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yet it on the bottom of the totem pole
is it really just the negative stigma? bc lifestyle is great too, right?
is it really just the negative stigma? bc lifestyle is great too, right?
It's a great specialty, but for the same reasons that surgery, optho, or other procedure heavy fields are popular for their immediate impact on the patient, psych is unpopular for the much longer course of recovery (if any at all).
However, is it possible your school's department is really good and skews impressions?
yet it on the bottom of the totem pole
is it really just the negative stigma? bc lifestyle is great too, right?
Psych is like Art/Music in public education
Its fun and enjoyable. The people who work in it are generally a little crazy themselves, but they like what they do.
When it comes to budgets, psych is the first to go. You don't get any respect from the smart teachers, and, in reality, any medicine doctor can fix what can be fixed... we leave the incurable psychotic diseases to the psychiatrsits. Plus its depressing, everyone being depressed all the time. And irritating, because, honestly, can't everyone tell the difference between dementia and delirium... do we really need a psych consult? Yes. Because who wants to deal with that?
Whenever I hear physicians in other specialties talk about psych and FM, it's like they could at any time pat the family docs and psychiatrists on the head and tell them to let the grown-up doctors take care of the real problems. I've heard very nice people sound fairly condescending toward those two specialties in particular.
Because they're tools.
But it's not hard to see why many people don't wanna do psych. The patient population is difficult, almost NOBODY respects psychiatrists (as indicated above), and you hear about psych residents and doctors being killed or assaulted by patients(which I guess factors into the 'difficult population'). Not surprising, although you will find many on these boards who will vehemently argue that psych is one of the few "hidden gems" in medicine.
I hated my psych rotation. To much pseudo intellectual masturbation.
I am kind of interested in psych but the danger aspect kind of scares me. I find it interesting, but I definitely wouldn't be able to physically hold my own against a crazed patient!
How do psychiatrists protect themselves from stuff like this?
I hated my psych rotation. To much pseudo intellectual masturbation.
As opposed to neurology, which is intellectual masturbation.
Too much of the actual practice of psych seemed to be mainly social work for me.
I'm sure you can have a lucrative practice listening to rich people complain and paying in cash, but it seems like a waste of an MD.
Also, the DSM is garbage and probably will still be garbage after the revision.
yet it on the bottom of the totem pole
is it really just the negative stigma? bc lifestyle is great too, right?
Recently there was that paper that described Alzheimer's (and potentially Parkinson's) as behaving in a prion-disease kind of fashion.
I feel like more advances in that regard are on the way, so psychiatry seems like a really exciting field to be entering now.
What an asinine sentiment.If there's a clear biological basis to something in the brain, it belongs to neurology.
What an asinine sentiment.
Is depression abiological?
Psych is like Art/Music in public education
Its fun and enjoyable. The people who work in it are generally a little crazy themselves, but they like what they do.
When it comes to budgets, psych is the first to go. You don't get any respect from the smart teachers, and, in reality, any medicine doctor can fix what can be fixed... we leave the incurable psychotic diseases to the psychiatrsits. Plus its depressing, everyone being depressed all the time. And irritating, because, honestly, can't everyone tell the difference between dementia and delirium... do we really need a psych consult? Yes. Because who wants to deal with that?
Wow, that's a lot of condescension.
I am kind of interested in psych but the danger aspect kind of scares me. I find it interesting, but I definitely wouldn't be able to physically hold my own against a crazed patient!
How do psychiatrists protect themselves from stuff like this?
i think if you've been training for over 9 years+ in undergrad, then med school, and soon residency---and you're still thinking about climbing that totem pole, and not about finding a specialty that best fits your personality and skills while supporting your recreational life--then I don't know what to say. Screw the totem pole, and do something you enjoy.
Screw the totem pole eh?
You might need the product in this ad:
Just matched in psych. Why?
1. I enjoyed my psych rotation, so I did another. Liked that one too.
2. Massive shortage. > 55% of practicing psychiatrists are over 55yo. Shortage only going to get worse.
3. Ability to practice free from insurance system. Getting easier as shortage gets worse. Less headaches and...
4. Low office overhead. Rent, utilities, me. Easy.
5. Research is insane right now. New schizophrenia drugs with less side effects, new imaging/labs/diagnostics on the horizon, more efficacious treatments for various disorders (ECT advances, TMS, deep brain stimulation, etc).
6. Lifestyle is awesome. Great hours, little call. Good pay, especially if considered per hour. I know the salary averages say $180k, but I haven't met anyone making less then 200k for a 40h work week. Grads going to shortage areas have been getting 250-300k.
7. Detective work. Many docs get "psych patients" and don't even try. The amount of undiagnosed or misdiagnosed medical problems is astounding. Thyroid, hemochromatosis, cancer, the list goes on and on.
Regarding safety: it's something I was mildly concerned about, but after looking into it am not. Research has shown that ED docs and IM (esp Geri) are more likely to be victims of violence. Most psych wards have very good security. Take precautions with no ties, easy escape routes, etc. not usually an issue.
I enjoy usually having time to talk to my patients. Where else is medicine can you make this kind of salary with 1h pt visits? Some can be difficult, bu you learn ways to handle them.
