I didn't hate med school but I was never happy to go classes or rotation, except for this one.
So that was it
It was 4PM and my psych attending got a call from the ED. They had a patient who needed inpatient admission. It would take some time to get them to the psych unit, so I asked if we would go seem them in the ED (I had just finished an IM rotation so was feeling fairly ambitious). The attending said, we'll let them get to the psych unit and settle in, and we'll see them first thing tomorrow.
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When I was on the floor of a psychiatrist's office bawling my eyes out thinking things were over.
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Is that you Dr. Menninger? (totally a joke, not trying to dox anyone, lol)
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The title and question are two very different answers for me.
What made me want to be a psychiatrist over other specialties? Interesting pathology, endless research potential, the importance of clinical judgment for diagnosis and treatment, significant flexibility in treatment setting and area of specialty, lifestyle/"normal" work schedule, need for more MH care/job security, earning potential, all the crazy patient experiences, and just being generally happy on all my psych rotations.
What was the moment that made me fall in love with psychiatry? I've had several and continue to have them, but the initial moment was actually the first psych patient I ever saw. Had a kid in his early 20's who was admitted for "psychosis" and was fairly aggressive on admission. The only reason he came in was that his GF said that he was acting weird and that she was really worried for him. I connected really well with him as we had a lot in common in terms of background and life experiences. I actually got close enough that I kind of became his tether to reality and he trusted that what I said was the truth. Example: his dad came to visit and the next day the kid was convinced the whole visit was all just AVH and that his dad was never really there. Didn't believe anyone until I told him his dad really did come and that I'd met him. Obviously, he was started on meds immediately and they were extremely effective. Two weeks later he was almost completely back to his normal self; it absolutely blew my mind. Before that rotation, I had a completely different view of what psychiatry was and was 99% sure I'd never do it. I kept an open mind for the rest of my M3 year, but nothing else came close to that rotation for me.
I still find it almost magical when someone comes in completely manic or bat-s*** crazy and by the end of their stay you're having calm, lucid conversations with them.
What made me want to be a psychiatrist over other specialties? Interesting pathology, endless research potential, the importance of clinical judgment for diagnosis and treatment, significant flexibility in treatment setting and area of specialty, lifestyle/"normal" work schedule, need for more MH care/job security, earning potential, all the crazy patient experiences, and just being generally happy on all my psych rotations.
What was the moment that made me fall in love with psychiatry? I've had several and continue to have them, but the initial moment was actually the first psych patient I ever saw. Had a kid in his early 20's who was admitted for "psychosis" and was fairly aggressive on admission. The only reason he came in was that his GF said that he was acting weird and that she was really worried for him. I connected really well with him as we had a lot in common in terms of background and life experiences. I actually got close enough that I kind of became his tether to reality and he trusted that what I said was the truth. Example: his dad came to visit and the next day the kid was convinced the whole visit was all just AVH and that his dad was never really there. Didn't believe anyone until I told him his dad really did come and that I'd met him. Obviously, he was started on meds immediately and they were extremely effective. Two weeks later he was almost completely back to his normal self; it absolutely blew my mind. Before that rotation, I had a completely different view of what psychiatry was and was 99% sure I'd never do it. I kept an open mind for the rest of my M3 year, but nothing else came close to that rotation for me.
I still find it almost magical when someone comes in completely manic or bat-s*** crazy and by the end of their stay you're having calm, lucid conversations with them.
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I'm a 4th year submitting my rank list in the coming weeks so am likely out of line in posting here but this is a relatively fresh answer in my life. It was tough/scary to commit to something during 3rd year but I now regularly wake up SO happy and excited to be pursuing psychiatry (if I match). It was more of the realization of how stacked the pros/cons list is that did it for me:
+pharmacology and pathology in psych is fascinating
+observation is important; less formulaic or algorithmic than other specialties
+prevalence ofold experienced psychiatrists (indicating some component of sustained interest and physical ability to practice as long as one wants)
+work as much or as little as one wants with commensurate pay (can push 400k if you hustle)
+patients are less commonly 100% responsible for their diseases than in other fields
+additional training relative to midlevels confers actual skill = job protection and growth in face of midlevel explosion
+tons of mid-career pivoting options for fun, interest, pay
+ability to live essentially anywhere in the US with reasonably fair pay
+current and likely future societal need
+uncommon to work nights, weekends, call, holidays
+private practice available in light of insurance/medicare issues
+ability to have patient ownership longitudinally or acutely based on preference
+procedures if wanted
+can lead a team or work independently
+many options to avoid a sedentary work day
-less well paid on average than other specialties (though higher ceiling than many)
-certain types of patients are exhausting based on one's personality
-increasing employed model = vulnerability to hospital exploitation
-midlevels seem to love becoming PMHNPs
-some lack of respect/recognition as a "physician"
-likely losing that fancy medical differential/aspects of the depth of knowledge from med school
-unclear to me how much "hustling" involves providing substandard care
All told, if one discontinues the fetishization of "work" and "sacrifice" that is inherent among folks pursuing medicine, and instead focuses on both personal balance/happiness as well as pt satisfaction and impact, I feel like psychiatry is pretty well near the top of the list.
