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Tuesday, March 20, 2012

Final Thoughts: Psychiatry


My fifth clerkship of third year (Psychiatry) has come to an end...
  • 5 weeks, 20 days, and 117 hours of work in areas ranging from Outpatient psychiatry, Childhood & Adolescent Psychiatry, and Inpatient Psychiatry, 
  • Working 10 days at the Outpatient Clinics, I averaged 6.1 hours/day, 24.4 hours/week.
  • Working 8 days at the Inpatient hospital, I averaged over 4 hours/day, 12.8 hours/week.
  • I enjoyed 14 days off in the last 35 (that's 2.8 days/week). 
    • Affectionately known as "Psych-ation", somewhat of a vacation while still completing clerkships. Almost TOO MUCH free time, believe it or not.
    • Plus 5 days off for my Grandfather's funeral (of which I had to be excused for 2 days).
  • There were NO call days.
  • I studied Psychiatry outside of work a total of around 50 hours.
  • My total work in Psychiatry over the past 5 weeks is: 167 hours in 5weeks (33.4 hrs/week...4.8 hrs/day).
What I LOVED about Psychiatry:
  • The lifestyle is brilliant. I could easily work less than 40 hours per week and still make a modest wage. Amazingly wonderful lifestyle.
  • People are pretty relaxed, and the residents are mindful of the effects of feeling too stressed or anxious or down.
  • Short residency. Really short. I mean, like 3 years. That's not bad!
  • You can spend over an hour talking with one person about his/her problems and not feel like you're rushed.
  • There are seriously next to no labs drawn. The few that are drawn are to rule out any complications from some medications.
  • There aren't many medications that you need to know.
  • It's a rapidly evolving field, sometimes called "the final frontier" of medicine. It's the one area of medicine we really don't know all that much about!
  • You can make a huge difference to each patient.
  • It genuinely feels like patient-centered care. It's a "You tell me what's going on, and I'll search through my options before you and I decide what will help you most" kind of feeling.
What I DIDN'T love about Psychiatry:
  • The therapy we can offer is limited. The best we can hope for is an improvement in symptoms or fewer cycles of the psychiatric illness.
  • Some people can truly be hopeless cases, which is extremely difficult for me to take. I want to help people that need someone to help them.
  • When I see a depressed person, I feel depressed. When I see a manic person, I feel extremely happy. I mirror the patient's feelings excessively - not a good trait to have in regards to me own personal mental health, but it does help with my ability to empathize with the patient.
  • Some patients terrify me. Psychosis is a bit scary for me. I'm just a little thing, so I'm always a little apprehensive in the Inpatient wards when I'm surrounded by psychotic patients, especially those with a criminal history.
  • Not all patients think they need help. So not all patients are able to be helped. The first part of confronting any illness is acceptance!
  • There is still a huge stigma against psychiatrists, which leads to a lack of respect from fellow medical doctors and even some patients. I hate to admit this, but my pride might not allow me to work in this field due to the lack of respect given. I already have to struggle against people's prejudices because of my blonde hair, it might be more than I could bear to have another thing I would need to prove people wrong!
  • I like diagnoses to be more "black and white", more cut-and-dry and not open to much interpretation. Psychiatry involves a lot of subjective diagnoses of patients, which is something I certainly struggle with. I like to have a clearer diagnosis before diagnosing!



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