With a high average salary, wide-ranging areas to explore and an excellent job outlook, getting a degree in psychiatry opens the doors to a multitude of employment opportunities and options to concentrate on a specific field, from pediatrics to geriatrics. Psychiatry is a profession also associated with many intrinsic rewards, as the field assists people in need of improving the state of their mental health, and who require treatment for life-altering conditions and disorders, such as depression, stress, anxiety, and behavioral problems.
However, this career path also comes with a range of concerns for a prospective psychiatrist, such as elevated stress levels and multiple hazards which include potentially dangerous environments and people. The emotional and mental obstacles, such as dealing with insurance companies and lack of job satisfaction, can lead to early career burnout. It also takes a long time to complete the education needed to become a psychiatrist – one of few factors mentioned below that play a role in the total cost versus the rewards of getting a degree in psychiatry:
The overall cost of education to become a psychiatrist is a substantial investment, and is often compared to the financial burden experienced by specialized physicians. Since psychiatrists must earn a medical degree, complete specialized training and undergo a four-year psychiatric residency, they face many of the same hardships and concerns as a medical doctor. According to the Association of American Medical Colleges (AAMC), eighty-four percent of 2014’s graduating medical school class accumulated a median debt of between $170,000 and $200,000 – a 3% increase from the previous year.
Additionally, the results of an AAMC survey of 85 public schools and 55 private schools revealed an overall 3 to 4% rise in the overall cost of attendance (COA) associated with medical school, which took into account fees and tuition costs. Preliminary data for the 2014-2015 academic year identified the median cost to attend a four-year medical school was between $226,447 (public schools) and $298,538 (private schools). Median tuition costs (with fees) ranged from $34,540 to $53,714 for the 2014-2015 academic year.
As with all educational paths, the actual cost to become a psychiatrist varies according to the following factors that either contribute to or offset the total amount of debt a graduate amasses while earning a psychiatry degree:
Psychiatrists must first earn a four-year bachelor’s degree, followed by four to five years of medical school. A medical school graduate then enters a psychiatric residency for four years, where they spend a great deal of time working in outpatient-, inpatient-, and various sub-specialty areas. In the end, it takes at least 12 years of school for an individual to become a psychiatrist, which qualifies a graduate to gain licensure in order to work in the U.S. and become certified from the American Board of Psychiatry and Neurology (ABPN), if desired.
The lengthy time commitment involved with becoming a psychiatrist is not the only concern that a prospective student will face, and there are several considerations associated with the decision to embark on this type of educational journey:
Lost Wages: The time it takes a student to obtain a degree in psychiatry also leads to lost wages that a graduate could otherwise earn if they had chosen to join the workforce after completing his or her undergraduate education.
Workplace Hazards: As a doctor associated with diagnosing and treating disorders related to a patient’s behavior, way of thinking and emotions, psychiatrists often come in contact with people who pose the threat of physical danger. Violence is a common act that takes place in a psychiatrist’s office, as chemically dependent or mentally ill patients may become intense and threaten to harm themselves, others, and/or their psychiatrist. Dealing with emotionally charged workplace situations can often take a toll on a mental health professional over time.
According to an American Journal of Psychiatry piece, more than one-third of psychiatrists have been assaulted by a patient at least once with estimations that 72% to 96% of psychiatric residents have been verbally threatened [1].
In severe instances, psychiatrists have also been stalked, mortally wounded, or killed by patients.
“…assaults against mental health professionals by clients is a concern that is addressed in many training programs,” wrote psychologist Will Meek Ph.D., in response to the murder of a prominent psychiatrist. “Unfortunately there is not a simple solution since those prone to violence are often those in the most need.”
High Stress Levels: Psychiatry is a career plagued by high stress levels. The bulk of their typical six-to-eight-hour workdays are spent listening to people expressing their frustrations and personal problems. The ability to separate job responsibilities from their personal lives can be difficult and exhausting. Over the course of a career, problematic or demanding patients can lead to psychiatrists suffering from the same types of anxiety and depression as their patients.
The International Journal of Social Psychiatry reported in one of their reviews that 57 percent of psychiatrists admitted to having post-traumatic stress symptoms – some of which stem from workplace difficulties such as coping with patient suicide. The Southern Medical Journal also reported that physicians (including psychiatrists) face a dramatically higher risk for committing suicide than non-physicians – nearly more than double the rate per 100,000 people.
Career Burnout: Psychiatrists are also prone to burnout, and are susceptible to developing a secondary trauma response and what the medical community calls “compassion fatigue” – a psychological syndrome marked by decreased job engagement. The emotionally charged sessions that psychiatrists can experience with their patients represent one of the leading causes of burnout. It can lead to cynicism, indifference, decreased energy and enthusiasm, and an overall negative attitude that can cause dysfunction and ineffectiveness in the workplace.
