July 9, 2014

Why Become a Psychiatrist? The Id Speaks.

Author Picture

Aditya Joshi, MD

Penn State Hershey Medical Center, Hershey, Pennsylvania


“I am not sure how you do it. I would never do this.” (Jolly good, then. I guess my job is safe for now, and so is the world…from you!)

“What is the point of wasting time on something you cannot cure?” (Ah, yes, and you just won the Nobel Prize for curing [insert illness name here]. What’s that? You can only manage it and not cure it? Interesting.)

There. I have finally blurted out the impure thoughts that have often crossed my mind during conversations with colleagues over the years. Years of simmering in a cauldron of narcissistic injury finally culminating in an eruption of bile, which, I suspect, I may have been stewing in all this while.

It comes as no surprise that a career in psychiatry is not particularly coveted by medical students worldwide,1 even though their clerkship experience may have positively influenced their attitudes toward the field.2 Stigma toward mental illness in general and stigmatization of students interested in psychiatry might serve as deterrents. A perceived lack of effectiveness of treatment and concerns about working with people with mental health issues may also turn students away from a career in the field.

Which begs the question, what makes me want to do it? Well, my interest in psychiatry could have something to do with fellow physicians who contemplated giving up their careers as their depression took root, the accomplished professor who was no longer able to do what she did best, the brilliant lawyer reduced to a shadow of herself, who were able to return to productive lives with the appropriate treatment. It may have to do with the medical student contemplating self-harm, who ultimately made it into a competitive residency program after receiving help. Or perhaps the manic lady who ranted for 45 minutes, only to capitulate and take her mood stabilizer “because you are the only one who has ever listened to me for this long.” The overwhelmed caregiver, the wife desperate to get her husband back, the son who lost his father to suicide, the anxious parents wanting their child to just be able to sit still for a while, and the wounded warrior unable to find solace even in the relative safety of his home. Their despair turning to hope as their treatment bore fruit. Their transformation, priceless.

Do any of these people sound like someone you might know? These people could easily be (and perhaps are) our loved ones, colleagues, and neighbors. And that is why a career in psychiatry matters. That is why, no matter how bad my workday might be, at the end of it, there is at least one person whose life is better for what I may have done for them. This is why I do what I do. Because it is worth it!

PS: The author reports no financial conflicts, but (in the recent words of a colleague) a number of ongoing psychological conflicts may be apparent to readers!

Financial disclosure:Dr Joshi had no relevant personal financial relationships to report.


1. Lyons Z. Attitudes of medical students toward psychiatry and psychiatry as a career: a systematic review. Acad Psychiatry. 2013;37(3):150–157. PubMed

2. Lyons Z. Impact of the psychiatry clerkship on medical student attitudes towards psychiatry and to psychiatry as a career. Acad Psychiatry. 2014;38(1):35–42. PubMed

Category: Mental Illness
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10 thoughts on “Why Become a Psychiatrist? The Id Speaks.

  1. Precisely! This is one of the last medical specialties where we can still actually talk with the patient, and take the time to listen. I had never given psychiatry a thought as a career until first exposed in medical school. The actual patient-clinician interface attracted me 20 years ago and still does today.
  2. Thanks for your clever and accurate response to anyone who asks why psychiatry.

    I went into psychiatry because my family of origin and extended family are riddled with Bipolar Disorder or depression. Medication and psychotherapy therapy work for all who are compliant with treatment.

    Treatment hasn’t cured the disease but there are an overwhelming number of diseases in medicine which are not yet cured by the available treatment.

  3. Why becoming a psychistryst..firt what can be more facinating, interesting, mysterious, intriguing that the study of the Mind. All subjects are realted to our profession, movies, novels, art, etc.
    To be there for some one that is in great dispaire and help, perhaps not cure them but direct them inspire them motivated and assisting them to find sence of self, to be able to returne to been functional again, is one of the most gratifiying experience. Other MD will tell you ” you are not a real doctor” My is response you can live been blind, deaft etc, but with out your mind and been rule by emotions you will no make it. It an honor and a privelege to be a Psychiatrist. It is really a Vocation. I have been doing for more than 28 years and I find my self apprecaiate it more each day.
  4. Well, Psychiatry is one of the fields where one’s individuality and way of handling situations is still an asset and you have considerable freedom of choice in treating individual patients, unlike most medical specialties which are becoming protocol-based and the doctor conceivably could be replaced by a computer/ robot in the not-too-distant future! As Dr. Joshi says, our jobs are quite secure for the near future! As a bonus, you can dole out free advice on most facets of life without fear of being told off!
  5. This is the only Medical Field that is not monotonous( except maybe ER) and ( Psychiatry)continues to be more and more exciting the longer you do it. I couldn’t imagine doing the same surgery, treating the same never changing illness day after day, or delivering babys day after day for years. Psychiatry is never the same, all patients are different, knowledge in the field is constantly growing . Quality of Life tends to be better in this field as well.
  6. I experience a deep privilege when a person trusts me enough to allow me to share in their secret thoughts, wishes, desires and fears and allows me to act as a midwife assisting their birth into a more rewarding life experience.
  7. Because next to this kind of interaction with patients, everything else was boring. I have been frustrated in my chosen career, but NEVER have I been bored.
  8. I am in an NP in family medicine and frankly I wish I had a degree in psych. I find that we are so often trying to manage in primary care what should be done by pyschiatrists. I think it is an amazing profession and given the state of our country we could use 2 times more than we have. My son (age 14) has recently expressed an interest in physchiatry and I had him read this blog. Don’t give up!
  9. Well said! We see the sympathy relatives and family has for people with other medical illnesses.But we can’t expect that for a patient with Schiz or BPAD. Also, people with other illness can know what’s happening with them and express. It’s not so here. Hence, SPEAK FOR THE SPEECHLESS…,

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