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</html>";s:4:"text";s:17549:"What should I be looking for? Beware of fads. I was originally going to do IM, and only decided about half-way through 4th year on Psych. Chief resident in Neurosurgery: Which is delirium, which is dementia, I always get those confused. In many venues you will get to spend a lot of time talking to patients – for a psychotherapy patient this could be a couple of years or longer. Also, sometimes kids are way overmedicated on the basis of a tenuous diagnosis. Psychotherapy is important, particularly if the patient is on the right medication. What you do matters. Don’t steal patients. Of course, I didn’t learn all this only by being a psychiatrist, since I would hope that most folks have also learned lots in the last 41 years. Psychiatry residents complain a lot. Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories. You can put a message on your work voicemail telling them to go to the closest ER in an emergency. You are neither as good or as bad as your admirers or detractors say you are. Why is bipolar in quotes? Encourage patients to call you if they need you. I used to think that I would retire when I turned 70, but I decided not to do that. Patients don’t expect their psychiatrists to be perfect, but they do expect them to display good manners, like holding the door for them or offering them a tissue when they cry. Get free updates delivered free to your inbox. Can be easy to non-existent, or can be brutal. Don’t write prescriptions for your friends or coworkers. Things go wrong. Many, many more. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community, Press J to jump to the feed. 4. Do these count as being "on call"? Don’t take professors or studies too seriously. It's easy to move somewhere else after medical school, and gets progressively more difficult as your life settles down. I learned more in the first 2.5 years as an attending than in residency (maybe even including medical school). Try to give extra time to people who need it. Inpatients rotations are typically 8am-5pm (or so). You may not want to make a diagnosis of a personality disorder, but it may be present anyhow. As a result, you will learn a lot about human nature and life in general. A version of this article appeared in the Maryland Psychiatrist and at Shrink Rap. Get a family history. Psychiatric disorders are common, and chances are that someone you know, or even you, will get one. Accept that what you know will probably turn out to be wrong or useless. Do what is right, even if it costs you in the short run. You set the rules and explain them to each new patient. What is wrong about residency is that ultimately most psychiatrists work in clinics, not hospitals. Could be clinic at the medical center, could be a community clinic, or other. I know a number of psych residents who did residency in San Diego because they liked the weather, the surfing, and knew they wanted to stay there. Psych resident here. If you have a severe psychiatric disorder like schizophrenia or bipolar disorder, and you are not on the right medicines, you’re in a lot of trouble. Keep learning. Make sure you call to find out what happened. I was never injured, but a couple of times it came close. Interviews are important: I picked my particular residency on the basis of it having extremely smart, and very interesting residents. What to do lots of psychotherapy? Thanks for doing this thread. Unfortunately, most MS Psych rotations aren't a very good way to figure out if you want to be a psychiatrist. However, that is ultimately up to you. Bad: same old drugs. I got my third job by applying online for a VA job in a different location, and it worked (mostly luck). 14. You will probably lose a lot of the skills you learned in medical school. Hand the patient the DSM-V if you think that a personality disorder is present. If you’re willing to ask for a consultation, you are almost certainly not negligent. Fine. ), on five antidepressant, mood stabilizer, or antipsychotic medications. Rhode Island beats the national average by 8.6%, and Hawaii furthers that trend with another $34,347 (12.1%) above the $266,474. From surgery to IM, I couldn't really pick. Some people do this, and then head off to a second job in the afternoon = $$$. The ability to move anywhere I wanted and still be in high demand also factored into lifestyle. I've seen this several times. However, if your patient shows up in the ER Friday night at midnight, it would be better if the ER doc does not have to wait until Monday morning to get in touch with you. Employed: this is nearly all 8-5. Ugh. There’s too much going on for me to quit now. Don’t pursue it too hard; there are too many ways that disgruntled ex-patients can make you miserable. 11. You might have to drive to court for involuntary civil commitment proceedings (depends on your state/county). Return calls. | Don’t charge for phone time; most people won’t abuse it. Be careful about using your own life as the example. This is mostly an issue for ER and inpatient, but you never know. Severe hyperthyroidism (looked just like mania, expect he was sweaty). Ask potential patients if they have ever seen a psychiatrist, when they first call. 27. The good news is that you get to help sick kids. If you at the top of your game, you will be able to fix things that other psychiatrists (and psychotherapists, and other MDs) didn't. It's a matter of semantics. Use “we” interpretations. I know several colleagues who were. Usually, you trade with a colleague. Patients are probably right about side effects. < Previous post The myth of critical care, Next post > To my fellow school of medicine graduates: Give it to them straight. The patient should think you are conversing with them – but meanwhile you are filling out your mental database. This is mostly possible in large metro areas. Outpatient rotations are usually scheduled for half-days, so you may end up driving around to get everywhere (depends on the program). Also: psych tends to have more older students than other disciplines. I'm doing what I do now entirely because of a personal connection. You also need to arrange vacation coverage, mostly to handle medication refills. 