Imagine you’re depressed or anxious, but don’t know why. Perhaps you use drugs or alcohol to cope with your emotions. Maybe you see or hear things that no one else does, or you have obsessive thoughts about something that leads you to engage in compulsive behaviors.
Each of these situations is more common than you think. However, the human mind is an incredibly complex structure that we are still struggling to fully understand. For centuries, scientists have sought to gain a better understanding of why people behave the way they do.
Likewise, studies of mental health conditions, emotional problems, behavioral disorders, and the like, have been undertaken for generations, and though much more is known about the human mind now, there’s still much more to learn.
That’s where psychiatrists come in – they investigate human behavior, diagnose mental disorders, and provide treatments to people that suffer from such disorders.
What Does a Psychiatrist Do?
In short, a psychiatrist diagnoses and treats mental disorders. Psychiatrists are medical doctors with specialized training in psychiatry that allows them to provide mental health treatment to their patients.
More specifically, psychiatrists are highly trained in both psychology and medicine. This not only gives them the background knowledge needed to understand how people think, behave, and act the way they do, but it also gives them critical medical knowledge that can assist them in helping their patients overcome their psychological troubles.
Psychiatrists use their combination of psychological and medical knowledge to diagnose patients with a variety of mental, emotional, and behavioral disorders. In many instances, psychiatrists use the medical model for diagnosis. That is, they use the Diagnostic and Statistical Manual of the Mental Disorders (5th Ed.) to determine the specific mental condition their patients have.
But diagnosis is just one part of the job. Psychiatrists also treat mental, emotional, and behavioral conditions. Of course, the treatment that’s pursued depends on a host of factors, not the least of which is the patient’s diagnosis.
For example, a psychiatrist might use psychotherapy as their primary treatment for a patient that has depression. In psychotherapy, the psychiatrist helps bring about positive change through talk therapy. So, with a depressed patient, the goal of psychotherapy would be to help the patient minimize or even control depressed thoughts by exploring past experiences and how they influence current behaviors.
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As another example, a patient that has an anxiety disorder might be treated using systematic desensitization. In this form of therapy, a psychiatrist would help walk the patient through baby steps in order to help reduce their anxiety.
So, a patient that’s afraid of flying might be guided through various steps starting with talking about flying. Then perhaps they would visit an airport (with their psychiatrist). From there, they might be asked to stand next to an airplane, then sit in an airplane on the tarmac, and so forth, until the patient’s anxiety has been minimized enough to be able to comfortably fly.
Because psychiatrists are medical doctors, they can also treat mental disorders by prescribing medication. Again, a prescription is only given after a thorough examination and diagnosis of the patient, with appropriate medications being supplied to address the specific problem.
For example, a patient with bipolar disorder might be prescribed lithium by their psychiatrist. Alternatively, a patient with ADHD might be prescribed Adderall or Concerta to minimize their symptoms. In many cases, psychiatrists rely on a mixture of treatments (i.e., psychotherapy and drug therapy) to treat their patients most effectively.
What are the Educational Requirements to Become a Psychiatrist?
Psychiatry is a career that requires a long-term commitment to education, with various steps along the way that must be completed before one is eligible to practice. Those steps include:
Step 1: Undergraduate Studies
To begin, students that wish to pursue a career in psychiatry must complete a bachelor’s degree program. Since students will complete medical school in the next step, it’s important that the undergraduate studies focus on majors that are closely aligned with medicine, like biology or chemistry.
Bachelor’s degree programs in these fields are designed to take approximately four years, provided that a student attends school full-time. Of the approximately 120 credit hours required to complete a bachelor’s degree, about half of them focus on general education courses, like science, math, humanities, art, English, and so forth. These courses are usually completed in the first two years of a four-year degree.
The latter two years of a four-year degree focus more on the major area of study. For pre-med students, that means completing coursework in biology, chemistry, physics, anatomy, psychology, genetics, and so forth.
Step 2: Medical School
Upon successful completion of a bachelor’s degree program, the next step in becoming a psychiatrist is to pass the MCAT exam and be admitted to medical school. Like undergraduate programs, medical school typically lasts four years.
During medical school, students are trained in all manner of medical topics. Regardless of their desired area of specialization, medical school students study the same general topics. That is, a future psychiatrist and a future surgeon will participate in the same coursework.
At this level, that coursework is focused on helping students learn more about the body, how it’s structured, physiological problems that can occur, and how to rectify those issues. Common coursework in medical school includes biochemistry, physiology, immunology, and histology. Typically, coursework in psychology is also required in medical school.
Step 3: Psychiatric Residency
Future psychiatrists get their formal psychiatric training during a four-year residency that occurs after the successful completion of medical school. It is during residency that residents put their learning to the test by working in real-world environments with actual psychiatric patients. Naturally, an experienced psychiatrist closely supervises their work during residency.
