Intern here. Pretty much hate my life. All I do is work and dread every minute of it. I thought I'd like residency because I'd finally be doing psych and it was my favorite part of medical school. Well not the case. Apparently I do not like psychiatry anymore. Also I suck at it. It does not come naturally. I have no time to study so I feel like I am thrown out to sea, as if I making it up as I go along. I've found myself having brief periods of enjoyment on my off-service rotations (in which I've received positive feedback) while I absolute HATE my psychiatry months 🙁 I don't like any of it. Also, based on feedback, I'm not even sure I'm good enough. I don't know how I'm going to survive in my program. I am utterly miserable. I also don't like medicine in general so switching to another specialty is out. I do not want my job to consume my life! Working so much at a job I detest is making me so depressed. I would have left already but I have something like 350k to my name. Essentially I'm in debt prison. I really do not know what to do. I tell people who hate their job, find one they love but I am unable to take my own advice. I already put my life on hold for medical school. Here it goes again for residency. Its changed me. I'm so negative I can't stand myself. I don't like this person I've become. I feel bad for the few people left in my life who have to endure my suffering with me. Seriously I have only a couple friends, one of which is my roommate. I hardly ever talk to family. I have no time for dating. I miss being happy and optimistic. I miss having a 'life.' For the people who will think to respond that intern year sucks and it'll get better ect - I really do not believe that. The second years at my program still look miserable. 3rd/4th years appear to suck too. I could probably go on and on.....but I will spare you guys. If you read this, thanks for listening.
So, I'm miserable
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It appears to me you are suffering at least from burnout and maybe from something more. You should talk with your colleagues, and possibly with a mental health professional. There is no shame in seeking help.
I personally think we can learn to love things, so even if you are not enjoying psychiatry right now as you learn more and improve you will hopefully come to like it more. Also keep in mind that while PGY2 can end up more intense than PGY1 (because there is no 16hr shift limit) PGY3 and 4 generally offer much more personal time in most psychiatry programs, and as an attending you can choose your practice and work some kind of sweet 3 or 4 day a week gig if you want to (although you might choose to go a little harder at first to knock out that loan debt). Coming from where you are I think it is hard to be optimistic, but I'd bet things will not stay this bad even if it could take a while to get there.
I personally think we can learn to love things, so even if you are not enjoying psychiatry right now as you learn more and improve you will hopefully come to like it more. Also keep in mind that while PGY2 can end up more intense than PGY1 (because there is no 16hr shift limit) PGY3 and 4 generally offer much more personal time in most psychiatry programs, and as an attending you can choose your practice and work some kind of sweet 3 or 4 day a week gig if you want to (although you might choose to go a little harder at first to knock out that loan debt). Coming from where you are I think it is hard to be optimistic, but I'd bet things will not stay this bad even if it could take a while to get there.
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And one more thing: there is more intern year behind us than ahead of us at this point!
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While I'm certainly not offering medical advice or offering a diagnosis via the internet, it was remarkable the degree to which your post fulfilled Beck's Cognitive Triad. If a friend told me the same story, I would strongly exhort them to seek some treatment.
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You are at a tough psych program if you are working that hard. Each year lightens up. The end is much more fun.
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Man, what a great experience to shape you into an effective, compassionate psychiatrist!
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That's what I thought when my heart got broken. It didn't make the experience any more pleasant though. :-/
To the OP:
I hear you and I echo the above concerns and advice. EAP might be something to look into.
It will get better, I think. I'm not promising that you'll like it more (though I hope you will), but I am promising (so much as anyone can) that you will get better and more efficient at it. And residency is only so long. If you really don't like psychiatry and really are stuck with it anyway, console yourself that you'll always have a job and will be well-compensated for it. Then start to cultivate your hobbies.
To the OP:
I hear you and I echo the above concerns and advice. EAP might be something to look into.
