A rant for this morning

[Wilf]

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Psychiatry is definitely a field that you can practice into your 80's and I've seen a lot of good, quite elderly psychiatrists. Retirement is very, very challenging. I find that people dramatically underestimate how much of a challenge it is. I see so many psych hospitalizations very soon after retirement, generally with significant SI. There is a very high chance of "failing" at retirement and really taking a horrific mood hit that you might not recover from. Sure if you have some sort of massive extended family commitments, it might help. You could really help raise the grandkids, but people are having fewer kids in general, so that's less likely. I think the final Erikson's stage is, by far, the hardest to master. It can be a heck of a lot easier to just grind along in the second to last right up until you literally die. All that said, biology does tend to catch up with people and we will, albeit delayed, see massive retirements that will fortunately be able to be filled by all these new residency graduates and NP/PAs.

I certainly have not seen this phenomenon in practice or in my life. Almost all the people in my family and extended family retired as soon as they were able and all have been thoroughly happy being retired. And they had "professional" careers. I have never seen a patient in the clinic or the hospital with depression due to retirement. There are so many things to see and do in this world and loved ones to spend time with; it's sad to me that work would be such an important part of many people's lives. Some sure, but I would hope not many.

 

[Stagg737]

I certainly have not seen this phenomenon in practice or in my life. Almost all the people in my family and extended family retired as soon as they were able and all have been thoroughly happy being retired. And they had "professional" careers. I have never seen a patient in the clinic or the hospital with depression due to retirement. There are so many things to see and do in this world and loved ones to spend time with; it's sad to me that work would be such an important part of many people's lives. Some sure, but I would hope not many.

I would say a solid 10-20% of my outpatient consults are due to elderly people becoming depressed or anxious after they retire. I'm shocked that this isn't something you've encountered, as it is something we received lectures on in residency from geri psych docs. For these people it's not that they miss "work" so much, it's that work was how they socialized or it was something that they felt gave them purpose. Through that lens it should be very easy for anyone to understand why losing that could lead to depression.

You also make the assumption that everyone has the means to see many things in the world or that they have supportive loved ones to spend time with, which I've found to be far less common than I thought as someone who grew up in a supportive family with reasonable means. Keep in mind that 1 out of 4 retired Americans have ONLY social security to live off and for 2 out of 3 Americans social security makes up over half of their monthly budget in retirement.

 

[comp1]

If you have extended family to begin with then they are less likely in general to have experienced the phenomena. I think 20% is a good number, but the subclinical is much higher. It's rough.

 

[clausewitz2]

I would say a solid 10-20% of my outpatient consults are due to elderly people becoming depressed or anxious after they retire. I'm shocked that this isn't something you've encountered, as it is something we received lectures on in residency from geri psych docs. For these people it's not that they miss "work" so much, it's that work was how they socialized or it was something that they felt gave them purpose. Through that lens it should be very easy for anyone to understand why losing that could lead to depression.

You also make the assumption that everyone has the means to see many things in the world or that they have supportive loved ones to spend time with, which I've found to be far less common than I thought as someone who grew up in a supportive family with reasonable means. Keep in mind that 1 out of 4 retired Americans have ONLY social security to live off and for 2 out of 3 Americans social security makes up over half of their monthly budget in retirement.

so much this, I have seen it so many times. I am at such great pains to tell my patients nearing retirement that all the available research suggests much better outcomes for retirees who work or volunteer at least IIRC ~10 hours per week. It is really hard for many people to feel okay about their lives if they have no sense of purpose. It is easier to feel a sense of purpose when someone does expect you to show up somewhere at specific times and do something.

 

[Stagg737]

so much this, I have seen it so many times. I am at such great pains to tell my patients nearing retirement that all the available research suggests much better outcomes for retirees who work or volunteer at least IIRC ~10 hours per week. It is really hard for many people to feel okay about their lives if they have no sense of purpose. It is easier to feel a sense of purpose when someone does expect you to show up somewhere at specific times and do something.

