How I chose psychiatry (Serious) 

honestly it makes so much sense that someone who can make these skits and pick out the strange quirks of medicine would do well in psych

I used to work in a cancer hospital and one of the patients said that the doctor who helped them most wasn't their oncologist but their psychiatrist who gave them the mental will to keep going. Congratulations, you're going to make a great psychiatrist!

“They have to live in their minds for the rest of their lives and I want to make that a better place for them”… chills. Go Preston!

I’ve been a psychiatrist for 15 years. You’re correct. You can be happy in multiple specialties- I switched from IM. A sense of humor is incredibly helpful for psych. Happy you are joining us.

As someone in need of a better psychiatrist, thank you for entering the profession. It really needs more people like you. And please take care of yourself so you don't burn out and lose empathy for your patients - see your self care as a prerequisite for good patient care. I believe in you.

I'm not in medicine but as a childhood cancer survivor I can 100% say that doctors who go for their passion make the biggest difference in our lives. It's great that you recognized what you enjoyed about medicine the most and were able to find a way to fully apply that. I appreciate your videos for providing a more lighthearted take on the stress of medicine. Also it's unfortunately amazing that toxic doctors are just like the toxic bosses everywhere else, at least an annoying surgeon can do something useful, lol.

Hey Preston, I was also a surgery gunner who did the same thing and am now choosing to apply to psychiatry. Hearing your journey sounded like what went through my own head. I think I've said the exact same thing about improving quality of life being my aim through my practice. It's awesome to hear that other people have done the same thing. Best of luck to you in your intern year!

I'm a nurse and whenever i hear "I want to help people" I always think: how. How are you wanting to help people? Through palliative, helping those that are dying? Critical care, those at their most vulnerable? through surgery, those at their most, pardon the pun, open? Like the How is as important as the why. I'm so glad you found the specialty for you! It's a part of medicine people don't realize matters a lot. I mean I'm in clinical research, I love helping people have an opportunity for treatment that they'd never have and helping push new evidence based medicine. I also loved my time in crirical care. It's abiout finding out the how where you find where you belong.

I have SPMI and I've had the same psychiatrist since 2004. He listens to me, he remembers things that I tell him, he believes in me, and he is the kindest, most wonderful doctor. Best of luck to you.

This was absolutely beautiful. I’m so glad you’re going into that field with such compassion. This online auntie is rooting for you! ❤

Thanks for sharing! I'm starting med school in a couple of months and your videos have been psyching me up! I love how the pre-med/med school world is starting to trend away from "I need to do what I think everyone else thinks I should do" to "I'm going to follow my passion and interests". Thanks for all you do!

Hi Preston. I always enjoy your content. Premed career switcher here, so naturally I search a lot of medical content and the algorithm threw me one of your videos - and I'm glad it did! I think there is a lot of strength in sharing inner thoughts and vulnerabilities, but also can cause apprehension (especially online), so it's pretty admirable that you shared a little bit about who you are with all of us. Thanks for the great content & best of luck!!

Beautifully articulated video Preston. I’m glad you found your passion for psychiatry which really shows in this video. You will do a lot of good for a much needed and very understaffed specialty. I tell my third and fourth year students every day no matter what you do, make sure you do what you love.

Hi from Sweden. Love your videos Preston, they bring joy during some really long days and especially interesting to hear more about you. Looking forward too follow you on your path. Best of luck and I know you will do great.

Thanks for an honest reflection on your journey! I graduate in a couple weeks and your skits have been a great distraction from the gloom of residency around the corner. Keep up the vids man!

I say this from the bottom of my heart. Thank you for all your videos. They really help me with medschool and in general with life. I'm so glad I found you.😊

This was a really powerful video, thank you for sharing :) I'm about to finish M1 and it's always really interesting to see how people who are a few years ahead of me learn, grow and develop into physicians. Makes it really tangible to see how different med school years can heavily impact and shape who you will become. Good luck to you and pls keep making videos, they are such a breath of fresh air and I get a laugh every time!

I truly appreciate your honesty, your openness, and your vulnerability, man! Thank you for sharing your experience in this video. I myself am Bi-Polar, and I too love helping others through a combination of talk therapy as well as through the medication side. Our minds are very precious and knowing that we are going to be living within our own mind for the rest of our lives, like you similarly explained, is very powerful. If you are able to help someone fundamentally feel better about themselves, the perspective, how the experience life through a lense of joy, happiness, optimism, and gratitude, than that is a true honor, gift, and blessing! Thank you again for this video, very much!