It will get better, I think. I'm not promising that you'll like it more (though I hope you will), but I am promising (so much as anyone can) that you will get better and more efficient at it. And residency is only so long. If you really don't like psychiatry and really are stuck with it anyway, console yourself that you'll always have a job and will be well-compensated for it. Then start to cultivate your hobbies.
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Have you looked at therapy? I'm in therapy and find it helpful.
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Residency does suck but you will get through it. I know when I am doing stuff I suck at, I feel like crap, but I know part of the process of getting better is doing something that maybe is not that much fun. Do you think your frustration is related to the program that you are in? How is your relationship with your fellow interns? Hopefully I can see your reply.
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i used to be on sdn years ago and i looked over my old posts...
i have now finished my education and am a bc psychiatrist..
is everything awesome now?
no..
im currently working on starting a private practice..if you dont take insurance, it takes a long time....and all of our coding is getting messed up...
noctors are pushing for more of our jobs without any of the responsibility..
was there a point of no return into this machine that is medicine? yes, but only before i started taking mad loans in med school..
i have now finished my education and am a bc psychiatrist..
is everything awesome now?
no..
im currently working on starting a private practice..if you dont take insurance, it takes a long time....and all of our coding is getting messed up...
noctors are pushing for more of our jobs without any of the responsibility..
was there a point of no return into this machine that is medicine? yes, but only before i started taking mad loans in med school..
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This is also not meant to be medical advice.
For a number of reasons, I think insight-oriented psychotherapy is vital during psychiatry residency.
For a number of reasons, I think insight-oriented psychotherapy is vital during psychiatry residency.
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Anecdotally, I didn't like psych much as an intern, which can be demoralizing since it's the career you've signed up for, and I also found myself getting more support on off service rotations than on on service rotations as well. I don't know that any of this is applicable to what's going on with you, but things have gotten better for me. I don't have any advice beyond what's already been offered, but I hope things get better.
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To OP--I can definitely understand the intern blues! I'm a pgy-2 now, and for me intern year was pretty rough but now with some more experience under my belt, I feel way more confident about my skills. One thing I realized WAY later about psych is that it really is like learning a new field, different from other specialties in which you had much more exposure in med school. Also, inherently it is a little less team-based, so the learning style is also different from med school, just making it challenging in a different way. From what you say, it sounds like you really enjoyed psych in med school but intern year is more challenging. I would reach out to senior residents you like or attendings and ask them to go over some cases. I did this for a while and it really helped. Also, please take care of yourself! I hope the year gets better for you, and feel free to PM me if you need anything.
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I appreciated the replies.
I do have a therapy appointment scheduled but again (in my head, I think) that's not going to change the fact that my whole life is pretty much spent doing something I don't want to do and I can't do anything about it.
At this point, I'm telling myself to suck it up and do what I have to do. Stop complaining about it. It's disheartening to get to this point and be so unhappy but it is what it is.
Maybe when my motivation comes back I'll try to look into types of jobs I might like doing as a psychiatrist. Perhaps having a potential plan, will make the present less painful. A lot of these feelings worsened when I could not think of any area of psychiatry that appealed to me anymore.
I do have a therapy appointment scheduled but again (in my head, I think) that's not going to change the fact that my whole life is pretty much spent doing something I don't want to do and I can't do anything about it.
At this point, I'm telling myself to suck it up and do what I have to do. Stop complaining about it. It's disheartening to get to this point and be so unhappy but it is what it is.
Maybe when my motivation comes back I'll try to look into types of jobs I might like doing as a psychiatrist. Perhaps having a potential plan, will make the present less painful. A lot of these feelings worsened when I could not think of any area of psychiatry that appealed to me anymore.
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I wrote this earlier but didn't post it due to forces out of my control, but in case you were still looking for advice, I wrote:
Try imagining that this was the only job you could have gotten. I would say that for the vast majority of people in the world, the job they have is the best one they could get, and they likely didn't have a lot of choices into the type of work they do.
