MS3 afraid to go into psych...need help

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northprinter

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I would appreciate everyone's insight on this.

Now that it's towards the end of my third year, I find myself drawn to psych more than ever. Like my psych rotation, always looking for psych issues in peds/IM. While many disorders are fascinating and exciting to learn about, I'm just not as interested in their other medical problems. Hate scrub nurses and surgeons.Of course the nice hours and flexibility of work setting are big ++. I'm a woman, planning to have kids with my boyfriend during residency, and would like to have a balanced family life in the long run as well.

My concerns are..

1. Stigma and prestige. I had done decently well in med school and family are expecting me to go into more competitive and well paying fields. My mom especially. She is hoping for me to become a cardiologist or surgeon. She also think psych patients will turn me crazy. She's trying to stomach my desire to go into psych after knowing about the nice hours and decent pay/hour. but still, she's unhappy. My dad, on the other, kept reminding me that Hannibal is a psychiatrist. While McDreamy is a surgeon. Of course, there are also my friends who are talking about doing rad-onc, plastics, ENT, all that, and looking at me like I'm lying when I say psych. Anyone else in the same boat in the past?

2. Getting bored? A child psychiatrist close to retirement told me he's extremely bored, esp now he's dealing with 10 min med checks more than ever. A neurologist also said the same thing, that all psychiatrists are bored out of their minds. I am very fascinated by all my patients thus far. However, practicing docs, are you now bored? I tend to think that problem would come with most specialists.

3. One very attractive psych resident told me she was stalked by a few patients and had to switch program and got the court involved. Any other woman psychiatrist here/ anyone heard of someone involved in similar situation or was physically/sexually attacked?

4. Pay. What is the realistic pay for a woman psychiatrist who works say 40 hours per day? Is the gender gap in pay check better/worse in psychiatry vs surgical specialties? Also, how is OBAMAcare going to affect psych vs other specialties? How is the psych shortage going to look like in a few years?

Thanks for any input. I tried to lurk around the forum quite a bit, but couldn't find specific answers to my concerns.

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I would appreciate everyone's insight on this.

Now that it's towards the end of my third year, I find myself drawn to psych more than ever. Like my psych rotation, always looking for psych issues in peds/IM. While many disorders are fascinating and exciting to learn about, I'm just not as interested in their other medical problems. Hate scrub nurses and surgeons.Of course the nice hours and flexibility of work setting are big ++. I'm a woman, planning to have kids with my boyfriend during residency, and would like to have a balanced family life in the long run as well.

My concerns are..

1. Stigma and prestige. I had done decently well in med school and family are expecting me to go into more competitive and well paying fields. My mom especially. She is hoping for me to become a cardiologist or surgeon. She also think psych patients will turn me crazy. She's trying to stomach my desire to go into psych after knowing about the nice hours and decent pay/hour. but still, she's unhappy. My dad, on the other, kept reminding me that Hannibal is a psychiatrist. While McDreamy is a surgeon. Of course, there are also my friends who are talking about doing rad-onc, plastics, ENT, all that, and looking at me like I'm lying when I say psych. Anyone else in the same boat in the past?
.

You don't really have a question here, so I don't really know what to tell you.......only you can determine how much a negative this is. Surgeons and medicine specialties are going to have a lot more prestige...that's fairly obvious. The question is- why does that bother you so much? Note that Im not saying it is a bad(or good thing) that it does bother you....just maybe it is worth investigating and determining how important it is.
 
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You don't really have a question here, so I don't really know what to tell you.......only you can determine how much a negative this is. Surgeons and medicine specialties are going to have a lot more prestige...that's fairly obvious. The question is- why does that bother you so much? Note that Im not saying it is a bad(or good thing) that it does bother you....just maybe it is worth investigating and determining how important it is.

I respect and love my parents very much for what they've done for me. They never went to college nor worked in professional fields. And they have very high hopes for me. I tried to explain the nature of the work a psychiatrist do vs. what is portrayed in the media, and how rewarding the job is. However, I do want them to be happy and proud of me. Not disappointed...Yes, I wonder about why do people other than my parents' opinions get to me? Because I should do what I love. Maybe I myself have issues too. I'm hoping to get some advice from those who might have had similar struggles as asking about these sort of questions at our school seems to be a taboo.
 
