Choosing Psychiatry

[Neurotic123]

Dear All
I am a medicine four student, I still have one month to chose which residency program I want to apply to
I am very interested in Psychiatry, it's research, it's content, and the relationship with patients, it's direct gratification, and it's life style.
I myself am an anxious person and I know what it means to be anxious, I can understand what patients feel and can empathize with them.
If I go by elimination, psychiatry will be the only one on the list, but this is not enough, I guess, one should be sure that he is really into it.
How does it affect you to be around manic patient? Schizoid? Does it ever change who you are, and how you deal with others, I.e some people tell me that I will b depressed or will go crazy! I know it is ******ed to think like that, I just want to know how it affects you.
Is it okey to get bored when a patient s interview last long and he is telling about every detail in his life? I am not the patient kind of a person but I do empathize with my patients, does it make me a bad psychiatrist?
Do you ever miss using a stethoscope or a needle?
A lot of people tell me that you studied anatomy and lots of other things, to go into a field where u will never use any of this, that it's a loss, they say. what do u think?
Thank you all

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[SomeDoc]

Dear All
I am a medicine four student, I still have one month to chose which residency program I want to apply to
I am very interested in Psychiatry, it's research, it's content, and the relationship with patients, it's direct gratification, and it's life style.
I myself am an anxious person and I know what it means to be anxious, I can understand what patients feel and can empathize with them.
If I go by elimination, psychiatry will be the only one on the list, but this is not enough, I guess, one should be sure that he is really into it.
How does it affect you to be around manic patient? Schizoid? Does it ever change who you are, and how you deal with others, I.e some people tell me that I will b depressed or will go crazy! I know it is ******ed to think like that, I just want to know how it affects you.
Is it okey to get bored when a patient s interview last long and he is telling about every detail in his life? I am not the patient kind of a person but I do empathize with my patients, does it make me a bad psychiatrist?
Do you ever miss using a stethoscope or a needle?
A lot of people tell me that you studied anatomy and lots of other things, to go into a field where u will never use any of this, that it's a loss, they say. what do u think?
Thank you all

You will have to frequently use knowledge in medicine and neuroanatomy when evaluating a patient for the first time. A good psychiatrist is a physician who can identify urgent or emergent medical issues that arise frequently on the psychiatry inpatient floors- and can treat, or consult the appropriate services accordingly. Medical issues on the psychiatry unit occur frequently, especially in the geriatric population. I can guarantee that you will also not be hanging up your stethoscope, as you have to do regular history and physicals on all new patients, including a psychiatric history and mental status exam. Your day will never be boring, as every patient is unique. It is rewarding getting to interact with patients in the context as a psychiatrist. It's a great field, I can certainly tell you this, but you should go into the field which you feel is the best fit for you as an individual.

 

[peppy]

Did you do a psychiatry rotation in school? That should give you a better idea of what you will think of the patients than anything we can say here, and it's definitely expected that you will have rotated in psychiatry if you want to get an American psych residency spot.

How does it affect you to be around manic patient? Schizoid?

I think it's interesting to talk to manic patients, as long as they aren't agitated enough to be aggressive in which case I keep my distance and try to keep the interaction brief.

Perhaps when you say schizoid you mean schizophrenic? Psychotic people are quite diverse actually. Some of them are very easy to talk to and even pleasant. Some are very agitated and paranoid, which of course is more challenging. I never felt like it had an impact on my own mental health. Talking to someone about their delusions and hallucinations won't make you have them yourself. You know when you're talking to them that what they're experiencing is a trick of the mind.

If you really did mean schizoid, well, that's a pretty rare diagnosis in the patients I see. Schizoids don't typically bother other people and they usually don't perceive themselves to have a problem, so they don't often end up getting psychiatric treatment. On the occasions I have had a patient who seemed to have schizoid traits, they were easy to deal with. They don't ask for much from other people.

I think everyone has different preferences about which patients they like seeing and which they find annoying or difficult.

Is it okey to get bored when a patient s interview last long and he is telling about every detail in his life? I am not the patient kind of a person but I do empathize with my patients, does it make me a bad psychiatrist?

I think we all get bored at times when talking with some patients. Still, it is important to force yourself to pay attention to what the patient is saying because the better you listen to them the more likely it is that you will learn something about the patient that might help you...as long as you keep them focused on talking about relevant things. Learning to re-direct patients that are just rambling about stuff that doesn't matter is a skill that you do need to learn.

Do you ever miss using a stethoscope or a needle?

I still use a stethoscope, though not with the same frequency as an IM doc. I don't miss using needles or scalpels. Never liked procedures in the first place. It made me very happy when I realized that I will never again have to do a pelvic or rectal exam, ever.

