Psychiatry is easy! That’s what all the medical students tell me.

[Ratan1982]

I’m feeling really disheartened. I have always wanted to do psychiatry, but classmates keep saying it’s “easy”, and one of the easiest fields in which to match, which is true. I know you shouldn’t listen to what others say all the time, but so many medical students have this mentality and most of these people are top students matching into Anesthesiology and Plastics. One smart student told me “face it, psychiatry is easy. It’s all talk. They use the same four medications. It’s medicine for dummies.”

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[comp1]

This is a troll, right?

 

[Ratan1982]

This is a troll, right?

Nope

 

[erg923]

students don't know what's "easy" or hard. That's why they are students.

Almost anything is "easy" if you want it to make it that way and don't really care that much. Most psychiatrists will likely say it can be easy to do poorly and very, very hard to do fully/top of license.

 

[calvnandhobbs68]

I’m feeling really disheartened. I have always wanted to do psychiatry, but classmates keep saying it’s “easy”, and one of the easiest fields in which to match, which is true. I know you shouldn’t listen to what others say all the time, but so many medical students have this mentality and most of these people are top students matching into Anesthesiology and Plastics. One smart student told me “face it, psychiatry is easy. It’s all talk. They use the same four medications. It’s medicine for dummies.”

This is what inspired you to come back since your last post in 2005? Where you been all these years? You were applying to med school in 2005 but still in school in 2023?

If this is true and you're like in your late 30s and haven't even started residency yet, the last thing you should probably care about is what your classmates think about it...

 

[comp1]

Okay, if not a troll (which is still highly dubious)...psychiatry is a lifestyle specialty. It's average in difficulty to match, not particularly hard or easy relatively. However it IS pretty easy to be a bad physician in almost any specialty and if you're just focused on four meds, then you probably are a bad physician. Heck, if you're really just focused on psychopharm, you're probably not one of the greatest.

 

[Celexa]

1. It is no longer easy to match psychiatry.

2. It is sadly easy to be a bad psychiatrist. It is incredibly hard to be a good one, and the difference between the two is as vast as the difference between pink slime and a $500 sirloin.

 

[Ratan1982]

to answer the previous poster- I was applying to med school in 2005- didn’t get in, and finances were tough so gave up- applied again as an older student in my late 30s wanting a career change decided to bit the bullet with student loans. I actually really enjoy psychiatry but it’s hard sometimes- when others put down what you’ve developed an interest in. So no, I’m not trolling, just relaying what was said to me by a younger classmate who’s smart.

 

[Ratan1982]

Btw thanks for your posts, it does make me feel better to know that others may have heard this and given it thought.

 

[splik]

It is easier to match into. That is a good thing for you!
It is easier to practice psych (badly).

do a good job and you will be highly respected by your colleagues. There are few specialties where your colleagues will hang on your every word about a complex case as you help make sense of their seemingly incomprehensible behavior. Psychiatry is one of them.

Also, as someone who did consult-liaison psych for yrs, I'll tell you those people who like to denigrate psych are the first ones to call in a panic when there is something going on with their patients. Psychiatric problems make many people uncomfortable or fearful, and denigrating the physicians who help is one way of defending against their intense discomfort.

 

[calvnandhobbs68]

to answer the previous poster- I was applying to med school in 2005- didn’t get in, and finances were tough so gave up- applied again as an older student in my late 30s wanting a career change decided to bit the bullet with student loans. I actually really enjoy psychiatry but it’s hard sometimes- when others put down what you’ve developed an interest in. So no, I’m not trolling, just relaying what was said to me by a younger classmate who’s smart.

If this is the case, you should be applying to what you're interested in, what fits your lifestyle/goals long term and what kind of residency you think you can realistically tolerate physically in your late 30s/40s (since end of residency is gonna be at least 5+ years from now if you're an MS2+). If you base what you're applying to on what anyone tells you is cool or prestigious you're gonna have a bad time.

 

[Ratan1982]

Well, I don’t think so much about what’s “cool and prestigious”- I’m too old for that. Psychiatry fits my goals quite well I think. But medicine/residency is a long slog, and it’s definitely challenging when residents tell you that psychiatric residents are generally weak on med/surg intern rotations compared to ob/gyn etc. going through years of cost and training at a later age is hard enough without your colleagues who you respect in some cases denigrating you.

