How to Become a Psychiatrist

Psychiatry is a medical specialty

A psychiatrist is a medical doctor who specializes in mental health. This is the most important distinction in the whole field: psychiatrists go to medical school and train as physicians, while psychologists earn doctoral degrees in psychology and therapists earn master's degrees in counseling, social work, or related fields. Because psychiatrists are physicians, they can prescribe medication, order medical tests, and treat the biological dimensions of mental illness.

Psychiatrists diagnose and treat the full range of mental-health conditions, often combining medication management with psychotherapy and coordinating with other clinicians. They work in hospitals, private practice, community mental-health centers, and academic medicine.

Because it is a medical path, the training is long and standardized. There is no master's-level shortcut to becoming a psychiatrist.

Undergraduate and medical school

Start with a bachelor's degree. Your major can be anything, but you must complete the premedical prerequisites: biology, chemistry, organic chemistry, physics, and related coursework, with strong grades. You also take the Medical College Admission Test (MCAT) to apply to medical school.

Medical school is four years and leads to one of two degrees: the MD (allopathic) or the DO (osteopathic). Both qualify you to become a psychiatrist. The first two years focus on the basic medical sciences and the second two on clinical rotations across specialties, including a psychiatry rotation.

During medical school you take the licensing exam sequence: the USMLE Steps for MD students or the COMLEX-USA series for DO students. These exams, taken in stages, are required for medical licensure.

Residency and specialization

After medical school, you enter a psychiatry residency through the national residency match. General psychiatry residency is four years. During residency you train in inpatient and outpatient psychiatry, emergency psychiatry, consultation, child and adolescent settings, and psychotherapy, while working as a physician under supervision.

If you want a subspecialty, you complete an additional fellowship after residency: child and adolescent psychiatry, addiction psychiatry, forensic psychiatry, geriatric psychiatry, or consultation-liaison psychiatry, typically one to two years each.

Residency is where you become a practicing psychiatrist. It is the longest single phase after medical school and the point at which you focus entirely on mental health.

Licensure and board certification

To practice, you need a state medical license, granted by the state medical board after you complete the required training and pass the full USMLE or COMLEX sequence. Medical licensure is what legally allows you to practice medicine, including prescribing.

Beyond licensure, most psychiatrists become board certified through the American Board of Psychiatry and Neurology (ABPN). Board certification requires completing an accredited residency and passing the ABPN certification exam, and it is maintained through ongoing continuing certification. While not strictly required to practice everywhere, board certification is expected by most employers and insurers.

After all of this, psychiatrists maintain their license and certification through continuing medical education throughout their careers.

Salary and job outlook

The US Bureau of Labor Statistics reports psychiatrists as a distinct physician specialty, and they are among the highest earners in mental health, reflecting the length and rigor of medical training. Pay varies by setting, region, and subspecialty.

The outlook is strong. BLS projects continued demand for psychiatrists, and there is a well-documented shortage of psychiatric physicians in many parts of the country, particularly in rural and underserved areas. That shortage supports both job security and earning potential.