I agree and think there's a misconception among many retirees that when they retire they're supposed to just relax and not really do anything. I've had several who started working part time jobs doing things they enjoyed like working in boutique shops or building things who have done really well and don't need meds. I have another group who aren't really capable of that due to living in very small towns (<100 people) or medical problems that prevent them from getting out of their house regularly. Those individuals really struggle and it's one of the worst parts of treating very rural communities where it's not just mental health but social supports that are really lacking.

 

[FlowRate]

I would say a solid 10-20% of my outpatient consults are due to elderly people becoming depressed or anxious after they retire. I'm shocked that this isn't something you've encountered, as it is something we received lectures on in residency from geri psych docs. For these people it's not that they miss "work" so much, it's that work was how they socialized or it was something that they felt gave them purpose. Through that lens it should be very easy for anyone to understand why losing that could lead to depression.

You also make the assumption that everyone has the means to see many things in the world or that they have supportive loved ones to spend time with, which I've found to be far less common than I thought as someone who grew up in a supportive family with reasonable means. Keep in mind that 1 out of 4 retired Americans have ONLY social security to live off and for 2 out of 3 Americans social security makes up over half of their monthly budget in retirement.

It was so much worse during early COVID with people's big retirement trips and post-retirement activities being curtailed or fully canceled.

 

[FatherPsychiatry]

Retirement definitely isn't for everyone... a lot of the older people in my circles seem to work because "I don't know what I'd do if I didn't work" (which itself is kind of sad to me).

People need something(s) to retire TO, meaningful stuff that has longevity.

 

[Stagg737]

It was so much worse during early COVID with people's big retirement trips and post-retirement activities being curtailed or fully canceled.

I mean, everything was so much worse during COVID, lol. It was my outpatient year in residency and part of the reason why I am a horrible person to get an opinion from in regards to my view of outpatient psychiatry.

Retirement definitely isn't for everyone... a lot of the older people in my circles seem to work because "I don't know what I'd do if I didn't work" (which itself is kind of sad to me).

People need something(s) to retire TO, meaningful stuff that has longevity.

Other people have referenced this above and idk that it's really sad. Plenty of people enjoy what they do or at least really enjoy their co-workers and work environment. Hobbies are great, but plenty of people make their hobbies or passions their job and I don't think it's sad that they'd feel lost without work at all. I do agree that if someone hates their job and doesn't want to work there but continues because they wouldn't know what to do would be sad, but for plenty of people their jobs are meaningful.

The beauty of healthy retirement (emotionally and financially) isn't that someone doesn't have to do anything anymore, it's that they have the means and security to do what they want (even their same job) without worrying about security if they stop doing it or cut back to their desired workload. Idk that I could ever really "retire" completely, but I'd love to be able to just work 2-3 partial days per week or shift to a career I'm really passionate about (which would inevitably make much less than a physician).

 

[clausewitz2]

I mean, everything was so much worse during COVID, lol. It was my outpatient year in residency and part of the reason why I am a horrible person to get an opinion from in regards to my view of outpatient psychiatry.


Other people have referenced this above and idk that it's really sad. Plenty of people enjoy what they do or at least really enjoy their co-workers and work environment. Hobbies are great, but plenty of people make their hobbies or passions their job and I don't think it's sad that they'd feel lost without work at all. I do agree that if someone hates their job and doesn't want to work there but continues because they wouldn't know what to do would be sad, but for plenty of people their jobs are meaningful.

The beauty of healthy retirement (emotionally and financially) isn't that someone doesn't have to do anything anymore, it's that they have the means and security to do what they want (even their same job) without worrying about security if they stop doing it or cut back to their desired workload. Idk that I could ever really "retire" completely, but I'd love to be able to just work 2-3 partial days per week or shift to a career I'm really passionate about (which would inevitably make much less than a physician).

Part of the appeal of psychiatry for me is that you have to be pretty seriously debilitated to be truly incapable of doing the work at least part time, so it's very possible to keep working well into old age. My old residency program just recently lost an attending who was still going into his 90s. After a few years in practice I aspire to this more and more.

