I'm not familiar with the issue you are having with California, as I believe all US med schools offer reciprical recognition of degrees. I'm assuming you completed medical school outside of the US? If so, I wasn't aware there are differences between states, but it seems like that is what you have experienced. If you could provide some more details, I'm sure we can help direct you to the information you are looking for, assuming you haven't already gotten the answers you want.

As for your questions about income - I think that psychiatrists working in his or her own practice probably have the most potential for high income, but not all psychiatrists working for themselves are going to make that much money. When a doctor works for him/herself, the biggest advantage seems to be that the doctor can choose how they want to practice. They can work very few hours and see patients for as long as they want, or they can work a ton of hours and see many patients every hour. Because of this, some doctors make less money and some more - but they practice how they WANT to. The usual downside is that the doctor has to pay for their own benefits (health insurance, malpractice insurance), and they have to do their own business management. I know some people who work for hospitals and make very good money - so I don't think you can say one setting necessarily makes more money than another.

Adolescent psychiatry is part of the child and adolescent fellowship program and subspecialty. Having said that, there is nothing that generally prevents any psychiatrist from seeing children and adoloscents, even without having completed the fellowship program and being board certified. Depending on the setting you are working, you may or may not be able to see adolescents without board certification. In many more rural areas, there is no child and adolescent psychiatrist and therefore the adult psychiatrists will also treat the children. All general adult psychiatry residencies require a certain amount of child rotations. In the end, though, if you plan on seeing primarily children and adolescents, it would seem to me that you really should complete the fellowship and get board certified though.

Most rewarding thing about being a psychiatrist: there are many different things I enjoy. I find the science and theory behind the diseases interesting. I also enjoy working with these particular clients.

If you have more questions - let me know!

Dr. Admin has, as usual, provided an accurate and focused response which agrees with my own experience.

I'll add a few things:

1) I can't understand the Calif. issue unless it is an issue of an out of U.S. undergrad school.
2)In general the income of a private practicioner will depend more on his or her own choices and business skills. For example, one motivated by income could develop a wonderful referral network and work long hours, or work for short visits with lots of patients, or alternatively might wish to work 15 hours per week and earn less. Maximizing income ultimately would depend on the ability to get a lot of high paying referrals, (or, and this is anathema to me personally, to doing a ton of micro-visits - say 15-minute medication visits and seeing 30 patients in a day. I personally see 8 to 11 patients per day, mostly in self-pay 45 minute therapy sessions.).

3)A big advantage of private practice is - depending on the area in which one practices - the ability to opt out of insurance and managed care, with the patient receiving whatever out-of-network reimbursement his insurance will provide. This allows the private practicioner to control his own professional life, setting his own fees, providing treatment he feels is called for with whatever frequency and modality(ies) he and the patient agree to.

4)Working in a hospital offers opportunities for social contact and collegial interaction. Relatively speaking, private practice can be more isolating, and one has to assess how one is suited for that.

5)The most rewarding thing(s) about psychiatry for me: the privilege and fascination of being allowed into the minds and lives of people in order to try to be of help to them; control over the conditions of my work life; opportunity for good income.

Good luck!