I'll go ahed and chime in: I would absolutely choose psychiatry if I had to do it again. (And I am a picky person.)
However, I've had the good fortune of creating a successful private practice. It came at the expense of a lot of hard work though.
If you're curious, here are some stats. I'm located in a major metropolitan area in California. I am only a few years out of residency. I work probably about 40 hours/week (sometimes more), and income is about 500-700,000/year (yes, you read that correctly). Although I was reluctant to specify my income, I did so because I want young/interested people to know that the "median salary" of 180k (or whatever pathetic figure it is) isn't always right. A colleague of mine makes bw $1-1.5M/year (but he is running basically a pill mill, which I would not conscionably do). Minimum appt is 25 min and up to 90 mins, so I am definitely not running a pill mill.
My work is extremely interesting and intellectually stimulating. Patients are generally intelligent and motivated to improve. I see a wide variety of ages and diagnoses, which is great. I am lucky enough to not have a ton of hardcore personality disorder cases. My patients and their families are generally very grateful and appreciative. I'm well regarded by colleagues - but perhaps if I were in a backwards part of the country then I would be disrespected. But here in CA, I often see the family members of fellow physicians, etc. Psychiatry is really well regarded here. My patient load is absolutely great - ranging from creative people (filmmakers, actors, musicians, writers), entrepreneurs & highly successful businesspeople, other professionals (physicians, laywers) to students and young adults. I have a sliding scale for needy patients - not being I need to, but because I want to.
Downsides? Honestly, none are specifically related to psychiatry. If anything, sometimes I wonder what it'd be like in some other high-stimulus field (eg TV work, business of health/care, or law). I basically *never* wonder about other specialties. Then again, if I were trapped in some awful county job with hardcore schizophrenics trying to bite me etc (and making 150k doing it), I'm sure I would. Hmm.. I guess downsides would include typical "psych" ones, like how it is a field of opposites - sometimes the people who need meds the most need pursuading but refuse (would someone refuse meds for cardiac or cancer reasons? rarely).. there is still a bit of a stigma (but honestly not much here in CA).. also, certain patients can be real tough (especially if it's combo of severe Axis 1 + 2 +3).
Again, I'm fortunate in that I have been able to create for myself a wonderful setting (which has turned out to be successful financially). The reason? I can only speculate that I've created a "product" that people and their families really value and appreciate, because they keep coming back, and refer their friends & family, etc. Why some people complain about their salary (or any other metric) -- in any specialty -- is beyond me. If that's the case, then get off your butt and find a better job. Or better yet, make one. Quit passively complaining. And for anyone wanting to be skeptical of my listed salary - although I've created a successful practice, I am nothing special. It's not like I am seeing just the uber-wealthy, etc. I wish I could explain the details of my practice model - but I want to remain anonymous, and frankly, I do not want to give out my secrets. To those people who are critical of individuals who don't willingly publicize their secrets: get a life and go figure out the secrets yourself. You will take hard knocks along the way, but you'll figure them out. In any case, I would consider this sorta the upper end of what one can realistically hope to make in CA as a psychiatrist in private practice (if want more, they'd have to be marketing/business masters + work a ton + open a rehab/clinic/program of some sort). I don't think a ton of psychiatrists make this amount, but to be honest - I don't really know because friends don't ask each other their income, really.
Anyway, it's a potentially great field. You develop long-lasting relationships with people and you see the results of your efforts. You watch people improve literally in front of your eyes. For those in med school or residency: try not to judge the field based on your one possibly crappy rotation. Rotations are on inpatient units where people are involuntary hospitalized and pissed because of that (wouldn't you be?). You barely get to see outpatient psychiatry, which is the setting that 95% of psychiatrists work in.
Would I want to be a psychiatrist somewhere like Indiana, Texas, Louisiana, etc? Hell no (working against the grain of high stigma, low professional respect, low income, etc) If I'm wrong on those assumptions, then sorry. Would I want to be a radiologist? Sure they make great money. But staring at a computer screen & dictating all day? Please shoot me. IM/subspecialty? Chase sodiums all day - no thanks. In the grind of surgery? Stressed with little sleep, chronically pissed off etc Haha shoot me twice. Neurology always seemed interesting but too boring/bookish. Pain management might have been cool. Although derm/plastics could be mildly neat from a creative aspect, cosmetic work would be superficial to me.
That's just my opinion. I hope it helps at least someone. Feel free to message me with any questions. But to be honest, I never really take the time to post on here. Good luck, everyone.
I keep thinking that I might be better suited to a public health career where I could actually maybe make a difference at fixing the systems level problems that make dealing with individual level stuff so frustrating. But I haven't been able to figure out how to figure out if that job exists, how to get trained for it, and how much I'd get paid to do it. Plus the thought of going back to school or into training . . . I kind of like my attending salary and free time a bit too much for those options to sound pleasant. I don't necessarily like what I think that says about me, but there you go.
