This job is awesome

[SmallBird]

It's been about four years since my last hypomanic post, where I try and offer a contrasting perspective to some of the concerns and challenges that are rather often highlighted on this forum. These include frustration with obnoxious systems, mid-level 'encroachment', poor reimbursement, clinical hopelessness, diagnostic confusion, and witnessing poor treatment. All of these are real issues. But for many of us the experience can be quite different.

I really loved residency, and I really, really love my job. I run an adolescent unit at an academically affiliated hospital in New England. I have to cover about 7 - 10 patients, depending on the day. My social workers are thoughtful, savvy, and hardworking, and the nurses are experienced. For most of my patients, I'm able to spend about an hour with them on the first day, and a full hour with them and the family the next day. I have access to a terrific neuropsychologist who can get preliminary reports back to me by day 4 of the admission. We keep our length of stay reasonable. There are challenging families, and challenging patients, but there is also so much gratification - even when the patients are tough, the parents will thank you for caring. When the parents are difficulty, the team is there to support each other. I certainly encounter poor prescribing practices in the community, but have the opportunity to peel away meds, or transfer people to a partial hospital level of care if they need more time to observe their treatment response. I don't think that inpatient stays are 'transformative' for most, but they are certainly useful for some, and I'm sure of that often enough that I don't doubt my usefulness most days.

I find my days to be intense, busy, but rewarding, and I'm always done by 5pm. I am very happy with my lifestyle and make enough to pay for my jaguar without any guilt. I am 100% that I'm not the only one who experiences things in a positive way, and I think its important that medical students know - this is a career that can be tremendously satisfying.

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[OldPsychDoc]

 

[nitemagi]

I'm very happy in this career. It can be a grind, as can any job, but I get immense satisfaction helping people, seeing patients get better (often), and have a good level of autonomy.

My old sales pitch to medical students:

1. It's a secret lifestyle specialty. You work less hours, though you have to learn to balance the emotional toll it takes.
2. You make more for less time. See #1.
3. It's a more diverse specialty than almost anything else out there. While IM has the illusion of options (so many organ subspecialties), it's really the same job -- morning procedure (dialysis, caths, etc), followed by rounding on hospital patients, then afternoon clinic.
In Psych you can split jobs and do very diverse jobs all in the same week. I used to do homeless street medicine work in the mornings and cash fee private practice in the afternoons. It's also perfectly acceptable to change jobs every so often. Because at 10 years of practicing, the biggest issues are boredom and burnout.
4. You won't be bored. Even besides the stories and "Crazy" presentations you see, there's no end to configurations.
Love medicine? Do consult-liaison psychiatry where you have to understand every other medical specialty AND the brain and how they all interact.
Love procedures? Do ECT, TMS, or my personal favorite (and the most complex procedure) -- psychotherapy.
Want to do minimal insurance work? There's shortages in government positions, or start a specialized private practice.
Dislike clinical work? Get forensically trained and do court evaluations.
Hate adults? Do child/adolescent psychiatry, THE most underserved medical subspecialty there is.
5. We need smart people. The brain is the most complex structure there is. We need help in understanding it.
6. In line with #5, this is the only specialty where you will continue to see progress throughout your career. How much more do you really expect to learn about heart disease. Maybe some, but our field has so much further to go. And we can use your help.

There were more points back when I was a chief resident, but I can't find them at the moment.

 

[Monocles]

Hate adults? Do child/adolescent psychiatry, THE most underserved medical subspecialty there is.

As someone who is set on CAP fast track, I did not know this! Is there a statistic that I can find on this somewhere?

 

[erg923]

I'm very happy in this career. It can be a grind, as can any job, but I get immense satisfaction helping people, seeing patients get better (often), and have a good level of autonomy.

Great point. Something I used to tell students and post-docs/residents is that work is called "work" for a reason. Right?

However, both the MD and Ph.D. give latitude for a variety of careers that can satisfy. Not all of us are built for the clinical trenches full-time.

 

[nitemagi]

As someone who is set on CAP fast track, I did not know this! Is there a statistic that I can find on this somewhere?

