What do you love about being a psychiatrist?

[heroesjourney]

Hey, long time lurker and MS2. I've been really interested in psychiatry since before I knew I was interested in psychiatry. I've seen threads asking "Why did you choose psychiatry?". I'm more interested in what practicing psychiatrists (and residents) currently enjoy about their jobs, now. I'm trying to form realistic ideas of what fulfillment the field looks like. What do you like about practicing psychiatry in general, and what do you like about practicing in your specific ecological niche within the field? I'd love to hear anecdotal stories, generalities, and everything in-between.

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[Med student 18]

I am happy you opened this thread. I am close to having to make a decision and this is a major option...

 

[nexus73]

For the most part, at least for now though changes are probably coming, I get more time than most doctors to talk with patients to really get to know them and know what's going on with their care.

 

[slappy]

 

[lyla]

- Work life balance
- Interacting with people who severe mental illness (bipolar disorder, schizophrenia, etc) Most people will never have the privilege to know what these patients have to deal with, let alone help improve their quality of life.
- psychopharmacology
- not Having to chase lab values or numbers to guide my treatment
- having other tools besides medications (like meditation, psychotherapy) to help patients.

I could go on and on

 

[deleted407021]

Current OMS-2. I'd love to hear some more perspectives, as well!

The idea of getting more time with patients than you would perhaps on a family med or IM service is a draw for me

 

[TexasPhysician]

- strong patient relationships
- great work/life balance
- reasonable income
- all cash practice options
- diversity of work environments
- longer appointments
- lots of respect in the community

 

[bonedrone14]

I picked psych in August of 4th year after agonizing for a long time. I seriously considered ortho, em, and ophtho prior to making the final decision. I'm in my second year of residency and would make the same decision again every time.

Things I love
-great lifestyle, whatever that means to you. You can work surgeon hours if you want or you can be home by dinner to play with the kids.
- an extension of the above...less people in this field are self righteous and view wanting to have a good lifestyle as "beneath" medicine or "selfish"
-good money. Granted, I've never held a big boy job besides residency and I know our field on avg earns lower than some. But if we worked the hours most other fields do, the numbers would be less different.
-one of my favorites...stress level. There are obviously situations when something is needed emergently, but on the whole, psychiatry is the lowest stress field i experienced. I love this because it lends itself to career longevity and overall health.
-psychiatric pathology. Gotta love it to do the field and lots of people don't. I tend to think it's because they dont really understand the patients (think personality disorders) and the reasons they act the way they do. Psychosis and mania are fascinating. Depression and anxiety are less so in my own opinion but I'm realizing I enjoy treating even these spectrums more the more I learn
- the "unknown"...i kind of conceptualize psychiatry as being where modern medicine was 100 years ago. Still so much we don't understand. Things we consider standard of care now will probably look totally different by the time I retire. I'm learning so much more depth to the field than in medical school and it's amazing and exciting.
-connected to above, psychiatry is less algorithmic than other fields. You've got the Texas algorithm etc but there's a lot more room for experience and gut feeling, especially in therapy.
-therapy...im just starting to learn the theory and practice of this now, so I'm terrible at it. But, it blows my mind the depth of the human mind that can be reached via therapy techniques. I think understanding human psychology better makes any physician a better interviewer and doctor.
-pharmacology...who else knows literally every receptor that their medication binds to? (Granted we don't know specifically how some of them work...)

Just some stuff off the top of my head. As you can see I'm a homer and recruit anyone I can into psych. If y'all wanna talk more pm me as I relied heavily on experiences of those ahead of me to help make my decision so I'm happy to do the same.

 

[MedMan80]

Echoing what has been said here, the stress level is certainly lower than other specialities. In residency our service was amongst the busiest however we never had the added stress of knowing our patients could code any die at any minute, the OBGYN resident's on the other hand..

Also our field is the among the few which one can become more mindful themselves and ultimately help their own lives.

 

[bonedrone14]

Also our field is the among the few which one can become more mindful themselves and ultimately help their own lives.

Forgot to add this on my post but this may actually be my favorite part of psychiatry. In learning how to conceptualize patients, I'm learning how to see patterns in my own life and change maladaptive behaviors I've learned...

 

[michaelrack]

-
- not Having to chase lab values or numbers to guide my treatment


I could go on and on

baseline and f/u labs along with drug level for Li, VPA, tegretol? lipids and glucose with antipsychotics?

 

[birchswing]

lipids and glucose with antipsychotics?

Been on Seroquel since 2001, over which time I've had at least 5 psychiatrists prescribing it. None have ever ordered blood tests—and I asked repeatedly. I asked for fasting glucose back in the early 2000s and the psychiatrist said I was a spaz
(refused test). One told me Seroquel only causes side effects in beagles (refused test). Fortunately my PCP will prescribe any blood test I ask for. So I've been able to get fasting and A1C tests from him along with cholesterol. Initially A1C was 6.4. PCP wouldn't prescribe metformin. With careful eating and Cinnulin (cinnamon water extract) was able to get it to 5.3. But even doing that I am so insulin resistant now (I can't have even small amount of beans without blood sugar going to 180s) finally have had to go on metformin, even though A1c was normal due to extremely careful eating (low glycemic eating--but it encroached on me more and more so that I had to be impossibly careful to keep numbers in "safe" zone). Often I have an N of 1 experience. But in this case I have an N of at least 5 of psychiatrists who would not do blood testing. Cholesterol is also bad (high LDL, low HDL, and high LDL particle count), but they don't want to treat that specifically. Metformin has some research showing it can help with cholesterol so I'm hoping it does.

 

[Crayola227]

sorry for your experiences

thankfully the psychiatrists of my acquaintance have been pretty excellent about following standards of care with lipids and glucose monitoring in the setting of antipsychotic use, and have kept an eye on patient weight too

 

[birchswing]

sorry for your experiences

thankfully the psychiatrists of my acquaintance have been pretty excellent about following standards of care with lipids and glucose monitoring in the setting of antipsychotic use, and have kept an eye on patient weight too

That's good to hear. The only time I was weighed by a psychiatrist was the brief time I went to a community services board, and an aide would weigh me before I saw the doctor. The private places I've been don't even have scales.

 

[Crayola227]

That's good to hear. The only time I was weighed by a psychiatrist was the brief time I went to a community services board, and an aide would weigh me before I saw the doctor. The private places I've been don't even have scales.

that's why I was impressed with these psychiatrists - they didn't have scales either. So it wasn't just standard practice and procedure for them to track a patient's weight; it was something they had to keep in mind and inquire after.

