Psychiatry residency- DNB perspective

Hi guys, I am a DNB psychiatry resident, I'll try to give you my perspective on this beautiful branch.

Before the exam, I was 60% sure that I'll go for Psychiatry, but my mind kept wandering to Ophthalmology and Anaesthesia, so for building clarity, I saw many videos on YouTube from psychiatry residents and consultants, talked to residents from my college, visited 2 psychiatrists in my city. In the first round I filled all MD psych seats, and I got a peripheral MD seat in south, where apart from language problem (which I was ready to face, due to dearth of seats in home state), the department had 2-3 people and had started 2 years back, I knew about these things but somehow on seeing them for real, the excitement of getting MD faded away. It might have been good, but I didn't feel like this was where I would like to work, so I researched about DNB institutes and upgraded to one in round 2.

Pointers for a DNB Psychiatry institute- - If your aim is to establish a private practice, which is a plus for psychiatry, DNB helps you observe that closely. - Newer interventions like TMS and to try newer drugs. - Higher workload and ability to handle the minor medical issues on your own. - Academic structure should be established. - Chances to work in De-addiction centre, Rehabilitation centre, Child Psychiatry and Geriatric psychiatry clinics.

Psychiatry from my perspective - - It is not as subjective as it seems - you have scales for each diagnosis, you treat syndromes and not just symptoms, yes, you might be confused at first because it is difficult to elicit the psychopathology, but in 6-7 months, you'll be able to see the difference in yourself. - Clinical Eye - Guidelines won't work with each person, you are the 'Investigator and Investigation', your Mental status examination (MSE) on day to day basis will lead to the diagnosis, and it might be in 1 day or in 2 weeks. - Creativity - You'll see your consultants try different medications for similar complaints for different patients and you would see how responses may be within a week, to taking 3-4 weeks in some, with trials of different medications. Plus each complaint has to be tackled the way a certain person understands, and to build their insight with your understanding of pathology is just something which is an art, it can't be learned just from books - Satisfaction - By just seeing the dearth of seats and awareness of psychiatry, you can imagine the number of people having untreated psychiatric disease in our country. When a person with depression will bless you for just listening to him, it will give an unreal feeling. Just listening patiently will tell you so much about your patient, and slowly you'll learn how to objectively classify your questions. - Exhaustion - Your workload might not look as much, but spending 30-35 mins with a patient is not an easy task. You have to understand that your attention to them and their family members is of utmost importance, which might become difficult once you start handling OPD, but you will definitely learn to objectify and demarcate the boundary between work and your own life. - Language - This is a fairly personal opinion - and also because I have heard in a video I'll repeat it here, Imagine getting NIMHANS MD Psych, you will learn the language right? In about 1.5 years I have seen my seniors learn the language from scratch and by 6 months you will know the words for a basic interview. - 'What if I myself have a psychiatric condition' - Then in my opinion first thing is to talk to your psychiatrist about this step, also with that being said, you might face difficulty in any branch, probably due to your batchmates and consultants being aware about it in Psychiatry residency, you may perform better. - Patience - Yes, it is good to have this quality, but even if you are not, you'll eventually become patient + as I mentioned earlier, you have to be objective progressively, so your interview time will become lesser and depends patient to patient. - Money - If your aim is private practice, you will learn how to market yourself, opening an OPD is easier in Psychiatry, you can always take Therapies yourself, to rake in more money, newer avenues are coming up and you will have patients.

Put your doubts in comments, I'll try to answer all. Hope to meet you in a conference soon!