Why did you choose Psychiatry as your career?

To all the respected and reputed seniors in the field of Psychiatry on this forum. I would like to hear a genuine reply from you.

1 - Are you happy in the current profession of Psychiatry. Are things going the way you thought when you choose your speciality as Psychiatry ? What do you think this speciality has given you which the other speciality wouldn't have ?

redapple123 said:

To all the respected and reputed seniors in the field of Psychiatry on this forum. I would like to hear a genuine reply from you.

1 - Are you happy in the current profession of Psychiatry. Are things going the way you thought when you choose your speciality as Psychiatry ? What do you think this speciality has given you which the other speciality wouldn't have ?

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Respected AND reputed? I think I'm reputed at least...

Yes, I'm happy with my career, and things are actually going better than I expected. I chose Psychiatry (after going to med school with intentions of IM and Nephrology that lasted until the very beginnings of 4th year) specifically to be a consultation psychiatrist - I get to be in the general hospital, see sick patients, keep up on my non-psychiatric medical knowledge, and (here's the kicker) actually have time to sit and talk with patients. In addition, I get called in on all the most complicated cases that no-one else can figure out (no secret that House is at least loosely based on a consult psychiatrist) that keep me on my toes. I get to advocate for patients on both a micro- and macro- level and generally feel (most days) that I make people's lives better. Now, given that I chose all of this expecting to never make a salary >130k per year in an academic setting and am currently making significantly more than this, I am completely f%&*ing ecstatic about my choice.

I don't know how respected or reputed or even senior I am, but I'll answer your question.

Right now I just started my first "real" job working as a psychiatrist in a private practice. I am working harder than I worked as a resident and expect to continue to do so for some time. People generally don't think of "real job" being longer hours than residency, but in my case it is. Though I think right now part of the reason I am working such long hours is because I need to learn to be efficient all over again. I'm also making a good bit less than $130,000/year. But I really wouldn't change it. I chose to be where I am because I feel I have a lot still to learn about psychiatry and the medical director of my practice is a trusted mentor who has the knowledge and experience that I want. I also have the freedom to do psychotherapy there, which isn't something available in a lot of places. And so even though I am really tired, working harder than I worked as a resident (the patients in private practice land actually show up!), and making significantly less than everyone assumes I am making, I still wouldn't change it. It just feels right. My long term goal is to leave my current city and hang up my own shingle to focus on meds/therapy for the type of patients/diagnoses I am most interested in. But I don't at all feel ready to do that now either professionally or financially. But I feel I am working toward it by being where I am now.

I wouldn't be nearly as fulfilled in any other specialty. I started out doing an internal medicine residency and switched after one year. I just kinda liked those patients with vague somatic complaints, fibromyalgia, and negative work-ups. 😉

redapple123 said:

To all the respected and reputed seniors in the field of Psychiatry on this forum. I would like to hear a genuine reply from you.

1 - Are you happy in the current profession of Psychiatry. Are things going the way you thought when you choose your speciality as Psychiatry ? What do you think this speciality has given you which the other speciality wouldn't have ?

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Well, I probably fit the "senior" piece of this anyway...

Things are going mostly better than I expected. I wouldn't have thought 8 years ago that I'd end up doing as much inpatient as I do, but I love working on a team, and I'm making a LOT more than I thought I would be. And everytime I'm about to think I'm getting bored, I get someone new with a story right out of left field. Case in point: 50-ish guy today with a kind of Asperger-y vibe...was in a state hospital 30 years ago after randomly shooting at some people, never got any meds, no subsequent treatment. Now separated from his wife of 22 years, and made a impulsive suicide attempt because the male lover/cross-dressing business partner he's had on the side for the past 20 years hurt his feelings...
I mean really, you just can't make this stuff up! And to sit there with the student while he delivers this entire narrative in a passionless, matter-of-fact monologue---priceless. 🙄

And when I see how many of my patients live their lives, I KNOW I'm going to have job security--I mean this guy's got a 16 y/o son with ADD and God-knows-what-else. And down the hall is a 19 y/o pregnant meth addict, so I figure i'm getting that kid in 18 years.... 🙁

The variety you describe is part of what is drawing me more and more toward Psychiatry.

OldPsychDoc said:

Well, I probably fit the "senior" piece of this anyway...

Things are going mostly better than I expected. I wouldn't have thought 8 years ago that I'd end up doing as much inpatient as I do, but I love working on a team, and I'm making a LOT more than I thought I would be. And everytime I'm about to think I'm getting bored, I get someone new with a story right out of left field. Case in point: 50-ish guy today with a kind of Asperger-y vibe...was in a state hospital 30 years ago after randomly shooting at some people, never got any meds, no subsequent treatment. Now separated from his wife of 22 years, and made a impulsive suicide attempt because the male lover/cross-dressing business partner he's had on the side for the past 20 years hurt his feelings...
I mean really, you just can't make this stuff up! And to sit there with the student while he delivers this entire narrative in a passionless, matter-of-fact monologue---priceless. 🙄

And when I see how many of my patients live their lives, I KNOW I'm going to have job security--I mean this guy's got a 16 y/o son with ADD and God-knows-what-else. And down the hall is a 19 y/o pregnant meth addict, so I figure i'm getting that kid in 18 years.... 🙁

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A brilliant example of Psychiatry and her seductive dance...she had me at hello.

Best kept secret in medicine.

For me, it's because it's utterly fascinating. And mysterious. You can uncover things about people that you may never be able to in any other occupation, and that's pretty thrilling.

redapple123 said:

What do you think this speciality has given you which the other speciality wouldn't have ?

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I like the tremendous diversity in the field. A psychiatrist can do anything from psychotherapy to reading sleep studies and treating sleep apnea (if he has the approp subspecialty training). Psychiatry has also given me the ability to almost instantly understand what a person means when the chief complaint is "my father is also my grandfather".

michaelrack said:

Psychiatry has also given me the ability to almost instantly understand what a person means when the chief complaint is "my father is also my grandfather".

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If that's actually the chief complaint, you've got yourself someone with the capacity for insight-oriented work. I only find out that juicy little tidbit when I'm constructing the genogram, and there's the "Ah-ha" moment.

I like having the ability to make real change in a person/child's life that can often change the trajectory for them. And, at my core I'm a gossip hound, so listening to people's stories and helping them construct new narratives is really quite fun for me.

MBK2003 said:

If that's actually the chief complaint, you've got yourself someone with the capacity for insight-oriented work. I only find out that juicy little tidbit when I'm constructing the genogram, and there's the "Ah-ha" moment.
.

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It was an actual chief complaint years ago when I was in residency; don't remember anything else about the case.