A psychiatrist is a medical doctor who has had extra training to diagnose and treat psychiatric conditions. After graduating from college, psychiatrists attend a 4-year medical school like other medical doctors. In a typical medical school, students spend most of their first two years in classes and labs learning about the normal workings of the human body, about illnesses that affect the
body and mind, and about the various treatments, including medications, to keep the body and mind healthy. In the second two years, they train in different types of hospital departments, such as internal medicine, pediatrics, psychiatry, surgery, and obstetrics/gynecology, to become familiar with all aspects of medicine. If they successfully pass their courses, they graduate from medical school and become physicians. They receive an M.D. degree and may be referred to as “Doctor Smith” instead of “Mr.” , “Ms. , or “Mx” Smith.”
In their last year of medical school, students decide which type of medicine they wish to practice. They apply for residencies, which are like medical apprenticeships. Residency positions are offered by certain hospitals, called training hospitals, which are usually associated with medical schools. In order to have an accredited residency program, the hospitals must periodically pass a detailed inspection by the Joint Commission.
Psychiatry residents learn how to become psychiatrists by evaluating and treating patients while being supervised by experienced psychiatrists. They continue to have some lectures and classes important for psychiatry. They study for a series of national examinations that they must pass to practice medicine after residency.
Residents work long hours and treat many patients. The first year of residency, called an internship, is often the hardest. In addition to their psychiatry rotations, psychiatry interns work in other hospital departments: medicine, pediatrics, neurology, the intensive care unit, and the emergency room. A residency in adult psychiatry lasts for three years after internship and includes rotations on psychiatry inpatient hospital wards and outpatient clinics. Psychiatry residents also work as consultants to other hospital departments, giving advice on psychiatric issues affecting medical or surgical patients (consultation-liason psychiatry). They learn different kinds of counseling techniques, called “psychotherapies,” substance use treatment, and use of psychiatric medications.
Residents subspecialize (receive additional expertise) to treat children and teenagers if they participate in a fellowship in child and adolescent psychiatry. They may begin this after their third or fourth year of adult psychiatry residency (the fourth year of adult residency is optional for a child fellow.) Other psychiatry subspecialties include geriatric (older adult), consultation-liaison, addiction, forensic (legal aspects of psychiatry), and pain medicine.
A child and adolescent psychiatry residency lasts for two years and includes training in pediatric inpatient and outpatient psychiatry, alcohol and drug abuse, counseling techniques, medications, and legal issues that affect children such as divorce or child abuse. (Adult psychiatrists are not prohibited from treating children, but many prefer not to treat those younger than age 16.)
After residency, the graduate is a full-fledged psychiatrist who can treat patients independently. Like other specialists, many psychiatrists chose to become “board-certified.” This means that they must pass an examination given by the American Board of Psychiatry and Neurology (ABPN). A graduate of a child and adolescent psychiatry residency is eligible for subspecialty board certification in child and adolescent psychiatry. They must be re-certified every ten years.
In order to receive a medical license from a particular state, physicians must participate in several hours each year of continued medical education (CME), by attending conferences or reading articles about their fields of medicine.
As you can see, psychiatrists have worked very hard for many years to achieve expertise to help people with psychiatric conditions.