A Career in Detail –
By Al McGrath, 4FN
Becoming a Psychiatrist
Working as a Psychiatrist
A Day in the Life
For my careers project, I chose to take a close look at psychiatry. There are several reasons for this, but first of all, what exactly is psychiatry? According to the College of Psychiatrists of Ireland (CPsychI) “psychiatry is the branch of medicine which is concerned with the understanding, assessment, diagnosis and treatment of disorders of the mind.”
The word “psychiatry”, which has its origins in the Medieval Latin word “psychiatria”, literally means “a healing of the soul.”
So, psychiatry concerns itself with mental health and treating patients who might be affected by or struggling with their own mental health. Everyone will struggle with their mental wellbeing at some stage in their life, some people more so than others, but psychiatry aims to provide help to those who need it.
The name given to those working in this field is a psychiatrist. A psychiatrist’s work involves assessing patients, making diagnoses, investigating medical problems, offering advice, and recommending different treatments. These treatments could include medication, counselling or other lifestyle interventions. Of course, psychiatrists don’t work alone when it comes to their patients. Psychiatric nurses, social workers, psychologists, psychotherapists, occupational therapists, physiotherapists, and drama/art/music therapists often work closely alongside each other with patients, along with any other doctors/specialists necessary. This is also according to the CPsychI.
One of the main reasons I picked psychiatry for this project is my mother. She has been in the field of psychiatry for the past 26 years, and trained in general medicine and gastroenterology for 7 years before that. In addition to this, she was a general practitioner (GP) for a year, whose careers also involve lots of dealings with mental illnesses. Both my grandfathers had medical careers as well, with one being a pharmacist and the other choosing to be a GP for many years as well.
Because of this, I have been surrounded by and immersed in medicine and psychiatry from a young age. Also, I have had my fair share of hospitals and doctors in the past two years, which has steered me towards medicine as a career path for myself. I have seen many different specialities and fields, and I would definitely rank psychiatry as one of the most interesting and relevant there is.
Psychiatry appeals to me because, among other things, it is shaped by scientific results and evidence. It seems like it would be a very rewarding career – being able to shape and improve people’s lives and helping them become able to work and live at home again.
Also, there have been many considerable advances in neuroscience in the past few years, and we now know more about the brain and human behaviours than ever. Neurotransmitters and BST (brain stimulation therapies) are just two examples of ongoing research that could significantly affect the field in years to come.
With the topic of mental health gaining media coverage and recognition every day, there has never been a better time to take a closer look at why exactly professionals trained to help our minds, just as some are trained to help our bodies, are so important. If somebody was in an accident and was injured as a result, for example, they would go to a hospital or see a doctor to receive the proper care, so why should anybody do any differently when it comes to their mind?
The charity Centre for Mental Health ran a study, and estimated that (in the UK) around £8 billion per year is the cost for sickness absence because of mental ill health. There are around 70 million work days missed every year, with an average of 2.8 days taken off per UK employee due to stress, anxiety, depression or other mental health problems.
In Ireland, research supplied by the Irish Medical Times stated that mental health problems cost over €3 billion in 2008 alone. The most part of this comes from “lost economic outputs”, such as people not being able to work.
Those statistics show that now, more than ever, it vitally important to have access to basic psychological health care for everyone. Everyone will benefit if we do, and that is why I decided to look into being a psychiatrist, via this project.
Becoming a Psychiatrist –
Becoming a psychiatrist is a long process that can be quite complicated, especially if you plan to train in America. The first part of this section is going to be a step-by-step guide on how exactly you can become a psychiatrist.
Psychiatry is only available as a postgraduate course, which means that you must have a degree in medicine before you begin your speciality training (in this case, psychiatry). While the College of Psychiatrists of Ireland is responsible for this postgraduate training, there are six medical schools in Ireland, where you have to do an undergraduate course in medicine first. There six schools are:
Trinity College Dublin
Royal College of Surgeons in Ireland
University College Dublin (UCD)
National University of Ireland (NUI) Galway
University of Limerick
University College Cork (UCC)
In Northern Ireland, Queens University Belfast offer undergrad medical courses, and Ulster University plan on opening a medical school in 2019.
In Ireland, you can go straight from secondary school to studying medicine in university, but in America you must have a degree before you can go to medical school at all.
However, the year before you intend to apply for university, you must take a test called the HPAT – the Health Professions Admission Test. You can retake it as many times as you need, but you must pass it in order to apply for medicine at university.
You can choose either a five-year or a six-year course at medical school. The curriculum is almost exactly the same for the last five years of the six-year course, the difference is that the six-year course includes a year of ‘pre-med’ at the start. Pre-med is usually for students who didn’t do chemistry for the Leaving Certificate. It is more like general science for a year with a special focus on chemistry.
Pre-med covers the first year of a six-year long university course. From there on, the six- and five-year courses are identical in the things you study, though the order you study them in may vary.
UCD, for example, has a six-year course. Here is a list of what you would learn about and do each year of this particular course:
Healthcare imaging (any kind of scan/x-ray)
Science, medicine & society
Focuses on the structure and function of healthy organ systems, including:
Year Three & Year Four
Completes looking at healthy organs
Focuses on organs in disease
Pathology (studying causes and effects of diseases)
Microbiology (studying microorganisms)
Pharmacology (studying uses and effects of drugs)
Neuroscience (studying the nervous system, when healthy and diseased)
Clinical skills and attachments (practical skills like examining a patient, taking blood pressure, assess breathing etc., and work placements)
Clinical diagnoses and therapeutics (diagnosing patients based on assessments rather than lab tests/scans, and learning how to treat different diseases and with what)
Year Five & Year Six
Many clinical attachments (placements shadowing fully trained doctors)
Experience in different speciality fields
An elective in a different university/country
Obstetrics and gynaecology (studying female health)
Paediatrics (studying children’s health)
Community medicine and GP (studying healthcare issues affecting communities as a whole, and general practice)
Legal medicine (studying medicine in relation to the law eg. inquests and forensics)
Public health medicine (studying how to improve and protect the health of the population)
Professional completion (certification/qualification)
Usually medicine courses like this one are made up of a combination of lectures, tutorials, practical or clinical learning, seminar (a small group being given information, and talking together about it), simulations, and patient educator sessions (giving medical advice to patients). As well as end of term exams, you would be tested with practicals too, and continuous assessment.
After you graduate from university, you will have an undergraduate degree. The next step, no matter what you want to specialise in, you must complete a ‘residency’, or internship. This is the time when you will earn your first salary as a doctor. In Ireland, the residency programme is usually about a year, but can be much longer. In America, they vary in length from three to eight years. A residency is basically supervised training, usually in a clinic or hospital. You choose one (or more, but then the residency can get longer) specialised area to do this residency in. If you chose psychiatry for this, then you would be ‘shadowing’ a licensed psychiatrist – going with them to see patients, making notes for them, going through procedures together, and learning from them. The residency you pick doesn’t necessarily have to be the area you stick with – my mother did general medicine and then gastroenterology before she settled on psychiatry. Doing more than one residency is encouraged, because it helps students decide what areas of medicine they want to continue training in. I think the residency is a good idea because it allows you to really get a taste for a particular field before you decide if you want to stick with that, or keep looking.
Towards the end of this residency, or intern year, you choose which area of medicine to specialise in.