 

[OldPsychDoc]

To add to the above--something you really only scratch the surface of in residency: long term continuity of care over years, even decades, with the same patients. You get to know them, become a significant influence in their lives, see their ups & downs, relapses and remissions.
Also the sense that I'm making the world a better place.

 

[deleted407021]

I'm curious, how flexible is psychiatry as far as practice style and patient focus? For instance, could one work specifically with women or adolescents/young adults? Are there jobs for psychiatrists working with universities, treating college-aged students?

Thanks!

 

[Shikima]

Pretty flexible. You call the shots on what and where you work. There are many jobs which work with specific populations only. You can even create positions where there are none.

 

[splik]

omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:
1. you can spend as much time as you like doing evaluations (depending on the settings). In forensic evals I can spend the whole day just evaluating one person taking a complete detailed history of all sorts of things people have never told anyone before.
2. beyond getting a window into the mind of the delusional, neurotic, and personality disordered you learn how serial killers, rapists, pedophiles, white collar criminals, stalkers and so on think - compelling and disturbing at the same time
3. there's no one explanatory model for the kinds of problems we deal with that span the breadth of human misery from problems in living, to behaviors, to disorders of thought and emotion, to frank diseases of the brain. We draw on multiple explanatory models (neurobiological, psychodynamic, cognitive behavioral, systemic, social constructivist, social realist, cultural etc) to make sense of people's problems
4. psychopharmacology is fascinating - the effects of drugs on mental experiences is one of the most understudied and compelling aspects of our fields, and some of the more experimental treatments including ketamine, psilocybin, LSD, and MDMA have been gaining renewed attention
5. catatonia is eminently treatable and the results so dramatic it is incredibly satisfying to see someone go from non communicative or frenzied to alert and calm with a little ativan or electricity
6. we can take the paralyzed and hypnotize them out of it (if the paralysis is an hysterical symptom!) - again extremely satisfying to treat.
7. working with couples and families gives you a fascinating windows of how much pressure there is to enact our roles, and how you need to treat the whole system if you want to get someone better
8. we are masters of building expectancy and offering hope. so often we see patients who are written off as hopeless and recalcitrant but a little love and care and reformulating the patient go along way.
9. i love testifying in court and the sparring and jousting of a good cross-examination
10. i love providing a valuable service to the courts and attorneys by educating them about mental health problems, often helping people in very tangible and concrete ways
11. i love the philosophical aspects of the field - what is mental disorder? how to we conceptualize people? are psychiatric disorders disorders of the brain, and if so, how does this affect one's free will? how do psychiatric drugs shape the experience of the self? etc
12. i love stories. patients present with stories: narratives of disillusionment, disharmony and despair as well as ones of resilience and recovery
13. i love language. psychiatry is all about language - whether it is the fact that some carelessly and cruelly deployed words in childhood can alter someone's trajectory, or in their power to heal.
14. i love connecting with people - people i might never otherwise get to talk to, to interact with, and learn their life story. even the most ostensibly odious person can become likeable when you see their scars and vulnerabilities.
15. while we palliate most patients, there are some things we can cure. panic disorder, phobias, and PTSD are all eminently curable, often with short-term treatment)
16. lots of different fellowship/subspecialty opportunities available including pain medicine, palliaitive medicine, sleep medicine, neuropsychiatry, child psychiatry, geriatrics, psychoanalysis, psychological medicine, CBT, family/couples therapy, group therapy, eating disorders, psychosexual medicine, LGBTQ mental health, HIV, clinical informatics, occupational medicine/psychiatry, addiction medicine/psychiatry, brain stimulation etc etc
17. there is no shortage of jobs. even in saturated cities there is plenty of work for psychiatrists and this is unlikely to change anytime soon.
18. you get to spend your days talking about sex with your patients.
19. the mind-brain relationship is extremely fascinating - cognitive neurology is a particularly fascinating area
20. there are lots of research opportunities because there are so many unanswered questions in psychiatry and neuroscience
21. our textbooks dont really go out of date. I have all these books from 100 years ago or more that are still full of rich descriptions relevant to this day
22. while a lot of it can be depressing, some patients are absolutely f'ing hilarious and will have you howling with laughter
23. there are lots of criticisms and controversies in the field but we mostly tend to talk about these things in an open manner (e.g. influence of pharmaceutical companies, illness mongering, psychiatrization of everyday life, overselling of neurobiology, coercion, alternatives to the medical approach to psychiatry etc)
25. you get to work with some of the most disadvantaged, marginalized and disenfranchized individuals (particularly in correctional settings) if you choose to
26. lots of opportunities for innovation: for example developing new psychotherapies, or using tech to enhance patient care or develop and disseminate new treatments
27. psych lends itself well to telemedicine so you can if you so wish see pts from the comfort of your own home, or even from another country depending on the contract
28. i love group therapy - working with groups is a lot of fun, adds a layer of complexity to the work and more importantly can be immensely therapeutic and healing. if therapy is not your jam, then you can do group psychopharm visits which are becoming more popular
29. you definitely grow as a person in this field, confronted with so much of other people's issues forces you to confront your own
30. it is very difficult to get successfully sued as an outpatient psychiatrist
31. it is very easy to diversify you practice and switch jobs, patient populations, settings etc multiple times over your career or have a portfolio career working in multiple settings contemporaneously
32. there are lots of things besides clinical care you can do to (expert witness work, consulting, mediation, teaching, public education, writing, advocacy, policy, research, administration, clinical trials, utilization review, quality assurance, MRO [medical review officer] etc) to break up the monotony

I could go on, but you get the picture. It's not for everyone (most med students are not suited to it) and sometimes i miss being a real doctor but i'm really quite happy for the most part and feel the field provides enough intellectual stimulation for me.

