How to Become a Psychiatrist

Career Description

A Psychiatrist specializes in assessing, diagnosing and treating mental health conditions and disorders. These conditions can include substance abuse and mental illness. Ultimately, these professionals may also work to prevent mental health problems through counseling mechanisms and management plans.They can also refer patients to other healthcare professionals when necessary.

Psychiatrist may additionally choose to prescribe medication. Examples of patients who may be prescribed medication as part of their treatment plan can include those with schizophrenia, bipolar disorder or depression. Along with providing treatments, Psychiatrists also counsel patients (as do Psychologists and Counselors) on long-term management techniques, lifestyle best practices and mental health triggers. Learn the difference between a Psychologist vs Psychiatrist.

“A Psychiatrist is a Physician (MD or DO) who diagnoses, treats and prevents mental, emotional and behavioral disorders with the use of medication, neuromodulation and/or psychotherapy,” Danielle Johnson, MD, FAPA, a Psychiatrist practicing in Ohio, confirmed. “This career is rewarding, sometimes due to more intangible outcomes than the tangible ones seen in other specialties. There are always labs, EKGs or imaging studies to show improvement.”

Johnson added that in her field, she sees students who had their first manic episode during college, and who then return to school, graduate and who now have a career. There are also people seen who have attempted suicide and through psychiatric assistance find a reason to live. Another patient example are people diagnosed with schizophrenia who eventually become able to live on their own.

“Psychiatrists often see people at their lowest points, but helping them get back up and stay there is an amazing experience,” Johnson explained.

Education & Training

To become a Psychiatrist, professionals must first enroll in and complete a Bachelor’s Degree program. With the goal of later entering medical school, most learners who wish to become a Psychiatrist choose to major in a psychology, ethics, statistic or a life science. So, what can you do with a psychology degree?

Upon graduating from a Bachelor’s Degree program, learners must next take the Medical College Admission Test (MCAT), and submit their scores, along with general applications, to medical schools which they hope to attend. Ideally, learners will take this examination the year before they intend to apply to medical schools, to ensure that they are able to retake the exam to pass and achieve a competitive score.

Once enrolled into a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (OD) program, which typically takes five years to complete, learners can expect to take advanced courses in anatomy, biology, pathology and other sciences. During the second half of medical school, learners experience clinical rotations, during which they are able to experience first-hand psychiatric practice. During these rotations, learners will receive instruction on behavioral science, psychopathology, and may also choose to participate in additional psychiatric research programs.

“Training to become any type of physician can be difficult due to long hours in the classroom, lab, studying, and patient care,” Johnson said. “There are many exams along the way, and time with friends and family and to pursue outside interests can become scarce. There can also be significant debt afterward due to the student loans required to pay for medical education.”

After medical school, learners will apply for their medical license through taking either the U.S. Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination, and must obtain board certification from the American Board of Psychiatry and Neurology (ABPN). Psychiatric professionals are next expected to complete supervised training through a residency, normally lasting three to eight years. Working under the supervision of licensed Psychiatrists enables them to hone their skills and learn more about the inner-workings of the career overall. Johnson noted that the entire educational process, including obtaining her undergraduate degree, completing medical school and finishing her residency, took her 12 years.

Lastly, certification must be renewed every 10 years, meaning that Psychiatrists must continuously seek to keep their knowledge of the industry up-to-date. Often, continued education credits are required on an annual basis to remain certified as well.

“I attend conferences, read journals and discuss new treatments with colleagues to stay up-to-date in the field,” Johnson said. “There is a lot of continuing medical education and research articles available online that provides current info about new medications, non-medication treatments and more information about how the brain works and the causes of mental illnesses.”

Advancement

One way to advance in a career as a Psychiatrist is to focus on a particular sub-specialty. These areas of specialty include geriatric, pediatric, forensic, psychotherapy and perinatal psychiatry. They may also choose to open their own practice, or enter the fields of psychiatric research or education.

“To sub-specialize, Psychiatrists must complete a fellowship, meaning an additional one to two years of training, in child and adolescent, addiction, forensic, geriatric or consultation-liaison,” Johnson said. “Involvement in medical settings and resident education, along with training opportunities, can occur in an academic setting. Research, administrative positions and additional degrees, including a Master’s in Health Administration, Master’s in Business Administration, Master’s in Public Health and others, can also be ways to advance.”

