Thursday Born

The everyday life of a psychiatry resident (who was born on a Thursday).

Archive for the ‘Residency’ Category

Suddenly Doctor

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It’s funny how jarring the “sudden” transition from medical student to Doctor feels, because it’s not sudden at all. It’s 12 + 4 + 4 years of school, at least, in the making. Exam after exam, rotation after rotation. And then you graduate, and next thing you know people are calling you Doctor, and you not only have responsibility, but you can actually make decisions. As a first year resident, fresh out of medical school, I still had a lot of supervision, but there were also a lot of things I could decide to do without asking someone else about it. There’s a little bit of thrill with that first order you write without telling your senior resident or attending what you’re about to do.

I’m still growing into the role of Doctor. It fits. It’s me. But sometimes it feels a bit stiff, too formal. When I hear the nurses talking to a patient in the background and saying, “The doctor said ____,” there’s a voice in my head that giggles at the acknowledgement that “the doctor” is me. While I will usually introduce myself to my patients as “Dr Aba,” to other medical staff I lead with “I’m Aba, the psychiatry resident.”

Unlike many of my co-residents, I am comfortable with my specialty, even with strangers. Other psychiatry residents, when asked what they do, will say simply that they are doctors. I did in the beginning, when I had not yet done any psychiatry rotations. Now? I’m a psychiatrist. Maybe someday the response will be negative enough that I will reconsider and supply the ambiguous “Doctor,” but so far I’ve enjoyed the surprise, and the opportunity to educate (often in the form of explaining the difference between psychiatrists and psychologists). Yes, I went to medical school. Yes, I do therapy. Actually, electric shock therapy is a very safe and effective treatment for depression.

I’m on call right now. Home call, which is a blessing and a curse. On a good night, I get paged only when I’m incidentally awake, and I get to stay at home all night. Some nights I get to stay at home, but I get paged every few hours to write or fix an order, or to talk to the nurses about a situation with a patient. And other nights, I get called in, stay a few hours then go home, or decide the odds I’ll have to come back are too great so I sleep in a call room instead. Not knowing what my night is going to be like is, as to be expected, quite anxiety provoking. Will the pager go off? When it goes off, why am I being called? After I’ve made my decision, was it the right choice? Will the patient finally calm down? Were those vital signs really nothing to worry about? Some people run many of their decisions by the Attending on call; I tend to only call for the situations I have to call about (new consults, patients who want to leave Against Medical Advice, etc), but I am comforted by the knowledge that should I ever feel out of my league, backup is a quick phone call away. Someday, it’ll just be me, but I’ve got time before that final safety net is gone.

Written by Aba

December 24, 2014 at 9:32 pm

Posted in Residency

Off Service

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Psychiatry intern year is half psychiatry, and half “off service” rotations, usually a mix of Internal Medicine and Neurology. My program offers us the option of doing some Pediatrics rotations, either pediatric inpatient or pediatric neurology, and I decided that if I was considering doing the Child and Adolescent Psychiatry fellowship, perhaps I should have a better foundation of pediatric medicine than just what I got in medical school.

So my Intern year is a little bit more intense than most of my co-Interns. Usually you have two or three off service “ward” months, two months of neurology, and then another two or three somewhat lighter medicine related months like Medicine Consults or Emergency Medicine. And when you start Off Service instead of on psychiatry, you get a total of seven months (month = a four week block) of off service rotations instead of six. Since I opted to start Off Service, and I wanted to do some pediatrics, I (and one other intern) have two adult medicine ward months, three pediatric ward months, one adult neurology month, and one pediatric neurology month (which I’m on right now and it is a very welcome break). And in addition to having three weeks of night float for Psychiatry this year, I also have three weeks of Pediatrics night float.

I’m mostly glad I chose this, because it’s Intern year. This is essentially my last chance to explore other fields in a hands on way, so I should take advantage of all the learning opportunities I can. I’m a bit apprehensive about January/February/March though, because it will be winter, and I will have adult medicine, followed by two months of pediatrics, all months during which I can’t take vacation. It’s going to be an intense 12 weeks and you bet I’m buying a happy light because I’ll likely only be seeing the sun through my patients’ windows. I’m really excited about April, because I will be back on Psychiatry, and I’ll be on psychiatry for good.

So starting Off Service is a bit rough, because I’m finally a doctor and that’s exciting and awesome! But wait, this isn’t the kind of medicine I signed up for!

Thankfully, we have didactics from 1pm to 5pm every Thursday afternoon, and except for my medicine month at the beginning, and when I was on night float for a week, I’ve been able to make it over. It’s been a nice weekly trip to my “home base,” and it helps keep me grounded.

I feel kind of guilty for whining about having five ward months, when pediatric and medicine interns have so many more, but they also enjoy it (or so I’ve been told). I definitely don’t hate my ward months – sometimes they are actually fun, and they’re always very rewarding – but there’s something missing for me.

Written by Aba

September 22, 2013 at 8:42 am

Intern Year Data – Preliminary Results

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2013-07-07 10.04.58

Fitbit flex + mandatory duty hours logging = lots of fun data to play with.

12 days of work in a row for a total of 134.5hrs (today’s my first day off since I started; we get one day off every seven, averaged over four weeks). Past seven days stats = 81.5hrs at work, and 6.5hrs average actual sleep per night. Apparently I need to enforce my bedtime better, and maybe invest in blackout curtains, but I think intern year is off to a good start (Internal Medicine at the VA), and I have a better handle on CPRS (the VA EMR system) so my hours should improve from here on out.

Now if I just didn’t feel silly wearing a blue rubber wristband at work, I could see if I need to make myself take the stairs more often.

(backdated post)

Written by Aba

July 7, 2013 at 10:00 am

Posted in Intern Year, Residency

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