 

[heroesjourney]

omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:
1. you can spend as much time as you like doing evaluations (depending on the settings). In forensic evals I can spend the whole day just evaluating one person taking a complete detailed history of all sorts of things people have never told anyone before.
2. beyond getting a window into the mind of the delusional, neurotic, and personality disordered you learn how serial killers, rapists, pedophiles, white collar criminals, stalkers and so on think - compelling and disturbing at the same time
3. there's no one explanatory model for the kinds of problems we deal with that span the breadth of human misery from problems in living, to behaviors, to disorders of thought and emotion, to frank diseases of the brain. We draw on multiple explanatory models (neurobiological, psychodynamic, cognitive behavioral, systemic, social constructivist, social realist, cultural etc) to make sense of people's problems
4. psychopharmacology is fascinating - the effects of drugs on mental experiences is one of the most understudied and compelling aspects of our fields, and some of the more experimental treatments including ketamine, psilocybin, LSD, and MDMA have been gaining renewed attention
5. catatonia is eminently treatable and the results so dramatic it is incredibly satisfying to see someone go from non communicative or frenzied to alert and calm with a little ativan or electricity
6. we can take the paralyzed and hypnotize them out of it (if the paralysis is an hysterical symptom!) - again extremely satisfying to treat.
7. working with couples and families gives you a fascinating windows of how much pressure there is to enact our roles, and how you need to treat the whole system if you want to get someone better
8. we are masters of building expectancy and offering hope. so often we see patients who are written off as hopeless and recalcitrant but a little love and care and reformulating the patient go along way.
9. i love testifying in court and the sparring and jousting of a good cross-examination
10. i love providing a valuable service to the courts and attorneys by educating them about mental health problems, often helping people in very tangible and concrete ways
11. i love the philosophical aspects of the field - what is mental disorder? how to we conceptualize people? are psychiatric disorders disorders of the brain, and if so, how does this affect one's free will? how do psychiatric drugs shape the experience of the self? etc
12. i love stories. patients present with stories: narratives of disillusionment, disharmony and despair as well as ones of resilience and recovery
13. i love language. psychiatry is all about language - whether it is the fact that some carelessly and cruelly deployed words in childhood can alter someone's trajectory, or in their power to heal.
14. i love connecting with people - people i might never otherwise get to talk to, to interact with, and learn their life story. even the most ostensibly odious person can become likeable when you see their scars and vulnerabilities.
15. while we palliate most patients, there are some things we can cure. panic disorder, phobias, and PTSD are all eminently curable, often with short-term treatment)
16. lots of different fellowship/subspecialty opportunities available including pain medicine, palliaitive medicine, sleep medicine, neuropsychiatry, child psychiatry, geriatrics, psychoanalysis, psychological medicine, CBT, family/couples therapy, group therapy, eating disorders, psychosexual medicine, LGBTQ mental health, HIV, clinical informatics, occupational medicine/psychiatry, addiction medicine/psychiatry, brain stimulation etc etc
17. there is no shortage of jobs. even in saturated cities there is plenty of work for psychiatrists and this is unlikely to change anytime soon.
18. you get to spend your days talking about sex with your patients.
19. the mind-brain relationship is extremely fascinating - cognitive neurology is a particularly fascinating area
20. there are lots of research opportunities because there are so many unanswered questions in psychiatry and neuroscience
21. our textbooks dont really go out of date. I have all these books from 100 years ago or more that are still full of rich descriptions relevant to this day
22. while a lot of it can be depressing, some patients are absolutely f'ing hilarious and will have you howling with laughter
23. there are lots of criticisms and controversies in the field but we mostly tend to talk about these things in an open manner (e.g. influence of pharmaceutical companies, illness mongering, psychiatrization of everyday life, overselling of neurobiology, coercion, alternatives to the medical approach to psychiatry etc)
25. you get to work with some of the most disadvantaged, marginalized and disenfranchized individuals (particularly in correctional settings) if you choose to
26. lots of opportunities for innovation: for example developing new psychotherapies, or using tech to enhance patient care or develop and disseminate new treatments
27. psych lends itself well to telemedicine so you can if you so wish see pts from the comfort of your own home, or even from another country depending on the contract
28. i love group therapy - working with groups is a lot of fun, adds a layer of complexity to the work and more importantly can be immensely therapeutic and healing. if therapy is not your jam, then you can do group psychopharm visits which are becoming more popular
29. you definitely grow as a person in this field, confronted with so much of other people's issues forces you to confront your own
30. it is very difficult to get successfully sued as an outpatient psychiatrist
31. it is very easy to diversify you practice and switch jobs, patient populations, settings etc multiple times over your career or have a portfolio career working in multiple settings contemporaneously
32. there are lots of things besides clinical care you can do to (expert witness work, consulting, mediation, teaching, public education, writing, advocacy, policy, research, administration, clinical trials, utilization review, quality assurance, MRO [medical review officer] etc) to break up the monotony

I could go on, but you get the picture. It's not for everyone (most med students are not suited to it) and sometimes i miss being a real doctor but i'm really quite happy for the most part and feel the field provides enough intellectual stimulation for me.

What a fantastic reply! Exactly what I'm looking for! I have two follow up questions: What about forensic psychiatry gave it a larger gravitational pull on you over the vast array of other subsections of the field? Do you still do non-forensic psychiatry?

Also, I've read some of your other posts in my casual perusing of this forum, and I think you would be a great subject for an AMA thread. I think it would give validation to a lot of the med students who are suited for it, in addition to being fascinating in itself. I personally found this validating as I came into medical school extremely interested in psych for every reason you listed, but sometimes I find myself being lured by the siren calls of other specialties, family/friend/class "pressure" (abundance of enthusiasm/support for interest in procedure oriented specialty/coolness when I talk about psych), and medical school/societal culture. All the fake-gold ego BS that distracts from the desires of the heart.

 

[thoffen]

Splik is never short on answers

For me, honestly, I love being able to work with people in a more meaningful way. I'm not a heavy socialite and detest superficial interactions. There are so many conflicting purposes in everyday interactions and not a lot of chance at depth. I also don't mind realizing that many problems can't be fixed and that many patients are destined to reject my care or advice. The good thing is that these realities are part of good psychiatric care. I can give the patient freedom to experience everything that goes on in their life within the treatment and recognize I have very little authority in directing it even if I wanted to.

The only patients I don't like are the ones who are actively using psychiatry to reinforce their helplessness and lack of responsibility in their own life. Too often the system just feeds right into it. And I stress the active part even if it's not conscious. Many other people are ambivalent, anxious, or simply doing the best they can but getting in their treatment allies in avoiding distress instead of sharing it. Often those are the patients you can help the most.

 

[splik]

What a fantastic reply! Exactly what I'm looking for! I have two follow up questions: What about forensic psychiatry gave it a larger gravitational pull on you over the vast array of other subsections of the field? Do you still do non-forensic psychiatry?

Also, I've read some of your other posts in my casual perusing of this forum, and I think you would be a great subject for an AMA thread..

No I do forensic work on the side though it's the summer so I have a bunch of cases because no one else wants them lol. I only take cases that sound really interesting even if the money is poor and increasss my fee if I'm on the fence about it. Most forensic psychiatrists do clinical work for much of the time since people are retaining you for your expertise as a clinical psychiatrist not a forensic psychiatrist (unless it's an insanity or sexual violence recidivism type case etc) and my regular job is doing c/l psych and neuropsych at an academic medical center. Im kind of all over the place but my main interests right now are at the interface of psychiatry and neurology. Even forensically, although I will take anything juicy I prefer geriatric and neuropsych type cases and when I'm a bit more established will try to focus more on that.

