Can medical students lean in to psychiatry?

I recently read an interesting article in Glamour about why Zosia Mamet, an actress on HBO’s Girls, refuses to “lean in.”  While the column focuses on the influence of modern-day feminism on notions of professional success, her words resonated with me as a medical student and an aspiring psychiatrist.

“I have been incredibly blessed with success in my chosen career. I’ve worked my a** off and had the support and encouragement of those around me to keep climbing. But what if tomorrow I decided I was content with the place I’d reached in acting and planned to open a small coffee shop in Vermont?” Mamet writes. “That job wouldn’t necessarily be any easier, but I believe I would be considered less successful. My friends, some of them, would ask me if it was what I really wanted (code for “You’re making a mistake”). My agent would think I was insane, and my family would definitely be confused.”

While many medical students end up choosing to specialize in what we love, many of us, at least for some time, seriously entertain the idea of pursuing what we don’t. We have to ask ourselves, why?

Somewhere between high school and medical school, the self-worth of many doctors-in-training becomes intrinsically linked to our achievements. That is, we feel happy when we accomplish goals like scoring well on the MCAT, getting into medical school or being selected for a prestigious fellowship. While we have already dedicated our lives to serving others, in order to really feel good about ourselves we must continue to aim for the best. As a community, we have a pervasive fear of mediocrity or even being perceived as average. “I just want to be an average doctor,” said no medical student, ever. Sometimes this fear manifests as pressure to seek specialties that are not only lucrative and respected, but also higher up on the hospital food chain.  As Mamet describes however, power and money are misguided indicators of success.

I recently attended the American Psychiatric Association’s annual meeting. During the conference, the medical student participants were addressed by APA president-elect, Dr. Paul Summergrad. After his speech, one student asked for advice on facing the stigma of the psychiatric profession. Our decision to become psychiatrists is sometimes met with the same reaction as Mamet’s decision to open a small coffee shop in Vermont:  “Why would you want to do that?” or, “You don’t want to be a doctor anymore?”  The atmosphere, saturated with the buzz of hopeful anticipation, was punctuated by a brief, almost unperceivable moment of silence. Perhaps it was our shared shame, as none of us are immune to the opinions of our professors, preceptors and peers. On Wednesdays, we kinda want to wear pink too.

In the Glamour article, the actress elaborates on the potential harms of expecting all women to aspire to the professional status of Beyoncé, Oprah and Hillary Clinton.  She despises the fact that any desire to deviate from this path is seen as a waste of potential.

“That is when we’re not supporting our own,” Mamet argues. “Who are we to put such a limited definition on success? The Merriam-Webster dictionary says success is ’the correct or desired result of an attempt.’ But you get to decide what you attempt.”

To the room full of future psychiatrists, Dr. Summergrad invoked the fervor of Dr. Martin Luther King Jr. by replying, “The arc of the moral universe is long, but it bends towards justice.” He went on to explain that there is a dire need for psychiatrists to provide quality mental health care all over the world. As students, our presence at the conference, and our contributions to a strong community of psychiatrists was a step towards breaking down barriers and misconceptions and eradicating the stigma of our patients and the profession. We have the power to do a great amount of good.

By embracing my interests, this is a future I can hope for. I’ve always been encouraged to keep climbing; I have no intention of stopping. By leaning into the path I’ve chosen, maybe one day I’ll be able to celebrate my success by breaking bread (or homemade muffins) with Zosia Mamet in her coffee shop.

Jennifer Adaeze Anyaegbunam is a medical student who blogs at her self-titled site, Jennifer Adaeze AnyaegbunamShe can be reached on Twitter @JenniferAdaeze.  This article originally appeared in The American Resident Project.

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  • James O’Brien, M.D.

    I would have asked Dr. Summergrad why his organization is embracing the collaborative care model, which will make the profession obsolete. If your dream was to talk to patients, you won’t get to do that under the model APA is endorsing. You will get to read a lot of PHQ-9s thought. Filled out by people you never meet.

    http://real-psychiatry.blogspot.com/2013/10/apa-continues-to-hype-managed-care.html

  • DeceasedMD

    my sense is the training has significantly deteriorated and the learning process will be hindered in a broken system. And whatever you do, don’t work in Philly!

    • buzzkillerjsmith

      Don’t even go to Philly, or even through it. Same with Roseburg OR.

      • J Rizzo

        Portland is a cluster of crap too, Buzz. In one small city there is an over celebrated university medical school that appears to be spending all of its money on German architectural design aesthetic from Gstaad with a wonky mountain top trauma center that you can only get to after a twenty minute windy road slalom (bwaahaaa!), there are like 5 million nursing schools so nobody gets good clinical experience, and four large medical systems that have everybody on lock down so EVERYBODY OF EVERY DISCIPLINE works for cheap. Salem is actually better. But then you have to live in Salem.

    • J Rizzo

      Sonny’s Famous Steaks though!

      • DeceasedMD

        Is it worth your life though to get a cheese steak? LOL. Speaking of Portland, are there any private practices left?

        • J Rizzo

          There are a few. I am proud to say I work in a family practice as a PMHNP that is owned and run by a MD. Because Oregon is an independent practice state for NP’s there are several NP run practices that also employ MD’s. Its sort of backwards land because the major hospital systems pay so badly for NP’s we can make four times as much on our own. We are largely excluded from hospitals which is where a vast majority of local MD’s are employed.

          • DeceasedMD

            Just wait. Mc Medicine will work out the cheapest employees that they can. But good for you that you won’t work for them. Consider yourself lucky!

  • buzzkillerjsmith

    So some young women have learned that working basically sucks. Not breaking any new ground there.

    I could have told you that after my high school gigs at Wong’s and the Sizzler. Dishwasher, abused by the waitresses and busboys. The cooks despised me and my kind. It still stings.

    • J Rizzo

      Wongs closed last year but STEAKS SEAFOOD SIZZLER! First time I ever saw the Heimlich in action was at a sizzler when I was 19. Changed my life. That an the ambrosia jello.