What it’s like to specialize in psychiatry: Shadowing Dr. Patel

. 7 MIN READ

As a medical student, do you ever wonder what it’s like to specialize in psychiatry? Meet Avani K. Patel, MD, MHA, a psychiatrist and a featured physician in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out her insights to help determine whether a career in psychiatry might be a good fit for you.

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Avani K. Patel, MD, MHA
Avani K. Patel, MD, MHA

“Shadowing” Dr. Patel

Specialty: Psychiatry.

Practice setting: University academic medical center.

Employment type: Resident physician.

Years in practice: Second year of residency.

A typical day and week in my practice: Because I’m in residency, my days vary a lot. The workweek can be anywhere from 50 to just under 80 hours. Most of my training has fallen under psychiatry emergency services (12-hour shifts Monday through Friday), adult consult liaison psychiatry service, child and adolescent psychiatry, and adult inpatient psychiatry.

Adult inpatient psychiatry tends to be more of our “rest” months. It consists of managing a unit which gives you more of the 8 a.m. to 5 p.m. job-type feel. You’ll generally complete pre-rounds in the morning and then team rounds later in the morning. We tend to have multidisciplinary rounds incorporating our social worker, nurses and medical students. The afternoon is reserved for writing notes, obtaining collateral information and tying up any loose ends.

Child and adolescent psychiatry can be a very busy month. You’re usually paired with a fellow or another second-year resident. Between the two, you can anticipate covering three services—the inpatient child unit, pediatric ER consults and inpatient child consults. Like the adult inpatient service, you tend to round first. The afternoon is left for writing notes, making phone calls to families, tying up loose ends on the unit and seeing any consults you may have in the ER or in the inpatient side of the children’s hospital.

Adult consult liaison psychiatry service is a unique service. You’re really considering both the medical and psychiatric problems a patient may be experiencing. You get to work with many different specialties, and you’ll learn quickly you’re a very popular person in the hospital. It stays quite busy as the psychiatric needs of patients have amped up here lately.

Psychiatry emergency services is probably the most taxing rotation and is like our call weekends in ways. Imagine working 12-hour shifts Monday through Friday for an entire month. That can be up to 20–23 shifts per month. As difficult as it can be, these are the months I have learned the most in terms of becoming a psychiatrist.

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Life in child and adolescent psychiatry: Shadowing Dr. Ambrose

The most challenging and rewarding aspects of psychiatry: The most challenging aspect of caring for psychiatric patients is not always getting to see them at the finish line with success. Oftentimes, I’ll see patients at their lowest point, and many times, I am able to help them reach a point that is much better but not necessarily their best. When patients are at their best, they tend to stop seeing you because you have done your job well. So, it can be difficult that we don’t always get to see the fruits of our labor in a way. On the flip side, that’s the most rewarding part.

There is something very special about knowing that I helped save a life—one that someone could have taken by choice. That feels very meaningful. It is also really rewarding to be able to help people “get their life back.” Mental illness can impact one’s life in a major way, so it’s nice to be able to help patients function in a way that allows them to be a contributing member of their community. 

How life in psychiatry has been affected by the global pandemic: My life has gotten so much busier and more isolating at times. Vulnerability is fundamental to humanity, and it is the piece that connects all of us. The pandemic has exposed that sense of vulnerability in all of us. We can’t hide behind the façade of what we once created.

The pandemic has shown us that we require connection and interaction at varying levels. So, what have I done to deal with this new sense of vulnerability? I gave in. It’s important to remember that I’m only human, and it’s OK to feel. I invested in myself and my relationships with friends and family. It’s about making a conscious effort to be my best self and nurture that sense of vulnerability. 

The long-term impact the pandemic will have on psychiatry: Mental health is finally getting the attention it deserves. During the pandemic, many have experienced what a toll it can create on one’s mental health. As we take care of our physical health, I strongly believe we should also share the same sense of motivation, dedication, and urgency in taking care of our mental health.

Three adjectives to describe the typical psychiatrist: Private, curious, observant.

How my lifestyle matches, or differs from, what I had envisioned: I hope my lifestyle looks different as an attending physician than it does right now as a resident physician. Simply put, residency is very demanding. You’ll find in medical school that your time is not your own, and residency can very much feel that way. Yet there is something very rewarding about taking ownership in patient care.

There is a lot of learning, fulfillment and reward that comes with being a resident. I do think it’s important to maintain work-life balance as best as you possibly can. If you create boundaries and develop time management skills prior to residency, then you will find a lot of success even when it gets really tough with time-consuming schedules.

Skills every physician in training should have for psychiatry but won’t be tested for on the board exam: I was once told by a very special physician mentor: “You have the thing. The thing that can’t be taught. The magic that doesn’t fade. Don’t ever lose that, and you will be successful. You already are an incredible physician.”

I will never forget her words and her encouragement. For me, that special “thing” is my sparkle and compassion. I will always walk into a room being genuinely myself, and I always hope I bring compassion to the table.

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One question physicians in training should ask themselves before pursuing psychiatry: Does this make me truly happy, and will I still feel a sense of fulfillment in 20 years?

Books every medical student interested in psychiatry should be reading: Building your emotional intelligence will help you get much further in your career—whether it involves a leadership position or taking care of patients. Emotional intelligence has always played a vital role, and it’s a skill we don’t pay enough attention to while in medical school.

With that being said, I recommend:

  • The EQ Edge: Emotional Intelligence and Your Success, by Steven J. Stein, PhD, and Howard E. Book, MD.
  • Emotional Intelligence 2.0, by Travis Bradberry, PhD, and Jean Greaves, PhD.
  • Elite Minds: How Winners Think Differently to Create a Competitive Edge and Maximize Success, by Stan Beecham, PhD.

The online resource students interested in psychiatry should follow: At Merck Manuals Med Student Stories you’ll get a chance to read from medical students and residents sharing about their journey through medicine and any advice they may share. It’s an amazing forum where you can relate and even start a conversation in the comments section.

Plus, I’m biased because I’ve been writing there for years, with more than 180 articles published about medical school and residency.

Quick insights I would give students who are considering psychiatry: If you do what makes you happy, you’ll never go wrong. Wherever life may take you, consider it a learning experience. If one door closes, another one will open.

Just be open to the possibilities of what that may be. Be curious, ask meaningful questions, and be observant. That is advice that can be used in any specialty.

Song to describe my life in psychiatry:Badass Woman,” by Meghan Trainor.

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