Residents move from one residency location to the next in order to get wide exposure to working with many different kinds of patients in many different kinds of environments. A psychiatric rotation might include working in an inpatient facility for children, then an outpatient facility that specializes in treating drug and alcohol-related disorders in adults.
Furthermore, residents often work in hospital settings, private practices, public health centers, and many other locations, again, to get as well-rounded an experience as possible.
Step 4: Fellowship
Many psychiatrists opt to complete a fellowship after their residency. Fellowships give psychiatrists an opportunity to train in a specialty within psychiatry. For example, one’s fellowship might focus on addictions, working with geriatric patients, or perhaps involve training in a specific type of treatment, like psychotherapy. Typically, fellowships last around one year.
What are the Licensure and Certification Requirements?
Once residency training is completed, new psychiatrists typically take the board exam, a written and oral exam administered by the American Board of Psychiatry and Neurology. Successful completion of the board exam means that the psychiatrist is board certified for a period of ten years.
Board certification is important because it’s a way for psychiatrists to demonstrate their knowledge and skills in their field. Not only does this help ensure improved outcomes for their patients, but because there are continuing education requirements to remain board certified, it encourages psychiatrists to be up-to-date on the latest developments and practices in the field of psychiatry.
Like any other medical doctor, a psychiatrist must also have a medical license from each state in which they practice. To become a licensed psychiatrist, multiple steps must be completed, the first of which is passing the U.S. Medical Licensing Examination.
This exam is comprised of three steps. Step 1 assess the student’s ability to apply their knowledge of necessary medical concepts to the practice of medicine. It is a one-day examination that includes seven separate 60-minute testing blocks. This examination usually takes place after the completion of the second year of medical school.
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Step 2 focuses on assessing a student’s ability to apply their understanding of medicine to patient care. This is a two-day exam taken after the fourth year of medical school. The first day of testing revolves around a multiple choice exam that questions students on knowledge-based topics related to medical practice. The second day of testing focuses on assessing clinical skills, during which test-takers must assess and diagnose actors that have been assigned the role of playing a patient with a specific condition.
The third step of the USMLE occurs over the course of two days after the first year of residency is completed. This step centers around the student’s ability to practice medicine on their own without any supervision, and focuses assessment on the student’s knowledge and skills as they pertain to diagnosing conditions and treating them.
Upon successful completion of all three parts of the USMLE, licensure can be obtained. Licenses are granted by the state board of medicine and must be renewed periodically, though the timeframe for which renewal must take place varies from state to state.
How Long Does it Take to Become a Psychiatrist?
To become a psychiatrist, one must invest roughly 12 years in educational and residency experiences. As noted above, a bachelor’s degree is the first step, which usually takes four years to complete.
After that, another four years of medical school are required. Upon completion of medical school, a four-year residency program must be completed before work as a fully licensed and independent psychiatrist can be undertaken.
What Does it Take to Become a Psychiatrist?
As with any career in the helping professions, there are a variety of skills and personal qualities that will make you better-suited to become a psychiatrist. These include:
People skills – Since psychiatrists help people work through very personal issues, it’s important that they have the ability to connect with people in a supportive and caring way.
Interpersonal communication skills – Psychiatrists must just be good speakers. More importantly, they must be excellent listeners that have the ability to extract meaning (both overt and covert) from what their clients are saying.
Organizational skills – Psychiatrists must create and maintain detailed records for all of their patients. Beyond that, they must have a commitment to keeping patient records confidential. Organizing notes and files under lock and key is a critical component of being a successful psychiatrist.
Patience – Psychiatry is often more about the long, slow process of recovering from mental health issues and less about short-term gains. As such, psychiatrists must be patient both with the process and with clients that might relapse along the way or might be overtly resistant to change.
Works well under pressure – Whether a psychiatrist works in a mental institution, in an emergency room, in private practice, or some other setting, they must be able to handle stress well, react to rapidly changing situations, and make important decisions under pressure.
Empathy – Psychiatrists must be able to put themselves in other people’s shoes and develop an understanding of other people’s behavior and thinking, no matter how different it is from their own behavior and thinking.
Compassion – Psychiatrists work with all manner and sort of people that have experienced all manner and sort of traumas. As such, it is crucial that psychiatrists have the capacity for compassion, no matter who their client might be.
Where Do Psychiatrists Work?
The employment locations for psychiatrists are about as varied as the populations that they serve.
Many psychiatrists work in an institutional setting and provide services to patients that are part of an inpatient or outpatient treatment program. An inpatient treatment center is a residential facility where patients live and get treatment and care, like a mental hospital.
Outpatient treatment centers, on the other hand, offer services to patients that come and go. For example, a patient being treated for alcohol addiction might visit an outpatient treatment center for therapy and a 12-step program three nights a week.
Another popular work setting for psychiatrists is in public institutions. This includes general hospitals, where they would like work on a psychiatric floor, community mental health clinics, where they would meet with clients on an individual or group basis, and universities, where psychiatrists would teach and conduct research.