 

[Stagg737]

Part of the appeal of psychiatry for me is that you have to be pretty seriously debilitated to be truly incapable of doing the work at least part time, so it's very possible to keep working well into old age. My old residency program just recently lost an attending who was still going into his 90s. After a few years in practice I aspire to this more and more.

Yep, one of my attendings in residency was essentially forced out because he was starting to have neurocognitive problems but practiced well into his 80's. Another just retired in his mid-80's (of his own accord). It's nice to be in a field where we can keep working full time practically into senility if we wanted to. In a different life I would probably be a surgeon and I'd be lying if I said job security and durability didn't play a factor in my decision to enter the field. We're also in a field where it is very easy and reasonable to scale back significantly into part time.

 

[VA Hopeful Dr]

Yep, one of my attendings in residency was essentially forced out because he was starting to have neurocognitive problems but practiced well into his 80's. Another just retired in his mid-80's (of his own accord). It's nice to be in a field where we can keep working full time practically into senility if we wanted to. In a different life I would probably be a surgeon and I'd be lying if I said job security and durability didn't play a factor in my decision to enter the field. We're also in a field where it is very easy and reasonable to scale back significantly into part time.

I'm not sure I'd call that a good thing. If you don't work in a group this sort of thing probably wouldn't get caught and you can (and do) have people practicing well into senility.

 

[tr]

I completely agree that having been board certified should be considered almost on par with currently being board certified. The initial examination is the "toughest" part intellectually of the process. Sitting through mindless CMEs does not indicate anything about a psychiatrist's knowledge. I do think the initial exam should be a little more difficult though, and the fail rate should be higher, especially with the proliferation of poor quality residencies popping up. Quite a number of questionable psychiatrists are board certified which is a shame.

Wow I totally disagree that board cert should be a bottleneck. There are so many previous selective bottlenecks in medical training (completion of premed requirements cuts the pool by half, admission to med school by another 2/3, and then additional minor weeding with Steps, admission to residency, etc). Once someone has jumped through 12 years of hoops I really disagree that this final written exam should be a disqualifier. That's just a huge waste of a medical education.

And I don't know that a written exam is ever going to capture the judgement required of a good clinician no matter how difficult you make it. Clinical care is a skill set that just is not adequately represented in a multiple choice format.

Separate topic, but I wish baby boomers would not tie their identity so much to work, and would retire in larger numbers. With all the new medical schools and residencies pumping out psychiatrists, and the ever higher number of midlevels, psychiatrists are already becoming less needed which means the quality of our job options are/will go down. I hope the younger generations want more out of life than a career and will retire by 65 at latest (God, I hope I am able to.) When I see these boomer psychiatrists working well into their 70's, it is quite depressing.

This is in no way accurate. There is already a shortage of psychiatrists and it is expected to increase.

Why is there a psychiatrist shortage?

It’s not just psychiatrists. We also need more psychologists, counselors, therapists, and support staff.

www.healthcare-brew.com

https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/state-of-the-behavioral-health-workforce-report-2024.pdf

 

[Stagg737]

I'm not sure I'd call that a good thing. If you don't work in a group this sort of thing probably wouldn't get caught and you can (and do) have people practicing well into senility.

I’m not saying we should be doing this, I’m saying that our job is so easy from a physical and administrative standpoint that we can.

 

[anonperson]

I mean, everything was so much worse during COVID, lol. It was my outpatient year in residency and part of the reason why I am a horrible person to get an opinion from in regards to my view of outpatient psychiatry.


Other people have referenced this above and idk that it's really sad. Plenty of people enjoy what they do or at least really enjoy their co-workers and work environment. Hobbies are great, but plenty of people make their hobbies or passions their job and I don't think it's sad that they'd feel lost without work at all. I do agree that if someone hates their job and doesn't want to work there but continues because they wouldn't know what to do would be sad, but for plenty of people their jobs are meaningful.

