Day in the Life of a PGY-1
Currently I am rotating on one of our inpatient psychiatry teams. My day starts by reviewing each of my patients to see if the night float intern left any notes about my patients or if any of them had any emergencies or issues. Then I greet each of my patients to assess how they are doing and their response to their treatment. I work together with a treatment team for each patient consisting of the nursing staff, technicians, and an attending physician to develop and adjust the treatment plan for each patient. We see a wide variety of pathology at Episcopal; each of the patients on my team presents unique challenges and has a complex treatment history, which provides an engaging and challenging learning environment. My work day finishes at 5 pm, which allows me plenty of time to make dinner and enjoy the evening by seeing friends, relaxing at home, or going to the gym. We have didactics every Wednesday, which for interns, focuses on making sure we understand the basics of psychiatric diseases and treatments but also addresses more medically-oriented issues and emergencies. The intern class gets together for a special group on Wednesdays called T-group which gives us time to bond and chat as a class.
Day in the Life of a PGY-2
The transition to PGY-2 is smoother than medical student to intern. I’ve started feeling more comfortable in my abilities as a physician and as a psychiatrist-in-training. Right now, I’m doing consultation-liaison psychiatry at Temple Main Hospital. This involves interacting with multiple specialties throughout the day. The cases in C-L are very interesting too. I see a range of presentations, from mild depression to psychosis. But I’d have to say the best part of second year is gaining independence and having the trust of the attendings.
Day in the Life of a PGY-3
The third year of our residency program, much like other psychiatry residencies across the nation, is a time for residents to learn and hone the essential skills of psychotherapy. Unlike the alternating rotations of the first two years, 12 whole months are dedicated to outpatient treatment. The transition from rotations into primary psychiatric care with your own caseload can be demanding but is eased through the aid of exiting fourth year residents who prepare transfer summaries and give sign outs on their patients who will be continuing their treatment in the clinic. Supplementing our share of transferred patients, who have varying histories in the clinic, are challenging but exciting new intakes. With these intakes, we have the opportunity to evaluate and establish care with some patients who may be in treatment for the first time. Developing treatment plans, writing comprehensive behavioral evaluations, conceptualizing psychodynamic formulations, prescribing medications, and providing long-acting injectable medications are some of the everyday tasks we learn and practice during this period of training. The foundation for this work comes from a series of didactics and small group seminars throughout the year. During these sessions we learn a multitude of psychotherapeutic theories and treatment modalities including: psychodynamic, cognitive behavioral and psychoanalytic therapies. Guiding and supporting our work are a dedicated group of supervisors including two outpatient department attendings, child & adolescent supervisor, several faculty supervisors, and external supervision from adjunct faculty members. Perhaps one of the greatest advantages of the third year is the morale boost provided by spending the year surrounded by your third year peers. Relying on each other for support, providing comic relief, offering treatment advice and planning outside activities are typical daily interactions in the OPD. The third year is a time to blossom in our roles as autonomous providers while enjoying the comfort of stable supervision and collegial support.
Day in the Life of a PGY-4
As a fourth year resident, my typical day involves working on an elective rotation. This year, I have been able to schedule many electives related to my field of interest, Child and Adolescent Psychiatry. This month, for example, I am doing an Inpatient Child and Adolescent rotation at Horsham Clinic. As a fourth year, I am given more autonomy and often work alongside Child and Adolescent fellows. Additionally, I continue to see outpatients for long term psychodynamic psychotherapy one day a week. Due to a lighter patient case load compared to third year, I also have time during my clinic day to work on research or attend to administrative responsibilities as one of the chief residents. Overall, fourth year gives residents the opportunity to hone the skills they have obtained over the course of residency, obtain additional training in their fields of interest and begin planning for the next step in their career.