Psychiatry Prestige

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Most people get less strongly gendered in their psychology as they get older anyway IMO. The same guy who couldn't wait to prove his manliness at age 20 will have often gained some wisdom and will step aside to let the young bulls get beat down by the time he's 40. Prestige is likewise subjective, and I strongly recommend spending leisure time after graduation with non-physicians whenever possible.

The issue about colleagues and wanting to use your hands are more relevant, because they both really have a big effect on what you do all day, and how you'll change over the course of your professional life. Don't forget, there are academic physicians in every specialty and guys chasing dollars in every specialty. But the smartest surgeon still spends a lot of time scrubbed in and operating, and the manliest, rugged-est lumberjack of a psychiatrist still spends most of his time sitting in a chair talking to people about their problems.

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You know what else about masculinity. Everyone likes to malign it—as dangerous, wild, oppressive, brut, unsophisticated—until big psychotic guy is wildin out.

Masculinity comes with demands of honor. Sacrifice. Courage. And toughness.

The paucity of this in our field. Slanted towards the overbearing mother. Gives maculinity value in our field.

We need it. And surgeons could use the influence of the anima.

I’d invite the OP to consider coming to our field and kicking ass in it.
 
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You know what else about masculinity. Everyone likes to malign it—as dangerous, wild, oppressive, brut, unsophisticated—until big psychotic guy is wildin out.

Masculinity comes with demands of honor. Sacrifice. Courage. And toughness.

The paucity of this in our field. Slanted towards the overbearing mother. Gives maculinity value in our field.

We need it. And surgeons could use the influence of the anima.

I’d invite the OP to consider coming to our field and kicking ass in it.
Check out the Good Men Project. An ongoing dialogue about changing the definition of masculine and being a man.
 
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Hey everyone, I have just started my psych rotation and am enjoying it a lot. I always thought I would enjoy psych given my interest in psychology, neuroscience, and human behavior. I was also an English major and loved to read and am learning that many psych residents also love to read. I also thought I valued long term relationships so I was thinking family med or psych. Did family med and realized that is not for me. I also did surgery as my first rotation, loved the OR and am strongly considering going into surgery.

Anyways, I told my parents now that I am interested in psychiatry in addition to surgery. They seemed kind of surprised out by the whole psych thing. But I know they will support me no matter what. I will sadly admit that the "lack" of prestige with psychiatry ("you're not a real doctor") does kind of bother me. I'm also a dude and find surgery and working with my hands to be very masculine whereas sitting and talking to psych patients is not that masculine. I realize that idea is totally dumb and not true. And I'm sure those ideas weren't really bother me if I'm doing something I really enjoy. So please tell me how you've dealt with these issues or how I should deal with them. Thanks!


I always thought myself an ER or ICU type. After working both, I decided on psych. 14 years later still loving my career! Keep an open mind. It's your life and happiness.
 
I'm a 4th year applying psych. My parents preferred me going neuro since that was the other specialty I considered. I told them I essentially didn't care what they or anyone else in my family thinks. They backed off.
swagger
 
Psych is the least prestigious specialty both within and outside the medical community. Gotta be able to deal with it if you wanna do it. Four factors come into play in selecting a speciality as one of my professors told us: Prestige, Passion, Lifestyle, Money. Pick your poison.
 
Psych is the least prestigious specialty both within and outside the medical community. Gotta be able to deal with it if you wanna do it. Four factors come into play in selecting a speciality as one of my professors told us: Prestige, Passion, Lifestyle, Money. Pick your poison.

This is clearly not true anymore. Psychiatry is significantly more competitive of a field than several areas of medicine. If you are talking about public perception, at least we get confused for PhD psychologists. Physiatrists get confused for a chiropractors and pathologists for government employed scientists (both of which are extremely important fields that should have MDs, but certainly not what public perception is). The prestige of fields has shifted dramatically over time, its terrible advice to choose a career based on these perceptions (e.g. dermatology when the pay was low).
 
Psychiatry is now more competitive than several other specialties among a long list. We were about third from the bottom, now we are 7th or 8th depending what measure you believe in. If were are all lucky, someday we might even hit average.
I think the place we have the lowest prestige is among non-psychiatric physicians. They rib our medical students, they sometimes berate our residents when giving appropriate consult advice. They are uncomfortable dealing with our patients and they discount our patient's chief complaints. I can say that this has all gotten better, but our PR efforts still have a long way to go.
 
