PSYCHIATRY: THE MEDICAL SIDE OF MENTAL HEALTH
As physicians who treat the mentally ill, psychiatrists have some of the most rewarding long-term relationships with their patients. This is an interdisciplinary specialty, well-suited for doctors who wish to use the broadest of all skills—psychosocial, scientific, and clinical.
Historically, psychotherapy has always formed the core of psychiatry. But with remarkable advances in neuroscience and drug therapy, this field of medicine has shifted to a more biological-based approach. Now, psychiatrists draw on the latest research in brain imaging, genetics, and psychopharmacology to treat many debilitating disorders.
Most medical students begin their psychiatry clerkship with a preconceived notion of this specialty. You probably imagine that all psychiatrists tell their patients to lie down on their leather couches and talk about their childhood. Or, you may think that these physicians are simply drug dispensers. In reality, the practice of contemporary psychiatry falls somewhere between these two extremes.
MENTAL HEALTH AND MEDICINE
Psychiatry is the field of medicine dedicated to the prevention, diagnosis, and treatment of mental illness. The diseases they treat include depression, bipolar disorder, schizophrenia, addiction, delirium and dementia, anxiety, and personality disorders.
Psychiatrists meet an essential need within medicine. Psychiatric disorders, which are extremely common in society, often remain undiagnosed. In a given year, nearly 22% of all Americans over the age of 18 suffer from a diagnosable mental disorder. Like physical diseases of the body, these conditions range in severity. They can cause mild social withdrawal, severe occupational impairment, or even be life threatening. Although many patients may not even appear ill, others present with withdrawal, psychosis, or confusion. This wide scope of disease provides intellectual stimulation and daily challenge.
There is no such thing as a typical psychiatric patient. In fact, many students discover that psychiatric patients are even more challenging than those with medical problems. You might be treating a depressed young woman with thoughts of suicide. Your next patient may be someone suffering from panic attacks, obsessive- compulsive disorder, or unusual phobias. Complex cases of schizophrenia, in which the patient presents with extremely distorted views of reality, are de rigueur for the typical psychiatrist. They also manage problems of sexual dysfunction, eating disorders like anorexia and bulimia, and all forms of substance abuse. If you are interested in working with children, the subspecialty of child psychiatry offers classic cases of attention-deficit/hyperactivity disorder, learning disorders, and other behavioral problems.
Many physicians are initially drawn to psychiatry because of the intriguing combination of medicine, psychology, and the social sciences. This specialty focuses on what makes people tick—how they feel, think, and behave.
It is important not to overlook the fact that psychiatrists are, first and foremost, medical doctors. Many organic diseases, whether an electrolyte imbalance or hypothyroidism, can cause psychiatric disorders. Psychiatrists need to rule out any possible underlying medical diseases or drug reactions before treating a mental illness. In the hospital, they are called upon as consultants to distinguish between psychiatric causes and other medical causes of patients’ symptoms. Every day, psychiatrists see first-hand the intricate relationships between mental disorders, emotional illness, and medical diseases of the body. Because psychotropic medications affect other organ systems, psychiatrists must recognize adverse side effects and drug–drug interactions. A strong background in internal medicine and neurology, therefore, is essential for the practice of psychiatry.
WHAT MAKES A GOOD PSYCHIATRIST?
Likes taking care of both mind and body.
Can deal with very personal and sensitive topics.
Is a nonjudgmental and independent thinker.
Prefers to focus on larger meanings and ideas.
Enjoys asking a lot of questions.
LISTENING TO PATIENTS’ STORIES
When evaluating their patients, psychiatrists conduct a specialized psychiatric interview to gather information and initiate psychotherapy. This workup includes a thorough medical and psychiatric history along with a complete mental status examination. Aspiring psychiatrists find that a patient’s interpersonal style, choice of subjects, and nonverbal communications—as well as your own emotional reactions to the patient—all constitute valuable data.
There are few mental illnesses for which a definitive laboratory test exists. In psychiatry, the patient interview is often the most important diagnostic instrument. With a complete history and interview, psychiatrists obtain indispensable information that goes beyond mere facts. To succeed well at these endeavors, medical students interested in psychiatry should have good communication and interpersonal skills. It also helps being flexible in your diagnostic thinking and tolerating some degree of uncertainty. Armed with this understanding, psychiatrists make accurate diagnoses and then recommend treatment options.
The doctor–patient relationship is absolutely essential to psychiatry. In this specialty, physicians take time to listen carefully to their patients’ personal problems.
More than anything, psychiatrists are caring, nonjudgmental, and genuinely interested in what goes on in their patients’ lives. Unlike other specialists, they get to spend more allotted time with their patients and maintain good working relationships under difficult circumstances. During these interactions, psychiatrists address the whole patient, including mental, physical, and psychosocial aspects.
WHAT ABOUT SUBSPECIALTIES?
Psychiatrists can choose to subspecialize in a number of areas, including the following:
Child and adolescent psychiatry
READY TO START YOUR CAREER AS A FUTURE PSYCHIATRIST?
If you are, then UHSA is for you. We are the second oldest medical school in the Caribbean Basin. That means we know what it takes to make great doctors. We have three programs for you to choose from.
Joint MD/MPH Program – for those who want to earn both their medical degree and a masters of public health (MPH), this is the program for you. An MPH is a highly coveted post-graduate qualification that will better equip you for careers in primary care, international health, or really any specialty.
Accelerated Premedical Program – for those who want to change careers, have always dreamt of being a physician, or are high school graduates, this program will give you the credits and background you need for direct admission to our MD program.
Contact our Admissions Team and begin your journey!