Need Advice

[mdwstresident]

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Hey everyone-

So I'm currently in my psychiatry intern year and due to maternity leave earlier this I've recently started my first inpatient psych rotation. Much to my surprise I'm really not liking it. Unlike my medicine months I'm not working with other residents so I'm loney and the attending I'll be working with for the next three months is weird/not that nice. Also I feel initmidated and stupid all the time because I don't remember any psych and it shows. This had got me feeling pretty down and wondering if I should've done internal medicine instead. It's hard to tell if I hate the circumstances or the actual field. Anyone have any similar experiences?

 

[silas2642]

Yes. During my first year, I had a period of burnout where I seriously considered medicine-- talked to other medicine residents about it, talked the the PD about it, etc. In the end, I stayed with psychiatry and it was definitely the right choice. It's really important to sort out what is life circumstance vs. not liking your profession. It's only your first inpatient rotation and psychiatry has so much more to offer than inpatient. Hang in there, talk with your classmates for support, and this will all likely pass. Whatever you do, don't do anything impulsive.

 

[michaelrack]

Hey everyone-

So I'm currently in my psychiatry intern year and due to maternity leave earlier this I've recently started my first inpatient psych rotation. Much to my surprise I'm really not liking it. Unlike my medicine months I'm not working with other residents so I'm loney and the attending I'll be working with for the next three months is weird/not that nice. Also I feel initmidated and stupid all the time because I don't remember any psych and it shows. This had got me feeling pretty down and wondering if I should've done internal medicine instead. It's hard to tell if I hate the circumstances or the actual field. Anyone have any similar experiences?

If you don't remember much psych, it's time to start reading. It won't be any easier doing inpatient IM (as an IM resident), though it would be less lonely.

 

[markglt]

forget that IM nonsense, crack a book, get tough...make baby proud..
inpatient is grueling on any service, especially as an intern..its just a few months....hang in there, you'll be fine👍

 

[MDchouette]

Sorry to hear about this. We've all had a period of burnout, and nobody likes feeling "intimidated and stupid" (and I am sure you are not the latter). You might see if one of the PGY2s or PGY3s would be willing to spend an hour or two with you going over the basics of inpatient psychopharm. Bribe him/her with coffee or food. Most residents like to teach and wish they could do more of it.

I would also agree with those who recommend reading a bit--First Aid For Psych is a good refresher on the basics and you can build from there.

Medicine as an intern can feel intellectually easier than psychiatry in some ways because there is usually a "right" answer in medicine that you either know or you don't. In psychiatry, there may be a "right" medication class, but then it's much more nuanced and (frankly) subject to the biases of your attending. And then there are the multiple-times-daily opportunities to feel like you don't know how to talk to your terribly depressed/irritable/psychotic patients. My point is: this work is hard, even if you are getting a lot more sleep than you were on your medicine months. It seems to me that a lot of new psych residents expect to know how to navigate patient interactions in psychiatry just because they like psychiatry so much. This certainly isn't true. Or, they think that their mastery of skills on medicine rotations will transfer over to psych patients, which is only partially true (and mostly related to how to be an efficient resident).

Again, sorry to hear you're in this spot, but it seems early to me to make any major decisions.

 

[MacDonaldTriad]

Probably not the time to make any really big decisions. Although some psychiatrists really enjoy inpatient work, very few do any. One inpatient rotation with one attending can hardly paint a whole picture. The worst thing psychiatry does is put medical students on a locked unit for one rotation and then ask them "is this something you would be interested in doing the rest of your life"?

 

[OldPsychDoc]

Probably not the time to make any really big decisions. Although some psychiatrists really enjoy inpatient work, very few do any. One inpatient rotation with one attending can hardly paint a whole picture. The worst thing psychiatry does is put medical students on a locked unit for one rotation and then ask them "is this something you would be interested in doing the rest of your life"?

👍 Well said.

 

[markglt]

OP...checking in...how we doing... whats ur MSE looking like?

 

[Rena]

I'm also confused and don't know what to make from it. I'm currently PGY III and kinda disappointed with psychiatry. I don't feel respect from other specialties and don't consider myself as a doctor anymore. Everything I'm doing is not worthy and I'm really surprised that patients keep coming back for follow-ups and therapy. Or maybe I just don't like how things are handled in our Department and I feel overwhelmed and treated unfair?