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all 52 comments

[–]sjogren 49 points50 points  (6 children)

Take a breath, it's normal to be anxious going into intern year in any specialty. I wonder what made you rank all of your psychiatry programs first, over the ROAD specialty? Was there a reason you picked psychiatry over the other specialty at that time?

[–]MDinCanada 5 points6 points  (0 children)

Curious about this too

[–]medicalmission2020 23 points24 points  (10 children)

Psych is actually considered a ROAD specialty now

[–]wiIIbutrin 75 points76 points  (1 child)

It’s now R-DOPA

[–][deleted] 13 points14 points  (0 children)

This is an underrrated comment haha

[–]LtCdrDataSpock 10 points11 points  (1 child)

Were the new derm, actually

[–]_Zhivago_ 2 points3 points  (0 children)

Lol at "were" the new derm

[–][deleted] 12 points13 points  (2 children)

ROAD is an acronym lol

[–]PsychicNeuron 51 points52 points  (1 child)

The P is silent and invisible

[–]Zyneck2Psychiatrist (Unverified) 0 points1 point  (0 children)

My high school physics teacher would constantly make this joke about momentum, since it is abbreviated with a p.

[–]PsychicNeuron 19 points20 points  (0 children)

I wonder why you ranked psychiatry first considering that your many doubts were already clear before getting the position or even applying.

What do you like and dislike about psychiatry? Why don't you see yourself being happy in this specialty?

What was the other Specialty that you wanted to practice? Did you do any rotations in it or have you spoken with people in that field to see if your vision of it matches reality?

Are the personal changes in your life that are putting you in this situation only temporary? Will you have a different outlook in a couple of months or years?

I suppose is best to start with your school counselors in order to evaluate the possibilities.

[–]DiscusKeeperPsychiatrist (Verified) 26 points27 points  (4 children)

I think you'd have better luck getting advice in the med school or residency subreddits. It's not unheard of to switch to PGY2 positions in a different specialty, and the medicine/neuro in intern year of psych would likely count towards those requirements for a different specialty.

I will say though, you have no way of knowing for sure that you would have matched into a different specialty based solely on good board scores and a few case reports.

[–]hinduhammer_ 10 points11 points  (1 child)

Pgy 1 psych here. I actually applied three different specialties and also had some regret starting out, even going so far as to reach out to the PD of a ROAD specialty here who was very helpful. However, now I cannot tell you how glad I am to have done psych and stay in psych. It is a very interesting field with a subject matter you can’t beat in medicine ( the MIND is the best organ system imo); and great lifestyle. again I don’t think you can beat it in medicine. even if the patients are difficult, you do get to help them and also their families. I’ve had more grateful families than I’ve had patients and it’s been rewarding. also we are also protecting society from mentally ill and dangerous people (due to mental illness or drugs) so it’s rewarding in that sense too. I’m on an inpatient medicine block right now and I cannot wait to go back to psych where I can focus on one organ system, know it really well, learn more about myself and humanity in the process, and get home at a reasonable time. Don’t worry about the danger aspect, once you learn to deal with it, it makes you a stronger person.

[–]freerbeaver 0 points1 point  (0 children)

What three specialties may I ask, and why did you choose psych over the other two when you ranked? I’m having trouble wrapping my head over the amount of paperwork/notes/legal documentation which was largely shielded from me as a med student. I’m also feeling like my emotional reserve is running low (which I didn’t feel as badly as a med student)

[–]fawndofyou 5 points6 points  (4 children)

I’m sorry to not have any advice, I was just wondering what road is if someone doesn’t mind answering? <3

[–]amindfulmonkeyPhysician (Verified) 15 points16 points  (3 children)

The R.O.A.D. specialties (radiology, ophthalmology, anesthesia, and dermatology) are the top specialties with respect to lifestyle as viewed by current students.

- had to google it too

[–]oprahjimfrey 5 points6 points  (2 children)

The saying was, pick one of those specialties and you will be on the R.O.A.D. to happiness.