A lot of people tell me that you studied anatomy and lots of other things, to go into a field where u will never use any of this, that it's a loss, they say. what do u think?

Psychiatrists can and should use their knowledge of other medical fields. I have on occasion picked up on the fact that a patient's psychiatric problem was caused by a physical problem that the ER doc overlooked. You also have to monitor patients for physical problems caused by psychiatric meds (like weight gain, lipid changes, sexual side effects, high blood pressure, etc.).

None of the specialties use EVERYTHING they learned in med school. For example, I remember talking with an ENT doc who admitted that he had forgotten most of what he used to know about reading EKGs. That's what being a specialist means: focusing on a narrow range of information so you can be the best at it.
If you do want to feel like you know a little bit about everything you learned in med school, well, primary care is probably the closest thing to that, but even primary care docs will not use some of the things they learned in med school (like how to perform major surgeries for example).

 

[Neurotic123]

Thank you both for ur replies! I defenetly did do paych roation, one month in med 3 and an elective now and i enjoyed both a lot! I just wanted to see of it has any long term effect on ones own psychology...
And thank for ur replies abt the use of medical skills in psych
It is simply that i liked psych while no one in my surrounding support my choice, and it is a pretty tough choice!
Thank you for your help

 

[ShrunkenHeads]

I'm not a med student, but have you looked into neuropsychiatry?

 

[Leo Aquarius]

I do physical exams on every patient as I had done on internal medicine, and just the other day I identified a grade 2 systolic murmur before the cards consult did on my psych patient. So you definitely use your stethoscope and should in my opinion. Psychiatrists must really know their medicine and neurology because their patients have many co-morbidities - from what I've seen psychiatric illness rarely stands alone, and if it does it's not for long.

I love psychiatry because psychiatrists treat mental illness with incorporation of internal medicine, neurology, and pharmacology to turn lives around. Every patient is vastly different (and interesting!), there are no repetitive procedures, you get to connect with patients on a personal level, research and technology is booming for the field, stress level is relatively low, job opportunities and how to construct your practice styles are endless, pharmacology is fascinating and becoming more effective and targeted, patients are usually very grateful, and the brain is that final frontier that is always fascinating and challenging us. Opportunities for long-term patient interaction are very meaningful. When a family thanks you for bringing their loved-one back to his or her normal self it's deeply gratifying. Yes, nobody likes to hear sad stories, but your mission is to be that one special person who gives both hope and treatment. I really like that. Plus, I'm the kind of person who is able to come home and leave everything at work and totally focus on my family and friends, and then totally focus on patients when working.

 

[Neurotic123]

Thank you so much! Those are the reasons that are driving me to do psych ( the brain, the challenges, the gratification, the interaction, the life style) i am so glad to hear that they are actually this true from people who are there already!
Thank you all soo much!

 

[pre med 2014]

Thank you so much! Those are the reasons that are driving me to do psych ( the brain, the challenges, the gratification, the interaction, the life style) i am so glad to hear that they are actually this true from people who are there already!
Thank you all soo much!

If you are interested in the brain and challenges, what about neurosurgery or neuropathology?

 

[nitemagi]

If you are interested in the brain and challenges, what about neurosurgery or neuropathology?

Silly troll. Amazingly demonizing psychiatry yet advocating for neurosurgery.

Hypocritical, at best.

 

[tryp]

When did you guys know you wanted psychiatry? I'm an MS1 and went in thinking that's what I want to do. Observerships so far are only confirming that, though I still have a long way to go - wondering if I'll stick or go off the rails and become a surgeon or something.

 

[PETRAN]

If you are interested in the brain and challenges, what about neurosurgery or neuropathology?

He'll probably need a psychiatrist then

 

[nitemagi]

When did you guys know you wanted psychiatry? I'm an MS1 and went in thinking that's what I want to do. Observerships so far are only confirming that, though I still have a long way to go - wondering if I'll stick or go off the rails and become a surgeon or something.

It was on my short list from the beginning. Knew for certain after 3rd year clerkship.

 

[Fastball32]

Dear All
I am a medicine four student, I still have one month to chose which residency program I want to apply to
I am very interested in Psychiatry,

Was this post started in December? Isn't this way late in the game to decide for next year? 2nd looks are coming up...

 

[mkeguy]

thought about it early third year and decided late third year

When did you guys know you wanted psychiatry? I'm an MS1 and went in thinking that's what I want to do. Observerships so far are only confirming that, though I still have a long way to go - wondering if I'll stick or go off the rails and become a surgeon or something.

