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Richard
Student
El Monte, California
1
Question
Asked
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To the psychiatrists out there, did you ever consider doing another specialty, and what ultimately made psychiatry feel like the right choice?
I'm currently a senior in high school and I have plans to pursue medicine in my future, but I'm not sure what specialty yet. I'm considering family medicine, but I'm also really interested in psychiatry.
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Gregory Barclay, M.D., DLFAPA, FASAP
Psychiatrist
33
Answers
Wilmington, Delaware
Updated
Gregory’s Answer
Richard,
Thank you for writing! I am glad to hear that you are planning a career in medicine. In the future we will need lots of psychiatrists and family physicians. As the US healthcare system changes, as it must, those two specialties will be in greater and greater demand. Both are similar in that they are patient-focused and not procedure-focused. Your letter suggests that the "helping people" aspect of medicine appeals to you more than "doing things to people" does. Very nice!
To your question now. When I went to medical school, psychiatry wasn't a strong interest of mine. I had actually considered going into pediatrics. However, I really enjoyed my psychiatry rotations during medical school and received very positive feedback from my supervisors as well. Since I was in the US Navy at the time, all interns did "rotating internships" to prepare us for working as general medical officers on ships or at naval bases where we would see active duty as well as dependent (spouses and children) patients. So, all interns did primary care-focused rotations for the year (pediatrics, emergency medicine, internal medicine, OB/GYN, psychiatry, orthopedics, alcohol/drug rehab, Adolescent medicine, surgery). After internship, I was assigned as medical officer to a destroyer squadron in Hawaii where I did a lot of primary care and occupational medicine and supervised a variety of non-physician medical staff on board. They asked me to see more complicated cases and often those ended up being the ones with psychiatric issues, and I not only enjoyed these cases but found psychiatry (and the interplay between mental and physical health) to be very interesting - Interesting enough for me to finally decide to apply for a residency in psychiatry at the US Naval Hospital in San Diego. It was there that I completed my psychiatry training and then worked for a few more years as a navy psychiatrist before moving into a civilian career as a specialist in adolescent and young adult psychiatry. Even though psychiatry has changed, along with all medical specialties, over those years, and has become more "medical", what I still enjoy the most and try to teach students and residents about, is the "relationship" aspects of psychiatric treatment, including how to conduct effective psychotherapy. That's still the part of psychiatry that turns me on the most - the ability (and permission given to me implicitly by my role) to communicate with people in a very private and intimate space where their deepest anxieties, fears, memories, traumas, hopes, and dreams reside. That said, I am thankful for all the experience in internship and as a navy general medical officer I had practicing primary care medicine because it made me a good diagnostician and able to easily identify medical and other complications to psychiatric treatment as well as to relate "in the language of doctors" to other specialists.
So, that is my story. Summing it up, I would say that keeping an open mind yet listening to the inner calling as it gets stronger inside of you as you pursue medical training is what helps you decide where to eventually land in the medical field. I had an interest in working with kids and although I did not end up in pediatrics, I ended up in child and adolescent psychiatry and then found myself called to working with older teens and young adults, perhaps because I was exposed to this age group heavily while in the US Navy and was most comfortable with them (or, as my wife says, I never grew up!). I think that having positive experiences in the field during your training is important and if they aren't positive, take note but also be open to exploring further if it was an interest of yours initially to be sure. My first pediatrics rotation in medical school as not positive, but I chose electives in pediatrics subsequently and then had rotations in pediatrics and adolescent medicine as an intern that were positive ones. Although I didn't become a pediatrician, I ended up working with a lot of kids eventually anyway. Getting (or seeking out) mentoring from physicians in your desired specialty is also important. I happened to get some really good ones during my psychiatry rotations, one of whom I have maintained a mentoring relationship with since 1981, and that relationship has been very helpful to me over my career.
I hope this is useful information. Write back sometime and let me know how things have gone for you.
Best Wishes,
Greg
Thank you for writing! I am glad to hear that you are planning a career in medicine. In the future we will need lots of psychiatrists and family physicians. As the US healthcare system changes, as it must, those two specialties will be in greater and greater demand. Both are similar in that they are patient-focused and not procedure-focused. Your letter suggests that the "helping people" aspect of medicine appeals to you more than "doing things to people" does. Very nice!
To your question now. When I went to medical school, psychiatry wasn't a strong interest of mine. I had actually considered going into pediatrics. However, I really enjoyed my psychiatry rotations during medical school and received very positive feedback from my supervisors as well. Since I was in the US Navy at the time, all interns did "rotating internships" to prepare us for working as general medical officers on ships or at naval bases where we would see active duty as well as dependent (spouses and children) patients. So, all interns did primary care-focused rotations for the year (pediatrics, emergency medicine, internal medicine, OB/GYN, psychiatry, orthopedics, alcohol/drug rehab, Adolescent medicine, surgery). After internship, I was assigned as medical officer to a destroyer squadron in Hawaii where I did a lot of primary care and occupational medicine and supervised a variety of non-physician medical staff on board. They asked me to see more complicated cases and often those ended up being the ones with psychiatric issues, and I not only enjoyed these cases but found psychiatry (and the interplay between mental and physical health) to be very interesting - Interesting enough for me to finally decide to apply for a residency in psychiatry at the US Naval Hospital in San Diego. It was there that I completed my psychiatry training and then worked for a few more years as a navy psychiatrist before moving into a civilian career as a specialist in adolescent and young adult psychiatry. Even though psychiatry has changed, along with all medical specialties, over those years, and has become more "medical", what I still enjoy the most and try to teach students and residents about, is the "relationship" aspects of psychiatric treatment, including how to conduct effective psychotherapy. That's still the part of psychiatry that turns me on the most - the ability (and permission given to me implicitly by my role) to communicate with people in a very private and intimate space where their deepest anxieties, fears, memories, traumas, hopes, and dreams reside. That said, I am thankful for all the experience in internship and as a navy general medical officer I had practicing primary care medicine because it made me a good diagnostician and able to easily identify medical and other complications to psychiatric treatment as well as to relate "in the language of doctors" to other specialists.
So, that is my story. Summing it up, I would say that keeping an open mind yet listening to the inner calling as it gets stronger inside of you as you pursue medical training is what helps you decide where to eventually land in the medical field. I had an interest in working with kids and although I did not end up in pediatrics, I ended up in child and adolescent psychiatry and then found myself called to working with older teens and young adults, perhaps because I was exposed to this age group heavily while in the US Navy and was most comfortable with them (or, as my wife says, I never grew up!). I think that having positive experiences in the field during your training is important and if they aren't positive, take note but also be open to exploring further if it was an interest of yours initially to be sure. My first pediatrics rotation in medical school as not positive, but I chose electives in pediatrics subsequently and then had rotations in pediatrics and adolescent medicine as an intern that were positive ones. Although I didn't become a pediatrician, I ended up working with a lot of kids eventually anyway. Getting (or seeking out) mentoring from physicians in your desired specialty is also important. I happened to get some really good ones during my psychiatry rotations, one of whom I have maintained a mentoring relationship with since 1981, and that relationship has been very helpful to me over my career.
I hope this is useful information. Write back sometime and let me know how things have gone for you.
Best Wishes,
Greg