Disclaimer: after lurking on SDN for close to 4 years I am finally ready to start contributing; as a newly minted MD/psych intern, I would like to share why I ended up choosing psychiatry with all of those MS3's who are thinking about taking the plunge. Enjoy! 10) psychiatry is interesting This could actually be number 1. I don't think I had a single interesting story for my significant other for the entire month that I was on neurology, which was my rotation immediately before psych. She would ask me how my day went, it was usually something like this: "eh, some guy had a stroke, I saw him in the ED; there weren't any major PE findings...we'd missed the window for intervention by the time I saw him and I don't think he would have been a candidate anyhow. Dinner?" 9) the science is coming along Psychiatry and neuroscience go hand in hand; lucky for us the hot topics in research at the moment involve brain circuits and genomics, both of which will greatly improve what we can offer our patients in the future. More likely than not, our generation is going to see an even greater shift away from psychoanalysis and talk therapy in favor of more imaging, devices, and quick interventions, none of which I feel is a bad thing... 8) psychiatry is mostly outpatient, office based Our hospitals are full of the sickest of the sick, but this is < 10% of the psychiatric population; ie 18 out of 20 people who have ever been to a psychiatrist are doing fine, walking among the rest of us, living out their lives grateful and happy. 7) the 'stigma' and lack of prestige - not really a big deal It will probably always be there, but generally I am finding the stigma worse inside the medical community than outside of it. Most people, (probably all people statistically) have at least one member of their immediate family suffering from mental illness, depression or addiction. How well we treat these people will ultimately determine how well we are viewed by the community. As far as respect goes, everyone in the hospital looks down on everyone else. Essentially if you aren't a neurosurgeon there is probably someone out there who will say 'ours are better doctors than yours.' Sadly a lot of these same people will one day have to call me because their spouse/kid/self is having a hard time and needs a consultation. And that's okay, because like lawyers and dentists, you can hate psychiatrists as much as you want but if you find yourself needing one you are going to want the best one you can get! 6) the patient population is deserving I found that on most of my third year rotations, 90% of my patients' health problems were caused by a combination of cigarettes, alcohol and generally poor choices with regard to diet, lifestyle and sexual partners. I felt sorry for those who truly didn't know better but mostly I was annoyed by their lack of common sense. We had some frequent fliers on the psych floors but most patients left the hospital in much better shape than when they had arrived. 5) psychiatry is not a particularly competitive field to get into. At the moment. My clerkship grades were okay but my board scores were only slightly above the US average. I got some pretty amazing interviews. Things will likely change, but for the next few cycles at least you are almost guaranteed a spot in a program assuming you are 1) an American grad and 2) not the guy that passed step 1 on his 3rd attempt. And things can change pretty quickly with a few reimbursement updates/saturated markets. On the interview trail I met a fair amount of PGY2 radiologists looking to get the heck out while they still could... 4) we work 9 to 5, M to F. Anything else is just extra $$. No one will ever write this one their personal statement, but seriously working 40 hours a week is great. And for the daredevils who want to work 65+ hours by adding 3 shifts/week in the CPEP or on call on top of their regular job for that extra $75k, some health system out there will accommodate you because: 3) psychiatry is in high high demand, even in the major cities. I have not yet met a senior psych resident who was lamenting her lack of choices post-residency. Despite all the doom and gloom I read on these forums about NPs and psychologists starting cash only practices on Park Avenue, there are jobs literally everywhere. And most of them start at $220k plus or minus 10% 2) our outpatients tend to be middle class Americans aged 18 to 49 This might be a little controversial, but for me it is huge. I don't generally like having to use a translator to explain that I am not the cardiologist here to tell you your ECHO results. This is not true in inpatient as you cannot choose who gets admitted, but in the office there is little chance you will have to take someone on who 1) cannot speak a word of English 2) cannot afford their care or 3) doesn't "believe" in psychiatry. When paying out of pocket, people aren't going to waste your time like they will if they know they will never see a bill. 1) I like psychiatry. The most important reason by far; really this could be numbers 1 through 5. Very few people seem to understand this one. I was told throughout med school to "do what you like," by the same faculty who would later explain to me why I shouldn't like psychiatry. By the end of third year I didn't need to play the game for grades anymore so I was quite honest: attending: "why do you want to do psych instead of my random specialty x?" me: "because your random specialty x isn't interesting to me and I like psych" That always took them by surprise.