I wouldn't really consider prestige at all for any healthcare job. This isn't the 50's anymore, where being a doctor or lawyer of some sort afforded you a great deal of social status. As a professional, you definitely have more general status than say, blue collar professions and such, but after that, I really don't see most people caring. Honestly, the only people who care, seem to be others in the same field, who are insecure about their place. Most of the lay public just hears doctor and lumps everyone into the same bucket. My peer group is pretty varied, and my closest friends actually do not work in healthcare, so I only see the insecure pissing matches in the workplace.
 
I wouldn't really consider prestige at all for any healthcare job. This isn't the 50's anymore, where being a doctor or lawyer of some sort afforded you a great deal of social status. As a professional, you definitely have more general status than say, blue collar professions and such, but after that, I really don't see most people caring. Honestly, the only people who care, seem to be others in the same field, who are insecure about their place. Most of the lay public just hears doctor and lumps everyone into the same bucket. My peer group is pretty varied, and my closest friends actually do not work in healthcare, so I only see the insecure pissing matches in the workplace.

FWIW, whenever I tell someone I'm in medical school or starting residency next year, more often than not, they say something along the lines of "oh wow..", "good for you!", etc. I never got that in my prior (white collar) career. I would say most people are still impressed/respect physicians.
 
FWIW, whenever I tell someone I'm in medical school or starting residency next year, more often than not, they say something along the lines of "oh wow..", "good for you!", etc. I never got that in my prior (white collar) career. I would say most people are still impressed/respect physicians.

They definitely do, I wasn't claiming that they didn't. I was getting more at the fact that most lay people have no idea how specialties within the ranks of physician or other doctors works. Most people just lump them into the group of "doctor." Maybe outside of "brain surgeon" because it sounds cool, the lay public really doesn't care or discriminate what kind you are. Pretty much the only people who care, are other doctors. And, the ones that do, are generally insufferable people.
 
FWIW, whenever I tell someone I'm in medical school or starting residency next year, more often than not, they say something along the lines of "oh wow..", "good for you!", etc. I never got that in my prior (white collar) career. I would say most people are still impressed/respect physicians.
I think you and Wis are both correct. Prestige in general is not what it once was due to the egalitarian mindset that has become much more pervasive over the past 20-30 years. "Who cares if I am a loser with no job and no real talents? I am as important and valuable as anyone else." The "I could have done something much more than I did" mindset is also quite popular I've noticed.

But at the same time, there is still respect for people with high level jobs such as physician, attorney, (certain types of) professors, high level politicians etc. Anything that only a few percent of the population can achieve is always going to retain some level of respect even if people don't want to admit it.
 
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FWIW, whenever I tell someone I'm in medical school or starting residency next year, more often than not, they say something along the lines of "oh wow..", "good for you!", etc. I never got that in my prior (white collar) career. I would say most people are still impressed/respect physicians.

Does their reaction change when you say I'm going into Psychiatry? Just curious
 
Psych is the least prestigious specialty both within and outside the medical community. Gotta be able to deal with it if you wanna do it. Four factors come into play in selecting a speciality as one of my professors told us: Prestige, Passion, Lifestyle, Money. Pick your poison.

Prestige is for the birds. I'm a doctor, I change lives, I earn a ton, and my hours are light. What a greedy bastard I'd be if I'd demand prestige on top of this delightful cake.
 
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Prestige is for the birds. I'm a doctor, I change lives, I earn a ton, and my hours are light. What a greedy bastard I'd be if I'd demand prestige on top of this delightful cake.

How does one earn a ton in psych? Get lucky in PP?
 
I think you and Wis are both correct. Prestige in general is not what it once was due to the egalitarian mindset that has become much more pervasive over the past 20-30 years. "Who cares if I am a loser with no job and no real talents? I am as important and valuable as anyone else." The "I could have done something much more than I did" mindset is also quite popular I've noticed.

But at the same time, there is still respect for people with high level jobs such as physician, attorney, (certain types of) professors, high level politicians etc. Anything that only a few percent of the population can achieve is always going to retain some level of respect even if people don't want to admit it.

So much. If I had a nickel for every time I heard someone say “I could have gone to/applies to medical school/law school but.......(whatever bullsh*t qualifier)” I’d have a lot of nickels.
 