1. Stigma and prestige.

It might be hard, but you really shouldn't care what other people think. In the end, that won't be what keeps you satisfied day to day. If you believe in what you're doing and enjoy it, then 1) you're doing it right, and 2) you'll be able to defend yourself if you ever feel the need.

2. Getting bored?

I have never heard this from anyone before now. Btw, do you think that these quick office visits are only happening to psych and neuro? Also, you don't have to work as an outpatient.
 
I respect and love my parents very much for what they've done for me. They never went to college nor worked in professional fields. And they have very high hopes for me. I tried to explain the nature of the work a psychiatrist do vs. what is portrayed in the media, and how rewarding the job is. However, I do want them to be happy and proud of me. Not disappointed...Yes, I wonder about why do people other than my parents' opinions get to me? Because I should do what I love. Maybe I myself have issues too. I'm hoping to get some advice from those who might have had similar struggles as asking about these sort of questions at our school seems to be a taboo.

I wonder how your parents would react if you told them you find it disappointing being the child of an uneducated couple. Also, Hannibal was a genius.
 
I wonder how your parents would react if you told them you find it disappointing being the child of an uneducated couple.

PS: Hannibal was a genius. McDreamy a narcissist.

I don't get the sense that the OP is disappointed in her parents; I think the OP meant that despite not being high-income, her parents sacrificed for her education, and that the OP appreciates the sacrifice.
 
I don't get the sense that the OP is disappointed in her parents; I think the OP meant that despite not being high-income, her parents sacrificed for her education, and that the OP appreciates the sacrifice.

I'm not suggesting she is. I'm just saying what's good for the goose is good for the gander.

If they want to her to choose a career based on complete and utter superficiality, with no recognition of her far greater insight into medicine and her own interests, then it's easy to look at their lives and point out their superficial failures, with no recognition of their true motivations, character, and desires.
 
oh man, OP, i know i don't know you but i really want to hug you. i can TOTALLY relate. i went to med school imagining myself doing primary care, and found that i really didn't like it...at all. so i thought, well, maybe i'll like some IM subspecialties (still have yet to do my IM clerkship). along the way i had my psych clerkship, which i had very low expectations for, but totally loved. i found myself really fascinated by the subject matter and enjoying the types of interactions you get to have with patients. meanwhile, i find myself growing more and more impatient with all of the rest of medicine.

like you, my family has been dismissive of my interest in psych, and sometimes downright mean about it. i keep telling myself that it's my life and i'm the one who has to be ok with what i do, but honestly, it's hard to hear negative comments from people i care about and not take these things to heart. and don't even get me started on the negative comments from people i DON'T care about. it seems almost every non-psych resident or attending i come into contact with who asks me what i'm interested in has zero respect for mental health professions, and automatically assumes i must be dumb or lazy (which is totally unfair, as i know i could be a competitive applicant in any field based on my grades and board schools). sometimes this is all so discouraging that i find myself trying to convince myself that there are other things i could be happy with, just because it's more "socially acceptable."

but the truth remains--i AM interested in psych, and i DO find mental health issues to be something i can be passionate about (unlike, say, hernia repairs or acute renal failure or diabetes or basically any other bread-and-butter surgery or medicine issue you can think of). my husband and i plan to have a family during residency, i have interests and hobbies outside of medicine, and i like to be able to enjoy my life--all of which i feel would be more achievable in psych than in almost any other specialty.

anyway...my point is, i know exactly where you're coming from. i feel like i am struggling so much to make a decision about my specialty choice, and not necessarily because i don't know what i like, but because i don't know how to make myself feel ok about what i do like.

things that have been helpful for me that might help you too:
--meeting your school's dean of students, whose job it is to help students feel ok about their career choices and figure out how to best get where they want to go
---find some psych docs that you like and respect, and ask them if they would be willing to meet with you to talk about their work, how satisfied they are with their choice to go into psych, etc. be bold--ask them all if they're bored if this is something that's really bothering you!
--be a careful observer of all the non-psych docs you work with. can you see yourself doing what they're doing? interacting with patients the way they do? do they seem happy? engaged with their field? overworked? burned out? every time i work with someone in another field who seems like a miserable human being, it makes me feel a little bit better about choosing psych. i've worked with a lot of people who seemed really bored, and none of them were psychiatrists.
--figure out who your sympathetic friends are, and talk to them about all of this. for me, this is a friend who wants to go into family medicine and has a cousin with schizophrenia.
--figure out who your non-sympathetic friends are, and avoid this line of conversation until you're feeling more sure of your decision. it's not their decision to make, and if they can't be nice and supportive, then you don't need their input on the issue while you're still trying to figure things out. after all--are you giving them the evil eye for going into plastics?

