As my first rotation in psychiatry comes to a close, I thought it would be a good idea to record my reflections on how this month has been.

Psychiatry is… so emotionally draining. You see how mental illnesses that are a lot of times unpredictable and have somewhat vague risk factors that are not modifiable (such as family dynamics, childhood, environment, family history of mental illnesses, psychosocial factors). You see how these mental illnesses make people debilitating, unaware of what is going on, limit insight and judgment. And for those who do have insight, they fear when the next episode of mania or depression will come.

Psychiatric institutes, unfortunately, don’t make a lot of money. They attract the lower class folks who are homeless, don’t have insurance, and can’t return to their previous living conditions so being frugal was on everyone’s minds. What I do like about this field is that the care coordinators and social workers are extremely essential to the system, helping patients where to go after discharge on a non-medical level.

Observing as a student, I loved the fact that psychiatrists (most at least…) spend way more than 15 minutes per patient to truly get to know them and build a rapport. I was amazed at how psychiatrists can help without laying a hand on the patient.

At the same time, when there is a communication barrier, mostly with patients who lack insight, it becomes excruciatingly frustrating and difficult to know what is going on or what to do. There’s no way to get an accurate history and timeline, which are so essential to the diagnosis and determining the next plan.

I did enjoy psychiatry for the most part. I think I am much more attracted to certain parts of psychiatry than others, but I’m not so sure if this field is right for me. I didn’t have a strong desire to learn more about the field; I didn’t wake up in the morning, excited to start the day at the psych ward. Although I felt scared at times and frustrated, I think I would be decent at it; having a calm demeanor, not being so emotionally attached to patients, being good at attentively listening to stories… But I want to do international work, and it would be really hard to effectively treat patients when the language barrier is so high.

This is only my first rotation, so I still have a lot to learn and experience. We shall see where this year takes me!


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