omg are you serious, if it's your jam, then there's nothing quite like it, i still cant believe people pay me for this:
1. you can spend as much time as you like doing evaluations (depending on the settings). In forensic evals I can spend the whole day just evaluating one person taking a complete detailed history of all sorts of things people have never told anyone before.
2. beyond getting a window into the mind of the delusional, neurotic, and personality disordered you learn how serial killers, rapists, pedophiles, white collar criminals, stalkers and so on think - compelling and disturbing at the same time
3. there's no one explanatory model for the kinds of problems we deal with that span the breadth of human misery from problems in living, to behaviors, to disorders of thought and emotion, to frank diseases of the brain. We draw on multiple explanatory models (neurobiological, psychodynamic, cognitive behavioral, systemic, social constructivist, social realist, cultural etc) to make sense of people's problems
4. psychopharmacology is fascinating - the effects of drugs on mental experiences is one of the most understudied and compelling aspects of our fields, and some of the more experimental treatments including ketamine, psilocybin, LSD, and MDMA have been gaining renewed attention
5. catatonia is eminently treatable and the results so dramatic it is incredibly satisfying to see someone go from non communicative or frenzied to alert and calm with a little ativan or electricity
6. we can take the paralyzed and hypnotize them out of it (if the paralysis is an hysterical symptom!) - again extremely satisfying to treat.
7. working with couples and families gives you a fascinating windows of how much pressure there is to enact our roles, and how you need to treat the whole system if you want to get someone better
8. we are masters of building expectancy and offering hope. so often we see patients who are written off as hopeless and recalcitrant but a little love and care and reformulating the patient go along way.
9. i love testifying in court and the sparring and jousting of a good cross-examination
10. i love providing a valuable service to the courts and attorneys by educating them about mental health problems, often helping people in very tangible and concrete ways
11. i love the philosophical aspects of the field - what is mental disorder? how to we conceptualize people? are psychiatric disorders disorders of the brain, and if so, how does this affect one's free will? how do psychiatric drugs shape the experience of the self? etc
12. i love stories. patients present with stories: narratives of disillusionment, disharmony and despair as well as ones of resilience and recovery
13. i love language. psychiatry is all about language - whether it is the fact that some carelessly and cruelly deployed words in childhood can alter someone's trajectory, or in their power to heal.
14. i love connecting with people - people i might never otherwise get to talk to, to interact with, and learn their life story. even the most ostensibly odious person can become likeable when you see their scars and vulnerabilities.
15. while we palliate most patients, there are some things we can cure. panic disorder, phobias, and PTSD are all eminently curable, often with short-term treatment)
16. lots of different fellowship/subspecialty opportunities available including pain medicine, palliaitive medicine, sleep medicine, neuropsychiatry, child psychiatry, geriatrics, psychoanalysis, psychological medicine, CBT, family/couples therapy, group therapy, eating disorders, psychosexual medicine, LGBTQ mental health, HIV, clinical informatics, occupational medicine/psychiatry, addiction medicine/psychiatry, brain stimulation etc etc
17. there is no shortage of jobs. even in saturated cities there is plenty of work for psychiatrists and this is unlikely to change anytime soon.
18. you get to spend your days talking about sex with your patients.
19. the mind-brain relationship is extremely fascinating - cognitive neurology is a particularly fascinating area
20. there are lots of research opportunities because there are so many unanswered questions in psychiatry and neuroscience
21. our textbooks dont really go out of date. I have all these books from 100 years ago or more that are still full of rich descriptions relevant to this day
22. while a lot of it can be depressing, some patients are absolutely f'ing hilarious and will have you howling with laughter
23. there are lots of criticisms and controversies in the field but we mostly tend to talk about these things in an open manner (e.g. influence of pharmaceutical companies, illness mongering, psychiatrization of everyday life, overselling of neurobiology, coercion, alternatives to the medical approach to psychiatry etc)
25. you get to work with some of the most disadvantaged, marginalized and disenfranchized individuals (particularly in correctional settings) if you choose to
26. lots of opportunities for innovation: for example developing new psychotherapies, or using tech to enhance patient care or develop and disseminate new treatments
27. psych lends itself well to telemedicine so you can if you so wish see pts from the comfort of your own home, or even from another country depending on the contract
28. i love group therapy - working with groups is a lot of fun, adds a layer of complexity to the work and more importantly can be immensely therapeutic and healing. if therapy is not your jam, then you can do group psychopharm visits which are becoming more popular
29. you definitely grow as a person in this field, confronted with so much of other people's issues forces you to confront your own
30. it is very difficult to get successfully sued as an outpatient psychiatrist
31. it is very easy to diversify you practice and switch jobs, patient populations, settings etc multiple times over your career or have a portfolio career working in multiple settings contemporaneously
32. there are lots of things besides clinical care you can do to (expert witness work, consulting, mediation, teaching, public education, writing, advocacy, policy, research, administration, clinical trials, utilization review, quality assurance, MRO [medical review officer] etc) to break up the monotony
I could go on, but you get the picture. It's not for everyone (most med students are not suited to it) and sometimes i miss being a real doctor but i'm really quite happy for the most part and feel the field provides enough intellectual stimulation for me.