Thank you for posting about this. I am a third year medical student and I was also previously gunning for a subspecialty until I realized I loved talking to patients, hearing their stories, and finding ways support patients back to their definition of returning to normalcy, and ultimately found psych to hit all those marks. Inspired by your content both in funny or serious ways and would love to see more of this reflective-type videos throughout your experience in residency

this was so inspiring and beautifully worded! i’m pre-med and people (like my family) are always a bit concerned when I say I want to do psychiatry lol but I resonated a lot with what you said here. wishing you the best!!

Dude I saw your EM resident video first and didn’t think for one second you were messing around! It just hit me you made a joke about psych residents! You’re awesome brother I wish you a great career!

Man I relate to this so strongly. I was pretty set on FM because I loved the patient relationships in primary care and the variety of conditions we see. Eventually I also realized my absolute favorite patient interactions were ones that addressed the psychosocial influences on the patients’ health. So I applied and matched family medicine/psychiatry and I think it will be the perfect combination for me. I’m so glad you were able to pause and reevaluate your experiences and desires. The fact that you were so self-aware and receptive enough to make such a drastic change indicates that you will be a fantastic psychiatrist. Good luck!

Underrated and super helpful part was listing your meaningful interactions. Just what I needed to hear right now as I refresh my own career path (Australian pursuing clinical psychology).

I thought (guessed) you were going into surgery. Best of luck on your psych journey, definitely a great field with much need!

As someone who is only alive because of mental health treatment and psychiatric medicine, I am so happy to see someone passionate going into the field. A passionate NP was the first person to understand that I needed help when I didn't know how to put it into words. I know that medications for mental illness can get a bad rap, especially when someone is on multiple, but it really does work. I suffered for so, so long because of a doctor unwilling to put me on more than one medication at a time. I am now on three meds directly related to my mental well being and I have never done better. Funny enough, a medication I had tried and been taken off of is one that I am on again now because when combined with the other two, I do fantastic on it. There are a bonus two other meds I am on that are categorized as a psych drug but I just have them because of my sleep issues xD. I hope you're able to find the balance that works for the patients you will help! The relationship I have with my provider is so special to me because I know how much she cares about me and I can see her in you when I watch your videos. I have no doubt that you will help give people like myself their joy back

Happy for you Preston, I wish I reach that spot where I know what is my passion. It feels like a life goal to me rn, because I keep telling myself that finding my passion is all what it takes for outstanding career. I'm about to finish my 4th in med school in UAE (one last year to go), I did Medicine I, Peds, Gyne and about to finish Surgery I and I doesn't feel like I found my passion. It makes me doubt if medicine was the right choice in the beginning.

Thanks for sharing and being open about your journey. The world is gaining a great psychiatrist! Keep up the great work. - a recovering surgeon :)

I just finished M1 year, not sure about what I want to go into yet but I love your videos! Keep it up and congrats on graduating!

Your future patients will be so lucky to have you! Speaking as a radiologist (basically the opposite of a psychiatrist 😂) I have a lot of respect for the unique challenges you face in that field and for anyone who can do the job well.

From an ED doctor who is adept at uncovering the underlying misery in people's lives that really brings them to the ED, bravo for the tactic you took in dissecting out what really interested you from all your experiences. The physical complaints that bring them to acute medical attention are not often not the main cause for their suffering but the final straw that has piled onto a psychological and/ or social morass that brings them to the breaking point. You've done the hard work of discovering your passion. The next five years will be a worthwhile journey of learning how to able to use it to help heal others. Good luck. P.S. The way you owned the critical care doc looking for the antipsychotic order on the comatose patient was golden. You have the makings of being a kick ass, no nonsense psychiatrist.

Love you Preston! You've verbalized everything I feel about psychiatry and I look forward to you becoming my psych colleague in the future!

You're very insightful and I wish you the best in your journey in medicine. I hope you always keep this passion and joy. Come back to this video whenever you feel low xoxo

Hey Preston, love these little serious videos too in addition to the skits, keep'em coming!

appreciate u sharing ur experience, great to see personally authentic content as well as the comedic stuff :)

Love your videos, and love your earnestness. Congrats on the decision and godspeed in residency!

