"Why Psychiatry?" Revisited

Nearly every medical student applying for residency in psychiatry is asked a simple but important question during their interviews: "Why psychiatry?" I think that we should ask ourselves this question not only as we embark on our training but throughout the course of our education—and our professional practice. Thus, as we begin a new academic year, it seems appropriate to pause to reflect on what initially attracted us to psychiatry.

In retrospect, it was not clear that medicine would be my vocation in life. In fact, I had originally planned to work as a lawyer, having graduated from Cornell University with an undergraduate degree in history and a J.D. from Cornell Law School. But law school stirred a strong and unexpected interest in human behavior. I became fascinated with cases in which the law had turned to the behavioral sciences to help answer a particular legal puzzle—for example, when assessing whether an offender met the basic requirements for criminal culpability. It was at this point that I decided to go to medical school and combine my interests in law and medicine. I continued my education at the University of Chicago Pritzker School of Medicine and quickly found that psychiatry would be a welcoming specialty for someone with my interests.

Now, as a resident in psychiatry at the University of Chicago, I am convinced that we have chosen to train in the most fascinating branch of medicine. We are called upon to treat patients with a sweeping range of psychopathology—from organic brain disorders to demoralization and adjustment reactions. Although neuroscience has advanced rapidly, we will always need insights from sociology, psychology, and anthropology, among other disciplines, to help bridge the gap in our understanding. No single explanatory framework can fully make sense of our patients and their problems.

Over the next year, I intend to more deeply explore one of the topics in psychiatry that most interests me: the neural mechanisms underlying impulsivity, compulsivity, and addiction (1). Under the mentorship of Dr. Jon Grant at the University of Chicago, I have learned to view impulsivity and compulsivity as multifaceted constructs that contribute to distress and impairment across a broad spectrum of mental illnesses. By better understanding the neurobiology of impulsivity and compulsivity, we may be able to improve how a number of disorders are assessed and treated.

We all came to psychiatry for different reasons and by different paths. The variety of answers we gave to that "Why psychiatry?" question in our interviews will, I hope, be multiplied and enriched by our years in training.