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Sneezing

Even Bears do it!
10+ Year Member
Jan 27, 2009
598
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Resident [Any Field]
Med school was very interesting and very revealing about humanity but not my favorite experience. Intern year was a bounce around of liking psych and having a minimal intrigue in off service rotations.

:love: is starting to show itself. I love my job! Don't get me wrong, call bites and can keep you down for several days, but overall I'm loving it. I feel such an excitement for the remaining rotations and mounds of knowledge I still need to master. I even have a few research ideas floating around my mind I need to put to the IRB. This job rocks even when the patient tries to attack you or compares you to satan on a daily basis.

Ahhh, psych is good. Helping patients along the way is good. Life is good.

Now if only there were less call...
 

Doctor Bagel

so cheap and juicy
Moderator Emeritus
15+ Year Member
Sep 26, 2002
10,919
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Attending Physician
Dude, I'm jealous. I like my job more this year than I did last year, but I'm nowhere near love right now. I'm super excited about starting outpatient -- I'm kinda digging my worried well population there. I'm still feeling kind of pessimistic about inpatient psychiatry, though, and not a fan of call.

I'm wondering if work settings are figuring in here somewhere, although I'm pretty sure I shouldn't do inpatient psych professionally. I'm currently at the state hospital, and the patients here really don't seem to get much better. And the whole forced hospitalization thing just makes me sad -- not to mention the system in my state is entirely screwed up regarding the state hospital and state mental health. The VA is full of relapsing addicts, Cluster B folks and malingerers (total exaggeration I know), and our university hospital is a bummer because we confront lack of access to care all the time.

Thinking back, I felt a lot more optimistic about inpatient work when I was in medical school and at a private psych unit. I almost feel like a bad person for saying this, but I liked seeing patients who had jobs and a fairly good hope of returning to stable life after discharge. Maybe I'd like inpatient psych more with that type of population?

Glad you're loving your year, though.
 
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Chimed

10+ Year Member
Aug 9, 2007
716
72
Status
Attending Physician
Thinking back, I felt a lot more optimistic about inpatient work when I was in medical school and at a private psych unit. I almost feel like a bad person for saying this, but I liked seeing patients who had jobs and a fairly good hope of returning to stable life after discharge. Maybe I'd like inpatient psych more with that type of population?

Glad you're loving your year, though.
Don't feel bad. It's better to be honest with what you like and can handle then develop some false sense of obligation to treat a population you're just not into treating. If not, you could end up bitter and not enjoying your profession. That, in turn, will make you a less effective doc. I struggled with this myself. Even though I'd like to think I'm very competent (and actually pretty good) at dealing with acute issues such as suicidal and aggressive teenagers, I just have to admit I really don't want to work with that population. Obviously, it will always come up even in the best of settings--that goes with the territory and I'm fine with that. However, I'm planning on working with a subset of patients such as "straight" anxiety and ADHD that tend to not be as much "suicidal, dramatic, teenagers" with multiple psychosocial issues. Even though those patients deserve great treatment and compassion, it's just not a population I want to treat. This is why I'll likely work in an academic center and have a subspecialty clinic to be able to screen a specific patient population. It might not be as noble as those working in underserved settings and I highly respect those who choose to work in those area, but it's just not for me. I have to be honest about that with myself.

You can find the patient population you're talking about. You just have to find the right area and do research on patient populations.
 

BobA

Member
10+ Year Member
Aug 23, 2004
931
4
43
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Dude, I'm jealous. I like my job more this year than I did last year, but I'm nowhere near love right now. I'm super excited about starting outpatient -- I'm kinda digging my worried well population there. I'm still feeling kind of pessimistic about inpatient psychiatry, though, and not a fan of call.

I'm wondering if work settings are figuring in here somewhere, although I'm pretty sure I shouldn't do inpatient psych professionally. I'm currently at the state hospital, and the patients here really don't seem to get much better. And the whole forced hospitalization thing just makes me sad -- not to mention the system in my state is entirely screwed up regarding the state hospital and state mental health. The VA is full of relapsing addicts, Cluster B folks and malingerers (total exaggeration I know), and our university hospital is a bummer because we confront lack of access to care all the time.

Thinking back, I felt a lot more optimistic about inpatient work when I was in medical school and at a private psych unit. I almost feel like a bad person for saying this, but I liked seeing patients who had jobs and a fairly good hope of returning to stable life after discharge. Maybe I'd like inpatient psych more with that type of population?

Glad you're loving your year, though.
I enjoy working in private, voluntary inpatient settings, but don't like working with involuntary patients. This came as a bit of surprise to me, as I thought I liked working with the psychotic illnesses, which I felt were more "medical."

It's been a pleasant surprise to find out that psych is a very very broad field where I can (sort of) avoid populations I don't like working with and focus on populations I find more rewarding (high functioning bipolar I, anyone?).
 

Doctor Bagel

so cheap and juicy
Moderator Emeritus
15+ Year Member
Sep 26, 2002
10,919
1,128
from the ministry of information
Status
Attending Physician
Yeah, I've been surprised by my feelings about pt care. I always saw myself as a community type of person, and I was drawn to residency programs that had a lot of that type of exposure. It's not where I'm at, though.
 
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