3rd year subspecialty gunner struggling too. I’m in a rural area with no psychiatrist. My US school essentially abandons us after 2nd year. I worked for nine months to get a psych rotation in a city 1 hour drive away and I didn’t really understand why until I heard your thoughts. I realize that my persistence has boiled down to wanting joy for my patients. I want them to know someone cares about them beyond bleeding out or their lipids. I want my patients to have joy and security and happiness in their own minds Thanks for sharing, best of luck. If you have any rotation recommendations, please share . Currently have 54 VSLO apps for psych and neurology pending and am feeling lost- but a little less lost after watching your video.

hey man, congrats on being at the end of school and I hope you find great fulfillment during this next part of your journey man :) you are gonna be a great psych doc. just remember to be nice to us nurses cause we need each other!

About to be an attending... I'm proud of you man!

So awesome to see your enthusiasm for psychiatry !

Thank you so much for this :') as a 4th year also interested in psych, a lot of these points hit home for me; when residents/attendings in other specialties scoffed and groaned at a new psych case/visit, those were the patients I gravitated towards.

explains how you get the time to make those videos!! big respect though, by far one of these specialties I appreciate but could never go for. You guys have even more resilience than the average doctor

I had a rotation at a psych/internal med combined program and I know how you feel. A lot of varied and interesting cases and dealing with a wide range of medications as well. Good luck, youll do great!

"they have to live inside their mind for the rest of their life, and I wanted to make that a better place for them" so poignantly spoken. As a fellow aspiring psychiatrist, I feel that but never expressed it. You brought tears.

this is a bit of an aside to the main point of this video, but you mentioned enjoying the process of interviewing psych patients . I find psychiatric assessment has been one of my favorite skills to develop as a psych nurse. Since its so wide ranging a skillset, i feel like im constantly learning new things from patients. I've been lucky that the two specialities I've worked at the beginning of my career have been settings + populations where the assessment process has unique challenges/learning curves, and it's helped me get comfortable with failing and taking risks, which I feel have ultimately made me better overall. (inpatient child/adolescent psych and ER crisis mental health. Let me tell you, nothing will make you see that humour can be a clinical tool than these two areas) I feel like psych assessment engages my brain in both practical/sciencey/concrete skill based ways, but also in philosophical ways. Exploring the nature of a pt's suicidality with them is an example of something that's both a skill and also a conversation about values and philosophy. (I'll hold back my rant about the concept of "risk assessment" here...) I never feel so focused/like I'm firing on so many cylinders as when I'm interviewing a patient. The ability to simply stay fully mentally present with someone who is suffering immensely feels like it is taking all myself sometimes. And distancing myself from the intensity of the moment can be so tempting. "Being present" is a bit of a nebulous, subjective concept, but nonetheless I feel for many patients, most people cannot be present with them in their worst pain, and that's a very lonely place to be. So in this way "being fully mentally present" is a skill that makes me better at the nuts and bolts of the work, but is also about demonstrating to someone you are on their side for real and are prepared to sit in the worst moments with them the vast majority of doctors I've worked with have been great or at the worst fine, I will also say that psychiatrists are generally another reason I enjoy and chose specialty While the kind of burnout psychiatry can lead to is often looks a little different than with medical specialties.... The body keeps the score and that's not only true for our patients -- secondary/vicarious trauma is a real risk of the job. Finding what anchors and balances you, finding where your limits are and setting boundaries around these things is going to be as important as anything else you learn/develop in training, imo. Take care of yourself. good luck!

this is really cool and i'm so glad that you found something that you were passionate about and weren't too scared to change plans last minute and change to something that will make you super happy. that actually took a lot of bravery and i know that it will definitely pay off for you in the future

love it, man, I believe you summed it up perfectly, that is exactly how i feel about psychiatry

Hey, :) I relate strongly to what you said in this video and just want to say that I love what you are doing and why! In my limited clinical experience, the doctors that I admired the most and that I felt helped patients the most were doctors like you (though from different specialties). Doctors who didn‘t just take a look at their patients through the door for two seconds a day but, even though they were stressed, told them a joke or just smiled at them when they walked in. Doctors who took their patients‘ emotional reality seriously. Thank you for this real video!

You're going to be a great psychiatrist, and your co-residents are going to love you : ) I had a similar path to psychiatry myself and have no regrets.

Same here man! Neurosurgery to Psych, pulled the switch this year. Stoked to start residency

man thank you so much for this video! i'm a very confused incoming med student and really appreciate your perspective

I need that “/serious” tone marker because I keep expecting every video to be a joke 😂😭 loving all your content! ❤️ keeping going!