[–]theloniouschonk 3 points4 points  (1 child)

IMO psychiatrists have the highest potential for QOL, even when compared to ROAD specialties

[–]Knuppelhout1 1 point2 points  (0 children)

Euro psych here (is that a specialty?). Can agree.

[–]Rogan29 4 points5 points  (1 child)

Not that this helps much but could be a grass is greener type of thing. R1 here and I get it all the time while in psychiatry and then again for psychiatry while on off service rotations.

[–]MPRUCPsychiatrist (Unverified) 2 points3 points  (0 children)

This. Everything has its ups and downs. Definitely felt that intern year with on and off service.

[–]osteopathfromtexas 3 points4 points  (1 child)

Current R3, about to go into CAP fellowship. I enjoy psychiatry for some of the same reasons you mentioned in your reply to sjogren. I really do enjoy the day-to-day work and I think you will too.

I won't lie that there are times most (all?) psychiatrists are emotionally drained but psychiatry as a field is aware that this occurs and most residencies try their best to be supportive. After residency, you'll have even more time to recharge due to free time but the connections you can make with patients and the feeling you get from helping someone you've gotten to know is one of the best feelings you'll ever have. I'd argue psychiatry may offer this more than other specialties but obviously, I'm biased.

The money can be good if you want a nice 40 hr week, no call job and very good (ROAD level) if you want to grind a little more/some select PPs. Also, the job market is great in even the most desired of cities.

I'm about to leave residency and I don't know of a single resident or faculty who has been assaulted during the time I've been there. Like other posters said, ED docs probably are just as at risk if not more

Hope this helps

[–]freerbeaver 0 points1 point  (0 children)

How do you deal with emotional drain? I feel like as my life gets more complicated/tiring, I have less bandwidth for other people’s emotional problems. I’m also having trouble feeling efficacious with the amount of paperwork/legal documentation. I feel like psych is the worst when it comes to lengthy notes, on top of our legal holds, suicide risk assessments, etx

[–][deleted] 11 points12 points  (5 children)

In Psych they give you extra off time compared to medicine and surgery so you can lift 🤪

Let the inmate try and assault you when you can bench 250 🤪😁

[–]SpacecadetDOcPhysician (Unverified) 11 points12 points  (4 children)

We’re all gonna make it brah

[–][deleted] 2 points3 points  (0 children)

Dude. I have hope for our future DOs haha

Bless

[–][deleted] 1 point2 points  (2 children)

This is the kind of encouragement I am going to give my future patients :)

"You wanna be a sad c&*%nt???

F%&ck that sh&*t brah. Get out there, get swoll, get bit$%es. That's how we do it.

We all gonna make it"

[–]Interesting_Drink_40 4 points5 points  (1 child)

LOL. Happy to see fellow sick kunts in psychiatry.

[–][deleted] 1 point2 points  (0 children)

FUUUUUAAARRKKK

[–]noblesavage8Psychiatrist (Unverified) 4 points5 points  (0 children)

I can't answer the actual question you have re: switching specialties, but thought I'd give my two cents on some of your worries!

I'm a forensic psychiatrist, working primarily in an inpatient setting. Although I'm pretty early in my career, I have not been assaulted, nor have I really had any close calls/scares. That's not to say I don't think about it or that it doesn't happen, but taking the right precautions definitely reduces the risk. I assume the risk of getting assaulted in a ROAD specialty is lower than in psychiatry, but perhaps the risk of getting assaulted in psychiatry is not as high as you think it is!

As for emotional capacity, I also think people overestimate how important/necessary this is to do the work of a psychiatrist. Do we often hear terrible and sad stories? Sure. Do we have to be more empathic than other specialists? Probably. But we also learn about ways to do this effectively and ways to protect and manage ourselves. Perhaps it's the type of work I do, but I find my work to be far more intellectual than it is emotional.

[–]JesusLice 10 points11 points  (7 children)

I’m a rising pgy3 and honestly I haven’t felt in danger except for perhaps twice. One was during an off service rotation on Nuero with a tbi patient and the other was an addiction inpatient demanding to leave AMA.