State and federal agencies also employ psychiatrists. For example, a psychiatrist might work for the Veteran’s Affairs Administration, providing services to veterans of the armed forces.
Psychiatrists might also be employed by a government entity like the National Institute of Mental Health, where their role would be more administrative and research-oriented, perhaps conducting research on a mental health disorder like autism or schizophrenia.
Of course, many psychiatrists work in private practice. In this setting, psychiatrists have a private office at which they meet their clients. Client meetings might be one-on-one therapy sessions, couples sessions, family sessions, or even group sessions.
Typically, private practice offers psychiatrists the most flexibility regarding when they work, though many psychiatrists in private practice see patients in the evenings and weekends to accommodate their patients’ schedules.
How Much Can You Earn With a Psychiatry Degree?
Psychiatry can be a lucrative field of work given that psychiatrists are medical doctors. As of May 2021, according to the Bureau of Labor Statistics, psychiatrists and other medical doctors make a yearly average wage of $208,000. However, the amount can make as a psychiatrist varies quite widely.
For example, during residency, the annual income is typically in the $35,000-$50,000 range, depending on the place of employment. Likewise, psychiatrists that have just entered the workforce will command a lower wage than those that have experience under their belt.
In addition to one’s level of experience, another factor that influences how much a psychiatrist makes is the location of their employment. For example, a psychiatrist in private practice can command a much higher wage than one that works at a non-profit mental health clinic. Psychiatrists that work in urban areas tend to earn higher wages than those in rural areas.
Specializations can also influence how much a psychiatrist earns. For example, a psychiatrist that specializes in working with children with autism – a very common condition – are more likely to have their services be in demand, and can therefore charge more money, than a psychiatrist that specializes in working with children that have schizoaffective disorder.
What is the Job Outlook for Psychiatrists?
The job outlook for psychiatrists is quite favorable over the next ten years or so. A report by the Bureau of Labor Statistics indicates that job growth for this occupational area is expected to be at 16 percent in the coming years.
Fueling that growth is an increased emphasis on mental health, addressing mental health concerns, and being proactive in health care in general. Likewise, with disorders like depression, anxiety, alcoholism, and drug addiction occurring at higher and higher rates in the population, the demand for psychiatric services appears as though it will continue to be strong.
One factor that could lead to slower job growth for psychiatrists is the cost of insurance and the diminishing access to health insurance by some groups, particularly the poor.
Additionally, the uncertainty surrounding the current health care system and potential changes to it in the future could lead to fewer people seeking mental health care because they don’t have insurance to pay for it.
What is the Difference Between a Psychiatrist and a Psychologist?
The primary difference between a psychiatrist and psychologist is the educational background.
On the one hand, a psychiatrist is a trained medical doctor that, as noted earlier, completes medical school and a psychiatric residency. On the other hand, a psychologist is not a medical doctor, and instead attends graduate school and likely completes a doctoral program as well.
A secondary difference is that since psychiatrists are medical doctors, they can prescribe medication to their patients. Typically, psychologists cannot prescribe medications, though some doctoral-level psychologists in some states do have the power to do so.
Naturally, the income that psychiatrists and psychologists make is different, given that psychiatrists command similar wages to other medical doctors. As explained above, the annual median salary for a psychiatrist is $208,000 compared to $98,010 for psychologists.
There is often a difference in approach to patient care as well. Psychiatrists typically take the medical model approach, that is, they seek to identify and diagnose a disorder and prescribe treatment for that disorder, be that drug therapy or otherwise.
Psychologists, on the other hand, might be less interested in labeling a client with a disorder and more focused on helping their clients work through their issues to find improved mental health.
What Careers are Similar to Psychiatry?
There are many career paths that are similar to psychiatry in that they involve working with clients to address mental, behavioral, and emotional disorders. These careers include:
Psychologist – Like psychiatrists, psychologists study human behavior and devise therapies that help their clients to better deal with life’s difficulties. They typically work with clients in a one-on-one or group setting, using techniques like talk therapy, cognitive behavioral therapy, and family therapy to assist their clients in effecting positive life changes.
Social worker – Social workers tend to work less with clients with long-term psychological issues and more with those who need short-term goals to overcome difficulties in everyday life. For example, a social worker might offer services to a young adult with a developmental disability that helps the client care for him or herself. This might include teaching them how to cook, clean house, grocery shop, and do laundry.
Marriage and family therapist – As their title implies, marriage and family therapists work with couples and families to help them develop healthier relationships. This is typically done in couples counseling and family therapy situations, in which the therapist works with the couple or family to help them develop stronger communication skills, process feelings and emotions, and rebuild trust in one another.
Substance abuse counselor – Substance abuse counselors work with individuals that are addicted to or dependent upon alcohol, drugs, and other addictive substances to help them recover from their addiction.
Much of a substance abuse counselor’s job is assisting their clients in identifying underlying problems that led to substance abuse, identifying triggers that cause them to use substances, and working with the client to develop the skills needed to cope with life’s problems without turning to substances.