Psychiatrists are physicians who specialize in the diagnosis and treatment of mental illnesses. While many people associate psychiatry with psychoanalysis, 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. The National Institute of Mental Health notes that there were an estimated 43.7 million adults aged 18 or older (18.6%) in the United States with a diagnosable mental illness in 2012.
One of the oldest medical specialties, psychiatry is also constantly evolving as researchers 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 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 private practices much the way other physicians do. They also practice in the public sector in 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.
Salary Range and Outlook
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 the public and private care sectors. The Council on Graduate Medical Education designated psychiatry as a shortage specialty and a priority specialty in a recent report. Subspecialists such as child psychiatrists and geriatric psychiatrists are in even greater demand.
Post-graduate education in psychiatry consists of four years of residency training, of which at least three 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 in neurology.
General psychiatry residents spend the next three years rotating through in-patient services, ER or crisis clinic coverage and outpatient services. These experiences are complemented by lectures, seminars and supervision sessions with faculty.
Introductory experiences in public health/community psychiatry, child psychiatry, geriatric psychiatry, substance abuse, forensic psychiatry and consultation/liaison programs are included throughout residency.
Following residency, psychiatrists may select a sub-specialty. Most sub-specialties require a one-year fellowship, although some (such as child/adolescent psychiatry) require two years. Those who complete the fellowships earn certificates of added qualification in one of the following fields:
- Child and adolescent psychiatry
- Geriatric psychiatry
- Addiction psychiatry
- Forensic psychiatry
- Psychosomatic medicine
Advanced training is also available for a number of informal subspecialties, including, among others:
- Community psychiatry
- Emergency psychiatry
- Research psychiatry
Physicians who have completed the 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.
Psychiatry has developed a number of combined programs with other medical specialties, including internal medicine, neurology and pediatrics. These programs allow for complete training in two specialties in a shorter time period than would be the case otherwise.
Learn More About a Career in Psychiatry
- Watch a video profile about psychiatrists (in the Health Science category).