Extracurricular Activities for Early-Career Psychiatrists

April 30, 2016
Jacob L. Freedman, MD

Volume 33, Issue 4

With the standard aversion to moonlighting in the emergency department at the local hospital, lots of us have asked the same question: “What else can I do to pay the bills?”

On graduating from residency training, most of my colleagues took a similar route and accepted a position at an academic hospital or an affiliated clinic. The adventurous ones left Harvard Medical School for California-and one even went to China. But no matter where we went, at some point in the midst of that first job just about everyone needed some extra money to pay down medical school debt. With the standard aversion to moonlighting in the emergency department at the local hospital, lots of us have asked the same question: “What else can I do to pay the bills?”

[[{"type":"media","view_mode":"media_crop","fid":"48035","attributes":{"alt":"© advent/shutterstock.com","class":"media-image media-image-right","id":"media_crop_4506353905442","media_crop_h":"63","media_crop_image_style":"-1","media_crop_instance":"5715","media_crop_rotate":"0","media_crop_scale_h":"154","media_crop_scale_w":"142","media_crop_w":"58","media_crop_x":"175","media_crop_y":"12","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":"© advent/shutterstock.com","typeof":"foaf:Image"}}]]With this in mind, allow me to share 5 extracurricular activities  for an early-career psychiatrist:

1) See psychotherapy patients. So much of our training was dedicated to learning the ins and outs of psychotherapy, but fewer and fewer psychiatrists are seeing psychotherapy patients as part of their daily endeavors. It doesn’t have to be Freudian or even Jungian. Having a pure psychotherapy patient can be a breath of fresh air from the intensity of working in a community psychiatry clinic or running a psychiatric emergency department. Private-pay patients are a good way to make some extra income, to develop your skills as a therapist, and to diversify your patient population. Even 1 or 2 patients a week can make for a very gratifying experience.

2) Do independent medical examinations. Most early- career psychiatrists are surprised to hear that you don’t need to complete a fellowship in forensic psychiatry to do independent medical examinations. These visits are more calculated and less about therapeutic alliance, which can be off-putting. Whether it’s for the local court system, disability claims, or a malpractice case, independent evaluations use a different part of the brain. Registering through your state’s forensic system as an “expert vendor in psychiatry” also allows you to travel to other institutions-including state hospitals-to complete evaluations. It’s fascinating to see how patients are managed in different settings. Independent reviews for external review organizations are another part-time gig that personally taught me a lot about documentation and the different standards of evidence-based care.

3)Work for “The Man.” I can’t say I’ve done it myself, but I have a few colleagues who tried working for insurance companies and the pharmaceutical industry who burned out pretty quickly. Nevertheless, there are interesting jobs out there as clinical investigators for novel psychiatric medications and other related positions. I know a number of psychiatrists with strong basic science and research backgrounds who have enjoyed the 9-to-5 work schedule associated with these jobs.

4) Try business consulting. Congratulations on having become a board-certified psychiatrist! As an expert in your field-yes, you are now officially an expert-many businesses are interested in your skills. Organizational consulting can consist of any number of abilities you have honed as a trainee working on the inpatient unit. This is not even limited to your risk-management, conflict resolution, and negotiation skills. I am very grateful to have had the privilege to work as a consultant with a number of start-ups: some health care–related and others not. I am currently the Chief Medical Officer for Mentegram, a company dedicated to increasing practice efficiency and reimbursement-through screening technology-and to improving patient care through electronic reminders and treatment protocols. It’s absolutely a pleasure to be part of a very different team than the one that I work with on the inpatient unit during my day job.

5)Start typing. While it usually doesn’t pay too well, medical writing is a unique experience that allows us to help patients on a grander scale. Medical writing jobs are an interesting experience, especially when they involve translating clinical protocols or diagnostic information into patient-friendly language. Furthermore, writing is a great opportunity to keep up with new and evolving health care issues while also getting your name out there when it’s time to start the next phase of your career or build your private practice. Or perhaps you’re a budding author who’s finally ready to write the sequel to One Flew Over the Cuckoo’s Nest.

Sure, there are other things you can do out there with your training, but space is limited here. Beyond the economic advice, early-career psychiatrists should also hear this wisdom and take it to heart: “Don’t forget to spend time with your loved ones.” This is the most important thing to consider now that the days of pre-rounding on patients and overnight call are finished. Plus, all of your training as a psychiatrist will come in handy at Little League games when parents from opposing teams inevitably lose their cool. . . .

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