The beauty of healthy retirement (emotionally and financially) isn't that someone doesn't have to do anything anymore, it's that they have the means and security to do what they want (even their same job) without worrying about security if they stop doing it or cut back to their desired workload. Idk that I could ever really "retire" completely, but I'd love to be able to just work 2-3 partial days per week or shift to a career I'm really passionate about (which would inevitably make much less than a physician).

At 93, he's one of Santa Monica's hottest yoga instructors. What's his secret?

Salomon Delgado offers his secrets for longevity, which include finding something that gives you joy and purpose.

www.latimes.com

93 years old in pretty good shape. Still teaching yoga to packed classes.

I think it's good to keep busy. If it's a job that's fine or an interesting hobby.

I know some physicians hate the field but honestly it's not bad. We can offer some meaningful help to people in an intellectually stimulating field. Getting paid decently helps also.

I can easily see myself working in some capacity for awhile even when I get "old"

 

[Merovinge]

Wow I totally disagree that board cert should be a bottleneck. There are so many previous selective bottlenecks in medical training (completion of premed requirements cuts the pool by half, admission to med school by another 2/3, and then additional minor weeding with Steps, admission to residency, etc). Once someone has jumped through 12 years of hoops I really disagree that this final written exam should be a disqualifier. That's just a huge waste of a medical education.

And I don't know that a written exam is ever going to capture the judgement required of a good clinician no matter how difficult you make it. Clinical care is a skill set that just is not adequately represented in a multiple choice format.

At any good training program I agree that 90%+ should be passing, but there has been a huge influx in spots and some at less than stellar programs that tend to attract folks who probably should need to do significant additional studying to be able to be called a BC psychiatrist. I don't see any reason why our testing should be substantially easier than other fields which have around double the failure rate and attract people who do better on standardized testing prior to training.

I do agree that clinical care cannot be fully summarized by MC questions, but given the rest of medical education is very MC heavy and no realistic alternative, I think it's what we have.

I'm sure you have forgotten more about residency training than I will ever know, so open to seeing this differently, but I just don't like the field carrying forward a lack of competitiveness. Psychiatrists should be at least as cognitively rigorous as our IM, peds, PCP brethren.

 

[tr]

At any good training program I agree that 90%+ should be passing, but there has been a huge influx in spots and some at less than stellar programs that tend to attract folks who probably should need to do significant additional studying to be able to be called a BC psychiatrist. I don't see any reason why our testing should be substantially easier than other fields which have around double the failure rate and attract people who do better on standardized testing prior to training.

Well to be fair, our declarative knowledge base is quite a bit smaller than in comparable fields like IM subspecialties or neuro. We have no pathophysiology to speak of; or at least, what we do have is not yet well fleshed out enough for clinical applicability in most cases. Our tests are easier because there is just less material to know.

Our procedural knowledge (i.e., psychotherapeutic skill) is quite complex as I said before, but that's definitely not something that will ever be captured on a multiple choice exam.

I do agree that clinical care cannot be fully summarized by MC questions, but given the rest of medical education is very MC heavy and no realistic alternative, I think it's what we have.

I'm sure you have forgotten more about residency training than I will ever know, so open to seeing this differently, but I just don't like the field carrying forward a lack of competitiveness. Psychiatrists should be at least as cognitively rigorous as our IM, peds, PCP brethren.

Psych is actually much more competitive than it used to be, since the Gen Zs caught on to the fact that it's a stealth lifestyle specialty. We don't need harder tests to attract better candidates. We can just focus on advertising our natural advantages.

 

[FatherPsychiatry]

Psych is actually much more competitive than it used to be, since the Gen Zs caught on to the fact that it's a stealth lifestyle specialty. We don't need harder tests to attract better candidates. We can just focus on advertising our natural advantages.

I interviewed a solid # of applicants dual applying to derm, and psych as safety. Lifestyle was clearly the priority.