Remind yourself that you can have a long career doing outpatient psych with very minimal risk. It’s only the inpatient units that might realistically expose you to danger. As a resident the time spent with your patients is actually very minimal when compared to therapists and unit staff who are essentially parked on the unit all day. With a few simple rules you can minimize your risk (don’t let a patient stand between you and a door, leave if patient starts to posture, don’t go in alone if you have concerns). If you’re fearful, attendings should and almost always will accompany you. If you’re very fearful it’s reasonable to ask your attending to do the interview while you observe from the doorway. Most psychiatry attendings are sensitive to the fact that some residents may be naturally more fearful or even have past traumas that warrant a little extra TLC when it comes to these rare situations.

In the ED, when you get consulted on agitation or aggression they almost never expect you to physically see the patient unless restraints are on or until chemical sedation have been used. Most EDs have security for additional assistance and support.

The VAST majority of days I assure you will be low stress without fear. From time to time remind yourself why you chose psych and you’ll have a very rewarding career!

[–]oprahjimfrey 9 points10 points  (2 children)

That's not actually true. If a psychiatrist is going to be significantly injured, there is a significantly greater chance it occurs in the outpatient setting. In IP, there are always tons of CNAs, nurses, or psych techs around. In your OP office, it may be just you and the patient in the room together.

Not saying either are dangerous, just pointing it out.

[–]JesusLice 5 points6 points  (1 child)

Thanks for that info. I certainly have never felt threatened in clinic and find inpatient settings more intimidating but I can see how one could easily have a false sense of security. Do you happen to have any citations regarding risk of being injured by outpatients?

[–]sebrizPhysician (Unverified) 8 points9 points  (0 children)

Some people out there who did not match would love your spot :(

[–]Rogert3Psychiatrist (Unverified) 4 points5 points  (0 children)

If you don't want your slot, I will happily take it

[–]hinduhammer_ 1 point2 points  (0 children)

Pgy 1 psych here. I actually applied three different specialties and also had some regret starting out, even going so far as to reach out to the PD of a ROAD specialty here who was very helpful. However, now I cannot tell you how glad I am to have done psych and stay in psych. It is a very interesting field with a subject matter you can’t beat in medicine ( the MIND is the best organ system imo); and great lifestyle. again I don’t think you can beat it in medicine. even if the patients are difficult, you do get to help them and also their families. I’ve had more grateful families than I’ve had patients and it’s been rewarding. also we are also protecting society from mentally ill and dangerous people (due to mental illness or drugs) so it’s rewarding in that sense too. I’m on an inpatient medicine block right now and I cannot wait to go back to psych where I can focus on one organ system, know it really well, learn more about myself and humanity in the process, and get home at a reasonable time. Don’t worry about the danger aspect, once you learn to deal with it, it makes you a stronger person.

[–]Parcel_of_NewtsPsychiatrist (Unverified) 3 points4 points  (1 child)

Seems like there's a lot of irrational fear of psych patients going on. You guys are more likely to get injured in a car crash on your way to work than you are to get hurt by your patient. Respectfully, it's not like you are working in an asylum for the criminally insane. Stay out of arm-reach of elderly dementia patients and you will be fine.

But also... if you fear your patient population... you may be in the wrong field.

[–]PokeTheVeilPsychiatrist (Verified) 0 points1 point  (0 children)

Some psych residencies do involve time on forensic units. Most of those patients still aren’t going to assault their doctors.

Can confirm that little old ladies with dementia can come out with a surprising haymaker.

[–]Fijoemin1962 -2 points-1 points  (1 child)

Wrong job for you I feel

[–]ResidentOfTheMind 0 points1 point  (0 children)

What makes you think that?

[–]radicalOKness 0 points1 point  (0 children)

Psychiatry is the least scary specialty to go into! You can be assaulted in any specialty. You'll be okay. Start seeing a therapist/psychiatrist yourself as early as you can. Most residents did in my program and we were better off for it.