Questions/Concerns Regarding Becoming a Psychiatrist

Happy to try to help.

The thing to understand is, psychiatrists are primarily doctors. They get all that premed coursework, do their MCATs, go through 4 years of medical school and get training in the main medical specialties like surgery, family medicine, internal medicine, ob-gyn etc., then spend another several years getting residency training in psychiatry.

The scope of their work ranges from ultra acute, medicating extremely aggressive patients in psychiatry emergency rooms and locked psychiatric wards, to outpatient treatment of patients who are overall very stable but may need medication refills/adjustments, side effect management, or psychotherapy.

They may be the ones to do psychotherapy for their patients, or they may outsource that to psychologists.

They might also work in more overtly medical capacities. They might take consultations for psychiatric issues for patients staying in a normal medical hospital. Say a patient in a medical floor says they want to kill themselves. Now a psychiatrist has to come and do a risk assessment, and decide whether or not the patient needs to be hospitalized for their own safety.

They also might work in a detox unit, medically managing the patients while drugs and alcohol leave their system. That requires a physician to manage, because it can be very dangerous, and also to prescribe treatments to make the withdrawal symptoms easier to deal with.

They also will deal with medication issues. They will have to look at the patient's other medical problems and decide which medication is safest and most likely to work for them. They will have patients complaining of side effects, and they will have to manage the side effects or decide on a new medication to use.

Outpatient psychiatry and clinical psychology may look very similar, a patient comes to them for psychotherapy. They are very similar, at that point.

However the psychologist then goes on to do a lot of things the psychiatrist generally won't, like administering psychological tests to the patient, working on research to help understand very subtle minutiae about human thought, behavior and society.

Again to reiterate, a psychiatrist is primarily a physician.

When the psychiatrist sees a schizophrenic patient, they will want to make sure that their clozapine is keeping their symptoms in remission without causing their white blood cell count to drop to the point they have a risk of infection, monitor the patient's tardive dyskinesia, and also discuss a new medication recently approved to treat it.

When the psychologist sees a schizophrenic patient, they might want to make sure their symptoms are in remission, engage them in psychotherapy to help them socially cope with their symptoms, and teach them reality testing techniques so they can start to prove to themselves that their hallucinations aren't actually real.

That's kinda how these things break down. The thing that bothers me to no end is how young people are supposed to be able to just magically know which path to take without having any reasonable chance of even knowing what is out there. I sure wish somebody talked to me more about this stuff earlier in life.

/r/Psychiatry Thread