 

[Stagg737]

Psych is actually much more competitive than it used to be, since the Gen Zs caught on to the fact that it's a stealth lifestyle specialty. We don't need harder tests to attract better candidates. We can just focus on advertising our natural advantages.

The problem is that being a lifestyle specialty that isn't as competitive or typically as lucrative as derm isn't going to just attract "better" candidates, it's going to attract candidates who just want an easy ride to what they see as solid income with minimal work.

I interviewed a solid # of applicants dual applying to derm, and psych as safety. Lifestyle was clearly the priority.

Agree, I'm seeing this more and more even with residents who are "passionate" about psychiatry. They're pretty passionate until they have to stay later than 4pm and then we start hearing complaints about how the service is just so demanding. I get that many people go into psychiatry because they don't want to be on the medical floors, but spending 4 weeks with us to learn stuff that's going to be essential to being a well-rounded psychiatrist should be seen at worst as a tolerable discomfort for everything they will be learning that they wouldn't otherwise get experience with.

 

[Wilf]

The problem is that being a lifestyle specialty that isn't as competitive or typically as lucrative as derm isn't going to just attract "better" candidates, it's going to attract candidates who just want an easy ride to what they see as solid income with minimal work.


Agree, I'm seeing this more and more even with residents who are "passionate" about psychiatry. They're pretty passionate until they have to stay later than 4pm and then we start hearing complaints about how the service is just so demanding. I get that many people go into psychiatry because they don't want to be on the medical floors, but spending 4 weeks with us to learn stuff that's going to be essential to being a well-rounded psychiatrist should be seen at worst as a tolerable discomfort for everything they will be learning that they wouldn't otherwise get experience with.

I have never understood the idea (most often from the Boomer or Gen X crowd) that a true liking of (or passion for 🙄) a field means that people should want to work long hours in it. Life is so much more than work and career. I am really hoping that Gen Z, and to a lesser extent, millennials, will change this mindset. Or, as I spoke about in a different thread, I hope (and believe) that AI will take almost all of our jobs. Not just in medicine.

 

[clausewitz2]

I have never understood the idea (most often from the Boomer or Gen X crowd) that a true liking of (or passion for 🙄) a field means that people should want to work long hours in it. Life is so much more than work and career. I am really hoping that Gen Z, and to a lesser extent, millennials, will change this mindset. Or, as I spoke about in a different thread, I hope (and believe) that AI will take almost all of our jobs. Not just in medicine.

For some people it's less a career and more of a calling. There aren't enough people that is true of to meet all the needs in the field so it's not a reasonable expectation that that be the case for everyone. But for the folks it is true for, not ever working again as is not the goal as psychiatric work is a source of meaning and fulfillment.

 

[comp1]

Life CAN be more than work and career. It CAN be more than family life too. It isn't in either case for everybody. I wouldn't wish an AI apocalypse on anybody. Regardless of where you find your meaning, that would create absolute chaos in it.

 

[Stagg737]

I have never understood the idea (most often from the Boomer or Gen X crowd) that a true liking of (or passion for 🙄) a field means that people should want to work long hours in it. Life is so much more than work and career. I am really hoping that Gen Z, and to a lesser extent, millennials, will change this mindset. Or, as I spoke about in a different thread, I hope (and believe) that AI will take almost all of our jobs. Not just in medicine.

I'm not saying people should want to work long hours. I'm saying that when you're in a field where residency already has vastly better hours than almost every other medical specialty other than PM&R that doing a 4 week rotation where you're occasionally working a 9-10 hour day in order to learn valuable information that you otherwise won't learn should not be seen as unreasonable. The entire point of residency is to gain the experience and knowledge to be a solid attending and be able to handle as many different situations as possible. That sometimes involves working hours/shifts or being exposed to situations where the learner is uncomfortable.

My lament is that a desire for "wellness" and "balance" has superseded the desire to learn to be a competent attending physician for many, which is the entire point of residency. I'm not saying someone should completely ignore or neglect their own well-being, but entering a field where we inevitably care for the most vulnerable individuals in society during their darkest times requires the practitioner to leave their own comfort zone to challenge and expand their capabilities as a physician. That sometimes requires us to sacrifice a piece of our "wellness" to do good for others, at least temporarily.

