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Medical Education
Medical Student Education

Career Information: Psychiatry

Specialty: Psychiatry

Completed by: Amin Azzam, Andrew Booty, Rob Daroff

Date completed/updated: Summer 2012

  1. What can students do in the 1st and 2nd years to explore and/or prepare for this career?
    Consider being active in the UCSF Psychiatry Student Interest Group. Talk to any of the psychiatrists who are involved in the Essential Core curriculum (there are several). Learn more by joining national psychiatry organizations, such as the American Psychiatric Association (http://www.psychiatry.org/), or the American Academy of Child & Adolescent Psychiatry (http://www.aacap.org/). A very useful informational website about psychiatry as a discipline is http://www.psychiatry.org/medical-students. See additional sites listed in #11 below.

  2. What common variations exist in the length/content of residency programs for this career?
    Most psychiatry residencies are four years long. There are a few programs that accept residents in their PGY-2 year (e.g. after completing a separate internship), but the majority include the intern year as part of the initial application process.

  3. What common variations exist in this career after training?
    The field is incredibly diverse, so there are a wide variety of ways to discuss “variations” in psychiatry. One axis is to consider location of practice (e.g. individual private practice, small groups, independent hospitals, large healthcare systems (e.g. Kaiser), and academic medical centers). Another axis is the location of patient care (e.g. inpatient, partial hospitalization, entirely outpatient). A third axis is the number of patients seen in any specific session (e.g. individual, couples, or groups). A fourth axis is the focus of treatment (e.g. psychotherapy, medication management, combination). Of course, there are also sub-specialties that require additional fellowship training after residency (i.e. child psychiatry, geriatrics, forensics, addiction, psychosomatic, public psychiatry, others). All of these axes can be combined in whatever ways individual psychiatrists find most fulfilling. It is also worth explicitly stating that there are psychiatrists who elect to work less than full-time, and/or work for more than one employer.

  4. What is a typical work day for someone in this field?
    Typical very much depends on what variation(s) any given psychiatrist elects to pursue (see question #3 above). One psychiatrist might engage in a combination of outpatient medication management and psychotherapy patient visits all day, while another is an entirely inpatient psychiatrist. Another might be conducting laboratory or clinical research on the biologic basis of a particular disorder, while another psychiatrist is working in a psychiatric emergency facility. Though there are always exceptions, in general work days are reasonably stable with predictable hours.

  5. What is the culture of this career?
    The culture of this career, although varied like any specialty, tends to be on the more laid back end of the spectrum. People do not tend to go into psychiatry as a means of achieving vast fame or fortune, but instead tend to see it as a calling. Inherent within psychiatric illnesses are often slow changes over time and along with this, longterm, intense relationships with patients, so psychiatrists tend to be patient and fairly relaxed. To be sure, psychiatry can be quite stressful, in particular if one chooses to work with more acutely ill patients. However, there are many choices of career path within psychiatry, so one can choose to be a part of a busy, acute inpatient unit or ER, or a more calm, predictable outpatient practice, for example, so to some degree one can determine a sub-culture for himself or herself.

  6. How compatible is this career with raising a family? How is this different for men and women?
    Psychiatry offers a great deal of flexibility in terms of career options, from very full time inpatient or consultation work plus private practice to part time private practice or ER work; one can truly construct a schedule as calm or as busy as one may like.

  7. What are the most important qualities or character traits for a person in this field?
    As is perhaps obvious, being a patient, good listener is key, whether one is doing medication management or psychodynamic psychotherapy. Very much related to this, curiosity is quite important, whether one is in private practice or in a research setting; being genuinely interested in understanding your patients’ experiences is key to any doctor/patient relationship. Psychiatry is less exact a science than many fields, so one must be flexible and creative at times in treatment approaches.

  8. How competitive are the residency programs in this field?
    Like most everything else, this varies depending on the location and size of the program. Applicants who are UCSF med students already start off very competitive because of our school's national reputation. If you have no blemishes on your record in the first two years and have done well in clinical rotations, you should go into the process feeling competitive anywhere in the country. Of course it helps to honor in clerkships and electives, particularly in psychiatry, but it is by no means a requirement. Programs know that our student body is incredibly competitive and that we don't grade inflate. Demonstrating leadership skills, passion for the work, and strong interpersonal skills are at least as important as grades for the most competitive programs. If you are definitely headed for a research career in psychiatry, that also scores lots of points.

  9. How competitive is the job market after residency?
    This really depends on how picky you are—if you only want to do a highly specialized niche within psychiatry (like specializing in transcranial magnetic stimulation [TMS]), then you may need to very flexible about where you end up living. If your interests are more general, you will be in demand and will likely be able to live and work anywhere. A significant percentage of psychiatrists open up at least a part-time private practice, and depending on the market, those practices seem to thrive. Public sector psychiatry including city, county, federal, and forensic positions seem to always be available, even in otherwise saturated markets like the Bay Area.

  10. What programs have been popular among UCSF applicants, or how should applicants go about considering programs?
    This is a tough one. The good news is that there are many outstanding programs out there like UCSF, UCLA, MGH, and Columbia among many others. Programs vary quite a bit in terms of size, focus, depth of faculty, opportunities for continuity, and emphasis on biological vs psychotherapeutic interventions. The selection process for you is therefore unique to your interests and learning style. I would also emphasize the importance of location: psychiatry residency training is stressful, and being in a program where you feel you will be jive well with your classmates and supervisors and feel at home in the city is very important for thriving. Ask yourself if it is a program and a city where you would be able to do the things you need to do for self-care and relaxation, and are the people you'll be working with people you can relate to and enjoy.

  11. What resources (eg, websites, books, professional groups) would you recommend for students interested in learning more about this field?
    The psychiatry training directors' organization (AADPRT) has a document titled "General Psychiatry Residency Application Process Guidelines" which is a helpful read for the application, interview, and match process. Their website (http://www.aadprt.org/) has a whole section for students and residents. The American Psychiatric Association (APA) (www.psychiatry.org) has some useful general info about the field, including some video interviews with psychiatrists practicing in a variety of treatment settings (see http://www.psychiatry.org/about-apa--psychiatry/more-about-psychiatry/more-about-psychiatry- ). Most importantly, talk to as many residents and practicing psychiatrists as possible to learn more about the life and why it is such a special field within medicine.

  12. How important is each the following for admission to a competitive program?

 

Very Important

Somewhat Important

Not Important

Comments

Extracurricular/
volunteer work

x

 

 

 

Research/publications

 

x

 

 

Honors in third year

 

x

 

 

AOA

 

x

x

 

Subinternship

x

 

 

 

Externship

 

x

 

 

 

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