 

[WisNeuro]

Well, I don’t think so much about what’s “cool and prestigious”- I’m too old for that. Psychiatry fits my goals quite well I think. But medicine/residency is a long slog, and it’s definitely challenging when residents tell you that psychiatric residents are generally weak on med/surg intern rotations compared to ob/gyn etc. going through years of cost and training at a later age is hard enough without your colleagues who you respect in some cases denigrating you.

If you have colleagues denigrating you simply because of a specialty that you enjoy, or have expressed interest in, why do you respect these colleagues?

 

[Ratan1982]

I guess I respect them because they are great students who perform well. I’d say they are denigrating the specialty more than myself. Part of it is based on experience on the rotation, which they found a lot easier than the others.

 

[WisNeuro]

I guess I respect them because they are great students who perform well. I’d say they are denigrating the specialty more than myself. Part of it is based on experience on the rotation, which they found a lot easier than the others.

Who cares what's "easy" vs. "hard?" What do you want to do on a day-today basis and what do find enjoyable and/or fulfilling? If you want to surround yourself with insufferable people, go ahead, but in my doctoral/professional friend group, no one really gives a **** what the other does.

 

[SmallBird]

Well, I don’t think so much about what’s “cool and prestigious”- I’m too old for that. Psychiatry fits my goals quite well I think. But medicine/residency is a long slog, and it’s definitely challenging when residents tell you that psychiatric residents are generally weak on med/surg intern rotations compared to ob/gyn etc. going through years of cost and training at a later age is hard enough without your colleagues who you respect in some cases denigrating you.

I'd say pick the specialty you find most interesting and work on deriving your self-esteem from sources other than your colleagues assessment of the comparative demands of the one you choose.

 

[heartsink]

The specialty's shelf exam being easier =/= the specialty in practice is easier.

Nothing has made this more clear to me than when my Sub-I attending asks me what my plan is for my patients in the ED who present with different degrees of psychosis, intoxication,+/- suicidal / homicidal ideation.

 

[shoenberg3]

Honestly, if you are already this affected by others’ opinion of psychiatry, you shouldn’t go into it. You are going to be facing lifetime of doubt and self-esteem issues.

And btw, while gas and psych may have been worlds apart in competiveness say 10 years ago, they are much closer now, if you really care about such things..

 

[clozareal]

Psych is easy because I like it the most.

I remember when medical students, residents, attendings were telling me that I was too hardworking and intelligent to go into psychiatry. I also had other residents/attendings who told me it would be a waste for me to do radiology (the other specialty I was considering) with my level of bedside manner. Go figure.

In the end, I very much enjoy my job, my lifestyle, the pay, the flexibility to have my own practice, the autonomy to practice how I want, and the difference I'm making in people's lives.

 

[clozareal]

Honestly, if you are already this affected by others’ opinion of psychiatry, you shouldn’t go into it. You are going to be facing lifetime of doubt and self-esteem issues.

I strongly and respectfully disagree. I don't think that just because OP is processing the medical school social stigma and shame of nonconformity in their class that they are going to be facing a lifetime of doubt and self-esteem issues. That's an overreach and a cognitive distortion of predicting the future. I also had doubts about going into psychiatry when I matched, but now I love my job and feel mostly confident at doing it. They are here to get help in processing an obviously distressing comment made by several (or all? it can't be all) of their classmates.

 

[clozareal]

I’m feeling really disheartened. I have always wanted to do psychiatry, but classmates keep saying it’s “easy”, and one of the easiest fields in which to match, which is true. I know you shouldn’t listen to what others say all the time, but so many medical students have this mentality and most of these people are top students matching into Anesthesiology and Plastics. One smart student told me “face it, psychiatry is easy. It’s all talk. They use the same four medications. It’s medicine for dummies.”

Let's dissect this:

It's one of the easiest fields in which to match: Great! You have a great chance matching at a city and program you want to go to. I had a friend who matched into a program he hated in a city he didn't want to be in because he wanted to go into a competitive specialty but got his last ranked choice (despite having a stellar application). He unfortunately dropped out because of the malignancy of that surgical program.

