most psychiatrists do not do inpatient at all. the vast majority of mental healthcare is delivered in the outpatient setting. psychiatry as a specialty has enormous breadth and depth that many students do not get a chance to appreciate. In addition, there are many different kinds of settings. For example inpatient consultation-liaison, intensive outpatient, partial hospital, residential treatment programs, corrections (jails and prisons), schools, nursing homes, solo office based practice, group single specialty practice, multispecialty practice, working for a hospital system, working for an academic medical center, community mental health, VA, military, various government entities (even ICE!
) In outpatient settings, psychiatrists are increasingly embedded or co-located in primary care of specialty medical clinics, or using integrated and collaborate care models. There are many opportunities to contract with other entities as your own scorp/pllc as well as employed opportunities. and then of course there are academic medical centers.
Even inpatient care occurs in different settings such as state hospitals, county hospitals, university hospitals, private for profit hospitals, private non-profit hospitals, and have different levels of acuity. Some inpatient units only have voluntary patients, others have a mix, others still are all involuntary, some may be just for forensic patients. some units are med/psych, eating disorders, addictions, or focus on patients with suicidal crises (e.g. mood/personality disorders), whereas others have patients with more psychotic disorders or severe personality disturbances. There are different payer mixes as well that shape patient population (some inpatient units are cash only, others take commercial insurance, others may be primarily medicaid/uninsured patients).
If you go to a real medical school, you should have the opportunity to have a mentor/advisor who is a psychiatrist and talk to you more about your career development, or arrange for to spend some time precepting psychiatrists in different settings as your schedule allows. If you are attending the APA next month, PsychSIGN typically arranges a med student dinner where you can meet psychiatrists from different specialties to learn more about the field. sdn is a great resource, but nothing beats having a real person you can talk to about these things. we psychiatrists are usually quite approachable and happy to spend some time talking to students about the field.