This was thrown around since I was in medical school. I guess I should vet such a stat before throwing it around in public.

 

[Suprachiasmatik]

I'm very happy in this career. It can be a grind, as can any job, but I get immense satisfaction helping people, seeing patients get better (often), and have a good level of autonomy.

My old sales pitch to medical students:

1. It's a secret lifestyle specialty. You work less hours, though you have to learn to balance the emotional toll it takes.
2. You make more for less time. See #1.
3. It's a more diverse specialty than almost anything else out there. While IM has the illusion of options (so many organ subspecialties), it's really the same job -- morning procedure (dialysis, caths, etc), followed by rounding on hospital patients, then afternoon clinic.
In Psych you can split jobs and do very diverse jobs all in the same week. I used to do homeless street medicine work in the mornings and cash fee private practice in the afternoons. It's also perfectly acceptable to change jobs every so often. Because at 10 years of practicing, the biggest issues are boredom and burnout.
4. You won't be bored. Even besides the stories and "Crazy" presentations you see, there's no end to configurations.
Love medicine? Do consult-liaison psychiatry where you have to understand every other medical specialty AND the brain and how they all interact.
Love procedures? Do ECT, TMS, or my personal favorite (and the most complex procedure) -- psychotherapy.
Want to do minimal insurance work? There's shortages in government positions, or start a specialized private practice.
Dislike clinical work? Get forensically trained and do court evaluations.
Hate adults? Do child/adolescent psychiatry, THE most underserved medical subspecialty there is.
5. We need smart people. The brain is the most complex structure there is. We need help in understanding it.
6. In line with #5, this is the only specialty where you will continue to see progress throughout your career. How much more do you really expect to learn about heart disease. Maybe some, but our field has so much further to go. And we can use your help.

There were more points back when I was a chief resident, but I can't find them at the moment.

Great post and inspiring to a nontrad premed who is deeply interested in psych.

 

[Shikima]

Great point. Something I used to tell students and post-docs/residents is that work is called "work" for a reason. Right?

However, both the MD and Ph.D. give latitude for a variety of careers that can satisfy. Not all of us are built for the clinical trenches full-time.

Stupid 4 letter word.

 

[Auvelity]

.

 

[Auvelity]

I'm very happy in this career. It can be a grind, as can any job, but I get immense satisfaction helping people, seeing patients get better (often), and have a good level of autonomy.

My old sales pitch to medical students:

1. It's a secret lifestyle specialty. You work less hours, though you have to learn to balance the emotional toll it takes.
2. You make more for less time. See #1.
3. It's a more diverse specialty than almost anything else out there. While IM has the illusion of options (so many organ subspecialties), it's really the same job -- morning procedure (dialysis, caths, etc), followed by rounding on hospital patients, then afternoon clinic.
In Psych you can split jobs and do very diverse jobs all in the same week. I used to do homeless street medicine work in the mornings and cash fee private practice in the afternoons. It's also perfectly acceptable to change jobs every so often. Because at 10 years of practicing, the biggest issues are boredom and burnout.
4. You won't be bored. Even besides the stories and "Crazy" presentations you see, there's no end to configurations.
Love medicine? Do consult-liaison psychiatry where you have to understand every other medical specialty AND the brain and how they all interact.
Love procedures? Do ECT, TMS, or my personal favorite (and the most complex procedure) -- psychotherapy.
Want to do minimal insurance work? There's shortages in government positions, or start a specialized private practice.
Dislike clinical work? Get forensically trained and do court evaluations.
Hate adults? Do child/adolescent psychiatry, THE most underserved medical subspecialty there is.
5. We need smart people. The brain is the most complex structure there is. We need help in understanding it.
6. In line with #5, this is the only specialty where you will continue to see progress throughout your career. How much more do you really expect to learn about heart disease. Maybe some, but our field has so much further to go. And we can use your help.

There were more points back when I was a chief resident, but I can't find them at the moment.

Just wondering. how often is advice for a psychiatry to see another psych or psychologist? In regards of dealing with patients suicides and the kind of stuff that takes a mental toll...

