Reflecting on My Clerkship Experience: Psychiatry

From the AAMC Careers in Medicine Clinical Evaluation 

1. Name and Location of Clinical Rotation: 

• Inpatient Psychiatry at LaRue Carter Memorial Hospital 
• Outpatient at the IU Health Neuroscience Center

2. What did I like most about this specialty? 
It was unlike anything I have experienced before. Very eye-opening on the reality of debilitating mental illness... It was fascinating to see how various illness effect the most basic characteristics of thought and personality.

I was assigned to the child unit, and I really enjoyed spending time with and getting to know the kids. A lot of child psychiatry involves talking during play and we had a lot of fun with them :-)  

3. What did I like least about this specialty?
One of my first tasks was to read up on the children I would be following during my clerkship. The resiliency of these kids was amazing but the trauma that they were exposed to was tragic and that was one of the hardest parts of beginning this service. But as you got to know them, you realized that somewhere amidst all the psychiatric issues was a kid just like any other kid you would meet. 

4. Did this clinical rotation give me a good sense of what practice in this specialty would be like? 

Yes, I think that I got a pretty good idea of what it would be like to practice both inpatient and outpatient psychiatry.

My inpatient preceptor is also the Chief Medical Officer of LaRue Carter so she (yes, SHE, girl power! woot!) was very busy and had great insight not only on the medicine side of things but also the business side of things too. She took a lot of time with us teaching and making what we read and saw relevant and applicable even if we were not considering a career in psychiatry.

When I spent time in the outpatient clinic, I got a pretty good exposure to managing "bread and butter psychiatry" i.e. depression, anxiety, ADHD, and even OCD. It was all VERY interesting.

5. Did my interests, values, skills and/or personality "fit" with this specialty? If yes, in what way did they "fit"? If no, why might they not be compatible? 
I think that my personality and demeanor would be a good fit for psychiatry because as you may have figured by now, talking it out is my specialty... Psychiatry is so interesting and you learn so much about how a person processes information - which can lead to positive or negative behaviors - just by having a conversation with them. 

6. What are the possible practice settings for specialists in this field? Which of these settings interest me and do I know enough about them? 

Inpatient
Outpatient
Academic
Administrative
Forensic

I know inpatient psychiatry would not be for me, but outpatient reminded me a lot like my psychiatry exposure during family medicine and I enjoyed that part.

7. What information do I still need to find out about this specialty? 

I think I have a pretty good background.

8. Has my perception of this specialty changed based on my clinical rotation experience? 

Yes, definitely!

9. Did my clinical rotation experience influence the likelihood of choosing a career in this specialty? If yes, how did it influence me? 

I do not think it made me want to choose a career in psychiatry, but it was a GREAT experience.

10. Right now, on a scale of 1-10, how interested am I in this specialty as a career option? 4

11. Other comments or reflections about this rotation or specialty: 

• Depression is one of the most prevalent AND under-diagnosed illness. If you or anyone you know if suffering from symptoms of depression, please encourage them to seek help. 
• One in four adults suffer a mental health condition in a given year. One in 17 live with a serious mental illness like schizophrenia, major depression, or bipolar disorder. 
• About 1 in 10 children live with a serious mental or emotional disorder. 
• The largest current provider of mental health services are the nation's prisons. 21% of local jail and 24% of state prisoners have a history of mental illness. 
• Many people with schizophrenia comprise a large portion of the homeless population. This is referred to as "downward drift" - the hypothesis that those with mental illness are unable to maintain financial stability in society via gainful employment, education, etc. 
• In addition to the HUGE stigma associated with mental illness, psychiatrists are declining in numbers comparable to the amount of people that need their help. 

Despite the disheartening facts, there are awesome organizations like NAMI who advocate for those touched by mental illness with the hopes of making resources available to all those who need them. 

*Information taken from the NAMI fact sheet.