Thursday, May 3, 2012

Why I Didn't Do Psychiatry

In some ways, psychiatry is sort of similar to PM&R. For one thing, psychiatry and physiatry sound really similar. They are both pretty laid back, have good hours, not too competitive, great pay. When my psychiatry rotation started and the hours were 8 to 5 with weekends off, I thought, "Hey, I could get used to this."

I thought most of the psychiatrists I worked with were really cool. And there was an abundance of great stories. I was never bored on my psych rotation. And I actually had a knack for it, I think.

So what went wrong?

1) I like procedures and psychiatry is one field where you really don't get to do any procedures.

2) My father is a psychiatrist and told me repeatedly, "Don't become a psychiatrist."

3) I don't know if I believe in a lot of the medical interventions psychiatrists do. Unlike physiatric interventions like TENS units, which are, of course, rigorously supported by randomized controlled trials.

4) Maybe it's because it was my first rotation, but I just found psychiatry really sad. I remember calling my mother crying one night because I felt sorry for my patients. I suspect I would have gotten over this though.

5) When I was on my psychiatry rotation, I spent much of the rotation scared that I was going crazy.

Actually, #5 was probably my most important reason for not doing psychiatry. After talking to a string of schizophrenics, I literally started to worry that I was going crazy, and wondering what set me apart from my patients. I was about the right age for a schizophrenic break. I was so relieved when the rotation ended and I got to do inpatient renal, because I was pretty sure I didn't have kidney failure.

14 comments:

  1. I recall having similar thoughts about psych nursing. I actually told one of the preceptor psych nurses that I "couldn't do that area because I would be too good at getting into people's heads" she didn't understand what I meant by that.. I think she took it as an affront that I didn't think she was good at that at all. What I meant was, being so sympathetic to someone's pain pulls you into it. You try to understand it and think about it so much that their irrational fears and thoughts can actually become your own. I also hated the unnatural way a psych nurse has to communicate with said pts. (no "why" questions, don't offer suggestions, just ask questions so the patient gives more information) I still get some psych and I love helping the occasional pt. here and there, but.. all day every day?? no thanks.

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  2. I also dont like Psychiatry. It was my first rotation too- so I was pretty much interested but didnt get to do anything- like you said it has no procedures. Also, I have had some bad experiences with Psychi patients- one Mania patient kicked me hard in the shin in the emergency, one Schizophrenic threatened to stab me to death. So, I knew I couldnt handle crazy (sorry for the word, but yea that is what they are- crazy and me calling them crazy is another proof to the fact that Iam not fit to be a psychiatrist!)

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  3. Haha, this post is awesome! Especially since I just started psych as my first rotation this week! I have a lot of these same feelings so far. I absolutely love interacting with the patients so far, but I don't think I could see myself doing this long term? Oh well, at least I'll enjoy the 8 weeks!

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  4. #2 - what are your father's reasons?

    #5 - care to share some of those stories? i am curious what kind of talk you had with the patients to make you question what set you apart from them.

    i am not in the med field, but just curious and find this post interesting, thanks for sharing :)

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  5. I thought I wasn't going into psychiatry. I was wrong.

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  6. Psychiatry rounds were definitely interesting and fun for everyone, but when it comes to pursuing it, most people want to back out. For me, the deciding factor was because the patients just got really clingy, and some of the male patients kissed me, hugged me, or insisted I check out their penis. :/
    I don't think I could deal with such needy behavior in the long run.

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  7. I haven't had my psychiatry rotation yet, but I'm so scared of it. I have a few friends who were attacked by psych patients on rounds, and then quite a few who were very touched and saddened by their patients. But I think the lack of procedures will annoy me too.

    P.S: It seems that most doctor-parents tell their kids not to go into their specialty :P

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  8. Fizzy, I can totally picture you someday writing a "Why I didn't go to (...)" and, as you think about the list of reasons you suddenly realize you'd have wanted to follow something else instead of PM&R.

    ...although I seriously hope this won't happen - you seem to love your job.

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  9. when i was posted in psychiatry,the patient came and touched my feet ,telling that he can see God in me!! he knew so well how to make a person feel special.
    i never went near the ward again,stuck to opd only!! and yes personalisation was my problem as well.

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  10. I work at a mental hospital while I'm waiting to start med school...my thoughts EXACTLY! I thought I heard voices the other day. Ended up just being a patient screaming in his room down the hall. Phew!

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  11. my friend is an intern on her psych rotation. she's scared cos a patient is fixated on her. he insists she's his long lost daughter who he abandoned 20 years ago, & gets frustrated when she shows no signs of believing him or "forgiving" him

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  12. I'm glad that none of these reasons apply to me, since it would be really hard for me to switch my specialty choice one month before my ERAS application goes out...

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  13. Be careful about choosing psychiatry. Now days it is near impossible for a Psychiatrist have a job doing anything but prescribing medications....instead of helping people understand life better and learn change...very sad state of psychiatry.

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  14. I am a patient and would love to see a psychiatrist who cares and knows about treatments other than pills. We all make choices for our own reasons, i got overwelmed thinking of what it takes to be any doctor, so congradulations!

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