Memo to Medical Students: It’s a Great Time to Be a Psychiatrist

It won’t be too long before I graduate from my residency in adult psychiatry.  As I survey my options for post-graduation, I’m excited by the many opportunities I see. 

The classic reasons to choose psychiatry have not changed. Psychiatry allows you to really get to know your patients, and helping to alleviate their suffering feels satisfying.  Psychiatry touches on diverse disciplines from philosophy to endocrinology, and it requires subtlety and skill. 

In my opinion, psychiatry is one of the more introverted specialties – though extroverted psychiatrists certainly exist!  In training we are encouraged to reflect upon our own role in patient interactions, which can lead to greater self-awareness and personal growth. Some psychiatrists are so content that they practice into old age. 

In terms of research, now is an exciting time for psychiatry. Advances in neuroscience are creating breakthroughs in our understanding of mood, cognition, and behavior. Tools like neuroimaging are helping to illuminate brain pathways and validate treatments, including psychotherapies. (The Human Connectome Project is currently mapping every neural circuit in the brain.) 

Neurotransmitters such as glutamate and receptors such as the NMDA receptor are emerging as relevant players. Brain stimulation therapies like transcranial magnetic stimulation are becoming available, as well as neurosurgical interventions such as deep brain stimulation. Early research is exploring the potential of psychedelic drugs such as ketamine and psilocybin. Gut bacteria may mediate the relationship between stress, inflammation, and mood. And dozens of compounds are currently being evaluated for the treatment of Alzheimer’s disease. 

Currently, a high demand for psychiatrists and flux in the healthcare system are creating new and interesting opportunities for psychiatrists to learn, contribute, and lead.  Shortages of psychiatrists are marked in rural and inner-city areas, especially for child and geriatric psychiatrists.  To attract clinicians, the federal government and other organizations are offering loan repayment programs and raising salary ceilings. 

In the future, more psychiatrists will work closely with primary care physicians, both side-by-side and as consultants.  I like the idea of providing mental health leadership to a system of providers – not just seeing patients, but also educating primary care physicians, mid-level practitioners, case workers, and therapists. For those interested in policy or advocacy, there is much to be done in the sphere of mental health. The practice of telepsychiatry is also growing.  Imagine seeing all your patients from home!  

Psychiatrists work in many diverse settings that include residential treatment centers for teens, jails and prisons, eating disorder treatment centers, and nursing homes.  Forensic psychiatrists evaluate accused persons and function as expert witnesses in court.  Community psychiatrists work with teams of case managers to provide mental health care for the homeless and underprivileged.  Sleep doctors treat sleep disorders and run sleep labs.  Psychosomatic (aka Consult/Liaison) psychiatrists see medical/surgical inpatients.  Geriatric psychiatrists evaluate and treat late-life psychiatric syndromes. And researchers work for academic or private organizations creating and disseminating knowledge. 

Many medical students are concerned about lifestyle.  Psychiatrists earn an average of $186,000 annually and many work 40 hours per week or less.  Most psychiatrists practice in the outpatient setting .  Work hours appear to be negotiable: I know one colleague who works 80% time and another who takes extra call at a generous hourly rate.  Subspecialists– especially forensic, child, and geriatric - tend to earn more. 

Psychiatry is a fascinating specialty, in great demand.  It has much to offer both for future clinicians as well as those who are planning academic careers. Although not the most lucrative of medical specialties, psychiatry also provides substantial psychic rewards of being able to help a highly vulnerable, needy, but appreciative patient population. 

Are you happy with your decision to go into psychiatry? What piece of advice was most important to you when you were deciding whether to pursue psychiatry as a specialty? 

Leigh Jennings, MD, is a senior psychiatry resident in the Department of Neurology and Psychiatry at Saint Louis University School of Medicine.

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors.