Dissecting the challenges of a career in psychiatry
Dr Chang Wing-chung is a clinical assistant professor at the department of psychiatry at the University of Hong Kong's Li Ka-shing Faculty of Medicine and works in Queen Mary Hospital.
What attracted you to psychiatry?
Psychiatry is quite different from other medical specialities. It has long been regarded as the 'Cinderella' of medicine because it is relatively less developed, due to the complexities of the brain.
In psychiatry, the patients' complaints are different; they mainly complain about subjective experiences of mood, and about delusions and hallucinations.
Today, even though psychiatry has advanced in technology, it still does not benefit from investigative methods like blood tests or brain scans to help make diagnoses.
I find psychiatry fascinating. Observing the symptoms is even more fascinating.
What did you have to study?
First of all, we have to get an undergraduate degree in medicine. That usually takes five years. After that, we have houseman training - a one-year internship rotating through four different specialities.
After a year, we can choose an area to specialise in and get further training. I opted for psychiatry, and underwent six years of speciality training.
What are the challenges of the job?
In psychiatry, we deal with subjective experiences, and sometimes the personal growth of the patient. So if we lack personal and professional experience, it's difficult to help impact our patients' personal growth. We have to be very aware of the interaction we have with patients. On the one hand, we should set limits - we should not be too close to them or break the boundaries of the doctor-patient relationship. But on the other hand, we should not be too distant. Achieving this balance can be challenging. In addition, sometimes patients with severe mental disorders do not understand what they are suffering from, and reject our help. This is also challenging. But interacting with patients is also a rewarding experience.
What characteristics should a would-be psychiatrist develop?
First of all, they need to be willing to communicate. Psychiatrists rely on their interviewing skills to get information from patients and to build a relationship. If their communication skills are not good enough, it will be difficult to build a good rapport with the patient. It also takes time for a patient to recover during psychiatric treatment. It takes time to clarify the problems, and there are often ambiguities. So they need to be very patient.
What career development prospects can psychiatrists enjoy?
Academically, the dissertation is a very good opportunity to do your own research. It is very good exposure, and opens up further opportunities for pursuing an academic career. Outside of college, there is a whole lot of training available. There are psychotherapy workshops with distinguished speakers or master psychotherapists who can teach us. In the past, many people thought that psychiatry was a bit relaxed because it didn't use many diagnostic tools. But psychiatry links up with the most advanced neuroscience work; we apply a lot of advanced neuroscience data and skills when studying patients. So in this sense, psychiatry is very challenging.
What advice would you give to someone considering a career as a psychiatrist?
If medical students are not sure what psychiatry is, they can opt for a brief period of attachment with the department of psychiatry. That way, they can see exactly what happens, and experience the daily routine of psychiatrists and the care that they give, and can get a taste for it.
Dr Chang earned his degree from Chinese University, which has a psychiatric training centre. Visit psychiatry.cuhk.edu.hk for details