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Psychiatrist - DO/MD

Overview

Psychiatrists are physicians who specialize in the diagnosis and treatment of mental illnesses. The stereotype of the "bearded analyst" sitting by the couch is obsolete. While psychoanalysis is still practiced, most psychiatrists today provide a wide range of biological, psychotherapeutic, and psychosocial treatments tailored to the specific needs of the patient. Psychiatrists also serve as the medical experts for the mind/brain/body interface.

Like other medical conditions, mental illnesses can range from relatively mild and self-limiting conditions to severe and life-threatening disorders.  Recent research by the National Institute of Mental Health indicates that 26% of the adult population in the U.S. suffers from some diagnosable mental disorder in any given year. Nearly 6% of all Americans suffer from severe mental illness (i.e., schizophrenia or bipolar disorder). 

Psychiatry is one of the oldest medical specialties. The American Psychiatric Association (APA) is over 150 years old. Psychiatry is also one of the frontiers of medicine, as researchers constantly make new discoveries about the brain.  Recent advances in the neurosciences have led to significant new technologies in the diagnosis and treatment of many mental illnesses. Among other innovations, brain imaging and new pharmaceuticals have led to mental illness treatments that are just as effective as treatments in other medical specialties.

The prospects for finding a good job in this field are excellent for the foreseeable future. There is still a great need for psychiatrists in all aspects of the public, as well as in the private care sector.  Psychiatry was designated as a shortage specialty and a priority specialty in a recent report by the Graduate Medical Education National Advisory Committee.  Subspecialists such as child psychiatrists and geriatric psychiatrists are in even greater demand.

To learn more, watch a video profile about psychiatrists (in the Health Science category).

Working Conditions

The average psychiatrist spends more than 48 hours each week at work. Professional activities include administration, teaching, consultation and research. Most psychiatrists spend over 60% of their time with patients. Two-thirds of these patients are seen as outpatients, with the rest being seen in a hospital setting or, increasingly, in partial hospital or day programs and community residential programs. Psychiatric hospitalization is now more intense, more focused, and much shorter in duration than in previous years.

Psychiatrists work in group or solo private practice much the way other physicians do. They also practice in the public sector, such as Veterans Administration and state hospitals and community mental health centers that are unique to psychiatry. Other settings for psychiatric practice include medical schools, HMOs, and general hospitals, as well as specialized psychiatric hospitals.

Academic Requirements

To become a psychiatrist, you first must hold a medical degree.  Once you earn your MD or DO, you must enter a residency program in psychiatry.

Post-graduate education in psychiatry consists of 4 years of residency training, of which at least 3 are in psychiatry.  During the first year, the resident spends at least four months in general medical care, including internal medicine, family medicine or pediatrics, and at least two months of neurology. 

General psychiatry residents spend the next 3 years rotating through in-patient services, with full and partial hospitalization; ER and/or walk-in or crisis clinic coverage; and ambulatory services.  These experiences are complemented by lectures, seminars and case supervision. 

Introductory experiences in public health/community psychiatry, child psychiatry, geriatric psychiatry, substance abuse, forensic psychiatry and consultation/liaison programs usually are included in the final two years.

The last year offers numerous opportunities for electives.  Some residents become the chief resident of an in-patient or ambulatory care unit.  Others focus on special clinical and/or research interests. 

Following residency, you must select a sub-specialty.  Most sub-specialties require a one-year fellowship, although some (such as child/adolescent psychiatry) require two years.  Sub-specialty fellowships culminate in a certificate of added qualification in one of the following fields:

  • Child and adolescent psychiatry
  • Geriatric psychiatry
  • Addiction psychiatry
  • Forensic psychiatry
  • Psychosomatic medicine

In addition, there are a number of informal "subspecialties," for which advanced training is available.  These include, among others:

  • Consultation/Liaison psychiatry
  • Community psychiatry
  • Administrative psychiatry
  • Emergency psychiatry
  • Research psychiatry

Physicians who have completed the specialty residency training requirements are eligible to take the American Board of Psychiatry and Neurology (ABPN) certification examination. The ABPN also issues certificates on psychiatry subspecialties in addition to the general certification.

NOTE: Psychiatry has developed a number of combined programs with other medical specialties, including internal medicine, neurology, family medicine, and pediatrics.  These programs allow for complete training in two specialties in a shorter time period than would be the case otherwise.