I like real medicine too, and I'm apparently pretty good at it judging from my intern year feedback. However, I still enjoy psychiatry a lot more. It's open to a lot of interpretation and analysis (no pun intended) and less about what you have memorized and more about applying theories to reality. It's also a lot more satisfying to help save a couple's marriage or help a man enjoy his family again than to drop someone's A1c a couple points. Today, I did individual therapy on a patient with dysthymia and restarted her meds, did marital therapy on a couple at the precipice of divorce, therapized and started a man on medications who is so depressed he has no emotional connection to his family or desire to spend time with them, and thank by a former patient in the hallway for giving her life back to her.
Plus it's nice being a specialist. Remember, psychiatrists know a little bit about medicine, but internists apparently know nothing of psychiatry.
With regards to C/L, it helps to stay abreast of your medical knowledge for many reasons, the least of which being medication interactions. Many, many medical issues have neuropsychiatric manifestations and sometimes you will be consulted on a patient with a, "psych issue" who turns out to really have a medical issue. Our C/L team has diagnosed a patient with vocal cord dyskinesia after being consulted for possible factitious disorder or panic disorder.
I wanted to add, 3 months ago on the inpatient psych ward I had a hypotensive patient I was called to evaluate. I did an evaluation, diagnosed the problem, ordered the appropriate labs and began fluid resuscitation on the patient ON THE PSYCH WARD. Because we don't have IVs on the ward available for use, I had to be creative (I called an RRT just to have them show up and get access to their stuff). I realized they also carry an iStat around and I ordered a CBC on it, knowing that they tend to read low, because I noticed some bruising on the patient that was unusual and appeared recent. Turns out she was severely hypovolemic with internal bleeding from a broken hip. I escorted her to the PCU in case she crashed. That whole time, I was the only physician available. Nobody ever said, "You're not a real doctor"