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Does their reaction change when you say I'm going into Psychiatry? Just curious

Lol most people don’t even know what psychiatry is outside of TV shows. Other specialities definitely have it worse. Most people think radiologists are some kind of radiology tech and don’t even grasp the concept that there’s a special doctor to read images (since you know all those TV doctors do surgery, work in the ER, volunteer in Ghana, read imaging and look at their own slides all at the same time).
 
Lol most people don’t even know what psychiatry is outside of TV shows. Other specialities definitely have it worse. Most people think radiologists are some kind of radiology tech and don’t even grasp the concept that there’s a special doctor to read images (since you know all those TV doctors do surgery, work in the ER, volunteer in Ghana, read imaging and look at their own slides all at the same time).

This. As a MS1, I told an uncle that I was considering radiology. He said that I shouldn’t waste my time as he met many of them doing that at community college. I mentioned derm to a family friend, and I was told that I should specialize in plastic surgery after derm, so that I could actually do surgery on the skin.
 
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Any physician specialty can earn a ton, but I guess it depends on what “a ton” really is.

A fair but somewhat low number of people know a "ton" = 2000 pounds. The real question is if anyone knows what a metric ton is.
 
That’s in-range for any physician. It may entail working 50+ hours/week, weekends, entrepreneurial skills, medical directorships, or practicing in a less desirable area.

agree. would add to the above have the ability to bill (have a billing company, be in network etc). be flexible. combine multiple part-time positions (some of which could be contract or salary)
 
Lol most people don’t even know what psychiatry is outside of TV shows. Other specialities definitely have it worse. Most people think radiologists are some kind of radiology tech and don’t even grasp the concept that there’s a special doctor to read images (since you know all those TV doctors do surgery, work in the ER, volunteer in Ghana, read imaging and look at their own slides all at the same time).
Not only do they read the images, they also run the imaging machines.
 
That’s in-range for any physician. It may entail working 50+ hours/week, weekends, entrepreneurial skills, medical directorships, or practicing in a less desirable area.

50 hours is fine and dandy...but creeping anywhere above that and I start to lose my sanity. Was hoping 50 hours would = 400k in psych...guess it sounds mostly doable though.
 
50 hours is fine and dandy...but creeping anywhere above that and I start to lose my sanity. Was hoping 50 hours would = 400k in psych...guess it sounds mostly doable though.

Doable. Can't speak for others but I'm above that number with fewer hours, 1 year out of training.
 
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Glad I'm not the only one with stuff life this bothering me...
 
Glad I'm not the only one with stuff life this bothering me...
Are you applying psych? If so, what are your reasons for doing so? I don't see why you would choose psych if you yourself have a stigma against it. It seems like you don't believe in the cause. I feel that if you truly believed psychiatrists have a necessary, important role to fill then you wouldn't care what other people thought about it.
 
Are you applying psych? If so, what are your reasons for doing so? I don't see why you would choose psych if you yourself have a stigma against it. It seems like you don't believe in the cause. I feel that if you truly believed psychiatrists have a necessary, important role to fill then you wouldn't care what other people thought about it.
this is all very well but young people are influenced by what other people think of them including parents, friends, extended family, professors etc. And it can be discouraging when you don't receive positive feedback from others about your career plans, especially from people who's opinions you value. internalizing prejudice (it's not stigma, it's prejudice) is a thing. It's a little naive and judgmental to assume that people aren't affected by how others perceive them. personally, as an attending I am secure in my career choices (though I still find it a bit irksome the complete lack of respect afforded to psychiatry in the hospital setting, and how often I am confused as a psychologist in the forensic setting), and very happy in my profession, but medical students who have not yet formed their physician identity let alone one as a psychiatrist are going to be very impressionable to others' attitudes and opinions.
 
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this is all very well but young people are influenced by what other people think of them including parents, friends, extended family, professors etc. And it can be discouraging when you don't receive positive feedback from others about your career plans, especially from people who's opinions you value. internalizing prejudice (it's not stigma, it's prejudice) is a thing. It's a little naive and judgmental to assume that people aren't affected by how others perceive them. personally, as an attending I am secure in my career choices (though I still find it a bit irksome the complete lack of respect afforded to psychiatry in the hospital setting, and how often I am confused as a psychologist in the forensic setting), and very happy in my profession, but medical students who have not yet formed their physician identity let alone one as a psychiatrist are going to be very impressionable to others' attitudes and opinions.
I agree 100% that people are impressionable. However when picking the career you're going to have for the rest of your life, it is your due diligence to self-reflect on what will truly make YOU happy in the long run, not the people around you.

