Psychiatry and psychotherapy: psychosis, mania, depression, addiction, dementia and crises. More acute medicine, law and psychopharmacology than in psychosomatic medicine, plus full psychotherapy training.
Training in Germany (model regulations)
• Training 60 months, including 24 inpatient and 6 in neurology
• 100 hours of self-experience and 35 double sessions of Balint group work
• Writing expert reports and arranging detentions under state and guardianship law are part of the training
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Core task
Closed acute ward
Some curricula, such as at Ulm University Hospital, include a year on the closed acute ward. Acutely psychotic, manic or intoxicated patients, sometimes aggression. You de-escalate and decide under pressure.
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Detention and coercive measures
You initiate detentions under state law and guardianship law. De-escalation takes priority over coercion, and you document every measure so that it holds up legally.
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Core task
Diagnosis from conversation and observation
The initial interview and the mental state examination are your main tools. Labs and imaging mainly rule out physical causes and rarely confirm the diagnosis.
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Psychopharmacology
Antipsychotics, antidepressants, lithium, clozapine. You keep an eye on levels, ECG, blood count and metabolism. It’s the most internal-medicine part of the specialty.
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Core task
Assessing suicide risk
You decide whether someone can go home or needs admission. There is no certain prediction, and the responsibility stays with you.
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Core task
Respecting patients’ values
Patients live, believe and love differently from you, including around substance use, sexuality and gender identity. You treat their illness by their goals, without bringing in your own values.
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Addiction and withdrawal
Alcohol withdrawal, delirium, seizures, substitution treatment for opioid dependence. It involves a lot of somatic medicine, and relapses are part of it.
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Old-age psychiatry
Dementia, delirium, late-life depression and polypharmacy. Often you discuss living arrangements and capacity with relatives and guardians.
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Learning psychotherapy
Many supervised therapy hours, theory seminars and 100 hours of self-experience, depending on the hospital also outside it. With supervision you also work on yourself.
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Six months of neurology
Six months of neurology are mandatory under the model training regulations, and some curricula plan twelve: stroke, epilepsy, MS. It often runs through a partner hospital.
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Revolving door and chronic courses
Some patients keep coming back, for example with schizophrenia or addiction. Progress often means stabilisation, not cure.
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Research on brain and mind
Imaging, spectroscopy, biomarkers and trials. At research hospitals this is a large part of the work.
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This test is a structured self-assessment, not a validated psychometric instrument. The specialty profiles are informed estimates. Use the result as a starting point for conversations and check it with shadowing days and talks with specialists. Training information applies to Germany; the binding rules are those of the relevant state medical chamber. Specialty preferences often change during medical school, so retake the test after new rotations.
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