What it's really like in psychiatry—from 5 physicians who know

As a medical student, do you ever wonder what it’s like to specialize in psychiatry? Over the years, five psychiatrists from around the country and working in a variety of practice settings have taken the time to be featured doctors in the AMA’s "Shadow Me” Specialty Series, which offers advice directly from AMA member physicians about life in their specialties. Check out their insights to help determine whether a career in psychiatry might be a good fit for you.

1. Shadowing Alpa Shah, MD

   1. Dr. Shah has been in practice for 25 years, most recently as a perinatal and reproductive psychiatrist. Previously, before she moved to the U.S. from India, she was an ob-gyn. She is employed by Marshfield Clinic Health System, in Marshfield, Wisconsin. Marshfield Clinic Health System is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
   2. “Psychiatry is unique in the sense that you have to be able to establish rapport and have therapeutic alliance,” she said. “It’s not just going through a checklist of symptoms. You’re not going to get patients to talk with you and engage with you unless you can establish that alliance and rapport. Active listening and empathy are important in general in medicine, but more so in psychiatry and I’m not sure the board exams can really get to that.”

2. Shadowing Lisa MacLean, MD

   1. At the time of this 2021 profile, Dr. MacLean had been in practice for 28 years. “One of the wonderful things about a career in psychiatry is the diversity of things you can do within the field and as part of a larger institution including leadership, education and research,” she said. Dr. MacLean is employed as an outpatient psychiatrist by Henry Ford Health, in Detroit. Henry Ford Health is also a member of the AMA Health System Program.
   2. She added, “Connecting with people, working with them during a difficult life trial and helping them to heal is the most rewarding aspect of my job.” On the other hand, despite the fact that the field has developed a huge number of tools to treat patients, “there is still work to be done to develop treatments which not only improve patients' symptoms but result in full remission. Caring deeply for patients who do not always get well is one of the most challenging aspects of a career in psychiatry.”

3. Shadowing Dionne Hart, MD

   1. At the time of this 2019 profile, Dr. Hart had been in practice for 15 years and was employed by a hospital, where she often worked overnight, 12-hour shifts. She is also a subspecialist in addiction medicine.
   2. “The most challenging aspect of my position is managing patients who present to the ED with intent to immediately begin treatment for a substance-use disorder,” she said. “In my practice area—similar to other major cities—there is a very limited number of detoxification beds and no options for admission to an inpatient substance-use disorder treatment program after hours or on weekends. It’s a challenge to develop a safe, effective treatment plan during off hours for patients with substance use disorders when there are limited resources.”
   3. At the same time, psychiatry “provides me the privilege to be available to provide support, crisis management, and treatment for these patients in a timely manner without judgment,” Dr. Hart said. 

4. Shadowing Alëna A. Balasanova, MD

   1. Dr. Balasanova works in the psychiatric subspecialty of addiction psychiatry. She has been in practice eight years and is employed at an academic medical center.
   2. She said the best part of the subspecialty is that “it’s multifaceted and truly transcends the continuum of care. Having a variety of clinical and academic responsibilities is what I find most stimulating and rewarding. I am especially passionate about clinical education and training for medical students, residents and fellows, and health professions students.”
   3. “I am passionate about reducing the stigma around SUDs [substance-use disorders] through language and exposure to patients,” Dr. Balasanova said. “An important component to addiction psychiatry is advocacy—advocating for our patients to receive the care they need and deserve. It is an honor to be able to use our voice to advocate for society’s most vulnerable.”

5. Shadowing Adrian Jacques Ambrose, MD, MPH

   1. Dr. Ambrose is a child and adolescent psychiatrist who had four years in practice at the time of this 2021 profile. He cited three adjectives to describe the typical child and adolescent psychiatrist: Kind, compassionate and dedicated. And when asked which books every medical student interested in child and adolescent psychiatry should be reading, he recommended a different approach.
   2. “Keeping up with different political perspectives on contemporary events in the world are crucial in this field,” Dr. Ambrose said. “Most of the time, our patients are reading these same articles, and it’s helpful to navigate the clinical frame if we can contextualize the news to the specific clinical situation. I make a habit to routinely examine different websites—across the political aisle—to ascertain their perspectives.”

The AMA Specialty Guide simplifies medical students’ specialty-selection process, highlights major specialties, details training information, and provides access to related association information. It is produced by FREIDA™, the AMA Residency & Fellowship Database^®. 

Learn more with the AMA about the medical specialty of psychiatry and its subspecialties of addiction medicine, addiction psychiatry and child and adolescent psychiatry.