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6 Ways for Psychiatry Residents to Find Their Niche

6 Ways for Psychiatry Residents to Find Their Niche

Psychiatry residentsWhen Dr Howard Forman invited me to write an essay for the Masters Series, he sent me the first contribution in the series, “Twenty Meditations For Residents,” by Drs James Knoll, IV, and James Knoll, III, as an example. My initial response was to wonder what I could possibly add to the Knolls’ masterful list. I agreed with everything they said. Therefore, my first recommendation to residents is to reread the first article in this series, and take it very seriously. It is a wonderful list.

I must admit that I did not follow the same track to an illustrious academic career, as did other Masters Series authors. I admire their achievements, and I read their journal articles voraciously—but I never attempted that feat. Going by statistics, I predict that most residents will also go in other directions.

Although I have enjoyed peripheral roles as an Assistant Clinical Professor at Albert Einstein College of Medicine and elsewhere and genuinely delight in mentoring residents and teaching medical students, I do not have an “authentic” academic career. My “claim to fame,” so to speak, is as an author of “atypical” (aka non-clinical) books that revolve around psychiatry and cinema; psychiatry and superheroes; and psychiatry and the arts and religion.

My most recent book is about Cinema’s Sinister Psychiatrists. It was in “previews” for 5 years, and was presented in workshop form at the APA Institute of Psychiatric Services.

My first book, Dreams in Myth, Medicine, and Movies, evolved out of several years of online classes that I taught at a local college, at the inception of the Internet era. Those classes had catchy names, such as “Different Approaches to Dreams;” “Meanings of Madness;” and “Insanity, Psychiatry, and Society.” Those topics attracted university students, but not medical students. Since then, the concept of “medical humanities” was coined, and the marriage of medical science and humanistic studies is now celebrated.

During that time, my private practice began to attract patients who were not necessarily wealthy or famous. Instead, they were interesting, creative people who believed that they could benefit from treatment with a psychiatrist who knew something extra about their college majors or their chosen careers. Even when appointment times became shorter in duration and psychopharmacology grew more and more prominent, having this self-selected patient population made psychiatric practice a rich experience to me.

There are a few morals to this story, as outlined by the following recommendations:

1. Find your niche. That niche may not necessarily be the same one that your supervisor or your first employer or your parents think you should pursue, but it will be yours. Choosing a position simply because it is safe and guarantees continuing employment opportunities may simply result in years of unfulfilling and frustrating work.

2. Distinguish yourself from the next doctor. Almost any psychiatrist can prescribe Prozac, or whatever the drug du jour is. Instead, seek a position that is uniquely “you.” If you are lucky, you will find a like-minded mentor, often by accident, maybe by synchronicity.

3. Carve out a career in an area that interests you. Responsibilities for some people, especially for those who rise high in academia, will revolve around clinical care or bench research. If you’re drawn to specialized topics, such as atypical bipolar disorder, club drugs, glutamate transporters, or genetic links to autism—and if you’re intrigued enough to work long hours on such projects without being paid well or paid at all—then pursue those avenues. You owe it to yourself and to society to fulfill your destiny.


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