Working as a psychiatrist – 5 pros and 5 cons
Here are five pros and five cons of working in psychiatry.
5 Pros
1. Variety
From dealing with extremely acute patients in the community as part of the crisis team, to following patients for years in Forensics, there is a great amount of variety in psychiatry. Specialties including Liaison and Eating Disorders offer opportunities for those interested in physical health, whilst training to be a medical psychotherapist is a completely different challenge. Every day is different, every patient is unique and you’ll likely find something for you!
2. Satisfying outcomes
Helping people to rise out of melancholy and suicidal depression, or watching a patient reclaim their life following a psychotic episode, are highlights of the job. Psychiatry is full exceptional outcomes for very unwell patients.
3. Compelling subject matter
Psychiatry presents a unique interface between a variety of diverse fields: psychology, biology, sociology, philosophy, pharmacology, statistics, and psychopathology – to name a few. As research and interest has increased in recent years, there has been a great expansion in special interests within psychiatry; including sports and exercise psychiatry, cultural psychiatry and research into psychedelics.
4. Connections built with colleagues and patients
It is the nature of psychiatry that more time is spent speaking with each patient, which allows a deeper understanding of the individual, and how they interact with the world around them. Ward rounds will focus not only on symptoms and presentation, but also the personal history, day-to-day life and barriers to compliance with a treatment plan. You have the opportunity to be creative and work closely with psychologists, occupational therapists and the wider MDT, to form individualised and pragmatic treatment plans.
5. Work-life balance
Most trainees and consultants would agree that psychiatry provides a comparatively good work-life balance, one not easily attained in many specialties. Often training programmes offer ample opportunity for learning, including protected study time, special interest days and psychotherapy training. There is also the prospect to generate extra income from various assessments or reports, private practice, providing more flexibility in your work.
5 Cons
1. It can be emotionally draining
Mental health patients often have dealt with significant hardship and can present at the most vulnerable moments in their lives. Caring for them day in, day out – and hearing what they have gone through – can take its toll on anyone. For this reason, there is an emphasis on maintaining your own well-being. Trainees get weekly one-to-one consultant supervision as well as the opportunity to attend Balint groups to reflect on difficult cases.
2. Paperwork
Psychiatrists often make difficult decisions, such as depriving people of their liberty. These decisions necessitate extensive justification and therefore detailed documentation. Paperwork can take the form of court reports, assessment reports and section paperwork. This work occurs in almost all areas of clinical psychiatry.
3. Dealing with difficult patients
Many mental health patients may not feel they require the expertise of the team or any support at all. This could be through a lack insight into their condition, or at times a lack of desire to work with you. This can lead to heated consultations with raised voices or, although rare, acts of violence. Part of developing the skill set of a psychiatrist involves learning to manage the challenge of these consultations but they can be uncomfortable.
4. Difficult outcomes
Sadly, not every patient with a mental health condition will have a positive outcome. Many of the conditions treated are chronic and some patients can frequently relapse despite good treatment. Catastrophes can occur and working closely with a patient to learn that they have taken their own life is one of the most difficult situations for a clinician to encounter.
This by itself can be a significant deterrent for juniors when considering a career in psychiatry. While it is an important aspect to be aware of, we take every effort to avoid poor outcomes – and most patients do very well. Many return to their ‘normal lives’.
5. Stigma
Psychiatry is a nuanced field but much of this nuance may not be obvious without the appropriate study. This could be part of the reason why many people (including patients, their families, and even other professionals) can be dismissive regarding mental illness. This misunderstanding of mental illness is often demoralising but can be counteracted with appropriate education.
There has also been a cultural shift, with the younger generation more aware of the importance of maintaining and speaking about their mental health. Despite this recent progress, you are likely to observe prejudice towards patients and the service provided throughout your career.
Summary
We have described 5 pros and 5 cons of working as a psychiatrist. We hope you have found it helpful.
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Written by: Dr Uzair Asif MBChB
Last Reviewed on 16 June 2024