Dealing with Insurance Companies: In addition to stressful interactions with patients, the Medscape Psychiatrist Lifestyle Report (2015) cited the number one cause of psychiatrist burnout was dealing with too many bureaucratic tasks.
Disadvantages for the Self-Employed: While opening a private practice has many perks, there are a few downsides that are not as much of an issue as when a psychiatrist works for an employer. For starters, self-employed psychiatrists typically spend more non-billable hours handling the details of paperwork. Those in private practice must also purchase their own insurance, as well as address start-up costs related to renting an office and paying applicable business fees and monthly costs, such as utilities, marketing, and payroll, in some cases.
Prejudices within the Medical Community: Although a psychiatrist goes through a similar, rigorous education as a medical doctor and typically spends more time with his or her patients, the profession tends to face prejudices from M.D.s and insurance companies. For example, insurance companies place what many professionals deem as unreasonable limits on the amount of psychiatric care that an individual may receive. Psychiatric illnesses also face a stigma that they are not true medical issues, and are instead, viewed as a sign of a personal weakness by some.
One of the most noteworthy benefits to becoming a psychiatrist is having the ability to work in a profession that helps others improve their quality of life. Whether a patient is suffering from mental health issues related to severe depression; nightmares stemming from a traumatic experience; battling substance abuse; or dealing with a challenging hereditary disorder, psychiatrists are trained to identify and treat these types of issues by using a variety of methods.
According to the Medscape Psychiatrist Compensation Report (2015), roughly 30 percent of respondents noted the relationships with patients and the gratitude they express was cited as the number one rewarding aspect of their job – beaten only by the satisfaction that comes with being good at what they do, and being able to end up with helpful solutions, answers, and correct diagnoses.
Oftentimes, the satisfaction obtained from being able to provide mental health relief is rewarding enough, but the following benefits are also an attractive part to pursuing a degree in psychiatry:
Healthy Salary: The U.S. Bureau of Labor Statistics cited the median salary for psychiatrists in 2014 was $182,700, meaning they earned about the same or more than some family doctors and pediatricians.
Promising Job Outlook: The job outlook is excellent for the psychiatry career field, especially for graduates willing to fill the growing demand for psychiatrists to satisfy specific areas of need.
According to medical staffing specialists Merritt Hawkins, their 2014 Review of Physician and Advanced Practitioner Recruiting Incentives revealed a staffing crisis spreading across areas of behavioral health that includes decreased interest in inpatient psychiatry.
Additionally, many psychiatrists are aging out of the workforce, as over half of practicing psychiatrists are currently 55 years old or older, and will soon retire. Increased numbers of psychiatric graduates are also setting up outpatient practices, which leaves various employment settings (such as inpatient facilities, federally funded facilities, and correctional institutions) scrambling to recruit.
This continual critical shortage of doctors who specialize in behavioral care has been going on for years, which has led to psychiatrists being the fourth most requested search assignment for the Merritt Hawkins’ staff.
Wide-Ranging Work Environments: The continued shortage in the psychiatry field also provides a variety of career opportunities for new graduates that span a range of employment settings such as general hospitals, university medical centers, community agencies, corporations, the judicial system, the military, colleges and universities, and emergency rooms.
The Flexibility of Self-Employment: Nearly half of all psychiatrists in the U.S. maintain a private practice. The flexibility and autonomy that a self-employed psychiatrist enjoys is one of the most attractive rewards of starting a private practice. Salary-wise, Medscape reports that self-employed psychiatrists in office-based solo practices make an average of $30,000 more per year than salaried professionals working in outpatient clinics and hospitals. Psychiatric entrepreneurs can also set their own schedules, and choose to combine private practice work with hours at a hospital or local facility, if they wish.
Job Security and Stability: Following in line with most other medical professions, a psychiatry career is one that comes with a high level of job security and financial stability.
Satisfying Work-Life Balance: “I love being a psychiatrist,” said Linda Worley, M.D. in a Vimeo video sharing a few reasons why she pursued the field. “The word ‘psychiatry’ means ‘healer of the soul’ and relieving the suffering of patients in the way you can as a psychiatrist, there’s nothing more meaningful.”
“Another thing that I love about being a psychiatrist is that I can have life balance,” said Worley, a member of the APA Council on Psychosomatic Medicine. “I can actually have a career that’s amazing, and I can be a parent, and I can have friends, and I can have a life.”