What's AMA? Against medical advice?

 

[heroesjourney]

No I do forensic work on the side though it's the summer so I have a bunch of cases because no one else wants them lol. I only take cases that sound really interesting even if the money is poor and increasss my fee if I'm on the fence about it. Most forensic psychiatrists do clinical work for much of the time since people are retaining you for your expertise as a clinical psychiatrist not a forensic psychiatrist (unless it's an insanity or sexual violence recidivism type case etc) and my regular job is doing c/l psych and neuropsych at an academic medical center. Im kind of all over the place but my main interests right now are at the interface of psychiatry and neurology. Even forensically, although I will take anything juicy I prefer geriatric and neuropsych type cases and when I'm a bit more established will try to focus more on that.

What's AMA? Against medical advice?

That sounds awesome! I've always been fascinated by the darker, grittier elements of the human mind, but I'm also really interested in helping "regular" people and people with severe non-criminal mental illness, as well as public policy, epidemiology, analysis, hypnosis, and a lot of other stuff. Glad to know I don't have to narrow too terribly much.

Hahaha no it stands for Ask Me Anything. It's a thread on forums where people open up about their lives, by inviting questions from the forum members. There was one opened by an ortho trauma surgeon recently: ortho attending AMA. I think there would be a lot of interest in forensic psych.

 

[Lunzio]

Just wanted to say thanks to all those who have contributed thus far! As a psych applicant, it definitely excites me for the years to come

 

[splik]

Hahaha no it stands for Ask Me Anything. It's a thread on forums where people open up about their lives, by inviting questions from the forum members. There was one opened by an ortho trauma surgeon recently: ortho attending AMA. I think there would be a lot of interest in forensic psych.

oh that makes more sense lol. i can do that, as long as i dont have to answer just anything haha.

 

[Armadillos]

Amazing to see how spliks posting seems a lot less jaded now that residency is over.

 

[deleted407021]

omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:
1. you can spend as much time as you like doing evaluations (depending on the settings). In forensic evals I can spend the whole day just evaluating one person taking a complete detailed history of all sorts of things people have never told anyone before.
2. beyond getting a window into the mind of the delusional, neurotic, and personality disordered you learn how serial killers, rapists, pedophiles, white collar criminals, stalkers and so on think - compelling and disturbing at the same time
3. there's no one explanatory model for the kinds of problems we deal with that span the breadth of human misery from problems in living, to behaviors, to disorders of thought and emotion, to frank diseases of the brain. We draw on multiple explanatory models (neurobiological, psychodynamic, cognitive behavioral, systemic, social constructivist, social realist, cultural etc) to make sense of people's problems
4. psychopharmacology is fascinating - the effects of drugs on mental experiences is one of the most understudied and compelling aspects of our fields, and some of the more experimental treatments including ketamine, psilocybin, LSD, and MDMA have been gaining renewed attention
5. catatonia is eminently treatable and the results so dramatic it is incredibly satisfying to see someone go from non communicative or frenzied to alert and calm with a little ativan or electricity
6. we can take the paralyzed and hypnotize them out of it (if the paralysis is an hysterical symptom!) - again extremely satisfying to treat.
7. working with couples and families gives you a fascinating windows of how much pressure there is to enact our roles, and how you need to treat the whole system if you want to get someone better
8. we are masters of building expectancy and offering hope. so often we see patients who are written off as hopeless and recalcitrant but a little love and care and reformulating the patient go along way.
9. i love testifying in court and the sparring and jousting of a good cross-examination
10. i love providing a valuable service to the courts and attorneys by educating them about mental health problems, often helping people in very tangible and concrete ways
11. i love the philosophical aspects of the field - what is mental disorder? how to we conceptualize people? are psychiatric disorders disorders of the brain, and if so, how does this affect one's free will? how do psychiatric drugs shape the experience of the self? etc
12. i love stories. patients present with stories: narratives of disillusionment, disharmony and despair as well as ones of resilience and recovery
13. i love language. psychiatry is all about language - whether it is the fact that some carelessly and cruelly deployed words in childhood can alter someone's trajectory, or in their power to heal.
14. i love connecting with people - people i might never otherwise get to talk to, to interact with, and learn their life story. even the most ostensibly odious person can become likeable when you see their scars and vulnerabilities.
15. while we palliate most patients, there are some things we can cure. panic disorder, phobias, and PTSD are all eminently curable, often with short-term treatment)
16. lots of different fellowship/subspecialty opportunities available including pain medicine, palliaitive medicine, sleep medicine, neuropsychiatry, child psychiatry, geriatrics, psychoanalysis, psychological medicine, CBT, family/couples therapy, group therapy, eating disorders, psychosexual medicine, LGBTQ mental health, HIV, clinical informatics, occupational medicine/psychiatry, addiction medicine/psychiatry, brain stimulation etc etc
17. there is no shortage of jobs. even in saturated cities there is plenty of work for psychiatrists and this is unlikely to change anytime soon.
18. you get to spend your days talking about sex with your patients.
19. the mind-brain relationship is extremely fascinating - cognitive neurology is a particularly fascinating area
20. there are lots of research opportunities because there are so many unanswered questions in psychiatry and neuroscience
21. our textbooks dont really go out of date. I have all these books from 100 years ago or more that are still full of rich descriptions relevant to this day
22. while a lot of it can be depressing, some patients are absolutely f'ing hilarious and will have you howling with laughter
23. there are lots of criticisms and controversies in the field but we mostly tend to talk about these things in an open manner (e.g. influence of pharmaceutical companies, illness mongering, psychiatrization of everyday life, overselling of neurobiology, coercion, alternatives to the medical approach to psychiatry etc)
25. you get to work with some of the most disadvantaged, marginalized and disenfranchized individuals (particularly in correctional settings) if you choose to
26. lots of opportunities for innovation: for example developing new psychotherapies, or using tech to enhance patient care or develop and disseminate new treatments
27. psych lends itself well to telemedicine so you can if you so wish see pts from the comfort of your own home, or even from another country depending on the contract
28. i love group therapy - working with groups is a lot of fun, adds a layer of complexity to the work and more importantly can be immensely therapeutic and healing. if therapy is not your jam, then you can do group psychopharm visits which are becoming more popular
29. you definitely grow as a person in this field, confronted with so much of other people's issues forces you to confront your own
30. it is very difficult to get successfully sued as an outpatient psychiatrist
31. it is very easy to diversify you practice and switch jobs, patient populations, settings etc multiple times over your career or have a portfolio career working in multiple settings contemporaneously
32. there are lots of things besides clinical care you can do to (expert witness work, consulting, mediation, teaching, public education, writing, advocacy, policy, research, administration, clinical trials, utilization review, quality assurance, MRO [medical review officer] etc) to break up the monotony

I could go on, but you get the picture. It's not for everyone (most med students are not suited to it) and sometimes i miss being a real doctor but i'm really quite happy for the most part and feel the field provides enough intellectual stimulation for me.