 

[nitemagi]

Just wondering. how often is advice for a psychiatry to see another psych or psychologist? In regards of dealing with patients suicides and the kind of stuff that takes a mental toll...

Recommended to either do that or get supervision.

 

[Shikima]

You can do that or not take it personal.

 

[MacDonaldTriad]

Smallbird, you have out grown your nom de guerre, you should now be called bigbird. Happy for you.

 

[Salpingo]

It's been about four years since my last hypomanic post, where I try and offer a contrasting perspective to some of the concerns and challenges that are rather often highlighted on this forum. These include frustration with obnoxious systems, mid-level 'encroachment', poor reimbursement, clinical hopelessness, diagnostic confusion, and witnessing poor treatment. All of these are real issues. But for many of us the experience can be quite different.

I really loved residency, and I really, really love my job. I run an adolescent unit at an academically affiliated hospital in New England. I have to cover about 7 - 10 patients, depending on the day. My social workers are thoughtful, savvy, and hardworking, and the nurses are experienced. For most of my patients, I'm able to spend about an hour with them on the first day, and a full hour with them and the family the next day. I have access to a terrific neuropsychologist who can get preliminary reports back to me by day 4 of the admission. We keep our length of stay reasonable. There are challenging families, and challenging patients, but there is also so much gratification - even when the patients are tough, the parents will thank you for caring. When the parents are difficulty, the team is there to support each other. I certainly encounter poor prescribing practices in the community, but have the opportunity to peel away meds, or transfer people to a partial hospital level of care if they need more time to observe their treatment response. I don't think that inpatient stays are 'transformative' for most, but they are certainly useful for some, and I'm sure of that often enough that I don't doubt my usefulness most days.

I find my days to be intense, busy, but rewarding, and I'm always done by 5pm. I am very happy with my lifestyle and make enough to pay for my jaguar without any guilt. I am 100% that I'm not the only one who experiences things in a positive way, and I think its important that medical students know - this is a career that can be tremendously satisfying.

That's great to hear! I'm always nervous that I'm in a honeymoon phase of my career, but I realize even if I am, I might as well enjoy it (while working out my catastrophic thinking in therapy). And its a nice cycle when you show up to work enjoying your job, then your patients/colleagues enjoy working with you, and then the job becomes all the more enjoyable.

I never fully understood the appeal of academic (or academically affiliated) jobs until I started one. Even then, I figured it would be a temporary stopover until I could launch a private practice, since why would I take such a dramatic pay cut using the same skill-set? I'm realizing now that there's no price tag to being part of a supportive community, where I have a chance to teach, learn, and be present with patients and colleagues. My sense looking around is that a lot of attending burnout happens when someone better suited for a private practice winds up in a predominantly academic setting, or vice versa.

 

[Trismegistus4]

If I could find an inpatient job seeing only 7-10 patients per day, I'd think my job was awesome too. That would virtually be a part-time job compared to what I'm doing now.

 

[Ahamis]

If I could find an inpatient job seeing only 7-10 patients per day, I'd think my job was awesome too. That would virtually be a part-time job compared to what I'm doing now.

Right!
Many positions have a census of 14-16 beds. In addition to that, you have 20-25 days of vacation, but you are required to work 1/4 weekends. 13 weekends in a year are equal to 26 days (Saturdays and Sundays).

20-26= - 6 days of vacation.
25-26= -1 day of vacation.

 

[dl2dp2]

If I could find an inpatient job seeing only 7-10 patients per day, I'd think my job was awesome too. That would virtually be a part-time job compared to what I'm doing now.

That does exist. Have you explored state/VA jobs? Tho they often pay less than 200k

 

[deleted736562]

If I could find an inpatient job seeing only 7-10 patients per day, I'd think my job was awesome too. That would virtually be a part-time job compared to what I'm doing now.

Well in my academically affiliated CMHC hospital attendings cap at 11 patients in total, 8 of those are taken by residents (i.e they write 2 lines on them every day). Pay is in low 200k, in one of the major metropolitan areas in the US.