Experience & Skills

“Completing a residency in psychiatry teaches the diagnostic criteria, appropriate medication choices, how to recognize medical causes of psychiatric symptoms, psychotherapy, etc., all necessary in this role,” Johnson explained. “Board certification expresses that a Psychiatrist possess these skills, and is required for most positions, but not all.”

So, to be successful in a career as a Psychiatrist, these professionals should possess strong listening skills, in addition to interpersonal skills. Psychiatrists must be able to effectively communicate with their patients to determine what their needs are, the best methods to achieve rapport with them and successful results. Therefore, they should also have problem-solving, observational skills and decision-making skills, as well as logical reasoning skills.

As technology has become an important element within this role, Psychiatrists must now also know how to operate electronic health records and software specific to their industry (i.e. SoftPsych Psychiatric Diagnosis, Advance Software Psych Advantage, etc.). Dexterity is also critical when taking a patient’s vitals, applying blood pressure cuffs or manipulating a stethoscope.

Personality

In this career in healthcare, professionals should have patience, empathy and be considerate. As many people struggle with different facets of their mental health, Psychiatrists must be perceptive to their conditions and be able to remain considerate, understanding and empathetic. Ultimately, Psychiatrists should be able to find ways to communicate with, respect and relate to all different types of people with a wide variety of conditions.

“Psychiatrists can have varying personalities but the most important qualities to have are being a good listener, having empathy and abstract thinking,” Johnson said. “Patients often see Psychiatrists when they are in crisis and in an inpatient setting, or when they have had symptoms long before they were seen in an outpatient setting. SO, these patients can be overwhelmed, frustrated, angry, anxious and embarrassed.”

She explained that people often have to discuss subjects with Psychiatrists that are difficult, such as trauma or substance abuse, and they need to feel confident and know that they are being listened to when they tell their story. Johnson added that when a patient tells their story, they need to feel understood from their perspective – which is why empathy is necessary.

“Although there are treatment protocols, guidelines, algorithms and evidenced-based treatment in psychiatry, they is not a ‘one size fits all’ approach and we encounter patients whose symptoms don’t respond to treatment as expected,” Johnson said. “Abstract thinking is helpful as we often have to re-evaluate if the diagnosis is correct, and if there are non-medical factors contributing to their symptoms, such as stressful work and home environment, difficulty taking medications daily, lack of sleep and more.”

Lifestyle

Most Psychiatrists work full-time schedules, with relatively “normal” (9 am to 5 pm) hours. This is because the majority of their patients schedule their appointments ahead of time, however, some Psychiatrists offer evening or weekend hours to accommodate patients. Determining hours worked in this profession is much more flexible when the Psychiatrist owns and operates their own practice.

“In general, Psychiatrists have a more consistent schedule and less demanding hours than other specialties,” Johnson confirmed.

During a typical day in this career, professionals will provide psychopharmacological and psychotherapeutic interventions, as well as complete all necessary paperwork. They may also research new trends and techniques in psychology, helping their practice methods stay current. At the end of the day, Psychiatrists may also review patient files for next-day appointments. Learn about other mental health careers, such as that of an Art Therapist, Music Therapist or Rehabilitation Counselor.

“I work in a suburban private psychiatric hospital that is affiliated with an academic medical center,” Johnson said. “I work in the inpatient and outpatient settings and also have an administrative role. In the mornings, I see patients in the hospital, usually patients who are suicidal, have attempted suicide, are severely depressed, manic or psychotic.”

She explained that next, she meets with the treatment team to discuss the events of the patient’s day. She then examines and assesses each patient to evaluate their symptoms, progress, medication effectiveness or side effects, and safety.

“I also spend time teaching residents and medical student who are rotating on the inpatient unit,” Johnson explained. “In the afternoons, I see patients in an outpatient clinic for medication management and psychotherapy. Patients will often see a Psychiatrist for medication management and a Psychologist or other Therapist for psychotherapy, but some Psychiatrists provide both.”