Thanks for such a thorough and passionate response!

I'm down with the AMA idea 100%, not just for forensics but for psych and medicine in general. And no, you don't have to answer "anything" haha

 

[surfguy84]

omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:
1. you can spend as much time as you like doing evaluations (depending on the settings). In forensic evals I can spend the whole day just evaluating one person taking a complete detailed history of all sorts of things people have never told anyone before.
2. beyond getting a window into the mind of the delusional, neurotic, and personality disordered you learn how serial killers, rapists, pedophiles, white collar criminals, stalkers and so on think - compelling and disturbing at the same time
3. there's no one explanatory model for the kinds of problems we deal with that span the breadth of human misery from problems in living, to behaviors, to disorders of thought and emotion, to frank diseases of the brain. We draw on multiple explanatory models (neurobiological, psychodynamic, cognitive behavioral, systemic, social constructivist, social realist, cultural etc) to make sense of people's problems
4. psychopharmacology is fascinating - the effects of drugs on mental experiences is one of the most understudied and compelling aspects of our fields, and some of the more experimental treatments including ketamine, psilocybin, LSD, and MDMA have been gaining renewed attention
5. catatonia is eminently treatable and the results so dramatic it is incredibly satisfying to see someone go from non communicative or frenzied to alert and calm with a little ativan or electricity
6. we can take the paralyzed and hypnotize them out of it (if the paralysis is an hysterical symptom!) - again extremely satisfying to treat.
7. working with couples and families gives you a fascinating windows of how much pressure there is to enact our roles, and how you need to treat the whole system if you want to get someone better
8. we are masters of building expectancy and offering hope. so often we see patients who are written off as hopeless and recalcitrant but a little love and care and reformulating the patient go along way.
9. i love testifying in court and the sparring and jousting of a good cross-examination
10. i love providing a valuable service to the courts and attorneys by educating them about mental health problems, often helping people in very tangible and concrete ways
11. i love the philosophical aspects of the field - what is mental disorder? how to we conceptualize people? are psychiatric disorders disorders of the brain, and if so, how does this affect one's free will? how do psychiatric drugs shape the experience of the self? etc
12. i love stories. patients present with stories: narratives of disillusionment, disharmony and despair as well as ones of resilience and recovery
13. i love language. psychiatry is all about language - whether it is the fact that some carelessly and cruelly deployed words in childhood can alter someone's trajectory, or in their power to heal.
14. i love connecting with people - people i might never otherwise get to talk to, to interact with, and learn their life story. even the most ostensibly odious person can become likeable when you see their scars and vulnerabilities.
15. while we palliate most patients, there are some things we can cure. panic disorder, phobias, and PTSD are all eminently curable, often with short-term treatment)
16. lots of different fellowship/subspecialty opportunities available including pain medicine, palliaitive medicine, sleep medicine, neuropsychiatry, child psychiatry, geriatrics, psychoanalysis, psychological medicine, CBT, family/couples therapy, group therapy, eating disorders, psychosexual medicine, LGBTQ mental health, HIV, clinical informatics, occupational medicine/psychiatry, addiction medicine/psychiatry, brain stimulation etc etc
17. there is no shortage of jobs. even in saturated cities there is plenty of work for psychiatrists and this is unlikely to change anytime soon.
18. you get to spend your days talking about sex with your patients.
19. the mind-brain relationship is extremely fascinating - cognitive neurology is a particularly fascinating area
20. there are lots of research opportunities because there are so many unanswered questions in psychiatry and neuroscience
21. our textbooks dont really go out of date. I have all these books from 100 years ago or more that are still full of rich descriptions relevant to this day
22. while a lot of it can be depressing, some patients are absolutely f'ing hilarious and will have you howling with laughter
23. there are lots of criticisms and controversies in the field but we mostly tend to talk about these things in an open manner (e.g. influence of pharmaceutical companies, illness mongering, psychiatrization of everyday life, overselling of neurobiology, coercion, alternatives to the medical approach to psychiatry etc)
25. you get to work with some of the most disadvantaged, marginalized and disenfranchized individuals (particularly in correctional settings) if you choose to
26. lots of opportunities for innovation: for example developing new psychotherapies, or using tech to enhance patient care or develop and disseminate new treatments
27. psych lends itself well to telemedicine so you can if you so wish see pts from the comfort of your own home, or even from another country depending on the contract
28. i love group therapy - working with groups is a lot of fun, adds a layer of complexity to the work and more importantly can be immensely therapeutic and healing. if therapy is not your jam, then you can do group psychopharm visits which are becoming more popular
29. you definitely grow as a person in this field, confronted with so much of other people's issues forces you to confront your own
30. it is very difficult to get successfully sued as an outpatient psychiatrist
31. it is very easy to diversify you practice and switch jobs, patient populations, settings etc multiple times over your career or have a portfolio career working in multiple settings contemporaneously
32. there are lots of things besides clinical care you can do to (expert witness work, consulting, mediation, teaching, public education, writing, advocacy, policy, research, administration, clinical trials, utilization review, quality assurance, MRO [medical review officer] etc) to break up the monotony

I could go on, but you get the picture. It's not for everyone (most med students are not suited to it) and sometimes i miss being a real doctor but i'm really quite happy for the most part and feel the field provides enough intellectual stimulation for me.

#2 on your list is so damn interesting to me. I would love to do this. Is this like a side job you can take on in addition to a salaried position/private practice? Do you need a forensics fellowship to do so?

EDIT: just saw you do this part-time. How difficult is it to find this type of work?

 

[heroesjourney]

To add to the above--something you really only scratch the surface of in residency: long term continuity of care over years, even decades, with the same patients. You get to know them, become a significant influence in their lives, see their ups & downs, relapses and remissions.
Also the sense that I'm making the world a better place.

That's a great insight and a great profile picture. Are there particular mental illnesses that these life long patients tend to struggle with? Do you have any favorites? Is there anything you find enjoyable about non-clinical aspects of your work?

