Insight Matters
Winter 2005

Editorial: Psychiatry's Bright Future
By Henry A. Nasrallah, M.D., Editor

Following a recent neurobiology lecture I delivered to the second year class at our medical school, a student approached me to say that he is interested in psychiatry as a career, but that he had heard that the profession faces many challenges and wanted to know what I thought about the future of psychiatry.

Needless to say, I was very eager to respond to his question. I looked straight into his bright bespectacled eyes and said, "There has never been a better time for a medical graduate to go into psychiatry, and the future has never been brighter." I then began recounting why I felt so positively about our specialty.

I reminded him how the psychopharmacology advances of the 1950s launched the remarkable neuroscience revolution of the past 30 years. The rate of growth of scientific knowledge in psychiatry outpaces most other medical specialties. Furthermore, the breathtaking advances in molecular genetics will have more dramatic implications for psychiatric disorders (with their complex gene-environment interactions) than any other set of clinical diseases. The annual NIH funding for scientific investigation is higher for psychiatry than any other specialty except internal medicine. Many of the best and the brightest medical students are now choosing psychiatry (consider the 16 senior medical students at the University of Cincinnati College of Medicine who are currently applying to psychiatric residency programs this year). Advances in neurobiology and neuroscience are shedding light almost daily on the molecular basis of neuropsychiatric disease and on the impact of psychotherapy and psychopharmacology on neuroplasticity. No wonder the stigma of mental illness will continue to dissipate and there is little doubt that insurance parity of psychiatric disorders will inevitably be attained in the foreseeable future. Society at large has developed a greater respect for the role of psychiatrists in health and wellness. Our peers in other specialties are much more cognizant of the importance of psychiatric manifestations of medical/surgical disorders. Even Hollywood is portraying psychiatrists in a more positive light than in the past!

From an economic and lifestyle perspective, the income of psychiatrists is actually quite competitive with several other non-surgical specialties while our malpractice premiums are in fact much lower. Our work schedule is more compatible with other important roles such as being a mother, a father or a spouse. There is a national shortage of psychiatrists and the law of supply and demand bodes well for future incomes, especially with a larger proportion of people seeking psychiatric healthcare or being referred for evaluation and treatment.

Another indicator of our dynamic growth and favorable trajectory is the ongoing evolution of our diagnostic criteria due to the rapid turnover of ideas and the surge of empirical evidence in the science of psychiatry. Many laboratory tests are being developed to buttress the validity and reliability of clinical diagnosis in the future.

Challenges? Sure we have our share but which medical specialty in the real world does not have hurdles to overcome or problems to solve? Psychiatry's prospects are much better than the pessimists claim, and professional satisfaction is high and will be even higher as psychiatrists at the local, state and national levels join hands and work together to support the patients and to advance the profession.

By now, the medical student, his eyes gleaming, was clearly excited about psychiatry as a career after medical school. To my delight, he asked me to involve him in a research project in schizophrenia. I urged him to join the APA as a student member to receive additional information and publications, as I quietly thought to myself, "How can psychiatry's future not be bright when it is attracting young physicians with a passion to help others and an intense interest in scientific discovery about the brain and behavior?"

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