I say that because I would offer that there are two separate issues: the stress/depression caused by the job/education itself and the belief that you need to be satisfied with your job/education, which could also cause stress.
I communicate with people in the "upper echelons" of society and those working in the lower rings of the service industry, and the more people find a job that is satisfying to them, the more they seem to form the belief that it's necessary that a job very uniquely satisfy them. When I was a young child and my dad, who is in academics, was complaining about his job, I once ineloquently said, "You're not an artist. It's a job."
It was a bit crass of course, and I don't repeat that to deny your feelings, especially if the job itself is the problem regardless of your belief that a job must be satisfying.
The one psychiatrist I know socially did not define his life around being a psychiatrist. He traveled a lot, bought nice cars, nice boats, a lot of "toys." He seemed to have a very full life outside of his job that didn't revolve around a passion for mental health.
Having said all that, once you become a psychiatrist, you're in the enviable position of always having something to fall back on that will probably always be in demand, while being able to think up other adventures: writing, writing about psychiatry, baking, who knows.
Try imagining that this was the only job you could have gotten. I would say that for the vast majority of people in the world, the job they have is the best one they could get, and they likely didn't have a lot of choices into the type of work they do.
I say that because I would offer that there are two separate issues: the stress/depression caused by the job/education itself and the belief that you need to be satisfied with your job/education, which could also cause stress.
I communicate with people in the "upper echelons" of society and those working in the lower rings of the service industry, and the more people find a job that is satisfying to them, the more they seem to form the belief that it's necessary that a job very uniquely satisfy them. When I was a young child and my dad, who is in academics, was complaining about his job, I once ineloquently said, "You're not an artist. It's a job."
It was a bit crass of course, and I don't repeat that to deny your feelings, especially if the job itself is the problem regardless of your belief that a job must be satisfying.
The one psychiatrist I know socially did not define his life around being a psychiatrist. He traveled a lot, bought nice cars, nice boats, a lot of "toys." He seemed to have a very full life outside of his job that didn't revolve around a passion for mental health.
Having said all that, once you become a psychiatrist, you're in the enviable position of always having something to fall back on that will probably always be in demand, while being able to think up other adventures: writing, writing about psychiatry, baking, who knows.
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Definitely sounds like you're in a particularly tough program. That would make anyone feel down, especially if you weren't able to get time off for the holidays. When I was a PGY-1/PGY-2 I definitely felt stressed and depressed at times because of the work. I'm a lot happier now than I was during those days. Even if life isn't perfect when you get to be a senior resident, it does get better (and you get better at dealing with the lousy parts).
I think every intern feels like they're not good enough at times. I remember feeling very anxious when some situation I had never dealt with before came up as an intern and everyone else was expecting me to know how to handle it because I was "The Doctor".
Just remember that you're not supposed to be perfect. If you already knew everything about being a good psychiatrist you wouldn't need a residency. I bet you have made progress since you started and by the time you're done with internship I bet you'll be surprised at how far you've come.
Have you had any exposure in residency to outpatient psych yet or has it all been inpatient? Remember that inpatient psych is quite different than the outpatient world and many psychiatrists really don't enjoy inpatient that much. (Personally I enjoy inpatient but I have many peers who don't).
One nice thing about psychiatry is that there is so much diversity in the specialty so almost everyone can find something they enjoy in the specialty (including totally non-clinical work). I bet you will find something you like over the next four years, even if it's not
what you pictured yourself doing originally in med school.
Even if you never do find a psych job you truly love, I do think that psychiatry is one of the best specialties for someone who doesn't want their job to be their whole identity. You can always do part-time work or locum tenens to pay the bills and pursue the other things you like in your free time.
