Choosing your focus in psychiatry

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Patients practice martial arts at a psychiatric hospital in Thailand Some doctors treat medical conditions, such as heart disease, cancer and infections—but physical ailments are not the only conditions that require treatment. Psychiatrists treat people with emotional, behavioral and mental disorders.

Psychiatrists are medical doctors and must initially follow the same path as doctors who treat physical conditions. After earning a bachelor’s degree, four years of medical school come next. Med students who plan to become psychiatrists must still complete clinical rotations in areas of medicine like internal medicine, emergency medicine and surgery.

After graduating from medical school, a four-year residency in psychiatry comes next. After completing a residency, doctors are eligible to take the exam to become board certified in psychiatry. Psychiatrists may choose to care for various patient populations, or they may choose to narrow their focus and specialize in one of the following areas:

Child psychiatry: Child psychiatrists specialize in providing care to children and teens who have mental health issues. Treatment may include counseling, art and play therapy, as well as family involvement. Child psychiatrists work in hospitals, juvenile justice centers, schools and social welfare agencies. 

Forensic psychiatry: Forensic psychiatrists may have varied responsibilities depending on where they work. Some forensic psychiatrists evaluate individuals charged with crimes to determine mental competency. Some psychiatrists evaluate and treat crime victims. Forensic psychiatrists work in private practice, universities, jails and with the court system.

Organizational psychiatry: Organizational psychiatrists work with companies to improve the emotional wellbeing of their employees. Some employers recognize the connection between emotional wellbeing and employment performance.   Psychiatrists in this subspecialty assist employees with a wide range of issues, such as addiction, conflicts in the workplace or other issues that may affect employees and their work performance.

Geriatric psychiatry: Psychiatrists who work in geriatrics treat older adults who have emotional or psychiatric conditions.  Psychiatrists in this field are trained in the psychological aspects of aging and how it can impact a person’s well-being. Geriatric psychiatrists work in hospitals, private practices and social service agencies.

Addiction psychiatry: Addiction psychiatrists treat patients suffering from some type of addiction, such as to drugs or alcohol. They may also treat people with gambling or food addictions. Patients with addiction problems may require a specific approach to their conditions since they may be facing a physical as well as psychological addiction. In addition to individual counseling, group therapy may be prescribed.

Neuropsychiatry: In some situations, medical conditions can lead to mental health problems, such as depression or anxiety. Neuropsychiatrists treat patients who have mental health conditions associated with brain injuries and central nervous system or brain disorders. Neuropsychiatrists work very closely with neurologists and other doctors to develop comprehensive treatment plans. Psychiatrists in this specialty work in rehabilitation facilities and hospitals. 

Additional training in the form of a post-residency fellowship is required for those who wish to become board certified in psychiatric subspecialties.  Fellowships for psychiatric subspecialties usually range from one to two years in length. Some psychiatrists choose to complete more than one fellowship and become board certified in a few subspecialties. 

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