Congrats on finishing med school! It sounds like you put a lot of thought into it and chose what would truly make you happy. You're going to be a great psychiatrist. Camera looks great btw

This was beautiful, Preston. I'm a nurse-midwife and found you on tiktok. It's clear that your emotional intelligence, perceptiveness, and wonderful sense of humor are going to make you a gifted psychiatrist. :)

I've been following your stuff throughout my 4th year and I've found all of it incredibly insightful. I just matched anesthesiology but choosing that over psychiatry was more difficult than I could've imagined. Your ability to grasp and digest a situation has made your content great, but understanding the feelings behind those situations will make you a great shrink. Congratulations and I wish you luck over the next four years!

I've greatly enjoyed your comedic content but I really appreciate you sharing this more personal and serious message:)

Ayyyyy! HUGE welcome to Psychiatry, Preston! :) R2 here and love your skits!

Perfectly said, it's wonderful you found out your passion

You inspire me! Congratulations!! I love your content

Its been difficult for me lately (senior year college pre-med) as I've been drastically overthinking what I want to do in medicine and why. I feel like I keep getting caught up in the flashiness of stuff like surgical subspecialties, etc., but what you said really resonated. What I love most is exploring the human psyche, and the human soul. Its why I love art and the humanities so much as well. But my Dad has worked his whole career in mental health (Clinical Psychologist for the VA), and has told me so many times not to pursue it. I feel compromised, because on one hand I value his judgement so much, but I also feel like psychiatry is something I'd have a real gift for. Anyways, I appreciate your words, and your honesty about your journey and the honest reflections youve done. I know I have a long time before I need to make my decision, but knowing there are other people out there who have struggled in similar ways and found the right choice is reassuring

Hey man, I just got into med school but was deferred a year. So I have a whole year to start and I’m just anxiously waiting because all I want to do is start. Your videos by far have been one of the most grounding things and have definitely made me less anxious about starting school and just making the most of this year before I start.

I look up to you. Sending best wishes!

From seeing your skits I could tell you were interested in psych...happy for you man your videos are hilarious but like this serious style video also !!

Love the channel bro, thanks for the reflection

I started making a stupid comment because clearly Preston do be a funny boy but seriously I'm so happy you've found what you love to do. I know you're gonna be incredible and you're really gonna help people. If you need a test subject I would love to help lmfao. Sincerely the loyal sun setters estates folks

As I'm wrapping up my intern year psych I'll only tell you one thing: You made the right choice dude.

You‘re awesome! I think I want to go into psych too and I related so much to a lot what you said, although I’m still at the start of uni.

I am a history teacher, not anywhere close to medicine. 😂 But, I came across your channel and your videos are hilarious! I am the type of person who still gets scared going to the doctor. But, your channel and Dr. Mike's Channel have given me a lot of peace of mind and you guys make me laugh!! And yes! I love my psychiatrist! Psychiatrists are amazing and I admire what you guys do!!

Thanks for sharing. It's nice to hear about the person behind the videos. I'm also final year but thankfully in Australia we don't have to commit to a speciality until much later (usually PGY3). I also prefer the human interactions in medicine, could never do a speciality where I wasn't regularly interacting with patients.

I love the tone of this youtube. It gives more of a sense of what you are like as a psychiatrist..and may i say- it is a really good vibe. Now this was posted 10 months ago, how do you feel about it now? I don't mean to plug another youtube, but Preston, you may find the channel Goertzpsychiatry interesting , he looks like a senior psychiatrist and alot of his channel is about being a psychiatrist.... 😊 forgive me if mentioning another channel is bothersome. I love how you say that we have to live inside our nind for the rest of our life and gow you feel about that and what yout motivations and interests are in psychiatry. I basically love this youtube post of yours the MOST! 😊

Thanks for making this, you’re a nice genuine guy with good insight

Also, by treating the mind, you treat their body. Because you speak with them about their nutrition habits, exercise, perspective on life, and everything stems from the brain. You can turn someones entire life around by changing their habits and mindset.

Preston, I love this video! I can tell that you are truly passionate about psychiatry

I'm on my way to becoming a psychiatrist and I wish you the best. Thankyou I really enjoyed your video

This was nice to hear. Thank you for sharing with us!

Thanks for sharing. I’m not in the medical field at all, but love your videos.

lol love your videos, but at first, I didnt know whether to think this was a sketch or for real. all the best on the journey!

I love this, i have wanted to do psych since day one of med school but seeing how psych seeps into literally every specialty, bc psych is everything about our lives. i wanted to be involved in my patients lives, their joys and pain, and sorrows, and achievements and psych is the only field where it is celebrated to be this invested in our patients lives

4th year Ortho gunner here. I feel you, but I really like Ortho so FML. Thanks for keeping it real my man.

