Dutch psychiatrists must sit through 50 sessions of their own therapy
A psychiatrist is a medical doctor first, which is why the job can involve brain scans, blood tests and prescriptions as well as talking. In the Netherlands, trainees need at least 200 psychotherapy sessions with patients plus at least 50 of personal therapy, and the full route takes a minimum of 10.5 years.
The core task is sorting out causes. A psychiatrist judges whether symptoms come from a physical illness, a mental one or a mix of both, using a mental status examination, a physical exam and sometimes CT, MRI or PET imaging and blood work. Treatment can be pharmacological, psychotherapeutic or interventional. Because psychiatrists hold an M.D. or D.O., they can prescribe drugs and order laboratory tests, and they often work alongside psychologists, social workers, occupational therapists and nurses within a biopsychosocial framework.
The specialty splinters into many niches. Some focus on children or on the elderly, the latter called geropsychiatrists. Forensic psychiatrists report to judges and juries and treat offenders held in secure units. Others concentrate on sleep, pain, eating disorders, early psychosis or conditions such as obsessive-compulsive disorder. Settings range from full-time research to private practice to consult liaison work in hospitals, where mental and physical illness overlap.
Every country demands a medical degree, but the paths diverge after that. In India an MBBS is followed by a three-year M.D. in psychiatry. Dutch doctors usually work for years as non-training physicians before competing for a 4.5-year residency, which under an October 2023 plan spans childhood to old age, includes 18 months of electives and requires 120 hours of supervision. Pakistan adds four years of training after a one-year internship, and Hong Kong requires at least six years of specialist training.
Access varies too. In Hong Kong a private consultation starts at HK$1,500, while public outpatient visits cost eligible residents HK$135 for the first and HK$80 thereafter, with waits that can stretch to two years. Methods keep evolving: a Japanese study of Open Dialogue, a Finnish approach, found that a technique called reflecting was linked to patients talking more about their past.
Source: Psychiatrist
