Psychation

Psych

Done with another rotation and though it feels good, I am bummed I didn’t do well enough on my shelf exam to honor. That thing was hard! I felt like I had really studied psych and understood the concepts. Heck, I was scoring 90s on Uworld but I didn’t prepare for the medicine questions and really random questions on the exam. At least I passed and it is one more down. Needless to say, I will not be going into psych but here are my thoughts:

What I liked:
- The hours. I can’t believe any medical specialty can be 9-3:30 most days. You can make $250K a year and have 60 days of vacation per year. WHAT???
- The stories: pysch patients are interesting, variable, and you never know what they are going to do or say next. I literally had a patient who was mumbled all the time and when you could catch a word, it would be an obscenity. On my last day of psych, I told her thanks for talking to me and without missing a beat, she said “you’re welcome B***H! Go to hell!” lol.
- Research opportunities: because we don’t know a lot in psych, I feel that this area may yield the most research advances in the coming years. It would be fun to be at the forefront of that.
- Child psych. I like children and I like thinking about their psych issues. I like learning about OCD and PTSD in children. I like how blunt and mallable they are and if you treat them early, it could really prevent later psychiatric issues.
- Short rounds, short notes, light patient load
-  Interviewing is hard! And an art! So it would take a life time to master so that aspect would be challenging.

What I hated:
- I hated the nebulous nature of the profession. We still don’t know why certain diseases occur or how certain drugs work. There is a set formula for treatment: 1) rule out medical conditions, 2) rule out substance abuse, 3) categorize the disease based on time and number of symptoms 3) Treat with either an antidepressant, antipsychotic, mood stabilizer, or benzo. I find it .very unsatisfying that we know so little.
- I dislike patients with substance abuse. Perhaps this is because I never did drugs (except trying marijuana once in Colorado where it is legal) and having the occasional social drink but I definitely have not experienced severe intoxication or withdraw and contrary to my ethnicity, I do make Aldehyde dehydrogenase so I don’t even know what Antabuse feels like!
- I DO NOT like studying psych. I don’t expect to love studying for what I go into because lets faces it…years of standardized testing has made studying a chore but I do expect to not hate it and I HATED studying for psych. I hate memorizing criteria and drugs to treat those criteria
- Lack of procedures. I want to do things….to fix things in a tangible way.
- Scary. A lot of psych patients are labile or dangerous. Though it is exciting not knowing what will happen next, I don’t want to be in a state of fear interviewing my patients.

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