She concluded that the majority of the patients she sees on a daily basis are women with mood and anxiety disorders. Additionally, in her administrative role, she is also involved in the policies and staffing of inpatient services.

Employment

Employment of Psychiatrists is projected to grow 16 percent over the next decade. This growth can largely be attributed to a growing awareness regarding mental health conditions, as well as more health insurance policies providing coverage for this type of healthcare. More facilities, such as outpatient centers, hospitals and schools, now offer psychiatric care as well, increasing demand for these roles.

The most frequent employers of Psychiatrists are the offices of Family Physicians, psychiatric and substance abuse hospitals, outpatient care centers, general and surgical hospitals and the state government. Additionally, the state with the highest employment level in this occupation is California, followed by New York, Ohio, Illinois and Massachusetts.

“I get job postings via email, LinkedIn and regular mail on an almost daily basis,” Johnson noted. “The best jobs depend on what type of practice you prefer, such as inpatient, outpatient, residential, Veterans Association, prison, state hospital, psychiatric emergency room and consulting facilities, and the geographic location you prefer to practice.”

Earnings

The median annual wage for Psychiatrists was $220,430. While the lowest earning 10 percent were recorded to have made less than $$74,530, the highest earning 10 percent made more than $350,000 annually. Ultimately, earnings are dependent upon experience, employer and location.

Top paying employers of these professionals are home healthcare services, the local government, the state government, outpatient care centers and mental health and substance abuse facilities. Top paying states for this occupation are South Dakota, California, Wyoming, Alaska and Indiana.

“Salaries vary widely depending on state, city and employer type, including research facilities, academic settings, the government and private practice,” Johnson explained. “Currently, salaries are higher on the West Coast. However, Psychiatrists can always earn more by doing chart reviews for disability, inpatient length of stay and medical necessity; being an expert witness; and working in more than one practice setting.”

Unions, Groups, Social Media, and Associations

The American Psychiatric Association (APA) is an organization comprised of Psychiatrists who wish to work together to achieve optimal human care and treatment for mental illnesses and conditions. Furthermore, the APA seeks to create a society where everyone has equal access to quality psychiatric care, diagnosis and treatment.

The American Psychological Association (APA) is an organization which represents Psychiatrists practicing within the United States. This organization is dedicated to fostering the education and training of Psychiatrists, in addition to educating the public on mental health and behavioral science. The APA is also designed to promote psychological science and related practice.

The American School Counselor Association (ASCA) is an organization which supports school counselors’ efforts to help students focus on academic, career and social / emotional development so they achieve success in school and life. The ASCA achieves this through providing professional development, publications and other resources, research and advocacy to professional school counselors around the globe.

Getting Started

• Speak with a Psychiatrist about their role, what they like about the career and the challenges involved
• Take psychology courses
• Attend a professional psychology conference as an undergraduate student
• Network with Psychiatrists to learn more about the field
• Find a mentor

All statistics are provided by the Bureau of Labor Statistics.

Meet the professional: Danielle Johnson

Age: 43
Practice: Linder Center of Hope, UC Health
Location: Mason, OH

What is the single biggest suggestion you would give to someone wanting to get into this career?

“Be patient. There is an art to listening and eliciting a story. Symptoms of depression, anxiety, mania or psychosis can impact their ability to tell their story. Listen and give them time to feel comfortable opening up.”

What’s the number one mistake people make when trying to get into this career?

“Not being ready to combat stigma on a regular basis. In 2018, there is still stigma about mental illness and seeking help from a Psychiatrist. Part of a psychiatrist’s job is to reduce stigma for the patients and the community – helping people view mental illness as they view any other illness.”

What is the question people should ask about this career but rarely do?

“How does the availability of other providers (nurse practitioners, physician assistants, prescribing psychologists) impact Psychiatrist opportunities?”

Why did you choose to become a Psychiatrist?

“I did not intend to go into psychiatry but during medical school, the patients that I enjoyed talking to and interacting with the most were those with psychiatric diagnoses. I also observed that sometimes they were treated differently than other patients or their physical complaints were minimized. I felt this was very unfair and wanted to advocate for and help patients that others ignored.”

In one word, what makes you successful in this career?”

“Calmness.”

Credentialing organizations: American Board of Psychiatry and Neurology