I love it. Future PROAD specialty IMO.
Or in the case of the Fusilli Jerry!that's the product i will recommend the psych patient who sticks a pencil up his penis.
Thanks for your input, really good to know. Quick question if you have time - how do you see yourself dealing with depressed/disturbed/generally unhappy patients day in and day out? Do you see it wearing on you, or is there a particular way that psychiatrists tend to cope with it? Thanks again.
Just matched in psych. Why?
Thanks for your input, really good to know. Quick question if you have time - how do you see yourself dealing with depressed/disturbed/generally unhappy patients day in and day out? Do you see it wearing on you, or is there a particular way that psychiatrists tend to cope with it? Thanks again.
Frankly, you will meet depressed, anxious, neurotic patients in every field. I am actually a trained obgyn who is now going into a psychiatry residency. Frankly, my job as an obgyn requires me to a therapist 50% of the time.
Frankly, you will meet depressed, anxious, neurotic patients in every field. I am actually a trained obgyn who is now going into a psychiatry residency. Frankly, my job as an obgyn requires me to a therapist 50% of the time.
i think if you've been training for over 9 years+ in undergrad, then med school, and soon residency---and you're still thinking about climbing that totem pole, and not about finding a specialty that best fits your personality and skills while supporting your recreational life--then I don't know what to say. Screw the totem pole, and do something you enjoy.
+1 on this being a very rewarding thing to observe (and one of the few things observable on a very short time frame)Stabilizing somebody suicidal is extremely valuable, which in my opinion compares to an emed saving someone's life.
Just matched in psych. Why?
1. I enjoyed my psych rotation, so I did another. Liked that one too.
2. Massive shortage. > 55% of practicing psychiatrists are over 55yo. Shortage only going to get worse.
3. Ability to practice free from insurance system. Getting easier as shortage gets worse. Less headaches and...
4. Low office overhead. Rent, utilities, me. Easy.
5. Research is insane right now. New schizophrenia drugs with less side effects, new imaging/labs/diagnostics on the horizon, more efficacious treatments for various disorders (ECT advances, TMS, deep brain stimulation, etc).
6. Lifestyle is awesome. Great hours, little call. Good pay, especially if considered per hour. I know the salary averages say $180k, but I haven't met anyone making less then 200k for a 40h work week. Grads going to shortage areas have been getting 250-300k.
7. Detective work. Many docs get "psych patients" and don't even try. The amount of undiagnosed or misdiagnosed medical problems is astounding. Thyroid, hemochromatosis, cancer, the list goes on and on.
Regarding safety: it's something I was mildly concerned about, but after looking into it am not. Research has shown that ED docs and IM (esp Geri) are more likely to be victims of violence. Most psych wards have very good security. Take precautions with no ties, easy escape routes, etc. not usually an issue.
I enjoy usually having time to talk to my patients. Where else is medicine can you make this kind of salary with 1h pt visits? Some can be difficult, bu you learn ways to handle them.
I love it. Future PROAD specialty IMO.
It's sort of like dealing with the Diabetics who won't follow their diet or watch their sugars. You just do the best you can and move on. That's all you can do.
I've also been dealing with it much of my life. I spent a good amount of time in the music biz in the late 90's, where everyone was gloomy and depressed, lol. No, seriously. There was tons of mental health problems around me, particularly depression, substance use, etc, and I learned how to deal with it...or adjusted to it.
I think it helps to really look at each patient as an individual. Wellbutrin might work wonders for the anhedonic depressed housewife, but not for others. One person might respond well to an exercise plan, another might prefer prescribed volunteerism. You just have to try and find the right combination of a) what makes them tick, and b) what they're willing to do/try, and c) meds.
Oh, I forgot to mention the awesomeness of tele psychiatry. And, that many psych jobs (both tele psych and live) are state/gov't jobs, which qualify for PSLF loan forgiveness and pay pretty well. I know a guy making $215k working 32 hours/week for a state hospital, plus seeing patients on the side in his private office 1-2 days a week.
Another nice thing is that psych isn't just depressed patients. There is a TON of variety. If you don't like the depression, you can see more schizophrenics. There addiction, forensics, Consult-Liason (hospital medical psych), etc, etc. You can do more ECT, or more med management. Love talking? Do therapy. hate talking? Do med management. It's very, very manageable and easily tailored to your own interests and personality.
I am planning on doing Child & Adolescent psych. Possibly Child Consult-Liason. ...but maybe not.
Thanks for this post.
Looking for combined psychiatry / real medicine programs..But I don't think they exist outside of peds and neuro.
I really enjoy psychiatry but since one my main drive to enter medical school was to open up an free / low cost outreach clinic for bread and butter family practice problems, I'm not sure I will be able to justify it to myself. I know that just as many poor people have psychiatry issues, but honestly letting go of "real" medicine after all this medical school seems like such a waste.
Looking for combined psychiatry / real medicine programs..But I don't think they exist outside of peds and neuro. Then again, there's my IMG stigma. My step was great, but I'm not sure I'm competitive enough for a dual program. Still have a year to decide...
I agree our medical system makes so little sense in some areas. I understand the reasons. You wouldn't want anybody with an MD opening up a surgery clinic...