by DrDave » Thu Feb 12, 2009 4:29 pm
Student loans are a big issue as you'll likely have loans from both college and medical school. It can vary significantly based on your family's financial situation, the cost of the schools you go to, whether you qualify for financial aid, and whether you get any scholarships. I think most people view their school debt as if they had a mortgage on a second property, and they pay it off over 20-30 years.
As far as psychiatrists go, I think my practice is a bit different from most. Most people do mostly outpatient work with some inpatient work. I'm doing 100% inpatient work, working at a state psychiatric hospital with a medium security forensic population. I mostly work with individuals who were found Not Guilty by Reason of Insanity (NGRI). I am essentially the team leader along with the other psychiatrists for my unit. We head a multidisciplinary team including social workers, psychologists, nurses, and activity therapists. We evaluate, treat, and make recommendations to the court. I mainly work with medication management issues, but also do some talk therapy. Even when I'm doing medication management sessions, some talk therapy is involved. When I do talk therapy, I usually spend between 15 and 30 minutes with the individual, as I tend to do more focused types of therapy. Some individuals I meet with several times a week, and some people once a week. Because the individuals I work with have been found NGRI, they tend to have very serious mental illnesses. The majority of the people on my unit have either schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features. Many of the individuals also have personality disorders and substance abuse disorders.
It's hard for me to say whether it's worth the time, money, and effort for you to pursue psychiatry over psychology. If you really only want to provide talk therapy, going to medical school and doing a residency is a HUGE undertaking. In my case, I never really considered being a psychologist. I knew I was going to be a physician before I knew I would be a psychiatrist. While I had been doing research in psychology through college and medical school, I hadn't seriously considered being a psychiatrist until I did my clinical rotation my 3rd year of medical school. I loved the experience, but I also really liked internal medicine. I wound up doing a combined residency in both internal medicine and psychiatry. It just so happens that the opportunities that were of interest to me after residency were in psychiatry and I really like the work I'm doing now.