Likes and Dislikes in Psychiatry

Finishing my Psych block, time once again for a reflection on the rotation with my "Likes and Dislikes" series.

1) Oh regular hours, how I missed you

After months of long, drawn-out hours, Psych has been an oasis in the desert. My days were typically 8-9 hours long with the odd day ending quite early. Start times were reasonable. Even the 24-hour call shifts weren't bad, at least by comparison - they were technically home call, so I got to leave the hospital on occasion, and generally got more sleep than on other rotations. I had the odd shift where I got only a small amount of rest, but it didn't feel that exhausting, maybe because I was rested going into it and had time to recover afterwards.

You never quite realize how tired you are until you're not tired and on Psych, I felt rested for perhaps the first time in months.

2) Once again, I like talking to patients

This long into clerkship, some themes are start to reoccur, and this is definitely one. When I can help a patient just by talking to them, I feel great. This is what I got into medicine to do! Psych provides a lot of those opportunities. Even when counselling isn't the main role Psychiatrists fill (other mental health workers seem to do that more often), it's a big part of a lot of interactions with patients and as a result, I thoroughly enjoyed those interactions.

3) Well, maybe not all patients...

The one part about Psych and patient interactions I didn't like was that the exchanges often had an adversarial component to them. When many patients are being admitted to hospital against their will, it kind of comes with the territory. The mental chess that gets played in some cases - while extremely interesting - was also rather draining. I understand that the conflict between patient and provider has a purpose, and that in working against a patient's wishes the physician is doing their best to help the patient, but it's not necessarily something I want to be doing on a regular basis.

It became obvious to me fairly quickly that my preferred patients were those who had ego dystonic conditions - the ones that they want to fix, like depression or anxiety. Individuals who didn't recognize or didn't want to fix their mental health issues weren't as interesting to me. I'm glad there are people dedicating their lives to helping these individuals, because they do need help, but I'm not sure I want to be one of them, at least not on this frequent of a basis.

4) The Happiness Test

I find Psychiatrists in general to be a bit of an eccentric group, so it's sometimes hard to tell their emotional state, but for the most part, the people I interacted with passed this test with flying colours. They were happy! Not joyous per se - this wasn't rainbow sunshine land like Peds was - but they seemed contented at the least.

I wrote off Psych as a potential specialty to match to almost immediately. The reasons behind that choice seem misguided and trivial now - if I had to give a Top 5 of specialties to match into right now, Psychiatry would almost certainly be on there. They say you can't really tell if you're a fit for a specialty until you see it first-hand. In this case, I agree.