Recruitment of young doctors into psychiatry is declining in many countries, which might become a threat to the survival of the profession.

To identify potential reasons for this threat.

To look at psychiatry with concepts used by the sociology of professions.

Professions are characterized – and these concept will be used for analysis here – by (1) ownership of a specialized body of knowledge and skills, which defines the field of competence and the scope of potential clients, including the demarcation from other professions; (2) holding a high status in society; (3) being granted autonomy by society, e.g. in recruiting and excluding members; and (4) being obliged, in return for the above, to guarantee high quality standards in providing services and following ethical rules.

Six intertwined areas of concern are identified: three of them, the increasing criticism by users and carers, the intrusion of other professions, and psychiatry's negative image in society, can be traced back to problems with the other three concerning the “ownership of a specialized body of knowledge and skills”. With the preparation and advent of DSM-5, discussions about the lack of validity of psychiatric disease entities have gone viral in the time of the internet. The attempts to “carve nature at its joints” have failed, and this is more and more perceived from outside, threatening psychiatry's status in society and potentially turning away to be psychiatrists.

Looking at psychiatry as a profession may help to better understand its current situation.