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Career Choices: Consultation-liaison psychiatry

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Editor’s note: Career Choices features a psychiatry resident/fellow interviewing a psychiatrist about why he (she) has chosen a specific career path. The goal is to inform trainees about the various psychiatric career options, and to give them a feel for the pros and cons of the various paths.

In this Career Choices, Cornel Stanciu, MD, talked with Peter Ganpat, MD, a consultation-liaison (C-L) psychiatrist at Florida Hospital, where he provides guidance to various medical specialties on managing acute and chronic mental illness and substance use disorders. In addition, he also is the medical director for the repetitive transcranial magnetic stimulation service and staffs the inpatient unit.

Dr. Stanciu: What made you choose to become a C-L psychiatrist?

Dr. Ganpat: In my opinion, C-L is the most challenging area of psychiatry because not only are you thinking along the realms of a psychiatrist, but you’re also considering the viewpoint of the other subspecialties at the same time. For me, it brings together my medical background with my passion for psychiatry, and the patients I see daily allow for this incorporation.

Dr. Stanciu: How did your career path prepare you to become a C-L psychiatrist?

Dr. Ganpat: My career path was unique in that I completed a family medicine residency, and then immediately pursued training in psychiatry. Some may consider this as “overkill” for C-L, but as I’ve come to learn, this background grants me a level of understanding and confidence to step in when dealing with a complex case and lend a hand to the consulting physician beyond psychiatry. I do not feel a fellowship is required to practice C-L psychiatry. However, a psychosomatic fellowship will definitely provide the experience needed for this career path, and also will enable one to get a second American Board of Psychiatry and Neurology board certification.

Dr. Stanciu: What types of clinical conditions are you asked to provide input on managing, and how do you find working alongside other specialties?

Dr. Ganpat: I have been managing the full breadth of psychiatry, and in some cases I also provide medical management. Practicing in a metropolitan area with a high influx of tourists also brings in unique cultural cases. The level of respect that the other specialties give is impressive, because they have now seen what a C-L psychiatrist can do. Their performance scores also have improved as a result of my involvement. They greatly appreciate my efforts to shed light on cases or assist with the ever-challenging patient whose psychiatric complexity impedes care.

Dr. Stanciu: How would you describe a physician who is well-suited for such a setting?

Dr. Ganpat: The perfect candidate for this role should be capable of abstract as well as objective thinking. Having a good understanding of the other medical specialties and being able to solve problems is essential, because often it isn’t a clear-cut picture. It is imperative for the C-L psychiatrist to have sound teaching abilities and to be able to educate and communicate his (her) reasoning to the consulting team. It also is important to be well-versed in the psychiatric manifestations of various medical disorders and the psychiatric iatrogenesis of widely used prescription medications.

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