Mental health medicine
Psychiatrist
The only mental health professional who can prescribe.
Typical pay
$230k-$350k
How you get in
MD or DO plus a 4-year psychiatry residency
Outlook
Extremely strong; shortages in nearly every region
Psychiatrists diagnose and treat mental illness with medication and, less often now, therapy. Insurance economics have pushed most practice toward brief medication management, and cash-pay private practice is where autonomy and income are highest.
A day in the life
- 8:00aReview overnight notes and any hospital consults
- 8:30aMedication management visits, 15-30 minutes each
- 12:00pLunch and documentation
- 1:00pNew patient evaluation, a full hour
- 3:00pAfternoon follow-ups and prior authorizations
- 5:30pCharting and refill requests
How to get in
Medical school to psychiatry residency
Duration
12 years total
Cost
$200,000-$400,000
Credential
MD or DO plus board certification in psychiatry
- Complete a bachelor's with premed prerequisites
- Finish four years of medical school
- Match into a four-year psychiatry residency
- Board certify, then choose employed practice, hospital work or private practice
Subspecialty fellowship
Duration
13-14 years total
Cost
$200,000-$400,000
Credential
Board certification plus fellowship
- Complete psychiatry residency
- Add a one to two year fellowship — child and adolescent, addiction, forensic or geriatric
- Child and adolescent psychiatry is the most severe shortage in the field
- Fellowship-trained psychiatrists can effectively name their terms
Cash-pay private practice
Duration
2-5 years after residency
Cost
$20,000-$100,000 to establish
Credential
Board certification plus business setup
- Work employed first to build clinical confidence and a referral network
- Open a practice outside insurance networks
- Offer longer visits and combined therapy plus medication
- Higher income and far more control over how you actually practice
What people love
- · Among the highest demand in all of medicine
- · Cash-pay private practice is genuinely viable
- · Telepsychiatry is fully established
- · Shorter residency than most surgical specialties
What wears people down
- · 12 years of training minimum
- · Insurance drives 15-minute medication visits
- · Patient suicide is a real occupational grief
- · Heavy administrative and authorization burden