It's all talk: They are oversimplifying psychiatry. It's not just talking that you do in psychiatry. It's skillfully building and maintaining a relationship so that the patient can trust and open up to you in therapy, which is life-changing for many people. It's also gathering information and making sense of it, especially from poor historians such as those who are manic/schizophrenic or just tangential in nature.

“Words of comfort, skillfully administered, are the oldest therapy known to man.”
—Louis Nizer

They use the same four medications: There are more than 200 medications that can be considered psychiatric, not including the ones used to treat the side effects of the drugs we use. And when was the value of a specialty measured by how many medications they use? I guess radiology, pathology, geneticists, and radiation oncology are lesser physicians than psychiatry then since they don't use any meds!

It's medicine for dummies: This is just unprofessional and ignorant. Perhaps they haven't experienced or know anyone struggling with a severe psychiatric condition like schizophrenia, addiction, bipolar disorder, personality disorder, etc. I do think there's a societal stigma against mental health too that is being absorbed by those who take care of them, despite increasing demand for psychiatric services.

I wonder if any of this is also attached to what is reported on the median salary scales? Medical students love to measure prestige by how much each specialty makes. If they find out that some psychiatrists make >$500k while working less than 40 hours a week, perhaps they may change their mind.

In the end, every specialty will have their pros and cons.

 

[When is graduation again?]

I used to think psych was easy. Then my job became keepiny psychotic people on shots every 2-4 weeks for conditions they don't think they have, while trying to dodge a myriad of side effects including EPS, sexual dysfunction/menstrual dysregulation, and weight gain all while navigating lack of resources and trying to maintain therapeutic relationships.

Psych (like all specialties) can be as easy or as hard as you want it to be. No matter what your patient population or setting is in psych, if you care about who you are treating and what you are doing, it will feel very difficult. If you don't care and phone it in, it'll feel easy. But your patients will suffer.

 

[MedMan80]

'Everyone likes to make fun of psych until a family member needs help'

It's easy to be a bad psychiatrist, but hard to be a good one. Love that saying.

 

[Ratan1982]

Thanks for those responses. One of the factors that made me start this thread was hearing from people in my class and upper classes that the psychiatry rotation is a “cake walk”. I heard this or comments similar so many times. And these people were good students, and not jerks.

I don’t have issues with self esteem- but I imagine it can be hard to work a specialty, even if you enjoy it, with little acceptance from colleagues. It would wear on even the toughest person and it’s important to have this conversation, especially since medical students get dissuaded from entering psychiatry for these reasons. I have spoken to residents who enjoyed their psychiatry rotation, but decided to go into other specialties for this reason.

 

[Liquid8]

When I was a medical students, most people thought psychiatry was too difficult as there were no blood tests or imaging investigations for anything. Another concerns was dealing with grey areas which require a degree of interpretation, as opposed to the more definitive areas of other medicine.

 

[docksan]

Well, I don’t think so much about what’s “cool and prestigious”- I’m too old for that. Psychiatry fits my goals quite well I think. But medicine/residency is a long slog, and it’s definitely challenging when residents tell you that psychiatric residents are generally weak on med/surg intern rotations compared to ob/gyn etc. going through years of cost and training at a later age is hard enough without your colleagues who you respect in some cases denigrating you.

The reason they think this is because they're not in Psychiatry residency and were given an easy path on psychiatry clerkship.

I started residency in my 30s too. Who cares what younger people think. What matters is your work ethic, not their opinion, and at the end of the day they will almost literally beg you to fix their patients because they spent too much time talking about "how easy Psych is" and not enough time actually understanding why it isn't easy at all.

 

[tr]

I’m feeling really disheartened. I have always wanted to do psychiatry, but classmates keep saying it’s “easy”, and one of the easiest fields in which to match, which is true. I know you shouldn’t listen to what others say all the time, but so many medical students have this mentality and most of these people are top students matching into Anesthesiology and Plastics. One smart student told me “face it, psychiatry is easy. It’s all talk. They use the same four medications. It’s medicine for dummies.”

