Went to med school thinking I wanted to do rads. Hated anatomy. By the start of 3rd year, it was wide open playing field, I had no idea. Did my first psych rotation early 3rd year. Loved it. Was pretty sure at that point. Did an elective late 3rd year that sealed the deal.
Yeah, my story was almost identical. After I realized that I hated anatomy, I moved on to my second choice, which was pathology. And then I realized that I still hated anatomy and wasn't a big fan of histology either. I just liked the detective-work part of rads and path, but I found that in the real world, it's mostly just about recognition of patterns that you've already seen a million times before.
I think that the reason why I loved psych was because the tricky part is learning how to communicate with people who can't effectively communicate with anybody else. That satisfied the puzzle-craver in me. And I'm also a scientist at heart, and clinical neuroscience is the final frontier in biology.
Psychiatry. I'm only an intern though, so it hasn't been that long...
Same here. Except that I'm not even an intern quite yet.
I feel like it WILL be. Look at some of the salary threads. My 4th year buddy got an offer for 200k+, at the VA, 40h/wk, plenty of time with patients, gov't benefits, 6 wks vacation...
Also, look up PSLF and do that. Seriously.
Again, exactly right. Psychiatrists earn a bit less than the rest, but remember that they also work fewer hours. If you work 40-50 hrs/week, you can earn as much as most other non-procedural specialists.
Also, when you're thinking about loans, look at it this way - you'll borrow $200-300k and you'll earn $200-300k/year. That's a 1:1 ratio. In my area, an average family earning $60-80k will get a mortgage worth $200-250k, which is a much less favorable ratio. And you need to spend at least $30-40k to raise a family comfortably, so that average family has a much much smaller dispensable income than you'll have.
Of course, student loans are annoying and they substantially limit your financial flexibilty. But as a psychiatrist, you'll never be impoverished due to your loans. Worst-case scenario, you can just live like a resident for another couple of years and use the savings to pay off your entire loan.
5.) What do you love/hate about psychiatry?
The quick version. Love the work, the patients, catching diagnoses that other doctors pass off as "a psych problem"...which are many. Hate the stigma, lack of funding, lack of resources (i.e. doctors willing to see patients), etc. Not a huge fan of acute mania...especially when I'm working nights. No sleep for them = no sleep for me.
Man, you and I have very similar views on these questions.
My favorite thing is being the go-to guy (even as a med student interested in psychiatry) for any patient who is too difficult to handle for the others. Every day, you have the opportunity to find creative ways to talk to people in order to get them to tell you all of their delusions or hallucinations or flashbacks or substance problems or whatever it is that they don't want to share with everybody else.
6.) What are your opinions on a D.O. entering psychiatry?
Non-issue, except at a handful of programs, as already mentioned. I just matched at a major academic program that's near the top of the NIH funding rankings (and happens to be in the same state as you), and we have plenty of DOs in the program. And I'm an IMG. As you know, psychiatry isn't too competitive, so it's a buyer's market... the DO degree won't be a huge hindrance to you.
8.) What is the outlook for psychiatry over the next 10 years?
In terms of psychiatric practice - The NIMH (National Institutes of Mental Health) is encouraging a move towards a more medically-oriented model of psychiatry. That means that we use interventions that are evidence-based, use diagnostic approaches that are based on actual pathophysiology (rather than the traditional approach of using diagnostic clusters based on similarity of symptoms), and using targeted treatments. We're probably more than 10 years away from making a significant shift toward that goal, but that's the model.
In terms of actual lifestyle - There's been a recent increase in Medicare reimbursement for psychiatrists who do a complete physical examination. That's not always necessary and you shouldn't subject the patient to unnecessary poking/prodding just for extra money, but it suggests that they want us to be more involved in the medical care of our patients. This is also in line with a general paradigm shift towards interdisciplinary care in medicine, and especially in psychiatry.
Telepsychiatry is an interesting development that is good for both the patient and the doctor. Rural/remote patients don't have to travel as far to see you, and you can see patients while sitting on a boat. It's also nice because there's very low overhead, so if you don't mind doing telepsych exclusively, then you can run an entire practice without having to pay for an office and the associated complications.
I'm really excited about some of our neuroscience research. When Barack Obama mentions something in the State of the Union address, you know that it might be worthy of some optimism.
As far as the stigma of mental illness - as we all know (and digitlnoize already mentioned), it's fading. I think that the baby boomer generation still perpetuates the bulk of that stigma, while Gen Xers seem to be a bit more ambivalent about mental health and Gen Yers seem to be the group that likes to talk about their psychiatric treatment on facebook. As GenX and GenY become the predominant presences in the media and in public health policy, I think that psychiatry will be forced to grow further. In the last few years, I've been hearing about the need for improved mental health services every time a mentally ill person does something terrible. 10 years ago, I don't think I ever heard about that.
Excellent post, thank you very, very much. Gunna do some research on SPS and the Brain Mapping Project now !!