Options to Advance and Grow: The field of psychiatry offers many opportunities that lead to growth, advancement and further recognition for professionals. Some may go on to teach at a university, offer consultation services, mentor students with an interest in the field, pursue a specific industry, or conduct research that positively impacts the profession as a whole.
Options for Offsetting Psychiatry Degree Costs
One of the most important factors that influences the overall cost of a psychiatry degree is the type and amount of financial aid that a student receives. Government student loans must be paid back, and interest rates increase the final amount that graduates pay. The following suggestions can help a prospective student cut their loan debt and make psychiatry school more affordable:
Understand the Difference Between a Psychiatrist and a Psychologist: To save money, it is important that students follow the appropriate educational pathway for the career that best suits their interests. Both psychiatry and psychology fields of study deal with mental health, as well as treating social, emotional and mental issues. Despite the various similarities, the two professions are completely different in their focus and educational track.
For starters, psychiatrists go to school and become an M.D. (medical doctor), while a psychologist obtains a doctorate-level degree, such as a Ph.D. or Doctor of Philosophy.
According to the U.S. Bureau of Labor Statistics, psychiatrists earn a higher median salary than psychologists: $182,700 versus $92,110 for 2014. Additionally, psychiatrists are able to prescribe psychotropic drugs, while psychologists do not in the majority of states in the U.S.
Thoroughly Research Financial Aid Possibilities: From research grants to scholarship programs catering to specializations within the field, such as addiction psychiatry, a student can find a variety of opportunities to fund his or her education with non-repayable financial assistance. Graduates who have borrowed the least amount of money from government student loan options receive a better ROI for their psychiatric degree.
Pursue a Fellowship: Several organizations, including the APA (American Psychiatry Association), award students with financial aid in the form of fellowships, as a way to increase interest in particular fields of psychiatry. Various criteria exist, and may seek applicants ranging from those who can decrease racial and ethnic disparities within the mental health field to those with an interest in child and adolescent psychiatry.
Consider Alternatives in Repayment: With approved sites in both urban and rural areas in the U.S., psychiatric graduates can receive up to $50,000 to repay their health profession student loans in exchange for a two-year commitment to serve a high-need, underserved community approved by the National Health Service Corps. Although a graduate may have to relocate, the payments are federal tax-free, and provided at the start of service to help a graduate pay down their loans quicker. Upon completion of an initial service commitment, psychiatrists can also apply for an extension which comes with an additional wave of loan repayment assistance.
While each professional encounters their own unique set of experiences and feelings regarding the psychiatry career path, the overall level of career satisfaction expressed by psychiatrists is one way to measure the total cost versus the rewards of a psychiatry degree.
When asked if they had to do it all over again, would they become a psychiatrist, 65% of respondents who participated in the 2015 Medscape Psychiatrist Compensation Report answered that they’d choose a career in medicine; 50% would pursue the same specialty; and 18% would enter the same practice setting. These statistics reveal a shift in overall career satisfaction regarding the psychiatry profession. The 2011 Medscape Psychiatrist Compensation Report cited 71% of psychiatrists would choose medicine again; 67% would select the same specialty; and 55% were pleased with the practice setting they had chosen.
Known for paying out one of the highest salaries in the U.S., more than half of the same employed psychiatrists answering questions for the 2015 Medscape Psychiatrist Compensation Report (58%) felt they have been fairly compensated for their work (with 53% of self-employed psychiatrists sharing the same sentiments).
Several favorable aspects related to gaining a psychiatry education makes pursuing this career field a stable and secure choice for a future mental health professional – namely the pay, job growth and overall work-life balance.
The psychiatrist occupation consistently fares well in multiple ‘best job’ and ‘best-paying job’ rankings by the likes of Money magazine, Glassdoor.com, and U.S. News & World Report. Forbes.com declared the psychiatric profession the number three out of ’10 Best Paying Jobs‘ in 2014 with a projected growth rate of 18 percent by 2022.
The profession certainly offers a wide variety of job opportunities to fit the interests and goals of individual psychiatrists. The job market is thriving for new graduates, and the income they earn makes it easier to repay student loan debt within a reasonable timeframe. However, there are serious concerns associated with becoming a psychiatrist. The profession can become emotionally-, mentally- and physically draining despite the majority of psychiatrists opening a private practice and having more control over their work hours and treatment approaches.
The probability of workplace violence stemming from treating mentally ill patients is a reality that threatens the safety and life of a psychiatrist. Due to the nature of their work, stress levels tend to be quite high among psychiatrists, and career burnout is a possibility for many young graduates. Overall, the decision to pursue a profession that generally brings gratifying results from helping others by improving their quality of life is ultimately a personal choice students must make when weighing the pros and cons of becoming a psychiatrist.
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