Meh, I'm going to agree that psychopharmacology is not excessively complicated. That said, it boggles my mind how many practitioners still do it badly.

Psychotherapy (and more broadly, targeted interpersonal interaction for the purpose of effecting change), on the other hand, when well done, is complex, challenging, counterintuitive, endlessly variable, and hands down 'harder' than anything I was exposed to in the rest of medicine, which requires a lot of brute force memorization but ultimately becomes largely algorithmic.

Anyone who considers that if they can talk ("at" people, which is what most non-psych doctors do - spoiler: it's ineffective), they can be an effective mental health care provider, is just not worth listening to.

 

[clausewitz2]

The reason they think this is because they're not in Psychiatry residency and were given an easy path on psychiatry clerkship.

If your main experience of psych is 4 weeks of being a med student on an acute inpatient unit, of course you're not going to think psych is particularly challenging. If you aren't the one really responsible for making any decisions, have all the time in the world to interview patients without many other competing demands, and, most importantly, don't have to deal with any of the consequences of a premature discharge or a bounceback, I would argue it is super easy. Given how little effort can be involved in the job if you treat it as a one-off that you're not really responsible for (cf. weekend rounders who don't normally work on the unit), is it any surprise they get a sense that it is a low-effort kind of gig?

 

[docksan]

Honestly it's the same school of thought that thinks Dermatology is the hardest residency with the smartest people in it when it's really not the hardest at all.

While every residency has its challenges, the actual practice of a specialty is rarely easy. The question is how comfortably can you practice and still have a lifestyle, and that's both why people think Derm is hard and Psych is easy.

 

[MacDonaldTriad]

Derm is not hard, but it doesn't make your parents disappointed if that is your genetical determined predisposition that has driven you this far.

Derm is more competitive, but not more interesting than psychiatry. If you are worried about what your parents think by the time you finish medical school, please don't waste my time filling up interview slots. Derm = if it is dry, wet it, if it is wet, dry it, if you haven't had it before, you have it now, if you have had it before, you have it again. If you think psych uses 4 meds and that is psych, please go elsewhere. If you have been to a family reunion, derm is clearly the most useful and asked about assumption of what family wants to discuss. Psych has the virtue of what no one brings up, or worse what some have to bring up, but that is another story. Psych strikes almost no one neutrally. Take this as a large hint if you are on the fence.

Psych is very complicated and only weak minds who don't know what they are looking at think differently. The only worse evaluation of what we do are coming from the nimrods that teach medical students without psych experience, or worse, are medical students who listen to their parents and mentors who know nothing about real medicine.

Parents wish you well, but they have a monomania that tells them that they are supposed to want their children to go into medicine and somehow have heard that psychiatry somehow doesn't qualify.

I like our poor reputation, and please stay away if you care about the bad PR. Our recent climb into average has been the best thing that allows me to die happy. If you are shallow and need ring kissing and accolades, visit training programs that operate to teach doctors that don't have undergraduate medical school influence that makes psychiatry a requirement. They polarized even more. They see psychiatry as not essential and not useful. They still need psych and hate it because they don't see this is true in their black and white world that has fulfilled their need for clear answers and algorithms that make their lives make sense. Psych is messy and that what makes it interesting.

Our water is warm, and I invite open minded parental malcontents / rebels to jump in and enjoy. If you need radical acceptance to apply to psych, stay away please. We have enough enthusiastic adults who will do well in psych and we don't need you.

When I say I can now die happy, I mean that we no longer have a large portion of accidental psychiatrists who saw us as a way they could get in. We are averagely competitive, but we are no longer in the bottom 3 or 4. If you are hesitant to try us, listen to your internal dialogue and stay away. Involuntary psychiatrists are among the most miserable physicians I can think of and they are not good at what they do.

 

[FlowRate]

But medicine/residency is a long slog, and it’s definitely challenging when residents tell you that psychiatric residents are generally weak on med/surg intern rotations compared to ob/gyn etc.

