“Don’t take up Psychiatry. You’ll end up like your patient eventually.” That was the response from a very senior doctor when I mentioned I was considering Psychiatry for my post-graduation after MBBS. This was one of the most daunting reactions I received. Casual comments like, ‘Why not choose a “good” speciality?’ or ‘It’ll be hard to get you married’ are common.
I chose Psychiatry because I found it fascinating. Among the various specialities we worked on during Internship, Psychiatry was the one I enjoyed the most. Maybe it’s because I wanted to understand people’s experiences and perspectives. I wanted to learn about how our minds work and why people behave the way they do. My enthusiasm was also fueled by my wonderful teachers. I remember staying long after the OPs were supposed to end, to watch them in action. By then, I was set on becoming a psychiatrist. No other speciality gave me that same thrill. So, if you feel a similar calling for any speciality during your internship, better go for it. It often leads to greater job satisfaction. However, do consider other factors like money, work-life balance, and family needs before making your final decision.
My goal here is to provide some insight for those considering Psychiatry as a post-graduate option. I hope you find this helpful. If this article also helps non-medicos better understand psychiatrists, that would be a bonus.
Psychiatry is more than just couch talk:
A psychiatrist primarily treats people with emotional difficulties, addictions, or behavioural changes, either on an outpatient basis or in an inpatient hospital setting. Treatment involves pharmacotherapy and psychotherapy. Knowledge of other areas like neurology, general medicine, and gastroenterology is pivotal.
Essential traits needed for a Psychiatrist:
Patience: Psychiatry relies heavily on patient history and mental status examination, which takes time. Patients expect you to listen to their concerns fully, and improvements in their conditions often happen gradually. Some may not improve significantly, requiring a reassessment and potential adjustment of treatment strategies.
Listening Skills: Patients come to you ready to share their worries. It’s important to listen actively, read between the lines, and identify what’s troubling them most.
A “Let It Go” Attitude: Some patients might openly express their reluctance to see a psychiatrist, and colleagues might not always be supportive. We can’t do much about it. There’s a certain stigma associated with Psychiatry, but attitudes are improving.
Why choose Psychiatry- The upsides:
Better Work-Life Balance: This is a significant advantage. Generally, psychiatrists have fewer night calls and off-duty day calls compared to other specialities, especially if you’re not working in a high-demand psychiatric care centre.
Spare Time: You can use this time to nurture other interests, which can improve your mental health and well-being and help you manage stress. It’s also an opportunity to earn a secondary income through business, trading, or other talents.
Lower Chances of Litigation: Psychiatry is less prone to litigation compared to high-risk specialities like surgery or obstetrics. This reduces the likelihood of legal troubles arising from patient care.
Philosopher in Disguise: If you enjoy philosophy, art, psychology, storytelling, or poetry, Psychiatry offers a fulfilling career that keeps you engaged with interesting daily experiences.
AI May Not Replace You Soon: The patient-doctor relationship and the empathy involved in therapy are aspects that AI currently struggles to replicate. This human connection remains crucial for successful treatment.
Potential challenges- The not-so-sunny side:
Lower Average Pay: Psychiatrists in India generally earn less compared to other lucrative specialities. If money-making is your top priority, you might be disappointed. Employability is also a potential issue when you choose Psychiatry. But, it’s certainly coming up from rock bottom. If you are planning to migrate abroad, prospects are much much better.
However, many psychiatrists in India manage to earn well through smart decisions and additional income sources.
Stigma: Patients often approach a psychiatrist with hesitation, having tried various other “treatments” like witchcraft, wizardry, mentalism etc to no effect. Although stigma is decreasing, it still exists. Efforts are being made to raise awareness about mental health, and you can contribute to this cause- which is rewarding in itself.
Emotional Burnout: Listening to patients’ stories of trauma, abuse, and loss can be emotionally draining. It’s important to stay empathetic while maintaining professional boundaries to avoid burnout and ensure effective treatment.
Unrewarding Aspects: Psychiatry is still evolving, and current treatments are not perfect. Some patients may not improve despite your best efforts. The key is to provide the best care based on existing guidelines and clinical experience and to refer patients when necessary. But research is happening at a very fast pace and newer diagnostic tools and treatments are on the way.
Unpredictable Patients: Occasionally, patients might react unpredictably, including using harsh language or even becoming physically aggressive. This is rare but possible, so caution is needed, especially with potentially hostile patients.
To fresh MBBS graduates, I hope this article somewhat clarifies whether Psychiatry is the right choice for you. Pardon me if I’ve further confused you. If you need more information, feel free to reach out—I’m happy to help.
And about that senior doctor’s comment: Psychiatric conditions are not infectious. There’s no human-to-human transmission of psychiatric disorders as per current literature. Of course, anyone, regardless of their profession, can develop a mental health condition in future, but it can be treated just like any other illness. There’s also no evidence to the hypothesis that being a psychiatrist is an independent risk factor for poor marriage prospects. If you’re passionate about Psychiatry, go for it. There are exciting opportunities ahead, and life always offers a second chance if things go wrong.