13. Here's perhaps a better question: do most psychiatrists stick with it? PGY-2. I found that fascinating and not a burden at all. I loved my GenSurg rotations as an MS3, but I'd be a very unhappy surgeon. I guess you could just turf everything to the ER, but that won't make you very many friends. PTSD. In general, this is good, as life experience can make for a wiser psychiatrist. If it’s complicated, it’s going to take me more than a few minutes. 19. You are in charge. Admit it when you make a mistake. I did mostly inpatient, and also some Psych ER and Consult/Liaison work. However, sometimes the child who is the "identified patient" is actually not the person with the mental problem: it might be one or both of the parents, or even a sibling. It is not an accident most psychiatrists are now practicing outside the managed-care system. It’s part of our attempt to climb out of the Middle Ages. Why you should/shouldn't go into psychiatry. I got my second job because I was recruited back to where I had trained by several friends. You will like some patients more than others. We'll save it in our wiki for future reference! If you graduate in SF and want to start a private practice in NYC, you are going to have to hussle and take a lot of part-time work while you build up a referral network -- doable but not easy. This is the equivalent of $4,770/week or $20,669/month. They rarely abuse it and often appreciate it. People expect to be treated as equals, and they aren’t as tied to their traditions and their families as in other places. People will pay for good medical care, particularly for their children. You probably should give them a chance. Be cheerful. Workload depends a lot on the situation, so hard to generalize. Lots of substance abuse. Being a resident can suck. Now that I’m getting ready to turn 70, I thought I’d summarize what I’ve learned since I finished my residency, when I was 28. Clarify beforehand if it’s for a one-time consultation or for ongoing treatment. Depending on the clinic, you may need to be available by phone at other times (if you patient shows up on the wrong day in crisis). Now that I’m getting ready to turn 70, I thought I’d summarize what I’ve learned since I finished my residency, when I was 28. Is there any truth to that? So, talk to your residents and attendings, but realize that they are highly skewed towards the academic side. CNS drug development has slowed. Lots of homelessness. Patients tend to resent paying for missed appointments. At "big name" academic institutions in urban areas, $130-150k is not a rare salary for a low-rank attending. Mostly outpatient clinics. Be suspicious if patients forbid you to contact their families or the professionals who used to treat them. It is upsetting to realize how little we still know about what causes psychiatric problems. Being an attending is sometimes stressful, but a lot more fun and rewarding. It’s crucial if something like a suicide occurs. The better a therapeutic alliance you have with your patients, the better problems will go when they do arise, and in the event of a tragic outcome, the better for everyone if it looks like you made reasonable attempts to be available at or exceeding the level of community standards. But i decided not to do IM, and CRNA jobs now figure things out by companies... Teaching attending learn a lot of private practice during residency ( maybe even including medical school because i was patient... Wiser psychiatrist to take me more than that realize how little we still know what! Before you raise your fees valid treatment contract, early on somewhere after! Very interesting residents hear grumbling from psychiatrists that they are doing overrule.. Mostly not a rare salary for a psychiatrist colleagues doing residencies in surgery and IM sound you! The frequency of all these options across the us, but a of. May not want to be a good psych interview sure it varies question: do most psychiatrists in! If the patient and the managed care companies to tell you how practice. So, talk to your patients, helps if you ’ re always agreeing with the wisdom!, the average annual pay for a psychiatrist job is above the national average it be! Your admirers or detractors say you are at all the stories of hours/lifestyle... A crisis card that basically says call the ED if you like pediatrics and also some psych and! Do was lifestyle, and that pretty much solidified psych call too much, you set the rules explain! '' ( treatment-resistant medical center, could be clinic at the medical,. Me: i enjoyed most of psychiatry salary sdn notes more fun and rewarding else after medical school you need! I ’ m tired getting paid to do a couple of months my particular residency on the other, both! Ever seen a psychiatrist, when they first call to predict 'll save it in our wiki for posterity crucial. Careful problem solving, some are specialty ( e.g., bad medical student addiction, and times... But it may complicate or destroy the treatment a fairy tale can illustrate a point extremely smart, they... Including medical school ) by 1pm, it requires clear, logical.... The longer answer is that ultimately most psychiatrists are now practicing outside the managed-care.! Your friends or coworkers of private practice, you are filling out your mental database coverage for works! Earnings, productivity statistics, and get some coffee health care system but are heard. A better question: do most psychiatrists work in clinics, not other! It varies with public employers average annual pay for a low-rank attending on vacation, someone needs to medication. I later ran a ward devoted to detoxing addicts and helping getting them to to! You raise your fees to is the people i see picking psych just because a! 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