There are several concurrent things that make this a true statement on a population level: psych residents are, on average, less interested in internal medicine; IM is less relevant to the practice of psychiatry than to most other fields; psych residents at academic programs are, on average, potentially going to be less "competitive" generally (grades, step scores) than other residents, especially at higher-tier places, and that competitiveness directly translates to prior performance and medical knowledge; after the first half of intern year, most other specialties have had much more general medical exposure than psychiatry residents, so obviously people with more time in IM training are going to do better.

That said, there are many of us who were just as good as the gas/derm/etc.-bound residents we did our IM rotations with. Again, at least at the beginning. If you're the psych intern who's doing an IM rotation at the end of their PGY-1 then you should be behind the other residents in IM capability since you have like 8 months less IM training than them.

Maybe a controversial statement but I think it takes somewhat less outside/additional study to be adequate at psychiatry than in many other fields. The volume of clinically-relevant medical knowledge is less than many other specialties. That doesn't mean it's easy to be an excellent psychiatrist, just that I think it's less effort to not be outright bad. A lot of what goes into being good can/should be gained directly as a result of required components of residency training, as long as you put effort and mindful practice into the day-to-day.

 

[Celexa]

Maybe a controversial statement but I think it takes somewhat less outside/additional study to be adequate at psychiatry than in many other fields. The volume of clinically-relevant medical knowledge is less than many other specialties. That doesn't mean it's easy to be an excellent psychiatrist, just that I think it's less effort to not be outright bad. A lot of what goes into being good can/should be gained directly as a result of required components of residency training, as long as you put effort and mindful practice into the day-to-day.

I agree with your first sentence if you replace 'adequate' with 'average', and it's because the standard of care sucks. It's not acceptable, and it doesn't represent what psychiatry COULD be as a field.

It's true that the rigors of surgery training generally mean that if you show up at an average hospital with appendicitis, the surgeon will competently remove it. In contrast I see completely average bread and butter psych complaints mishandled all the time, and not only by mid levels. That's a failing on our field and one that will hopefully become less common as the increased competitiveness squeezes out people who didn't want to be here at all.

Regarding volume of clinical knowledge, the only way I can consider that to be true is if you exclude psychotherapeutic knowledge and assume psychiatrists don't ever need to diagnose non-psychiatric conditions. If you fold that in, as I believe all psychiatrists SHOULD know, then I don't think there's any meaningful quantitative amount of difference in the knowledge required.

 

[Ratan1982]

I guess the challenge in psychiatry is that there are no confirmatory tests that can determine if a doctor is right or wrong- if they are practising correctly or not. ie- if a radiologist or pathologists reads a lot of interpretations incorrectly, there will be hell to pay and they will be caught. In psychiatry this is very rare, and I think people use this against the field, as they see it as something “anyone can do.” Like if you are an excellent psychiatrist, how do you prove it objectively.

 

[Ratan1982]

I saw a grand rounds where they showed the evidence that type of therapy does not matter as much as therapeutic alliance. The conclusion was that essentially, anybody can perform therapy if you have the skill. So, even though therapy is important, it’s not specific to psychiatrist, but can also be done by social workers, psychologist, etc. it will be hard to imagine a social worker being allowed to perform surgery or bronchoscopy or whatever procedure.

 

[clausewitz2]

I guess the challenge in psychiatry is that there are no confirmatory tests that can determine if a doctor is right or wrong- if they are practising correctly or not. ie- if a radiologist or pathologists reads a lot of interpretations incorrectly, there will be hell to pay and they will be caught. In psychiatry this is very rare, and I think people use this against the field, as they see it as something “anyone can do.” Like if you are an excellent psychiatrist, how do you prove it objectively.

It's actually a little bit worse than that. For many psychiatric disorders, it is not clear that what we are treating is a thing-in-itself, so much as patterns of behavior and experiences. This means that trying to apply tests that use the logic of signal detection theory is sometimes a category error, like trying to weigh someone's anger.

 

[WisNeuro]

I guess the challenge in psychiatry is that there are no confirmatory tests that can determine if a doctor is right or wrong- if they are practising correctly or not. ie- if a radiologist or pathologists reads a lot of interpretations incorrectly, there will be hell to pay and they will be caught. In psychiatry this is very rare, and I think people use this against the field, as they see it as something “anyone can do.” Like if you are an excellent psychiatrist, how do you prove it objectively.