+pharmacology and pathology in psych is fascinating
+observation is important; less formulaic or algorithmic than other specialties
+prevalence of
+work as much or as little as one wants with commensurate pay (can push 400k if you hustle)
+patients are less commonly 100% responsible for their diseases than in other fields
+additional training relative to midlevels confers actual skill = job protection and growth in face of midlevel explosion
+tons of mid-career pivoting options for fun, interest, pay
+ability to live essentially anywhere in the US with reasonably fair pay
+current and likely future societal need
+uncommon to work nights, weekends, call, holidays
+private practice available in light of insurance/medicare issues
+ability to have patient ownership longitudinally or acutely based on preference
+procedures if wanted
+can lead a team or work independently
+many options to avoid a sedentary work day
-less well paid on average than other specialties (though higher ceiling than many)
-certain types of patients are exhausting based on one's personality
-increasing employed model = vulnerability to hospital exploitation
-midlevels seem to love becoming PMHNPs
-some lack of respect/recognition as a "physician"
-likely losing that fancy medical differential/aspects of the depth of knowledge from med school
-unclear to me how much "hustling" involves providing substandard care
All told, if one discontinues the fetishization of "work" and "sacrifice" that is inherent among folks pursuing medicine, and instead focuses on both personal balance/happiness as well as pt satisfaction and impact, I feel like psychiatry is pretty well near the top of the list.
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I previously held more of an interest in the science of the mind (neuroscience, cognitive science, philosophy of mind) up until about my third year of medical school. It's also what had me flirt so much with neurology. Then, while on an elective in psychodynamic psychiatry at Austen Riggs, I was allowed to interview and follow one of the patients. It was then, when I got the privilege of hearing this one unique story, that my passions changed. I liked reading case histories from the textbooks and Oliver Sack's neurological tales, but this was different. It satisfied my curiosity like research did but engaged me differently. I wasn't looking for p<0.05 anymore. I was looking at "my" patient, who was hoping I was interested enough to help, and that was an amazing feeling.
Oh! Also, I had an entrepreneurial side and psychiatry is a perfect fit for creating a private practice.
Oh! Also, I had an entrepreneurial side and psychiatry is a perfect fit for creating a private practice.
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I don't know the exact moment I just know even in my worst weeks I have an interaction with a patient or colleague that reminds me I made the right choice, and it keeps me going.
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1) No two days are the same. Every patient has a different story and presentation of illness.
2) I watched my psych attending (inpatient) leave at 11am every day on my child rotation and thought, man this guy has it pretty good. I am now this guy, but I leave at noon because I get free food at the cafeteria. One day I may have ambitions to do something with my afternoons, but for now I just enjoy the afternoon naps and watching my toddler grow up.
2) I watched my psych attending (inpatient) leave at 11am every day on my child rotation and thought, man this guy has it pretty good. I am now this guy, but I leave at noon because I get free food at the cafeteria. One day I may have ambitions to do something with my afternoons, but for now I just enjoy the afternoon naps and watching my toddler grow up.
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- Jan 29, 2022
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I have loved having the opportunity to be able to sit with patients, walk with them through their journey in life, and listen to their stories. I think we are lucky in psychiatry that we get a lot of time with patients compared to other primary care providers (who often have only 15-20 minute visits).
Psychiatry is also fascinating because there is so much we still don't understand about the brain and, of course, room for us all learning more as we discover new intricacies.
We have a specialty that allows for a good work/life balance, with minimal call on weekends/nights/early mornings and with lots of flexibility in the type of work we can do (inpatient, outpatient, procedures, institutional vs community settings, collaborative care, telepsychiatry work from home vs all in person work). I think this leads to greater satisfaction and happiness as there are so many different things you can do and it's easy to change your career and incorporate new components in the future.
Psychiatry is also fascinating because there is so much we still don't understand about the brain and, of course, room for us all learning more as we discover new intricacies.
We have a specialty that allows for a good work/life balance, with minimal call on weekends/nights/early mornings and with lots of flexibility in the type of work we can do (inpatient, outpatient, procedures, institutional vs community settings, collaborative care, telepsychiatry work from home vs all in person work). I think this leads to greater satisfaction and happiness as there are so many different things you can do and it's easy to change your career and incorporate new components in the future.
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