 

[OldPsychDoc]

That's a great insight and a great profile picture. Are there particular mental illnesses that these life long patients tend to struggle with? Do you have any favorites? Is there anything you find enjoyable about non-clinical aspects of your work?

Favorite illnesses? No. Favorite patients? Yes.
My long termers have the full spectrum of stuff--PTSD/borderline, schizoaffective on clozaril, recurrent major depression...some long-term maintenance of sobriety with buprenorphine.
Non-clinical--it will sound cheesy, but I love getting a group of residents and getting to be a part of their lives for 4 years. They're good people.

 

[AD04]

i still cant believe people pay me for this

I love this quote.

 

[Liquid8]

Psychiatrists, at least the ones I trained and work with seem more willing to help each other out compared to other specialities.

When one of my former supervisors found out I was starting out in private land, she was very happy to offer me her overflow referrals as her waiting list was ridiculous. I also remember one professor discussing a tricky patient who he had admitted in order to commence an unorthodox medication regime. Was very keen to for his peers to review the patient and give a second/third/fourth opinion before he started it.

I doubt you’d see this sort of thing happen in any procedural based speciality. Peers in those fields seem to take the stance that if you delay operating, then someone else will and the opportunity to make money disappears.

Psychiatry can also be tremendously satisfying and you can make a big difference in people’s lives.

Recently one of my patients cancelled their appointment, leaving a message that they’d got into some car trouble. This patient has terrible OCD - for a couple of years he was recluse and would spend over 15 hours a day in the bathroom with cleaning behaviours but has responded extremely well to medication.

Then I get another message from his mother – she’s rebooked another appointment for him, but would like to come in to see me if she can. My first thought is that he has relapsed, but when she arrives she is beaming, and says that she just wanted to tell me how great he is doing - he’s now studying at university and going for his driver’s licence. She tells me that he actually wanted to tell me himself, so “try and act surprised” the next time he comes.

 

[Achillees]

Psychiatrists, at least the ones I trained and work with seem more willing to help each other out compared to other specialities.

When one of my former supervisors found out I was starting out in private land, she was very happy to offer me her overflow referrals as her waiting list was ridiculous. I also remember one professor discussing a tricky patient who he had admitted in order to commence an unorthodox medication regime. Was very keen to for his peers to review the patient and give a second/third/fourth opinion before he started it.

I doubt you’d see this sort of thing happen in any procedural based speciality. Peers in those fields seem to take the stance that if you delay operating, then someone else will and the opportunity to make money disappears.

Psychiatry can also be tremendously satisfying and you can make a big difference in people’s lives.

Recently one of my patients cancelled their appointment, leaving a message that they’d got into some car trouble. This patient has terrible OCD - for a couple of years he was recluse and would spend over 15 hours a day in the bathroom with cleaning behaviours but has responded extremely well to medication.

Then I get another message from his mother – she’s rebooked another appointment for him, but would like to come in to see me if she can. My first thought is that he has relapsed, but when she arrives she is beaming, and says that she just wanted to tell me how great he is doing - he’s now studying at university and going for his driver’s licence. She tells me that he actually wanted to tell me himself, so “try and act surprised” the next time he comes.

Logged in to LOVE this. Thanks for sharing.

 

[Salpingo]

Psychiatrists, at least the ones I trained and work with seem more willing to help each other out compared to other specialities.

When one of my former supervisors found out I was starting out in private land, she was very happy to offer me her overflow referrals as her waiting list was ridiculous. I also remember one professor discussing a tricky patient who he had admitted in order to commence an unorthodox medication regime. Was very keen to for his peers to review the patient and give a second/third/fourth opinion before he started it.

I doubt you’d see this sort of thing happen in any procedural based speciality. Peers in those fields seem to take the stance that if you delay operating, then someone else will and the opportunity to make money disappears.

Psychiatry can also be tremendously satisfying and you can make a big difference in people’s lives.

Recently one of my patients cancelled their appointment, leaving a message that they’d got into some car trouble. This patient has terrible OCD - for a couple of years he was recluse and would spend over 15 hours a day in the bathroom with cleaning behaviours but has responded extremely well to medication.

Then I get another message from his mother – she’s rebooked another appointment for him, but would like to come in to see me if she can. My first thought is that he has relapsed, but when she arrives she is beaming, and says that she just wanted to tell me how great he is doing - he’s now studying at university and going for his driver’s licence. She tells me that he actually wanted to tell me himself, so “try and act surprised” the next time he comes.

I'll echo this. Psychiatry can sort of be like parenting -- when your patients do well, its an unbelievably proud moment, because there's a sense of shared accomplishment (working WITH them, not doing something TO them).

But it can be frustrating for that same reason. You have to put your trust in the patient that they will get themselves better, to some degree and with some assistance. In fact, I realized in residency that the more work I was putting into micromanaging a patient with disposition, after-treatment planning, etc., the more likely something would fall apart, because ultimately it was a sign that the patient was a passive participant (for whatever reason).

One thing to add to the general list -- psychiatry still offers a very open career path. Its much easier to change practice setting and type. You can work in a prison, while training in psychoanalysis and starting a private practice, with the option to pick up and return to academics.

 

[okokok]

I'm a fourth-year student who was very excited when I discovered psychiatry in third year, but lately I've been seriously questioning my career choice as in I'm in the middle of an uninspiring inpatient psych rotation where my attending barely interacts with patients, gives everyone a bipolar diagnosis, and prescribes Seroquel. (Not necessarily trying to imply he's not a good doctor--I'm definitely not in any position to judge that--just that it looks like it'd become super monotonous and uninteresting to me.) This thread, however, reminded why I was so excited to go into psychiatry after my awesome third-year clerkship--so thank you all for taking the time to share your thoughts!

Sent from my SM-N910P using Tapatalk

 

[OldPsychDoc]

omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:...
18. you get to spend your days talking about sex with your patients...

Let us clarify: Talking, with your patients, about sex.

Can't believe I didn't catch that one the first time through.
Although I wonder, did @splik have a reason for writing it the way he did?

 

[DisorderedDoc417]

baseline and f/u labs along with drug level for Li, VPA, tegretol? lipids and glucose with antipsychotics?

I didn’t know what the above guy was smoking either. I feel like we monitor more labs than GPs.

 

[Merovinge]

Since this is being necroed by OPD anyway...