As a millennial, I see my generation and Gen Z's views of seeing work and career as less meaningful and pursuing outside endeavors like travel and experiences to be derivative of a more nihilistic, "YOLO" view as opposed to a means of self-actualization. I find that far more concerning and problematic than people finding meaning through their work.

 

[Wilf]

For some people it's less a career and more of a calling. There aren't enough people that is true of to meet all the needs in the field so it's not a reasonable expectation that that be the case for everyone. But for the folks it is true for, not ever working again as is not the goal as psychiatric work is a source of meaning and fulfillment.

I believe this to be an understatement. I know well over 100 psychiatrists and I would guess that maybe 10-15% are "passionate" in the way you and Stagg are describing. I know quite a few who would quit today if they became financially independent in some other way.

And from my experience midlevels are worse in this respect. I have quite a bit of experience with them and the majority are in the job for the "money."

 

[calvnandhobbs68]

I believe this to be an understatement. I know well over 100 psychiatrists and I would guess that maybe 10-15% are "passionate" in the way you and Stagg are describing. I know quite a few who would quit today if they became financially independent in some other way.

And from my experience midlevels are worse in this respect. I have quite a bit of experience with them and the majority are in the job for the "money."

For sure the midlevels are almost ALL in it for the money. You think all the freaking heme/onc, medicine, ER floor nurses who got their online PMHNP on the side suddenly found their passion in psychiatry while still complaining about the "psych" patient in room 3?

They all get on instagram and hear about some psych NP is working 30hrs a week in outpatient billing 99214s+90833s all day and making 300K/year.

I just wish patients actually understood this like at all.

 

[comp1]

You all need to hire some better PMHNPs. They are definitely out there. I work with lots of them.

 

[calvnandhobbs68]

You all need to hire some better PMHNPs. They are definitely out there. I work with lots of them.

I don't employ any of them. That's actually the only way I would work with NPs is if I actually employed them, could train them and had direct supervision over what they were and weren't doing.

Otherwise the quality bar is so low to be an NP it's ridiculous, across the board for all specialities. I remember the absolute dumbest psych nurse at the inpatient unit I was at for fellowship was finishing up a PMHNP program.

 

[Stagg737]

I believe this to be an understatement. I know well over 100 psychiatrists and I would guess that maybe 10-15% are "passionate" in the way you and Stagg are describing. I know quite a few who would quit today if they became financially independent in some other way.

And from my experience midlevels are worse in this respect. I have quite a bit of experience with them and the majority are in the job for the "money."

Oh, I think the number of psychiatrists who are "passionate" about their job is probably well under than number. Likely <5%. I was just pointing out that even many of the residents who are "passionate" and "love" psychiatry seem to suddenly lose their passion if they have to stay at work past 4-5pm a few days in a row and start complaining. I'm not saying that they should be begging to stay at work until 7pm every night or not looking forward to leaving, I was just pointing out that I've noticed a sense of entitlement to wellness and self-care over learning (and sometimes even competency) even with some "passionate" residents.

I realize that complaining is the national pastime of residents in every field, but seeing as most psych residents work 25-50% less than other residents, never have to deal with the BS of many other fields in residency, and will do great financially as attendings compared to almost any other profession, a little perspective from more residents would be nice. For all my complaining, I do work with some wonderful residents and keep in mind that consults is probably not something most of them particularly enjoy. Hearing constant complaints about the service and policies (especially when those policies were advocated for by other residents in their cohort!) gets tiresome. /venting

You all need to hire some better PMHNPs. They are definitely out there. I work with lots of them.

I've worked with a handful who are truly fantastic. Our NP that works on our service for the past several years is outstanding. She's clinically solid, is quick to ask for help when she's unsure or over her head, and advocates for other NPs to be sure to have a solid mentor/supervisor even after they move into independent practice. I've worked with probably 3-4 NPs like that and they were great.

