sloop

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Hey everyone. I'm a third year med student and I wanted to ask the psychiatrists here a little more about the field and what reasons for choosing psych are good ones. The reason I'm asking is that I went into med school pretty much confident that I want to go into psych. I'm still fairly sure that it will be the field I will like best, but there have been some things that have given me doubts. For instance, I have very much enjoyed my rotation on OB/GYN and have realized that I enjoy procedures a lot more than I thought I would. When I thought about it a bit more, I realized that even some of my interests in psych are procedurally oriented (ECT, etc). Still, every time I sit down and think about what I really want to do there's one thing above others that really draws me back to psych and that's what I perceive as the philosophical richness of the field.

My impression is that psych is unique in that it deals fairly directly with complicated philosophical questions of identity, autonomy, responsibility, a person's relationship with their mind, the role of medicine in society, the social responsibility of psychiatrists to combat unfairness and stigma for their patients, etc. Of course I also love talking to patients and have always found the interview to be the most fulfilling part of patient encounters, but I think what really drives me is this philosophical, head-in-the-clouds stuff. I had a bit of a crisis in college when I considered applying to graduate school for philosophy rather than med school but chose this route because I hoped I could do clinical work that was philosophically meaningful.

I know that was kind of a long story, but I'm just wondering if people think this is a good reason to believe psychiatry would be right for me or if I'm just being too abstract and idealistic when in reality the field never deals with this stuff. Is there a place in psychiatry for a person like me? Would it be possible to have a career trajectory that would allow me to do both clinical work and research along the lines of philosophy of medicine/philosophy of psychiatry? Is this all a pipe dream?

Of course I'll get a better idea when I have my psych rotation, but I'd just like some feedback about whether I'm thinking about this decision in a flawed way.
 

nitemagi

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I consider psychotherapy to be a procedure. If done well it's an intervention, skill based, operator dependent, and can be goal oriented. And it's a helluva lot more complex than the see one-do one-teach one process of most medical procedures. The difference is that the tool is you (and the way you guide the experience of the patient).
 
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sloop

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I consider psychotherapy to be a procedure. If done well it's an intervention, skill based, operator dependent, and can be goal oriented. And it's a helluva lot more complex than the see one-do one-teach one process of most medical procedures. The difference is that the tool is you (and the way you guide the experience of the patient).
Fair enough, but I think what I meant by liking procedural stuff was that I like the acuity, the physical intervention and doing stuff with your hands. I wouldn't say physical procedures are an absolute requirement for my happiness in a field but I do like them a lot. I was thoroughly surprised by how much I enjoyed the surgeries I scrubbed on in OB/GYN. I thought I'd hate them.
 

nitemagi

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Fair enough, but I think what I meant by liking procedural stuff was that I like the acuity, the physical intervention and doing stuff with your hands. I wouldn't say physical procedures are an absolute requirement for my happiness in a field but I do like them a lot. I was thoroughly surprised by how much I enjoyed the surgeries I scrubbed on in OB/GYN. I thought I'd hate them.
I know what you meant. I was trying to expand your definition, as you may enjoy this more than you think.
 
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Shikima

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There are ECT and frontal lobotomies if you wish to pursue this. You could do a fellowship in pain management and addictions and be able to treat a lot of people while being able to do sterile procedures.
 
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sloop

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I know what you meant. I was trying to expand your definition, as you may enjoy this more than you think.
There are ECT and frontal lobotomies if you wish to pursue this. You could do a fellowship in pain management and addictions and be able to treat a lot of people while being able to do sterile procedures.
Actually addiction psych is my other strong interest within psych.

I'm glad to hear that there are areas of psych that are procedurally oriented. It makes me very hopeful.

Does anyone have anything to add about whether it would be feasible to have an academic career in psych that involves philosophical research. I would imagine that the funding for this sort of research/writing is probably low to non-existent and possibly not highly valued by institutions.
 

clausewitz2

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These people were pretty active until just this month:

http://philpsychiatryresearchgroup.com

At UNC/Duke. Bear in mind that analytical philosophy is a highly technical subject, so you will always be a -collaborator- with academic philosophers, not necessarily the one driving projects. It's not like science where there is always a role for Figure Contributor #4 or Data Cruncher #3 or Guy Whose Lab This Is.
 

OldPsychDoc

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Actually addiction psych is my other strong interest within psych.

I'm glad to hear that there are areas of psych that are procedurally oriented. It makes me very hopeful.

Does anyone have anything to add about whether it would be feasible to have an academic career in psych that involves philosophical research. I would imagine that the funding for this sort of research/writing is probably low to non-existent and possibly not highly valued by institutions.
To be honest, it would be very unlikely that you would start your career in this direction--most of the time you see this kind of writing coming out of folks who are kind of wrapping up their careers--but there's no reason you couldn't lean in this direction, go to the right meetings, network/be mentored by the right people...you could work your way into that niche. There are a good number of psychiatric academicians who delve into historical/social/philosophical issues--it would be good to look for them as you start interviewing, and see if there would be someone you could hook up with.
 
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sloop

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These people were pretty active until just this month:

http://philpsychiatryresearchgroup.com

At UNC/Duke. Bear in mind that analytical philosophy is a highly technical subject, so you will always be a -collaborator- with academic philosophers, not necessarily the one driving projects. It's not like science where there is always a role for Figure Contributor #4 or Data Cruncher #3 or Guy Whose Lab This Is.
Thanks. Yeah, that would be fine. It was never my intention to make this the primary aspect of my career. Mostly it's just something I'm interested in that I would be motivated to keep working on in the future and possibly write a book at some point.

To be honest, it would be very unlikely that you would start your career in this direction--most of the time you see this kind of writing coming out of folks who are kind of wrapping up their careers--but there's no reason you couldn't lean in this direction, go to the right meetings, network/be mentored by the right people...you could work your way into that niche. There are a good number of psychiatric academicians who delve into historical/social/philosophical issues--it would be good to look for them as you start interviewing, and see if there would be someone you could hook up with.
Thanks. This is really helpful. Like I just told the previous poster, I never envisioned that philosophical work would constitute a huge portion of my time or even be my primary focus as a psychiatrist. I also recognize that at the beginning of a career I probably wouldn't have time to devote to this sort of stuff. I mostly just hope that it would be possible to pursue at some point. The question of identity in mental illness/addiction and the mind-brain problem have always fascinated me and I find those subjects at least as interesting and relevant as the diagnostic and therapeutic aspects of psychiatry.

To be honest, the thinking part is more important than the research part for me. While I'd love to eventually contribute to something in this area, it's really more important to me to know whether psych is a field where this type of thinking exists and is encouraged or at least accepted.