The problem with pre-med and med school is you're buried in the books and worried more about passing your next exam than about what your values are and what makes you unique.

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I agree 100% that people are impressionable. However when picking the career you're going to have for the rest of your life, it is your due diligence to self-reflect on what will truly make YOU happy in the long run, not the people around you.

The problem with pre-med and med school is you're buried in the books and worried more about passing your next exam than about what your values are and what makes you unique.

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But thats just not that easy to do. I don't know what truly will make me happy in the long run, and its not from lack of time or inclination to reflect. We all find ways to sustain our ego that are likely some mix of internal and external validation, and it comes over time, from experience, in fits and starts, and is fluid and intersectional. I care less now about what people think of me than I did at other times but don't regret those choices. And today I am making choices based on ego needs that might change in the future. Thats ok.
 
Is catering to one's ego in this way not something we should actively strive against? If you like psychiatry, and feel like you are doing good as a psychiatrist, how does what other people think about you and your job matter in any meaningful way?
 
Is catering to one's ego in this way not something we should actively strive against? If you like psychiatry, and feel like you are doing good as a psychiatrist, how does what other people think about you and your job matter in any meaningful way?

I often tell myself this; what other people think about you and your job should not matter.

For probably a variety of reasons, I think for a fair number of people it does matter. I find myself slightly bothered by it at times - being mistaken for a psychologist, people not realizing you're actually a doctor, etc. Every time I feel this, I try to remind myself it shouldn't matter and really try to think about what it is that's causing me to feel that way. Unfortunately I'm still not sure why I feel this way...but hopefully with time I'll figure it out.
 
I often tell myself this; what other people think about you and your job should not matter.

For probably a variety of reasons, I think for a fair number of people it does matter. I find myself slightly bothered by it at times - being mistaken for a psychologist, people not realizing you're actually a doctor, etc. Every time I feel this, I try to remind myself it shouldn't matter and really try to think about what it is that's causing me to feel that way. Unfortunately I'm still not sure why I feel this way...but hopefully with time I'll figure it out.


As long as they don’t confuse the paycheck...
 
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I have a really good friend with excellent board scores interviewing at top EM programs. One of his genuine concerns is that EM docs are seen as dumb by everyone else in the hospital and that he feels like PAs/NPs do his job in the ED.

I told him that he should live his life in a way where he doesn’t depend on other people’s approval for fulfillment because even if you’re a Harvard orthopedic surgeon, there’s always the IMG IM doc who you end up consulting to manage your patients’ diabetes.

Does prestige matter to you personally? And honestly should it ever? I don’t understand the value of it in actual daily life.


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(though I still find it a bit irksome the complete lack of respect afforded to psychiatry in the hospital setting, and how often I am confused as a psychologist in the forensic setting)

Could be worse. You could be a physiatrist, and then people would think you were one of us and get confused when you don't know much about mental illness and then when you explain what you do they go "Oh, I get it, you're a physical therapist!"
 
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I have a really good friend with excellent board scores interviewing at top EM programs. One of his genuine concerns is that EM docs are seen as dumb by everyone else in the hospital and that he feels like PAs/NPs do his job in the ED.

I told him that he should live his life in a way where he doesn’t depend on other people’s approval for fulfillment because even if you’re a Harvard orthopedic surgeon, there’s always the IMG IM doc who you end up consulting to manage your patients’ diabetes.

Does prestige matter to you personally? And honestly should it ever? I don’t understand the value of it in actual daily life.


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I don't really get sensitive about the whole IMG discussion that comes up here and there, but I find this pretty offensive. I don't think you need to degrade a whole class of physicians just because they did not go to medschool in the US.
 
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I don't really get sensitive about the whole IMG discussion that comes up here and there, but I find this pretty offensive. I don't think you need to degrade a whole class of physicians just because they did not go to medschool in the US.

They didn't degrade anyone, they are making a comparison between the most prestigious and least prestigious doctors, saying that we all work together regardless and prestige doesn't matter at all. Horners even goes on to say "I don't understand the value of (prestige) in daily life." Implying that Horners has absolutely no problem with IMGs. You seem to be actively trying to be offended.
 
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Could be worse. You could be a physiatrist, and then people would think you were one of us and get confused when you don't know much about mental illness and then when you explain what you do they go "Oh, I get it, you're a physical therapist!"

I didn't know physiatrists existed until 2nd year of med school, true story.
 
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