 

[TexasPhysician]

How does it affect you to be around manic patient? Schizoid? Does it ever change who you are, and how you deal with others, I.e some people tell me that I will b depressed or will go crazy! I know it is ******ed to think like that, I just want to know how it affects you.
Is it okey to get bored when a patient s interview last long and he is telling about every detail in his life? I am not the patient kind of a person but I do empathize with my patients, does it make me a bad psychiatrist?
Do you ever miss using a stethoscope or a needle?
Thank you all

The trick is to see roughly equal numbers of manic and depressed patients. This will keep you stabilized. The tough part is not becoming hyper-religious amongst all of the schizophrenics. Joking of course.

Being around Bipolar is no different than being around Diabetics. I won't catch Diabetes by talking to someone about insulin management, and the same goes with Bipolar.

I do not miss the stethoscope. Few doctors use it effectively any more. If anything, using a stethoscope has gotten me into trouble with other residents, because I would pick up on things they don't hear. How many upper years want to be shown up by a psych intern? The physical exam has been largely replaced by imaging in many fields. This upset me, but I won't go on a rant now.

I do miss using needles a bit. Steroid injections are a lot of fun, but what I am doing in psychiatry is even more fun.

 

[Fastball32]

Dear All
I am a medicine four student, I still have one month to chose which residency program I want to apply to
I am very interested in Psychiatry, it's research, it's content, and the relationship with patients, it's direct gratification, and it's life style.
I myself am an anxious person and I know what it means to be anxious, I can understand what patients feel and can empathize with them.
If I go by elimination, psychiatry will be the only one on the list, but this is not enough, I guess, one should be sure that he is really into it.
How does it affect you to be around manic patient? Schizoid? Does it ever change who you are, and how you deal with others, I.e some people tell me that I will b depressed or will go crazy! I know it is ******ed to think like that, I just want to know how it affects you.
Is it okey to get bored when a patient s interview last long and he is telling about every detail in his life? I am not the patient kind of a person but I do empathize with my patients, does it make me a bad psychiatrist?
Do you ever miss using a stethoscope or a needle?
A lot of people tell me that you studied anatomy and lots of other things, to go into a field where u will never use any of this, that it's a loss, they say. what do u think?
Thank you all

There are many people who go into Psychiatry who have disorders themselves.
You say you have anxiety, although it can help you sympathize with your patient, always remember to not let your own tribulations take away from the focus of the interaction, which will be your patients experience.

Mental health can be contagious and emotionally draining, however, the psychiatric encounter is so mentally stimulating that I don't think it affects most clinicians. Psychiatry is not for everyone, but it is extremely rewarding for all of us that are privileged to enter it.
I love psychiatry, I chose it for several reasons and I've never met a psychiatrist that regretted going into our field.

 

[pre med 2014]

Silly troll. Amazingly demonizing psychiatry yet advocating for neurosurgery.

Hypocritical, at best.

For the record. My position is against the misuse of psychiatry. I am not against the ethical use of psychiatry.

 

[Salpingo]

For the record. My position is against the misuse of psychiatry. I am not against the ethical use of psychiatry.

For the record.

Someone wrote a post stating they liked the (1) patient interaction and (2) lifestyle of psychiatry. You recommended (1) pathology and (2) surgery.

To the original poster, I think there are two different schools of people interested in psych. There are those who are wondering how the hell they even ended up in med school in the first place, a subset of whom actually matriculated thinking it would just be a stepping stone to psych. Then there are others, maybe the majority, of candidates who never really thought about mental health, but then sort of stumbled upon psych by 2nd or 3rd year. If you're the type of person that pursued medicine because of the intimacy of the patient-doctor relationship or the gratification of a long-term treatment plan, then psych is going to offer you something that few other specialties can. The question is, how do you make such a huge shift in your life. Are you just supposed to "forget" and give up everything you've been taught up to that point?

My plan is to stay grounded in some form of basic science research. I feel that there's been a huge vacuum created by the implosion of neuropharmacology, and now people are combining neuroanatomy, physiology, genetics with psychodynamics and behaviorism to create some really incredible, evidence-based therapies. A lot of people on this board have also pursued psychosomatics. I also think CAP can capture some of the broader medical principles, since you have to think somewhat like a pediatrician (although I don't have too much experience there).

 

[Ron Mexico]

For the record. My position is against the misuse of psychiatry. I am not against the ethical use of psychiatry.

how does one go about becoming a scientologist?

btw, everyone is against misuse in medicine. i don't go around prefacing every statement about surgery with, "i'm against the misuse of surgery. i am not against the ethical use of surgery."