i cannot really speak to your specific questions about pay by giving you real numbers, but i do know that on average, the outpatient psychiatrists in my university's system make basically the same amount as the primary care docs, but work fewer hours and see fewer patients in those hours. some would say primary care docs are way underpaid--but from my humble lower-middle-class background, anything over $120k is like....an insane amount of money, especially if i don't have to work myself totally into the ground to achieve it.

also regarding your stalking question--i have heard stories of attendings being tackled by patients, of residents being charged at, and of patients fighting each other on the wards (to the point of having to be admitted to the ICU...). it's a field where you have to be careful, for sure, and if i think about it too hard it definitely worries me. but i do think it's one of those things where you just have to be smart about your surroundings and take the proper precautions. i would argue that you're more likely to be in a serious car accident on your way to work than to suffer any significant harm at the hands of your patients (although I don't have statistics to prove it. future research project inspiration!)

good luck to you in deciding what to do! know that you're not alone in your struggles, and that, if nothing else, this random stranger on SDN doesn't think you're being superficial or petty by being worried about the negative reactions you're getting from people around you. hang in there, and hopefully you'll figure out what's right for you in due time.
 
wow, reading the OP's post just makes me so much more thankful to have the parents I grew up with. Neither of my parents went to college, but they would be proud of me even if I dropped out of med school and did something much less respected. They are happy I want to do psychiatry, even if they occasionally call it psychology :)

To the OP, choose what is best for you and then give your folks some time to get used to the idea. They might not be excited about psychiatry right now but they will be once you start reaping the perks of the field.
 
I usually get a kick out of hysterical reactions whenever I mention I'm interested in psychiatry (and that includes one of my parents and.... most of the people I know outside of medicine).
The best way to respond to such comments is to just tell how prevalent mental illness is, how much the mentally ill suffer and how much they need your help. Don't go into any technicality to justify your choices.

But, as people said, the more important thing is to pick a specialty you believe in, not one your parents believe in. Even though your parents worked very hard for you to be in med school and that's admirable, you are the one who will be practicing medicine for the rest of your life, not them. It's a tough thing to handle, especially if you are very close to them, but they will come to terms with it.
 
This isn't turning to the dark side. Drinking from the psychiatric Kool Aid is the best decision I ever made. Financial security is more a matter of living below your means and not as dependent upon income as you might think. It can be easily done in psychiatry. The reading is more interesting and our diseases are not infectious despite public oppinion. Attractive females can be stocked in or out of our field and I can not think of a more bordom resistant line of work. Almost all applicants into psychiatry tell stories of parental concern. It is time you do want makes you happy. This isn't the last moment to avoid a life long turn, but it is a big one. The job market is outstanding and the rewards are near the top (oncology, neurology, neurosurgery...talk about depressing)

Yes, there are moments when doctors who are uncomfortable with our patients make jokes, but a lot of this is jelousy. Students learn this from mentors, but most people don't see this and those who will come to you for help will see you as a source of medical help.
 
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This isn't turning to the dark side. Drinking from the psychiatric Kool Aid is the best decision I ever made. Financial security is more a matter of living below your means and not as dependent upon income as you might think. It can be easily done in psychiatry. The reading is more interesting and our diseases are not infectious despite public oppinion. Attractive females can be stocked in or out of our field and I can not think of a more bordom resistant line of work. Almost all applicants into psychiatry tell stories of parental concern. It is time you do want makes you happy. This isn't the last moment to avoid a life long turn, but it is a big one. The job market is outstanding and the rewards are near the top (oncology, neurology, neurosurgery...talk about depressing)

Yes, there are moments when doctors who are uncomfortable with our patients make jokes, but a lot of this is jelousy. Students learn this from mentors, but most people don't see this and those who will come to you for help will see you as a source of medical help.

Well said on many levels.
 
I would appreciate everyone's insight on this.