Spilk's #29 is definitely in my top 3 (past the patients themselves and teaching). When I started residency I had so many character flaws like struggling with empathy, talking over people, not active listening to friends, hubris, some laziness, etc. The work helps not only put life into perspective but surrounds you with people interested in your personal growth as a human. Work is not emphasized over humanity and the lifestyle balance lets you take your 20's and make something special out of them. It's almost impossible to not become a better version of yourself in psychiatry and if you put active transport energy into it, the results can be dramatic.

 

[designed]

Merovinge, that really resonated with me. I'm just finishing up my fourth year at a Canadian medical school and matched to psychiatry. Psych is 5 years long in Canada, and I had been on the fence about family medicine vs. psychiatry (which is, committing to a 2 year vs. 5 year program). I had felt like I might be letting my life pass me by, as I'll be spending my 24-29 doing residency. I think it's reassuring to know that I'd still have work life balance, that somehow, life doesn't just -pause- when you're in residency.

 

[Crabbygas]

I am enjoying this thread. I frequently find myself wishing that I knew what psychiatrists know about human behavior. Unfortunately my med school psych department was insanely bad. For instance they insisted that admitted patients get a full physical by the med students and residents. That included a pelvic exam for all females. Sticking a speculum in a crazy depressed woman at 2 in the morning didn't really seem very therapeutic for anyone involved. I don't know what that reasoning was but I'm pretty sure there was something really wrong with it.

 

[chocomorsel]

omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:
1. you can spend as much time as you like doing evaluations (depending on the settings). In forensic evals I can spend the whole day just evaluating one person taking a complete detailed history of all sorts of things people have never told anyone before.
2. beyond getting a window into the mind of the delusional, neurotic, and personality disordered you learn how serial killers, rapists, pedophiles, white collar criminals, stalkers and so on think - compelling and disturbing at the same time
3. there's no one explanatory model for the kinds of problems we deal with that span the breadth of human misery from problems in living, to behaviors, to disorders of thought and emotion, to frank diseases of the brain. We draw on multiple explanatory models (neurobiological, psychodynamic, cognitive behavioral, systemic, social constructivist, social realist, cultural etc) to make sense of people's problems
4. psychopharmacology is fascinating - the effects of drugs on mental experiences is one of the most understudied and compelling aspects of our fields, and some of the more experimental treatments including ketamine, psilocybin, LSD, and MDMA have been gaining renewed attention
5. catatonia is eminently treatable and the results so dramatic it is incredibly satisfying to see someone go from non communicative or frenzied to alert and calm with a little ativan or electricity
6. we can take the paralyzed and hypnotize them out of it (if the paralysis is an hysterical symptom!) - again extremely satisfying to treat.
7. working with couples and families gives you a fascinating windows of how much pressure there is to enact our roles, and how you need to treat the whole system if you want to get someone better
8. we are masters of building expectancy and offering hope. so often we see patients who are written off as hopeless and recalcitrant but a little love and care and reformulating the patient go along way.
9. i love testifying in court and the sparring and jousting of a good cross-examination
10. i love providing a valuable service to the courts and attorneys by educating them about mental health problems, often helping people in very tangible and concrete ways
11. i love the philosophical aspects of the field - what is mental disorder? how to we conceptualize people? are psychiatric disorders disorders of the brain, and if so, how does this affect one's free will? how do psychiatric drugs shape the experience of the self? etc
12. i love stories. patients present with stories: narratives of disillusionment, disharmony and despair as well as ones of resilience and recovery
13. i love language. psychiatry is all about language - whether it is the fact that some carelessly and cruelly deployed words in childhood can alter someone's trajectory, or in their power to heal.
14. i love connecting with people - people i might never otherwise get to talk to, to interact with, and learn their life story. even the most ostensibly odious person can become likeable when you see their scars and vulnerabilities.
15. while we palliate most patients, there are some things we can cure. panic disorder, phobias, and PTSD are all eminently curable, often with short-term treatment)
16. lots of different fellowship/subspecialty opportunities available including pain medicine, palliaitive medicine, sleep medicine, neuropsychiatry, child psychiatry, geriatrics, psychoanalysis, psychological medicine, CBT, family/couples therapy, group therapy, eating disorders, psychosexual medicine, LGBTQ mental health, HIV, clinical informatics, occupational medicine/psychiatry, addiction medicine/psychiatry, brain stimulation etc etc
17. there is no shortage of jobs. even in saturated cities there is plenty of work for psychiatrists and this is unlikely to change anytime soon.
18. you get to spend your days talking about sex with your patients.
19. the mind-brain relationship is extremely fascinating - cognitive neurology is a particularly fascinating area
20. there are lots of research opportunities because there are so many unanswered questions in psychiatry and neuroscience
21. our textbooks dont really go out of date. I have all these books from 100 years ago or more that are still full of rich descriptions relevant to this day
22. while a lot of it can be depressing, some patients are absolutely f'ing hilarious and will have you howling with laughter
23. there are lots of criticisms and controversies in the field but we mostly tend to talk about these things in an open manner (e.g. influence of pharmaceutical companies, illness mongering, psychiatrization of everyday life, overselling of neurobiology, coercion, alternatives to the medical approach to psychiatry etc)
25. you get to work with some of the most disadvantaged, marginalized and disenfranchized individuals (particularly in correctional settings) if you choose to
26. lots of opportunities for innovation: for example developing new psychotherapies, or using tech to enhance patient care or develop and disseminate new treatments
27. psych lends itself well to telemedicine so you can if you so wish see pts from the comfort of your own home, or even from another country depending on the contract
28. i love group therapy - working with groups is a lot of fun, adds a layer of complexity to the work and more importantly can be immensely therapeutic and healing. if therapy is not your jam, then you can do group psychopharm visits which are becoming more popular
29. you definitely grow as a person in this field, confronted with so much of other people's issues forces you to confront your own
30. it is very difficult to get successfully sued as an outpatient psychiatrist
31. it is very easy to diversify you practice and switch jobs, patient populations, settings etc multiple times over your career or have a portfolio career working in multiple settings contemporaneously
32. there are lots of things besides clinical care you can do to (expert witness work, consulting, mediation, teaching, public education, writing, advocacy, policy, research, administration, clinical trials, utilization review, quality assurance, MRO [medical review officer] etc) to break up the monotony

I could go on, but you get the picture. It's not for everyone (most med students are not suited to it) and sometimes i miss being a real doctor but i'm really quite happy for the most part and feel the field provides enough intellectual stimulation for me.

Who are you? You are my new jam. Lol

 

[calvnandhobbs68]

I am enjoying this thread. I frequently find myself wishing that I knew what psychiatrists know about human behavior. Unfortunately my med school psych department was insanely bad. For instance they insisted that admitted patients get a full physical by the med students and residents. That included a pelvic exam for all females. Sticking a speculum in a crazy depressed woman at 2 in the morning didn't really seem very therapeutic for anyone involved. I don't know what that reasoning was but I'm pretty sure there was something really wrong with it.

