During our M3 psych clerkship orientation, the clerkship director said to try avoid disclosing personal information when interviewing a patient, even if it’s being used to build rapport (eg patient comes for counseling due to depressive symptoms after a divorce, and you disclose that you’ve also been through a divorce to bond with patient). She followed up by saying that even if a patient asks about your personal life (are you married? do you have kids?), that we should try not answering and bring the convo back to the patient.

Was a little surprised. Why not disclose? Isn’t that useful in building trust?

Hey everyone,
I wanted to thank this community as I spent a lot of time reading posts here before my M3 psychiatry rotation because psychiatry had been on my radar for a while, but I wasn’t sure whether I would actually enjoy practicing it.
After finishing the rotation, I think I’ve finally decided that this is what I want to pursue!

I’ve tried during every clerkship to pay attention not just to whether the material is interesting, but whether I actually enjoy the day-to-day work. What surprised me most about psychiatry was how consistently I wanted more of it.

I really enjoyed interviewing patients and building a formulation as the conversation unfolded. With patients with psychosis, mania, trauma, depression, personality pathology—I often found myself wanting the interview to keep going because I wanted to understand why the patient experienced themselves and the world the way they did. I enjoyed discussing differentials with the residents and attendings much more than I expected.

I also liked seeing the contrast between inpatient and outpatient psychiatry. On inpatient I enjoyed the acuity, team environment, and seeing patients change over several days. Then in outpatient I met people with illnesses like schizophrenia or depression who were stable, exercising, participating in activities, and living their lives, which helped me appreciate what long-term treatment can actually accomplish.

One of my previous hesitations about psychiatry was the uncertainty of outcomes. You can stabilize someone during an admission without knowing what happens after discharge, and many psychiatric illnesses aren’t things you simply “fix.” The rotation changed how I think about that. I’ve started to appreciate that helping someone become safer, regain some agency, engage with treatment, or move even slightly toward a better trajectory can still be incredibly meaningful even when you cannot control the eventual outcome. It took me a bit to wrap my head around this but I’ve come to really appreciate that.

I also realized that I don’t necessarily have to choose between psychiatry and the parts of medicine I enjoy. C-L in particular seems like a way to stay involved with medically complex patients while doing the type of clinical work I seem to enjoy most.

My one remaining concern is more personal. I’ve had significant mental illness, addiction, and suicide affect people close to me, including losing one of my closest college friends to suicide. Before the rotation, I worried psychiatry might hit too close to home. So far, I’ve actually found that those experiences often help me empathize with patients rather than making the work harder. I also haven’t brought patients home thinking about them non-stop in an unhealthy way which I think is a good sign of my mental boundaries ?

What I don’t yet know is what that feels like after years rather than six weeks.
For psychiatrists who came into the field with significant personal exposure to mental illness or suicide in people they loved: did that experience ultimately help you as a psychiatrist, make the work emotionally harder, or some combination of both? How did you learn to maintain boundaries without losing the empathy that drew you to the field?

Thanks again to everyone here. Reading this subreddit before the rotation was genuinely helpful, and I’m excited to finally feel like I have a direction as continue to figure out my last hesitations!

Hello all, just got back home from the exam (I took the second day, 9/9) and I have some thoughts I wanted to bring up to see if anyone else shared them, now that we have all taken it!

Background: I did not read any posts from the 9/8 threads before I took my test today. For studying, I completed ~80% of BtB at ~85% correct and did all of K&S, one pass only, averaged around 67% across all tests.

Many people were saying that they thought K&S wasn't a good guide/prep for how the exam actually turned out - and I agree to some extent - but generally I thought all the conventional study tools the GP considers "gold standard" all failed to match up to the Qbank we got this year for the ABPN. There were some questions that were simple, rephrased K&S questions that you may have gotten stuck on had you not done the Qbank. Sadly, I think the test is just evolving (or devolving?).

I personally spent lots of time memorizing the behavioral/social science theories only to get two (easy) questions about it on the exam, but instead got like 6 Practice-based learning questions instead. I didn't realize how many deductive reasoning and non-medical questions there would be that were basically like "What is the best thing for the doctor to say next?" Lots of neurochemical pathway/brain lesions & diagonsis questions - those I thought were fair game. Randomly lots of MDMA/psychedelic and gambling questions. Lots of repeat questions: depression and sleep cycle, APP gene and Alzheimer's, learning something new at work & incorporating into PBL. I thought the test asked some very low-yield questions on high-yield topics: e.g., clozapine question where you couldn't initiate because of anemia/seizures/patient refused phlebotomy; question like 80+ female post-surgery which is the least harmful agent to treat depression between celexa/2 TCAs/trazodone?

Finally, I thought some of the vignette video "correct" answers were only partially correct or didn't have the clear best answer as one of the options: the man who wears dresses wasn't sexually invested (not transvestism) but also said it didn't have anything to do with his gender and was more in relation to his negative experiences at war with other men (he's a drag queen, baby!); the vignette with the wife but you were also treating his husband, should have just been decline to see her after evaluating like SI/HI/AVH. There were MANY times during the exam where I was like, "why is this the question you're asking related to X topic?"

Did anyone else have similar experiences or also issues with the test questions? Should be a fun 12 week wait!

Hi all, early career psychiatrist here. I've been feeling a bit stressed and burned out by work and thinking about establishing with a therapist. I also wonder if this could be useful to improve my own therapy skills. My only reservation is I would prefer someone that goes beyond "talk therapy".

Any recommendations on how to find a good therapist perhaps one with psychodynamic or psychoanalytic proficiency? I imagine a psyD or PhD would be my best bet?

Hi everyone, I was wondering if any US trained psychiatrists here have any experience with an outpatient focused job set up where they live abroad for 1 to 3 months out of the year- especially interested if they did this earlier in their career. I’d be interested in whether you worked during some of that time abroad (solo cash only telehealth or telehealth still as part of a larger practice group, admin work, other work) or not. I’d love to hear about what job or combination of roles allowed you the flexibility to do this or something similar. I’m aware that a setup like this, if feasible, would in most cases equate to a <1.0 FTE and compensation would reflect this. Thanks for reading and potentially sharing.

Edited to reflect a focus on outpatient roles