Now that it's towards the end of my third year, I find myself drawn to psych more than ever. Like my psych rotation, always looking for psych issues in peds/IM. While many disorders are fascinating and exciting to learn about, I'm just not as interested in their other medical problems. Hate scrub nurses and surgeons.Of course the nice hours and flexibility of work setting are big ++. I'm a woman, planning to have kids with my boyfriend during residency, and would like to have a balanced family life in the long run as well.

My concerns are..

1. Stigma and prestige. I had done decently well in med school and family are expecting me to go into more competitive and well paying fields. My mom especially. She is hoping for me to become a cardiologist or surgeon. She also think psych patients will turn me crazy. She's trying to stomach my desire to go into psych after knowing about the nice hours and decent pay/hour. but still, she's unhappy. My dad, on the other, kept reminding me that Hannibal is a psychiatrist. While McDreamy is a surgeon. Of course, there are also my friends who are talking about doing rad-onc, plastics, ENT, all that, and looking at me like I'm lying when I say psych. Anyone else in the same boat in the past?

2. Getting bored? A child psychiatrist close to retirement told me he's extremely bored, esp now he's dealing with 10 min med checks more than ever. A neurologist also said the same thing, that all psychiatrists are bored out of their minds. I am very fascinated by all my patients thus far. However, practicing docs, are you now bored? I tend to think that problem would come with most specialists.

3. One very attractive psych resident told me she was stalked by a few patients and had to switch program and got the court involved. Any other woman psychiatrist here/ anyone heard of someone involved in similar situation or was physically/sexually attacked?

4. Pay. What is the realistic pay for a woman psychiatrist who works say 40 hours per day? Is the gender gap in pay check better/worse in psychiatry vs surgical specialties? Also, how is OBAMAcare going to affect psych vs other specialties? How is the psych shortage going to look like in a few years?

Thanks for any input. I tried to lurk around the forum quite a bit, but couldn't find specific answers to my concerns.
I can totally relate to what the OP is feeling.
My father who is a Gynecologist in my home country still cannot understand why i have chosen to do psychiatry. We have had countless run-ins on the matter , this is partly because of the fact that the specialty is still at its infantile stage in my home country and people who make that career choice are viewed as lesser doctors.
However what matters to me ultimately is whether ill be happy. I smiled everytime during my psych rotations, i didnt spend the time looking endlessly at the clock waiting for the time i was allowed to leave.
My parents have come to understand that , and though we still butt-heads at this , i think they are genuinely happy for me.(they still try to make me change my mind though).
I probably wont earn millions but if i can earn a respectable salary to take care of my family while doing what i love , ill be more than happy.
My suggestion to the OP is to let your parents know how happy this profession makes you, eventually they will accept that and be happy for you as any parent would.value the happiness of their children above all else.
 
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This isn't turning to the dark side. Drinking from the psychiatric Kool Aid is the best decision I ever made. Financial security is more a matter of living below your means and not as dependent upon income as you might think. It can be easily done in psychiatry. The reading is more interesting and our diseases are not infectious despite public oppinion. Attractive females can be stocked in or out of our field and I can not think of a more bordom resistant line of work. Almost all applicants into psychiatry tell stories of parental concern. It is time you do want makes you happy. This isn't the last moment to avoid a life long turn, but it is a big one. The job market is outstanding and the rewards are near the top (oncology, neurology, neurosurgery...talk about depressing)

Yes, there are moments when doctors who are uncomfortable with our patients make jokes, but a lot of this is jelousy. Students learn this from mentors, but most people don't see this and those who will come to you for help will see you as a source of medical help.

i think i just need someone to say something like this to me every so often and then i'll feel just fine! thanks :thumbup:
 
1. Stigma and prestige. I had done decently well in med school and family are expecting me to go into more competitive and well paying fields. My mom especially. She is hoping for me to become a cardiologist or surgeon. She also think psych patients will turn me crazy. She's trying to stomach my desire to go into psych after knowing about the nice hours and decent pay/hour. but still, she's unhappy. My dad, on the other, kept reminding me that Hannibal is a psychiatrist. While McDreamy is a surgeon. Of course, there are also my friends who are talking about doing rad-onc, plastics, ENT, all that, and looking at me like I'm lying when I say psych. Anyone else in the same boat in the past?

