Day in the Life of a Resident & Core Attributes: Psychiatry

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Psychiatry is reputedly a slightly less time-intensive choice for residency – it’s therefore useful to refresh your mind on what a typical day for a resident might look like, the challenges posed, and what kind of attributes one must display in order to succeed.

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Day in the Life of a Psychiatry Resident

Expect to arrive sometime between 7.30am (likely as a PGY-1) or later – perhaps as late as 9am as you progress through your residency. Let’s assume that you arrive at 7.30am.

7:30am: Log in to the computer system and check to see if there are any new patients. If there are, look at their notes and ensure that you are ready to see them and manage them as required. Then check follow-up notes covering labs and imaging, nursing notes, or any monitoring.

8am: Education. Expect around half an hour or an hour of time to be dedicated to education in the morning – if not, then you will likely spend this time over your lunch break instead. Presentations will be from other residents, or more senior figures within the program, and are designed to cover interesting cases, core knowledge, or journal articles that have recently attracted attention.

8:30am: Rounding. The treatment team will consist of you, an attending, nurses, a social worker, and likely some medical students as well. Expect each patient discussion to be varied and perhaps a little more time-consuming than it might be in other specialties – as much as 15 minutes per patient, or more, with time dedicated to talking over the case, conducting an interview with the patient as appropriate, devising a management plan, and perhaps touching on some educational points or questions.

Rounds are likely to last for the morning, which then leaves you having your lunch. Assuming that you had educational activities in the morning, then you are able to relax (briefly) and catch up with other residents.

1pm: Start of the afternoon work. Like any residency, the afternoon is generally less structured than the morning, and will cover a range of administrative and clinical tasks, often with a skew towards admin. In particular, expect to write a significant amount of notes, work through discharges, and chase information or results for both yourself and other parts of the team. You may also have the chance to see some procedures and treatments being carried out, and will likely spend at least some time interacting directly with patients as well.

5:30pm: The night shift resident will take over, and you sign out. This is a relatively early finish when compared to other residencies, and it’s therefore vital that you have reflected on how you will spend time outside of work as well.

There’s a significant amount of responsibility placed on the shoulders of PGY1s in psychiatry, with residents already being responsible for providing psychotherapy and managing care for patients. This, allied to the potential difficulties encountered during a night shift, mean that beginning a psychiatry residency is still immensely challenging, despite the fact that the hours are less than elsewhere.

Patients spend a significant amount of time with a team (typically), which means you will have the chance to develop meaningful therapeutic relationships with them – this means that some of your day is likely to be spent simply talking to patients and hearing their ideas, concerns or expectations.

Expect to spend some time discussing cases with attendings during the afternoons as well, and you should work to develop productive relationships with your attendings to maximise the amount of information that they share with you, and the degree to which they tutor and encourage you.

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Core Attributes of Psychiatry Residents

Psychiatry requires a degree of analytical thought from the outset that might be lesser elsewhere (where learning by rote will take centre stage) – it’s therefore vital that you are ready to demonstrate an ability to reflect, discuss, and solve complex cases and problems. Equally, the level of communication required to interact with difficult patients means that you must consider your communication skills and reflect on this domain in particular. Of course, communication without empathy is difficult – so be ready to demonstrate empathy at interview.

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