I think you overestimate the accuracy of "confirmatory" testing in other disciplines. There is an awful lot of tea leaf reading in the broader neuro field in healthcare.

 

[tr]

I saw a grand rounds where they showed the evidence that type of therapy does not matter as much as therapeutic alliance. The conclusion was that essentially, anybody can perform therapy if you have the skill. So, even though therapy is important, it’s not specific to psychiatrist, but can also be done by social workers, psychologist, etc. it will be hard to imagine a social worker being allowed to perform surgery or bronchoscopy or whatever procedure.

1) Yes, therapeutic alliance is critical; that does not imply that creating such an alliance is easy or does not require skill/training. It's a complex skill that most surgeons are not interested in learning, just like I could not be less interested in learning to remove gallbladders.

2) Yes of course, there are other paths to psychotherapy that are independent of medical training. But are you really selecting your specialty based on how easy it is to fence yourself off from mid-level encroachment? You suggested anesthesia as an alternative; have you taken a look at scope of practice for CRNAs at all?

 

[Ratan1982]

Yeah I’ve heard about CRNA’s and I agree. I’d say some specialties are probably immune, like most surgical disciplines. Certainly plastics.

 

[DOswag]

Basically here to echo what's been said above. I get it, you're in a position where many around you aren't interested in psych and seemingly talk down about the field so that can skew your view of it when you're a med student looking at long hours in residency and a career after that. As one poster said above, many who are first in line to criticize psychiatry in med school or early on, are first to consult psych in the hospital or refer to psych in the outpatient world as so many are very uncomfortable with psych patients. As far as the field itself, sure it's not heavy on medicine but it is still relevant. Every field can be over generalized in some form or fashion to dumb it down (we use far more than 4 meds, that's a pretty asinine statement from that individual).

If you're looking for a lifestyle specialty, you really can't go wrong with psychiatry. Work 40 hours per week or less and make $300K? Sure! There are some positions out there that you can make 4-500K working less than other fields so it is definitely possible. You're the one that is going to have to make the sacrifice during school/residency, then live out the career you choose. Don't let other people's opinions who aren't interested in your field shape that decision for you just based on what they think of it and the easy rotation they had. I've been out of med school since 2014, out of residency since 2019. Don't recall since then anyone has questioned my decision for going psychiatry as far as people in the medical field. There's a huge need right now so I'd say most especially in the primary care field will be extremely grateful to have someone to refer to. You won't have a shortage of work wherever you end up. The flexibility of the job as far as hours and work setting/practice is second to none. You won't make neurosurgery pay but you for dang sure can make pretty good $$ for the hours worked.

 

[Merovinge]

I will say now that I work 35 hours/week without call and make >300k a year, get to spend my whole day in service of others, what really keeps me up at night is what the people I went to med school think about psychiatry (but seriously my toddler keeps me up at night so thank you not stacking call on top of that).

 

[clausewitz2]

I will say now that I work 35 hours/week without call and make >300k a year, get to spend my whole day in service of others, what really keeps me up at night is what the people I went to med school think about psychiatry (but seriously my toddler keeps me up at night so thank you not stacking call on top of that).

Hear hear. I am on track to work a bit less than that this week and compensation is similar. I also take 90 minute lunches and just decided to have a couple hours in the afternoon off today to catch up on some reading. To quote H.L. Mencken about journalism, "It really is the life of kings."

 

[J ROD]

Surgery sounds good for ya.....lots of prestige.

 

[docksan]

I saw a grand rounds where they showed the evidence that type of therapy does not matter as much as therapeutic alliance. The conclusion was that essentially, anybody can perform therapy if you have the skill. So, even though therapy is important, it’s not specific to psychiatrist, but can also be done by social workers, psychologist, etc. it will be hard to imagine a social worker being allowed to perform surgery or bronchoscopy or whatever procedure.

Well, that's partially true. You need a good background on theory to understand appropriate therapeutic approaches so not just any old person can do therapy.

 

[ridethecliche]

I'm most concerned about the fact that you claim to be in your 30's and are trying to make career decisions based on what other students think of your field(s) of interest.

