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deleted966724
Hello everyone, first time poster (but long-time lurker)!
Disclaimer: I've read basically ALL the threads on Applying to Psychiatry on "Psych vs neurology/IM/FM" and "Defending Psychiatry/Choosing Psychiatry", so it's not like I didn't search for answers...
Disclaimer 2: English is not my mother tongue, so a lot of sentences may sound a little off...
So, I've been having the toughest time this last few months deciding what to do with my life. I'm already matched (not the most correct term, since I'm not American, but whatevs) in IM since 2018, and "locked" my spot to work as a doctor in the military...my service will finish in weeks, and I will start my residency in two months. The thing is: I'm not really sure if I want to pursue IM, or have a shot at Psychiatry...
During all my medschool, sometimes I considered Psych, but shrugged it off because I always thought the professional was a pill-pusher with very poor and badly defined diagnostic tools. But this year, since I've been exposed to a lot of patients with mental illnessess, I think my view has changed: not only is the pharmacology hard and intricate, but the drugs alone won't do the trick - you need to have a very strong doctor-patient relationship, explain side-effects, listen, negotiate...and on top of that, there is the possibility of doing psychotherapy (or at least using bits of it on the more "med checks" side), something I've always liked.
The thing I enjoy the most is being able to listen to the stories of the people: in medschool, I've always volunteered to do the initial interview, because I could take my time, think, ask questions, listen, and enjoy my time with the patient. Also, I've always been interested in the mind, the psychology of things, and have read a lot about the subject.
Recently, I decided to give Psych a shot, and started exploring the material: there is SO MUCH to see and learn...from defense mechanisms on the more psychodynamic side, to the intricate mechanism of the SSRI's and it's applications...When I went back to the IM material, I felt it was "boring" and very...I dunno, algorithm/linear, didn't leave space for abstractions and subjectivity, which I enjoy very much.
Soooooo, from the way I worded things, it seems Psych is an easy choice, but there is so much in the field that eeks me: the hard patients are REALLY REALLY hard, and often have socioeconomic and familial problems that seem to simply be out of the scope of the psychiatrist, who can only raise the dosage of pt's Wellbutrim's and hope for a change. Also, the DSM is reducionistic and very flawed, specially in the less acute/psychotic patients...it seems that I'm trying to pidgeonhole people in categories that are empiric and essencialy atheoric, using flawed medications in a more or less "try and see" aproach, with sometimes severe side-effects....And finally, I worry that I can become emotionally exhausted after listening to people tell their intimate and complicated emotional problems all day, everyday...
I can say one thing, thought: the way a shrink thinks and elaborates problems is SO different from the rest of medicine - you need to have a lot of sensitivity to ask difficult questions, and kind of think in a more "lateral" fashion, since the very nature of the problem is one of subjectivity. Also, the hours and pay is amazing - althought I'm kinda idealistic, and don't want to decide based on that, it should be taken in consideration.
Phew, a true wall of text, sorry about that - at least it helped me organize my thoughts a little better...
Disclaimer: I've read basically ALL the threads on Applying to Psychiatry on "Psych vs neurology/IM/FM" and "Defending Psychiatry/Choosing Psychiatry", so it's not like I didn't search for answers...
Disclaimer 2: English is not my mother tongue, so a lot of sentences may sound a little off...
So, I've been having the toughest time this last few months deciding what to do with my life. I'm already matched (not the most correct term, since I'm not American, but whatevs) in IM since 2018, and "locked" my spot to work as a doctor in the military...my service will finish in weeks, and I will start my residency in two months. The thing is: I'm not really sure if I want to pursue IM, or have a shot at Psychiatry...
During all my medschool, sometimes I considered Psych, but shrugged it off because I always thought the professional was a pill-pusher with very poor and badly defined diagnostic tools. But this year, since I've been exposed to a lot of patients with mental illnessess, I think my view has changed: not only is the pharmacology hard and intricate, but the drugs alone won't do the trick - you need to have a very strong doctor-patient relationship, explain side-effects, listen, negotiate...and on top of that, there is the possibility of doing psychotherapy (or at least using bits of it on the more "med checks" side), something I've always liked.
The thing I enjoy the most is being able to listen to the stories of the people: in medschool, I've always volunteered to do the initial interview, because I could take my time, think, ask questions, listen, and enjoy my time with the patient. Also, I've always been interested in the mind, the psychology of things, and have read a lot about the subject.
Recently, I decided to give Psych a shot, and started exploring the material: there is SO MUCH to see and learn...from defense mechanisms on the more psychodynamic side, to the intricate mechanism of the SSRI's and it's applications...When I went back to the IM material, I felt it was "boring" and very...I dunno, algorithm/linear, didn't leave space for abstractions and subjectivity, which I enjoy very much.
Soooooo, from the way I worded things, it seems Psych is an easy choice, but there is so much in the field that eeks me: the hard patients are REALLY REALLY hard, and often have socioeconomic and familial problems that seem to simply be out of the scope of the psychiatrist, who can only raise the dosage of pt's Wellbutrim's and hope for a change. Also, the DSM is reducionistic and very flawed, specially in the less acute/psychotic patients...it seems that I'm trying to pidgeonhole people in categories that are empiric and essencialy atheoric, using flawed medications in a more or less "try and see" aproach, with sometimes severe side-effects....And finally, I worry that I can become emotionally exhausted after listening to people tell their intimate and complicated emotional problems all day, everyday...
I can say one thing, thought: the way a shrink thinks and elaborates problems is SO different from the rest of medicine - you need to have a lot of sensitivity to ask difficult questions, and kind of think in a more "lateral" fashion, since the very nature of the problem is one of subjectivity. Also, the hours and pay is amazing - althought I'm kinda idealistic, and don't want to decide based on that, it should be taken in consideration.
Phew, a true wall of text, sorry about that - at least it helped me organize my thoughts a little better...
