Dr. Jeffrey Kirwan is a psychiatry consultant at Eastern Health who hails from a small town in New Zealand. His experience in rural hospitals, he feels, greatly accelerated his learning as a junior doctor. He explains when the best time to undertake a rural rotation is and the myriad benefits we can glean from it, as well as why some of the disadvantages regarding references and lack of support are overblown. As interns, he implores us to speak us should we feel like we’re not being given enough clinical exposure.
We discuss with Jeffrey how a consultant persuaded him to switch from physician training to psychiatry, and why he has stayed in this specialty ever since. His typical week involves great variety, switching from inpatient, outpatient, and community work to interaction with the legal system and consultant liaising. Each of these are rewarding in their on right: he sees community visits, for example, as an “intrinsic” part of the service, and finds it “enlightening” and a privilege to step into someone else’s home. By contrast, there is also gratification in seeing someone recover from a long inpatient stay. Yet as with any profession, there are patients that give doctors grief, with psychiatry being no exception. Jeffrey portrays the stress placed on both patient and doctor by the unpredictability of patients, their lack of insight, and the need to invoke the Mental Health Act.
One of the major advantages of psychiatry seems to be the lifestyle, which Jeffrey argues is predictable and mostly relaxed, with the option to delve into on-call and private areas. However, this contrasts with the training, which involves intense supervision, psychotherapy training, and – of course – exams. Once specialised, there are several subspecialties available to psychiatrists. Jeffrey details why he has chosen old age psychiatry as his main focus outside of his administrative and organisational roles at the hospital.
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Pathways into Psychiatry
Medical School → Internship → Basic Psychiatric Training (3 years) → Advanced Psychiatric Training (2 years) in general, adult or paediatric psychiatry
According to the Australian Government Taxation Data, in the 2013-14 income year we had:
- 1,126 female psychiatrists earning an average of $152,437
- 1,485 male psychiatrists earning an average of $234,557
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