A week in the life of a 3rd year

Life is definitely different from PGY-2, as I’m not doing the same thing every day. It was slightly frustrating at first but now keeps me mentally active and sharp. And is an unexpectedly enjoyable change.

Most days are 0800 to 1630 and my afternoons and evenings are predominantly spent with my family, working around the home, doing a bit of prep for either clinic/prison/didactics, and discovering/rediscovering hobbies. I’m also in a D&D campaign with a few co-residents on Tuesday nights, which I absolutely love! Also there is some variability throughout the year in rotation sites. While I’m doing Geriatric work now, I’ll be getting Child Psych experience later on in the year as well as doing a research project rotation regarding ECT!

Monday:

VA Geriatric Consult and Outpatient Clinic: Check in with Dr. Gass (our fantastic PD and attending on Consult service) about new consults and follow-ups. About lunch time, I switch gears to see veterans in clinic who are dealing with both neurocognitive and psychiatric concerns. Day ends staffing with Dr. Gass though we have usually been checking in with each other throughout the day.

Tuesday:

Boise State University Health Services Clinic: I’ve usually chart prepped some the week prior, though this is not required. There is more autonomy in seeing patients and making decisions. I was slightly terrified of this. It became so satisfying though to complete an intake, develop a plan with the patient, and get the note done all on my own. Then I staff with the attending, where they say there was little they would have done differently. But also they provide pearls and nuances into the areas of practicing psychiatry that you won’t find in a textbook. All the experiences from 1st and 2nd year coalesce and I start to feel like I could maybe be an attending someday. BSU is a great place to get a solid feel for ADHD diagnosis and management, and seeing a younger patient group.

Wednesday:

Forensic rotation at Idaho State Correctional Institute: Earlier start (0725) though often an early end (around lunch). Usually I’ve done brief chart checking 1-2 days before. Then it’s a whirlwind of incarcerated individuals with varying acuity. Visits are usually 10-15 minutes while I and Dr. Eliason switch out interviewing or writing the note. You build efficient interviewing and how to write a note with the audience firmly in mind (legal entities specifically).

Thursday:

Didactic/learning: My favorite day of the week! There is a lot of attention paid towards our development as psychiatrists and humans. Psychotherapy supervision first, and I am fortunate to have a supervisor who shares my therapy interests (ACT, relationship/attachment). He is a Psychologist who has been with the VA for multiple years. We often learn from and receive supervision from Psychologists and LCSWs who have extensive experience in both practice and teaching. I find it deeply refreshing to get training and perspective from outside psychiatry. Didactics range from catatonia diagnosis and treatment, outpatient boundary settings, billing/coding in clinic (BIG DEAL to learn about), and even professional identity post-residency. A tasty lunch is provided while we have a business meeting, case conference, or journal club. Then psychotherapy didactics, currently about Attachment theory (a modality that I really vibe with). Thursdays are also great as I am with my co-residents which is fantastic for my own well-being to catch up with them.

Friday:

VA Geriatric Outpatient Clinic and my own VA Continuity Clinic: Geri clinic patients for intakes/follow-ups. Staff with Dr. Gass before lunch and then get prep for the veterans I see for long-term med management, psychotherapy, or both. Late afternoon I staff with my outpatient psychiatry supervisor (who is freaking fantastic), we talk through the day’s appointments, whom I will see next week, and other interesting ideas.

Then on to the weekend! Unless I have call, which is a healthy level of frequency and has strong attending support. Also, IT IS HOME CALL! Meaning you stay at home unless a patient needs to be assessed for admission. Not too stressful and great time to grow in my self-confidence.