People don’t get that thorough of physical exams for medicine admissions wtf. Your med school sounds messed up.

 

[LadyHalcyon]

omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:
1. you can spend as much time as you like doing evaluations (depending on the settings). In forensic evals I can spend the whole day just evaluating one person taking a complete detailed history of all sorts of things people have never told anyone before.
2. beyond getting a window into the mind of the delusional, neurotic, and personality disordered you learn how serial killers, rapists, pedophiles, white collar criminals, stalkers and so on think - compelling and disturbing at the same time
3. there's no one explanatory model for the kinds of problems we deal with that span the breadth of human misery from problems in living, to behaviors, to disorders of thought and emotion, to frank diseases of the brain. We draw on multiple explanatory models (neurobiological, psychodynamic, cognitive behavioral, systemic, social constructivist, social realist, cultural etc) to make sense of people's problems
4. psychopharmacology is fascinating - the effects of drugs on mental experiences is one of the most understudied and compelling aspects of our fields, and some of the more experimental treatments including ketamine, psilocybin, LSD, and MDMA have been gaining renewed attention
5. catatonia is eminently treatable and the results so dramatic it is incredibly satisfying to see someone go from non communicative or frenzied to alert and calm with a little ativan or electricity
6. we can take the paralyzed and hypnotize them out of it (if the paralysis is an hysterical symptom!) - again extremely satisfying to treat.
7. working with couples and families gives you a fascinating windows of how much pressure there is to enact our roles, and how you need to treat the whole system if you want to get someone better
8. we are masters of building expectancy and offering hope. so often we see patients who are written off as hopeless and recalcitrant but a little love and care and reformulating the patient go along way.
9. i love testifying in court and the sparring and jousting of a good cross-examination
10. i love providing a valuable service to the courts and attorneys by educating them about mental health problems, often helping people in very tangible and concrete ways
11. i love the philosophical aspects of the field - what is mental disorder? how to we conceptualize people? are psychiatric disorders disorders of the brain, and if so, how does this affect one's free will? how do psychiatric drugs shape the experience of the self? etc
12. i love stories. patients present with stories: narratives of disillusionment, disharmony and despair as well as ones of resilience and recovery
13. i love language. psychiatry is all about language - whether it is the fact that some carelessly and cruelly deployed words in childhood can alter someone's trajectory, or in their power to heal.
14. i love connecting with people - people i might never otherwise get to talk to, to interact with, and learn their life story. even the most ostensibly odious person can become likeable when you see their scars and vulnerabilities.
15. while we palliate most patients, there are some things we can cure. panic disorder, phobias, and PTSD are all eminently curable, often with short-term treatment)
16. lots of different fellowship/subspecialty opportunities available including pain medicine, palliaitive medicine, sleep medicine, neuropsychiatry, child psychiatry, geriatrics, psychoanalysis, psychological medicine, CBT, family/couples therapy, group therapy, eating disorders, psychosexual medicine, LGBTQ mental health, HIV, clinical informatics, occupational medicine/psychiatry, addiction medicine/psychiatry, brain stimulation etc etc
17. there is no shortage of jobs. even in saturated cities there is plenty of work for psychiatrists and this is unlikely to change anytime soon.
18. you get to spend your days talking about sex with your patients.
19. the mind-brain relationship is extremely fascinating - cognitive neurology is a particularly fascinating area
20. there are lots of research opportunities because there are so many unanswered questions in psychiatry and neuroscience
21. our textbooks dont really go out of date. I have all these books from 100 years ago or more that are still full of rich descriptions relevant to this day
22. while a lot of it can be depressing, some patients are absolutely f'ing hilarious and will have you howling with laughter
23. there are lots of criticisms and controversies in the field but we mostly tend to talk about these things in an open manner (e.g. influence of pharmaceutical companies, illness mongering, psychiatrization of everyday life, overselling of neurobiology, coercion, alternatives to the medical approach to psychiatry etc)
25. you get to work with some of the most disadvantaged, marginalized and disenfranchized individuals (particularly in correctional settings) if you choose to
26. lots of opportunities for innovation: for example developing new psychotherapies, or using tech to enhance patient care or develop and disseminate new treatments
27. psych lends itself well to telemedicine so you can if you so wish see pts from the comfort of your own home, or even from another country depending on the contract
28. i love group therapy - working with groups is a lot of fun, adds a layer of complexity to the work and more importantly can be immensely therapeutic and healing. if therapy is not your jam, then you can do group psychopharm visits which are becoming more popular
29. you definitely grow as a person in this field, confronted with so much of other people's issues forces you to confront your own
30. it is very difficult to get successfully sued as an outpatient psychiatrist
31. it is very easy to diversify you practice and switch jobs, patient populations, settings etc multiple times over your career or have a portfolio career working in multiple settings contemporaneously
32. there are lots of things besides clinical care you can do to (expert witness work, consulting, mediation, teaching, public education, writing, advocacy, policy, research, administration, clinical trials, utilization review, quality assurance, MRO [medical review officer] etc) to break up the monotony

I could go on, but you get the picture. It's not for everyone (most med students are not suited to it) and sometimes i miss being a real doctor but i'm really quite happy for the most part and feel the field provides enough intellectual stimulation for me.

Forensic evaluations are amazing! I'll have to agree with you on group therapy, ick. But I do love couples and family therapy.

Sent from my SM-G950U using SDN mobile

 

[Crayola227]

I didn’t know what the above guy was smoking either. I feel like we monitor more labs than GPs.

um no, sorry

 

[DisorderedDoc417]

um no, sorry

I guess you’re right. Some psychiatrists don’t monitor things correctly.

 

[mymembernames]

- strong patient relationships
- great work/life balance
- reasonable income
- all cash practice options
- diversity of work environments
- longer appointments
- lots of respect in the community

Really? Have had kinda the opposite experience when I mention my interest in psych...

 

[TexasPhysician]

Really? Have had kinda the opposite experience when I mention my interest in psych...

That’s because you are in medical school. This is the time when everyone has an opinion about their specialty (good and bad) and try to impact future generations. Stigma is huge against everyone. I never found a single specialty that was respected across all fields at my university center.

Once you are in the real world, physicians are generally very collegial and enjoy making connections in psychiatry. Many are jealous of our hours. Most people in the public that I meet seem to be excited and have plenty of questions. I’ve yet to hear a negative comment since residency.