What does a day in the life of a psychiatric registrar look like?
Day-to-day work in psychiatry is highly variable, which is both intellectually stimulating and professionally demanding. And psychiatry is far broader than people think; there are many subspecialties and sub-subspecialties. For the latter part of last year I was working in consultation-liaison on medical wards, taking referrals for different psychiatric presentations or for people with a psychiatric illness who also had a major medical illness. That setting is very different to what I'm doing now, which is child, adolescent and community mental health. Here I might spend two hours with one patient and their parents to provide care that is nuanced, compassionate, and effective. The intensity and responsibility of this work highlight why supporting doctors’ mental health is crucial –not just for us as clinicians, but for the patients and families who depend on us.
When did you know that psychiatry was the right specialty for you?
I was an intern in 2017, and that’s when I worked out that I wanted to work in psychiatry. I was fortunate in having a very good supervisor. Following this, I completed a year as an unaccredited registrar, which confirmed my choice: psychiatry engages both my intellect and my empathy. Plus, I had great supervisors at that time. Professional guidance supports learning, but can reduce the risks around burnout by creating an open environment for support.
What do you enjoy most about psychiatry?
What I value most in psychiatry is the consistent engagement with human stories, despite the variability of clinical work. Understanding people's journeys through either psychiatric illness or physical illness and hearing their story, sometimes going back several generations in their family and the impact that that's still having on them, is fascinating. The specialty blends biology, psychology, sociology, ethics, human rights and one’s own lived experience into diverse, and sometimes hotly contested perspectives about what seems to be one story. Then there’s the professional challenge of acknowledging our own psychological influences on our care, as well as how that interacts with the team more broadly.
What advice do you have for new interns?
Perfect is the enemy of the good. The attempt to ensure things go perfectly this year will almost certainly mean they won’t. Internship is always an intense adjustment. New skills, new responsibilities. But your own mental health is more important than any job assigned to you. Do not feel that you must perfectly know everything - you can’t. Escalate concerns and confusion. I certainly wish I’d done that more! There’s rarely a penalty for asking questions, even if you feel a bit awkward at the time. Lean on those around you and seek help if you’re struggling.
Dr Kieran Allen is a Psychiatry Registrar at Monash Health and a Doctors’ Mental Health Advocate.