A psychiatrist is a medical doctor who specializes in the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders. Unlike psychologists, who primarily use talk therapy, psychiatrists are physicians—holding either a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.) degree—which qualifies them to prescribe medication and manage the physical aspects of psychological conditions. The journey to this profession is a lengthy one, requiring years of higher education and intensive clinical training.
Complete an Undergraduate Degree
The first step toward a career in psychiatry is earning a four-year bachelor’s degree. While there is no single required major, successful applicants to medical school often pursue degrees in the sciences. Common choices like biology or psychology provide a strong basis for future studies. All students must complete a series of prerequisite courses often referred to as “pre-med.”
These prerequisites almost universally include a year of general chemistry, organic chemistry, biology, and physics, all with labs. Many medical schools also require courses in English, mathematics, and sometimes biochemistry or psychology. Excelling academically and maintaining a high grade point average (GPA) is a primary focus for any undergraduate on this path.
Beyond academics, medical schools look for candidates with a demonstrated commitment to healthcare. This is often shown through extracurricular activities like volunteering at a hospital, participating in scientific research, or shadowing physicians. These experiences allow applicants to gain a realistic understanding of the medical field and strengthen their applications.
Go to Medical School
Gaining entry to medical school is a highly competitive process, with the Medical College Admission Test (MCAT) being a central component. The MCAT is a standardized examination designed to assess problem-solving, critical thinking, and knowledge of natural, behavioral, and social science concepts. A high score on this exam is necessary for a competitive application.
Once accepted, students embark on a four-year program to earn a medical degree, either an M.D. or a D.O. The first two years are the pre-clinical years, which are classroom- and laboratory-based. This period is dedicated to building a comprehensive understanding of the foundational sciences of medicine, including anatomy, physiology, pharmacology, and pathology.
The latter two years of medical school consist of clinical rotations, where students transition from the classroom to the hospital and clinic. During this phase, students rotate through various medical specialties, such as internal medicine, surgery, pediatrics, and neurology. They learn to apply their scientific knowledge to real-patient situations, developing skills in taking medical histories, performing physical exams, and formulating diagnoses under supervision.
Complete a Psychiatry Residency
After graduating from medical school, the defining step in this specialization is the completion of a four-year residency program in psychiatry. This period of postgraduate training is where a physician develops the specific expertise required to practice in the mental health field. Residency is a paid position where doctors, known as residents, provide direct patient care under the supervision of senior physicians.
The first year, often called the intern year or PGY-1, includes rotations in general internal medicine and neurology. This ensures the psychiatrist has a strong foundation in treating the whole patient and understanding the complex ways physical health can impact mental well-being. This is followed by three years of dedicated, intensive training in psychiatry.
During these subsequent three years, residents rotate through a variety of psychiatric settings. They gain experience in inpatient units, outpatient clinics, and emergency rooms. Residents learn to conduct thorough psychiatric evaluations, diagnose conditions ranging from depression and anxiety to schizophrenia and bipolar disorder, and develop comprehensive treatment plans. A significant focus is placed on mastering both psychopharmacology and various forms of psychotherapy.
Obtain Licensure and Board Certification
Upon completing residency, a psychiatrist must obtain a state medical license to practice independently. To qualify, all physicians must pass a national standardized examination series. Graduates with an M.D. degree must pass the United States Medical Licensing Examination (USMLE), while D.O. graduates must pass the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA).
While licensure is mandatory, board certification is a voluntary credential that signifies a higher level of expertise. Certification for psychiatrists is granted by the American Board of Psychiatry and Neurology (ABPN). To become board-certified, a psychiatrist must pass an additional examination assessing their knowledge and clinical judgment.
Board certification demonstrates to patients and employers that a psychiatrist has met high professional standards. While not legally required for practice, most hospitals and insurance providers require board certification, making it a practical necessity for most career paths.
Pursue a Fellowship for Specialization
After completing a four-year residency, some psychiatrists choose to pursue further training in a subspecialty through a fellowship. A fellowship is an optional period of one to two additional years of training that allows a physician to develop expertise in a specific area of psychiatry. This training provides a deeper understanding of a particular patient population or clinical setting.
There are several subspecialties a psychiatrist can pursue, including:
- Child and adolescent psychiatry, which focuses on the diagnosis and treatment of mental health disorders in children, adolescents, and their families.
- Geriatric psychiatry, which concentrates on the mental health of older adults, addressing issues like dementia and late-life depression.
- Forensic psychiatry, which operates at the intersection of mental health and the law, often involving evaluations for court cases.
- Addiction psychiatry, which focuses on treating substance use disorders and individuals with co-occurring mental health conditions.
- Consultation-liaison psychiatry, which specializes in caring for patients with complex medical and psychiatric needs within a general hospital setting.