Med student here. Firstly I wanted to say thank you for this video. I am thinking of pursuing psychiatry too. A reason I rarely say to people as to why I want to select this specialty is that for me, mental health is more important than any organic disorder. I feel that what I care more about is for people to have quality of life, and not just life. And I believe that enhancing human experience is something that lies on a very large scale to our feelings towards a situation, and not the situation itself. I am not in any way disrespecting the hardship that a human with cancer goes through. But what moves my heart is to see people with many organic problems valuing their experience, having will to live, which is closely to unbelievable in some circumstances. And of course I understand from personal experience the internal psychological hardships that someone with seemingly no problems in their life may endure silently. My hope and my will is to give treat to mental health disorders, to assess and improve in any way thoughts, feelings and behavior that are for me the essence of human experience.

I’ve been a nurse for 12 years and was a social worker for 7 years prior to nursing school. you will have a very long successful career in psychiatry, you are literally perfect for it.

Great video man. Current M-0 here with my first day of classes in august. Trying to grapple with whether I’d have the emotional and mental stability to apply for a surgical specialty, or should I just prioritize my sanity during this rough process. We’ll see 🤷

I'm also a recovering sub specialty gunner now about to finish medicine residency. Leaving a subspecialty residency for medicine was the best decision I ever made. Do what you love, not what other people love for you. Good luck and stay well in residency

hello i appreciate your passionate take on psychiatry. im currently waiting on dental school admissions but i’m finding that mental health ties to it and im finding many reasons to go into it as well.

I was kind of hoping you'd choose a surgical field. We need your energy in our ranks. But it is selfish for me to want you to do what I want you to do. Thanks for sharing your process. Congratulations on the next step in your career.

I’m a premed looking to do psychiatry, and then specifically training to become a psychoanalyst. Analysis is pretty marginal in psychology and psychiatry atm with the dominance of the neurobio model, but I think it’s really valuable in conjunction with the pharmacological aspects of psychiatry. also, psychoanalysis is really useful for thinking about mental health (subjectivity in analysis speak) in political terms imo. All medicine is political in the sense that it deals with people who themselves and their ailments are shaped by social structures, but in psychiatry you really get up close and person to these realities. At least the type of analysis I’m interested in makes these connections explicit.

2:10 I almost cried, at times I feel like doesn't matter how good life gets, If the mind isn't right or doesn't have good thought or is constantly bombarded with negative thoughts, No place in the world will make one happy.

Wonderful video. I am considering working in the behavioral health field.

Thank you for sharing. This is really interesting. We need good psychiatrists so thank you!

Hi Preston! A sixth year medical student who's going to apply for Psych here in Italy. Thanks for sharing your motivations❤

I feel this for the most part. I had one incredible psych attending and one that was on a bit of a power trip, which kinda scared me away. Also had some patients that had some scary situations on inpatient, and was like "I like this, but I can't handle the stress of being so totally in control of someone's life." In other specialties, a competant patient has a say in their care. In psych (and in peds, which also deterred me from that) they don't always.

Excellent choice! I love being a psych resident ☺️

You definitely pulled off the EM persona so well. Thought for sure with your trauma shear quick draw time you'd be going into EM.

I have no idea why for so long I resisted peds when it was so obviously deep down “the one”and it was so freeing to just give in to it. So much pressure on the “right” choice and what your specialty choice signifies about who you are and whatever and feels good to just give up on others’ criteria and pick what feels fun

You've been an inspiration. I love your videos, and I hope you continue doing these. I'm a Pre-Med, hopefully going to apply next year to matriculate 2025.

We love you Preston

I started in IM and left after a year and went into Psychiatry. Best decision of my life.

Hard agree on what are the best parts of the job. Tried psych for a year after med school. Now in family medicine/gp (norwegian equivalent at least), with this field scoring even better for me on exactly those parameters. Things to keep in mind, Prest!

Psych pretty underrated in the icu too I have a charge nurse that pretty often suggests starting antidepressants on patients just because a lot of the stays can be prolonged or new medical problems being daunting and it keeps them from wanting to actively participate sometimes

So inspiration! I'm pursuing pre-med currently, but I'm going to join the military first!

Hello from one year in the future. Putting gunning behind me was the best decision I ever made. Everyone else from my Med IV cohort is still pursuing research to secure some prestigious residency whereas I'm about to start PGY2. When you enter residency people will start obsessing over money (understandably); don't listen to them or they will push you back into gunning for whatever reason. The differences in salaries between specialties do not matter in the grand scheme of things; it's the same lifestyle no matter where you end up.