confused about career directions

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thomasina

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I'm a PGY-1 at an academic program. I went into psychiatry because of all the intellectual flexibility it offered and the interesting patients. Though I was very enthusiastic and pretty sure about psych early on in med school, I now find myself having a lot of difficulty trying to figure out what I want to do later on in my career as an actual psychiatrist.

I don't know if I want to work inpatient or outpatient, psychodynamically or biologically-oriented, I don't know if I want to do a fellowship (I would love to not have to do any additional training, but am fine with pursuing something if it will actually enhance my skills as a psychiatrist. However, I am not specifically interested in any area - I mildly like all areas but my understanding of different subspecialties is somewhat limited to begin with, so it's hard for me to say "yes, definitely subspecialty x" at this point). I am interested in cultural psych but find "global mental health" kind of imposing on other cultures and because of that, I can't see myself wholeheartedly pursuing that, either. Additionally, this might be my ignorance speaking, but I feel like the research methods in psychiatry aren't terribly rigorous (I've done some small projects under some PIs at my med school) and I haven't had much or any training in how to craft a strong research question and come up with a clear and logical framework to approach those questions. Shoddy research seems worse than no research at all. Where can I learn about psychiatry research methods so that I can feel more confident in coming up with and approaching research questions? I don't want to half-heartedly pursue a project and be a bad mentee / waste other peoples' time, but in order to be truly enthusiastic about something I feel like I need to be confident about the entire premise and approach of the question. Psychiatry also feels fragmented and subject to intellectual fads (I mean, all fields can be like that) and I think that contributes to my uncertainty in moving forward.

Because I am at an academic program, I feel some pressure to start pursuing research about some topic, but I don't know where to begin. I have gone to some psychiatry conferences and will look into attending a few more to get a better sense of the range of opportunities and approaches out there. I personally find it easier to craft multiple pursuits around one core interest (for example, having the advocacy I pursue somewhat related to the research I'm working on, or whatever), but at this point I don't even have a core interest within psychiatry.

Would really appreciate any thoughts about what helped you find your own direction within psychiatry, especially as an early trainee. Thank you.
 
Take advantage of the electives opportunities too. Try all different settings. If there is a site you are considering working at, you can also try to see if you can set up an elective there to get a more in-depth trial.
 
You just need more reference experiences. As TexasPhysician stated, do a lot of moonlighting, and seek out experience/people in anything your program doesn't already offer.
 
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