Otoh, I've also worked with or encountered hundreds of NPs who are just awful and have no business seeing patients at all, let a lone independently. Imo, outpatient psych NPs are frequently terrible, possibly the worst in how likely they are to be bad only second to NPs who work in nursing homes or long-term care facilities...

 

[Cath Up]

I'm not saying people should want to work long hours. I'm saying that when you're in a field where residency already has vastly better hours than almost every other medical specialty other than PM&R that doing a 4 week rotation where you're occasionally working a 9-10 hour day in order to learn valuable information that you otherwise won't learn should not be seen as unreasonable. The entire point of residency is to gain the experience and knowledge to be a solid attending and be able to handle as many different situations as possible. That sometimes involves working hours/shifts or being exposed to situations where the learner is uncomfortable.

My lament is that a desire for "wellness" and "balance" has superseded the desire to learn to be a competent attending physician for many, which is the entire point of residency. I'm not saying someone should completely ignore or neglect their own well-being, but entering a field where we inevitably care for the most vulnerable individuals in society during their darkest times requires the practitioner to leave their own comfort zone to challenge and expand their capabilities as a physician. That sometimes requires us to sacrifice a piece of our "wellness" to do good for others, at least temporarily.

As a millennial, I see my generation and Gen Z's views of seeing work and career as less meaningful and pursuing outside endeavors like travel and experiences to be derivative of a more nihilistic, "YOLO" view as opposed to a means of self-actualization. I find that far more concerning and problematic than people finding meaning through their work.

I am in the latter part of the millennial generation and was non-trad so my med ed has abutted gen z. Truly along every step of my training it has felt like there is this marked shift that happens in the several years of trainees or students under me in which what you’re describing occurs even more than occurred in my generation.

Perhaps it is the first whole-life internet generation, or maybe something else, but there is an apathy and maybe higher prevalence of constant comparison, or sometimes narcissism, in this generation which causes them to focus on the self so much. These are half baked ideas but it seems to culminate in a palpable desire to work less. My value judgement is that some of that desire is good, and some is totally unrealistic and counterproductive for the reasons you describe.

 

[FatherPsychiatry]

I realize that complaining is the national pastime of residents in every field, but seeing as most psych residents work 25-50% less than other residents, never have to deal with the BS of many other fields in residency, and will do great financially as attendings compared to almost any other profession, a little perspective from more residents would be nice.

Agreed. Psychiatrists IMO are on average the most mentally (and physically) weak of all physicians.

 

[comp1]

And yet we get paid the same or more than general internists. It's pretty darn sweet.

 

[randomdoc1]

The problem is that being a lifestyle specialty that isn't as competitive or typically as lucrative as derm isn't going to just attract "better" candidates, it's going to attract candidates who just want an easy ride to what they see as solid income with minimal work.


Agree, I'm seeing this more and more even with residents who are "passionate" about psychiatry. They're pretty passionate until they have to stay later than 4pm and then we start hearing complaints about how the service is just so demanding. I get that many people go into psychiatry because they don't want to be on the medical floors, but spending 4 weeks with us to learn stuff that's going to be essential to being a well-rounded psychiatrist should be seen at worst as a tolerable discomfort for everything they will be learning that they wouldn't otherwise get experience with.

don't burst their bubble...
there's dreams of a 10-1 job all remote with 400k annual income

Edit: and the patients would just be prozac refills of high functioning professionals with zero complaints/concerns that would deliver praise of how great they are.

I sound very jaded, but I'm burnt out on the employer end. I'll just say that...

Now I'm off to drool over my portfolio and make some digital products to sell : P.

 

[randomdoc1]

Agreed. Psychiatrists IMO are on average the most mentally (and physically) weak of all physicians.

Fun fact, I was in a form of surg before psych. And I did not leave the surgical field as first choice. Something rather unexpected happened and it turned out to be a massively blessing redirection.