Residency is not always easy, but it'll be worth it in the end. You're doing the right thing by seeing a therapist to help you get some support through this. If there's any way you can reconnect with your family I think that's another great thing to do to try to cope with this. And don't be afraid to complain/vent on here. 🙂
I think every intern feels like they're not good enough at times. I remember feeling very anxious when some situation I had never dealt with before came up as an intern and everyone else was expecting me to know how to handle it because I was "The Doctor".
Just remember that you're not supposed to be perfect. If you already knew everything about being a good psychiatrist you wouldn't need a residency. I bet you have made progress since you started and by the time you're done with internship I bet you'll be surprised at how far you've come.
Have you had any exposure in residency to outpatient psych yet or has it all been inpatient? Remember that inpatient psych is quite different than the outpatient world and many psychiatrists really don't enjoy inpatient that much. (Personally I enjoy inpatient but I have many peers who don't).
One nice thing about psychiatry is that there is so much diversity in the specialty so almost everyone can find something they enjoy in the specialty (including totally non-clinical work). I bet you will find something you like over the next four years, even if it's not
what you pictured yourself doing originally in med school.
Even if you never do find a psych job you truly love, I do think that psychiatry is one of the best specialties for someone who doesn't want their job to be their whole identity. You can always do part-time work or locum tenens to pay the bills and pursue the other things you like in your free time.
Residency is not always easy, but it'll be worth it in the end. You're doing the right thing by seeing a therapist to help you get some support through this. If there's any way you can reconnect with your family I think that's another great thing to do to try to cope with this. And don't be afraid to complain/vent on here. 🙂
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Is it possible to switch programs? I absolutely adore my program, as do most of the other residents. Not that we dont have struggles, but our faculty is super supportive, so that environment does exist. It doesn't have to be so intensely awful, just maybe a different program would be a better fit?
Don't lose hope, it'll be over in a couple of years and then you'll be living the sort-of-good life (I mean, we don't exactly get paid like cardiologists) with nice hours and decent pay. Residency, especially the first couple years, is the hardest part but things will definitely turn around so don't get discouraged and do something crazy like resign. Therapy is not a bad idea at all. I would have done it myself if I had the money.
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One thing that the previous posters might have neglected is to look at exactly why you are not happy. If you think that psychiatry per se is the issue, then it's not too late to switch to a different specialty that you think is a better fit. However, you have to be careful, because it's entirely possible that you are a dim view of your job right now for some other reason (i.e. in the midst of a MDE, or some other psychosocial stressor coloring your worldview.)
I disagree with the fake it till you make it and suck it up mentality. If there is a genuinely legit reason and you have rationally considered your options and decided to move on, I think it's completely logical.
I disagree with the fake it till you make it and suck it up mentality. If there is a genuinely legit reason and you have rationally considered your options and decided to move on, I think it's completely logical.
To OP - Other than the general pressure and work demands of residency, learning psychiatry is extremely tough. It raises our level of self awareness and as that starts to happen we start scrutinizing our own behavior and emotions. This can create a lot of internal turmoil. My advice would be to talk to someone in your field. If its not a therapist then seek out a mentor that you can confide in.
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I've been fairly miserable throughout residency. My intern year was the worst year of my life. I was in a NYC IM program. Looking back, the major contributer to my misery was the program. Once I switched programs, I was instantly much happier (relatively speaking). Sometimes a program just isn't a good fit. It happens. If you think the program might be the issue, then I would def look into other programs for open PGY2 positions.
I'm still not thrilled with my choice of specialty. However, over the years I've become fairly good at it. I think many of us feel like we are learning nothing during intern year. But once you get deeper in the residency, you realize that you do know quite a bit, and that are good at your job. It gets better. Temper your expectations and don't expect it to suck so much or else it really will.
I'm still not thrilled with my choice of specialty. However, over the years I've become fairly good at it. I think many of us feel like we are learning nothing during intern year. But once you get deeper in the residency, you realize that you do know quite a bit, and that are good at your job. It gets better. Temper your expectations and don't expect it to suck so much or else it really will.