I know you're just using it as an example, but are you really going to let your dad's impression of medical specialties from movies and TV shows affect your career decision?

Stigma and prestige is only one part of the equation, and choosing to be a psychiatrist, in some part, means that you accept that others' initial reaction may be to be disappointed (in the case of your parents), or to be underwhelmed (in the case of your classmates). But none of them will be living your life, seeing the patients you choose to ultimately see, and be in the profession you choose.

Unless your parents are totally unreasonable, they aren't going to disown you for choosing to enter the specialty you really want to do, even if they are disappointed about your choice. For you to go into psychiatry, you need to decide that you're okay with them feeling disappointed with you for not being a cardiologist, surgeon, dermatologist, etc. I'm sure you know this already, but many of the people matching into psychiatry today could have chosen any other specialty and matched into any program they wanted to. There are candidates of extraordinary caliber entering the specialty every year, and they are choosing the specialty because they find it the most interesting/rewarding for them. Many of them faced the same disappointment from their parents/friends that you will potentially face.

Are you willing to accept their disappointment to enter the career you really want to enter?

2. Getting bored? A child psychiatrist close to retirement told me he's extremely bored, esp now he's dealing with 10 min med checks more than ever. A neurologist also said the same thing, that all psychiatrists are bored out of their minds. I am very fascinated by all my patients thus far. However, practicing docs, are you now bored? I tend to think that problem would come with most specialists.

I'm sorry for the child psychiatrist that he chose a practice model that he ended up being bored out of his mind doing. I'd probably be bored out of my mind too if all I did every day was 10 minute med checks. That is only one possible way to practice psychiatry. When you look for a job, you need to figure out what you're going to enjoy and choose to do it (does that sound similar to my response to #1? It should). The vast, vast majority of psychiatrists I've spoken to love what they do. Many psychiatrists practice well into their 70s because they just love what they do.

Bottom line - if you make choices based on what you're interested in and what you believe you will enjoy doing for the rest of your life, you will come out alright. If prestige and the approval of your parents and friends is important enough to you that you wouldn't feel happy in a specialty that you perceive they'd look down on you for choosing, then I hope you find a different specialty that you find equally (or more) interesting.
 
I respect and love my parents very much for what they've done for me. They never went to college nor worked in professional fields. And they have very high hopes for me. I tried to explain the nature of the work a psychiatrist do vs. what is portrayed in the media, and how rewarding the job is. However, I do want them to be happy and proud of me. Not disappointed...Yes, I wonder about why do people other than my parents' opinions get to me? Because I should do what I love.

Loving and respecting your parents doesn't mean only doing things that they will approve of you doing. That would limit your choices and your life quite a bit. They might not ever see psychiatry the way you do. Will you let that stop you from choosing a specialty that really excites and interests you?

Maybe I myself have issues too. I'm hoping to get some advice from those who might have had similar struggles as asking about these sort of questions at our school seems to be a taboo.

I faced a similar situation with my parents. I ultimately chose psychiatry despite being practically begged to go into a "real medical specialty." I'm very happy with my choice, partially exactly because it was my choice and not theirs. Their views on psychiatry have shifted pretty significantly in a positive direction since then, and I think they ultimately respected me for standing up for myself and doing what I wanted, even though they initially did not agree with it.
 
I know lots of dual boarded psychiatrists. One is doing family medicine, but all of the others are doing 100% psychiatry. In my own experience, the more I did electives in medical specialties, the more I could face the "not becoming a real doctor". Most psychiatrists have not dissappointed their families and friends all that much, and most of us are happy. We do need strong membrain between our patient's problems and our lives, but that isn't as hard as you might think. Look at what other doctors have to see and separate from. If you are like me, the more you explore specialties other than psychiatry the more you will be gravitated towards psychiatry. If not, you probably should go somewhere else. I suggest at least one more psych elective, but there will be plenty of psych in your future if you go our direction. We have a lot of refugies from other specialties trying to find that peacefull place. I haven't seen this in other specialties nearly so often.
 
