Welcome to Back from the Abyss. I'm Dr. Craig Hecock.

For years now, there's been an increasingly severe shortage of psychiatrists in the United

States.

But today, I'm going to explore a much more complicated and uncomfortable issue, and one

that I get asked about all the time, which is why is it so hard to find a good psychiatrist?

I'm going to break this down into three areas, the pipeline, the training, and the

practice. First, let's look at the selection process of future psychiatrists. Medical schools

selects students based on MCAT scores and grades, particularly in the pre-med ween-out classes,

such as analytical and organic chemistry,

and expressed interest and experience in medicine, such as volunteering in hospitals.

Note the things that medical schools don't typically select for, such as emotional intelligence,

insight, resilience, past experience and undergoing psychotherapy,

curiosity in the psyche, and why we do what we do, and finally, the willingness and ability

to withstand the negative psychiatry bias that still exists in some medical schools.

Med schools tend to select for introverted, highly analytical science and math-oriented hyperachievers. Those with an interest

in psychology are most welcome to apply, but they better evasive calculus, cell biology,

and organic chemistry, which unfortunately don't really have that much

to do with the current practice of clinical psychiatry. So from day one of year one in medical school,

the number of students who are likely to be drawn to psychiatry and to thrive there is

already small. And as the students reach their

clinical rotations, they may begin to get negative messages about psychiatry from residents

and attendings and other specialties. It's not uncommon for students who are thinking about

...