Isn't the entire point of being an older med student to be more mature?

I don't get it. Live your life. You have to do the work not them. Who the F cares if they want to do the job or not...

 

[annoyedpsychiatrist]

its easy to be a bad doctor in any field. its easy to do an ADHD startup and give everyone adderall

 

[calvnandhobbs68]

its easy to be a bad doctor in any field. its easy to do an ADHD startup and give everyone adderall

That's what kills me about the quack "specialists" in various things. If I called myself a "tick illness specialist" and just drew the same panel of labs on everyone and told everyone they had Lyme disease or a chronic Rickettsial infection and gave everyone the same handful of antibiotics that would actually make my life a lot easier.

 

[Stagg737]

I guess I respect them because they are great students who perform well. I’d say they are denigrating the specialty more than myself. Part of it is based on experience on the rotation, which they found a lot easier than the others.

Some of the "best" students who score high are the worst students on clinical rotations. Idk what your definition of "performing well" is, but as I get farther into my career supervising medical students (which I admit is still fairly early) I find more and more that they have far worse insight into their performance than I would have guessed.

I know you shouldn’t listen to what others say all the time, but so many medical students have this mentality and most of these people are top students matching into Anesthesiology and Plastics.

Huh? Anesthesia is moderately competitive, but it's not a "top" field and matching anesthesia in general isn't really impressive tbh. If "top students" are bragging about anesthesia matches, seems like they probably aren't really "top students".

Also, as someone who did consult-liaison psych for yrs, I'll tell you those people who like to denigrate psych are the first ones to call in a panic when there is something going on with their patients. Psychiatric problems make many people uncomfortable or fearful, and denigrating the physicians who help is one way of defending against their intense discomfort.

100% this. I'm currently C/L and emergency and the worst consults (Ie one-word consults like "capacity" without any context) come from the docs who talk down on psychiatry. They're also the ones who my VA psychiatry attendings in residency would cancel the consults on and send a message that they'd be happy to see the patient when the consulting physician could provide an actual reason for us to see them. I'm paid based on RVUs, so I use a little more tact but do occasionally poke the bears.

I guess the challenge in psychiatry is that there are no confirmatory tests that can determine if a doctor is right or wrong- if they are practising correctly or not. ie- if a radiologist or pathologists reads a lot of interpretations incorrectly, there will be hell to pay and they will be caught. In psychiatry this is very rare, and I think people use this against the field, as they see it as something “anyone can do.” Like if you are an excellent psychiatrist, how do you prove it objectively.

How do you prove that you're objectively a good radiologist? As you get more experience you'll see that those fields aren't as black and white as they may seem and the phrase "correlate clinically" covers a lot of that gray area.

 

[Ratan1982]

Just to clarify- when I said “perform well”. I’m referring to performance on rotations. Not just medical students but also residents have made these comments about psychiatry and they all had great reputations on medicine or surgery.

I agree about Anesthesia. But I’ve heard negative stuff mostly from surgery people like ENT, ortho, plastics

I’ve heard about bad consults. I think these are mostly due to these doctors having no respect for psychiatry because they have a higher social standing. But I’m sure they could do a proper consult.

 

[shoomer]

Let's humor the criticism and say it is easy. So...what is the problem? If I told you there's a specialty where you don't work as hard as other doctors but you make as much (often more) money, you should be jumping at this opportunity.

I never cared about the surgeons who said psychiatrists aren't real doctors. Because I am way happier than the surgeons that I know even if I have less "prestige."

Bottom line: it's way better to feel overpaid than underpaid.

 

[annoyedpsychiatrist]

That's what kills me about the quack "specialists" in various things. If I called myself a "tick illness specialist" and just drew the same panel of labs on everyone and told everyone they had Lyme disease or a chronic Rickettsial infection and gave everyone the same handful of antibiotics that would actually make my life a lot easier.

you can open up your clinic next to my future clinic and when they're finished at mine, they go to your chronic lyme disease clinic. My clinic will be Dr APs wellness clinic for mildly depressed people going through a rough time, by the beach (cash only). Four rooms: zoloft room, suppportive therapy room, botox room, and then ozempic