The PGY3 year is divided into 6 months focused on outpatient care and 6 months spent on consults, in the ED, and in the community. I’m currently in the outpatient half.
I wake up between 5:30 and 6:30am, depending on how ambitious I am and whether my pre-schooler has woken me up in the middle of the night. Two days a week, I go for a 20 minute run around my neighborhood before breakfast. I live in Baltimore city, a 7 minute drive from Hopkins hospital, so not having a long commute helps a lot.
Two days a week, I try to go in early to my office to write: I’m helping a faculty member write a book chapter on bipolar disorder and I’m working on personal essays that come out of my interest in psychiatry and my previous experience in journalism. From PGY2 year, we are assigned an office, something that still feels like a luxury, especially with two kids, since I’m not great at getting work done at home. One day a week, I walk my older son to elementary school before work and stay for circle time.
Lectures start at 8 or 10am. Third year affords the time to read that was harder to come by during the PGY2 year. In addition to more current research, we still read historical studies that changed the field and discuss them in a small group of 6 or 7 with faculty that I can’t believe spend so much time with us: Ray DePaulo, chairman of the department, Kay Jamison (yes, that Kay Jamison), and Karen Swartz, an amazingly experienced clinician and teacher, to name a few.
When not in lecture, I’m in half day clinics or seeing my own outpatients, some of whom I’ve worked with since PGY2 year, for hour long sessions doing combined medication management and psychotherapy. In addition to ongoing formal outpatient supervision, there is more time this year for informal supervision: bringing up a challenging case in lecture, meeting with mentors to get career advice, or having coffee with another resident.
Our half day clinics are focused on community psychiatry, mood disorders, and family therapy where we see and treat patients with an experienced attending and in anxiety and sexual behaviors where we do in-depth 1.5 hour consult interviews, sometimes before a mirror, present the history and discuss recommendations with a round table of faculty. This half of third year feels like we are practicing psychiatry at its best; it’s not the 15 minute med check model followed by many in the “real” world and it may not be the model we follow after residency, but it feels valuable to learn and makes psychiatry continue to feel like a vocation rather than a job.
Depending on how long clinic goes, I head home around 6pm. There is no overnight call this year although we still do 12 hour emergency room shifts, both days and nights, on some weekends. So far, I’ve made it to family dinner time much more often this year. There’s a race to cook, hear about everyone’s day, check homework, read books. I’m typically in bed by 10pm.
On the weekends, I coach my son’s soccer team 5 minutes from my house, catch up with my husband, take a nap with my youngest, have friends over for dinner. The pace this half of the year feels manageable, with time to reflect and plan for the future.
Dr. Leistikow is a PGY3 resident in the Department. - Ed.