Psychiatry’s Medical School Comeback

More medical students are choosing psychiatry as their specialty.

Posted Jun 13, 2018

Don’t look now, but psychiatry may be getting cool again among graduates of U.S. medical schools, as more and more of them each year choose the profession as their specialty.

For those of you unfamiliar with the education of psychiatrists (and there are many who still get very mixed up between the different training involved between psychologists and psychiatrists), it involves first going to medical school for 4 years during which all students receive training in the basics and exposure to all of the major specialties. Those choosing to pursue psychiatry as a specialty then enter a general psychiatry residency for an additional 4 years. Finally, folks who still haven’t had enough can pursue a subspecialty fellowship for an additional year (addiction, geriatric, forensic, consult liaison) or two years (child & adolescent psychiatry). 

This is a long haul, and is a more protracted course than the three-year residency for things like pediatrics, family medicine, and general internal medicine. But despite the length of training, increasing numbers of medical school graduates are pursuing psychiatry. For six straight years, the number of U.S. medical students choosing to enter a psychiatry residency has risen from 616 in 2012 to 982 this year, a whopping 59% increase. There are some less interesting reasons for why the increase is so large, but it’s clear that a real change in preference is upon us. These numbers are now close to the number entering specialties such as surgery and obstetrics/gynecology.

Despite the influx, there still remains a tremendous shortage of psychiatrists across the nation. There also remains more open positions in psychiatry residencies than there are U.S grads wanting them, which allows entry for well-trained graduates of medical schools from other countries.

With these increasing numbers come increasing competitiveness, which has created some additional stress and work for psychiatry interested students, who now need to apply and interview at more residency programs. Some students even need to apply to more than one specialty at the same time.

What accounts for this increase is, of course, hard to say. Most students who choose psychiatry had not decided upon the specialty when starting medical school, which suggests the importance of their psychiatry experience during medical school. Salaries are also increasing due to the high demand across the country. Others (myself included) are drawn to psychiatry’s appealing blend of neuroscience and humanism.

Of course, I’m well aware of the readers who don’t consider these statistics good news and who instead will see these number as more people who “drug” our kids. While there’s probably not much I will be able to write here to convince these folks otherwise, I personally think this increase in medical students turning to psychiatry is terrific. It certainly doesn’t hurt to have more medical students who could go into any specialty they want choosing psychiatry, and, frankly, fewer who choose the field due to a lack of alternatives. And somewhat ironically for the anti-psychiatry crowd, I also have to wonder whether the field’s slow but steady movement away from a narrower pharmacological focus on symptoms, and towards broader approaches designed to maximize true mental HEALTH, is also increasing its appeal.

Medical students and residents can be a superstitious bunch. For example, you never openly comment that someone is having a “quiet” night on call. In this vein, I hope my comments don’t jinx the trends we are seeing. Fortunately, there is no reason to expect that this momentum will abate any time soon.