As a medical student, do you ever wonder what it's like to specialize in psychiatry? Meet Lisa MacLean, MD, 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.
The AMA's Specialty Guide simplifies medical students' specialty selection process, highlight major specialties, detail training information, and provide 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.
"Shadowing" Dr. MacLean
Specialty: Psychiatry.
Practice setting: Large group practice, employed physician model, major quaternary urban hospital.
Employment type: Employed by Henry Ford Health System, an AMA Health System Program Partner.
Years in practice: 28.
A typical day and week in my practice: 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. Many of the skills you learn as a part of training are helpful in understanding group dynamics and people in general. I have been blessed in being able to use my skills to do a variety of work within the field and my organization. Throughout the day, I work clinically with patients, attend administrative meetings and teach medical students.
There is much variation in my work week. I spend half of my time working on initiatives to promote wellness and mitigate burnout within my organization. My work is primarily focused on residents, fellows and faculty but during COVID it has expanded to all employees within the organization. As a previous residency program director, I am grateful that I am able to continue to use my skills to direct the medical student clerkship for psychiatry. Working with medical students to inspire their love and passion for psychiatry is one of my favorite aspects of my job. I also spend about 25% of my time working clinically with patients. This includes seeing health care professionals within my organization. Being able to give back to my colleagues and to help them during a difficult time in their lives is very rewarding.
The most challenging and rewarding aspects of psychiatry: The field of psychiatry is rapidly changing. Now, more than ever, we are understanding the biology and neuroscience behind mental illness. As we work to understand the human brain, we recognize that the brain is the most complex organ and there is still so much to understand. The field of psychiatry has developed so many more tools to treat our patients. However, 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.
Connecting with people, working with them during a difficult life trial and helping them to heal is the most rewarding aspect of my job.
How life in psychiatry has been affected by the global pandemic: I am an outpatient psychiatrist. Psychiatry is one of the few fields where the work that I do can be done virtually. The pandemic has opened our eyes to the many ways we can provide mental health care to those most in need. Communities without previous mental health treatment support can now access care virtually.
Unfortunately, there continues to be a national shortage of mental health providers and, specifically, psychiatrists. Our nation has suffered much in the context of the pandemic with a rise in depression, substance abuse, isolation and suicide. There is more work to be done in psychiatry than we have providers. This pandemic has revealed how strongly the field is needed in medicine.
I am fortunate to work with medical students who I have the opportunity to inspire to enter into a field that is very rewarding.
The long-term impact the pandemic will have on psychiatry: I don't see the field going back to "business as usual." Now that we have become more comfortable in providing virtual care, I don't believe this treatment modality will disappear. Indeed, I think virtual care will now allow us to potentially reach more people.
Three adjectives to describe the typical psychiatrist: Caring, kind and curious.
How my lifestyle matches, or differs from, what I had envisioned: I have actually had better work-life balance in my chosen field than I did in medical school. One of the things I love about the field is that the nature of the training also results in your own personal growth. Learning to communicate better with patients has helped me immensely as I communicate with others in my life.
There is much flexibility in the field, and this has allowed me to not only be a doctor but also a mom, a daughter, a wife, a friend and an avid scrapbooker. Reading books has been an important part of my life. My field gives me an opportunity to explore who I am both in medicine and outside of medicine. I have found more satisfaction in the field than I thought possible. I am a bit of a perfectionist and the field has allowed me to see myself more clearly and even laugh at myself sometimes.
Being a physician is only one part of who I am, I love that my field gives me the time to be more than a psychiatrist. Because the field promotes introspection, I love that I am always thinking about why I felt a certain way in a particular situation. It really makes me think about my relationships and be more forgiving of those in my life.
Skills every physician in training should have for psychiatry but won't be tested for on the board exam: The main skills include your ability to relate to others. People entering psychiatry should be introspective, good communicators and genuinely interested in caring for a vulnerable population. We look for people who are flexible, warm and curious.
One question physicians in training should ask themselves before pursuing psychiatry: Can I work in a field where there is still so much to understand? Can I tolerate my role as healer and understand I cannot always cure those I serve?
Books every medical student interested in psychiatry should be reading:
- Unquiet Mind: A Memoir of Moods and Madness, by Kay Jamison, PhD, a psychologist who suffers from bipolar disorder. It's an easy read but also a testament of how successful a person can be with stable treatment.
- History of Psychiatry: From the Era of the Asylum to the Age of Prozac, by Edward Shorter, PhD. This book is a little on the long side but offers a comprehensive view of how psychiatry has evolved over time. It objectively points out our errors and helps us to more clearly see where we need to take the field.
- InCompassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference, by Anthony Massarelli, MD, JD, and Stephen Trzeciak, MD. This book is a must read for anyone entering any field of medicine and speaks to the importance, power and value of compassion in the practice of medicine.
The online resource students interested in psychiatry should follow: The Nocturnists is a great website. The Nocturnists is a medical storytelling live show and podcast where health care workers have permission to pause and examine their inner landscapes.
Quick insights I would give students who are considering psychiatry: Make sure the field is a good fit for you. You should be passionate about serving this population and want to build upon your strengths.
Mantra or song to describe life in psychiatry: "Think Good Thoughts," by Colbie Caillat.