Ask yourself whether those people will be strolling onto the surgery ward with you at 5 AM to start rounding or standing there for the third hour straight discussing your team's eleventh CHFer on the telemetry floor. I get wanting to be respected, but eventually you have to choose what will create happiness for you.
 
my dad was the first one to go psych out of his whole family and got a lot of heat about it

he has never regretted it and it is because he loves the field
his only regret is that he didn't get to practice it right out of med school because psychiatry is non-existent in the country where he was born

my uncles and cousins who are attendings in other specialties are constantly trying to talk me out of psychiatry because they think i'm too smart to waste my time in psychiatry (serious; people still think this way about psychiatry)

your post suggests that you have a strong interest in psychiatry
i wouldn't break my parent's hearts over a "strong interest"
only do psychiatry if it is love
 
Ask yourself whether those people will be strolling onto the surgery ward with you at 5 AM to start rounding or standing there for the third hour straight discussing your team's eleventh CHFer on the telemetry floor. .

Or likewise, ask yourself whether you want to round/play social worker on yet another antisocial SIMD inpatient who has spent all his drug money for the month and needs an inpatient bed for 5 more days until his next check comes in on the 1st.....vs draining a pericardial effusion in the CV suite.

Just the other side of the coin(and how people in medical specialties often look at it)....
 
1. Stigma and prestige. I had done decently well in med school and family are expecting me to go into more competitive and well paying fields. My mom especially. She is hoping for me to become a cardiologist or surgeon. She also think psych patients will turn me crazy. She's trying to stomach my desire to go into psych after knowing about the nice hours and decent pay/hour. but still, she's unhappy.
I come from a cultural background in which psychiatry bears a substantially stronger stigma than in the US. But I found that the "family disappointment" thing is mostly pretty transient. Pretty soon, they'll all realize that psychiatry is a respectable field that is the right job for you, and they'll get over the whole "competitiveness" thing. It might take a couple of years, but it will pass. On the other hand, you'll have to live with your specialty choice for the rest of your life.

In my case, I was lucky enough to come from a well-educated family, so they were pretty easy to convince. I have a close friend who chose to go into medical physics, much to the dismay of her family (who believed that if you can't get into med school, the next logical choices are pharmacy or dentistry or some other field that they understand better). But now that she has a $100k+ job and her husband (who is an internal medicine resident) is struggling with 80-hour work weeks, her family has come around to believe that she made the right call.



My dad, on the other, kept reminding me that Hannibal is a psychiatrist. While McDreamy is a surgeon.
Jack the Ripper was also a surgeon... and he was real. The President of the AMA is a psychiatrist.
The Todd is a surgeon.
Frasier is a psychiatrist. So is Heather Graham's character in Scrubs.


Of course, there are also my friends who are talking about doing rad-onc, plastics, ENT, all that, and looking at me like I'm lying when I say psych. Anyone else in the same boat in the past?
Yeah, I got a lot of that. Like, "you actually WANT to do psych?" I'd just respond with something like "you actually WANT to do surgery?"
 
Jack the Ripper was also a surgeon... and he was real. The President of the AMA is a psychiatrist.
The Todd is a surgeon.
Frasier is a psychiatrist. So is Heather Graham's character in Scrubs.



"

House is a presumably an internist (wikipedia lists him as a
"a board-certified diagnostician with a double specialty of infectious disease and nephrology")
 
I come from a cultural background in which psychiatry bears a substantially stronger stigma than in the US. But I found that the "family disappointment" thing is mostly pretty transient. Pretty soon, they'll all realize that psychiatry is a respectable field that is the right job for you, and they'll get over the whole "competitiveness" thing. It might take a couple of years, but it will pass. On the other hand, you'll have to live with your specialty choice for the rest of your life.

In my case, I was lucky enough to come from a well-educated family, so they were pretty easy to convince. I have a close friend who chose to go into medical physics, much to the dismay of her family (who believed that if you can't get into med school, the next logical choices are pharmacy or dentistry or some other field that they understand better). But now that she has a $100k+ job and her husband (who is an internal medicine resident) is struggling with 80-hour work weeks, her family has come around to believe that she made the right call.




Jack the Ripper was also a surgeon... and he was real. The President of the AMA is a psychiatrist.
The Todd is a surgeon.
Frasier is a psychiatrist. So is Heather Graham's character in Scrubs.



Yeah, I got a lot of that. Like, "you actually WANT to do psych?" I'd just respond with something like "you actually WANT to do surgery?"


we don't know who jack the ripper was for sure, so it's a reach to say he was a surgeon
 
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