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Psychiatry PGY-1: A Day in the Life with Alyssa Smith

Image of Alyssa Smith, MD with quote caption "As a resident now, I feel like a  valued member of a team, and am given the right balance of autonomy and support necessary to grow as a new physician." Experience as a PGY-1

By: Alyssa Smith, MD

Fourth year of medical school is such an exciting time! I was in your shoes only a year ago, and I know the application process can be a lot of stress at times - with editing your CV, personal statements, and figuring out which programs to add to your application list. But you’ve made it so far, and you’re almost to the finish line! Congratulations! You have so many events to look forward to this year; interview season, Match Day, and graduation were some of the highlights of my time in medical school. You’ll get to meet so many wonderful residents and faculty members on your interview trail, and see what different programs have to offer you on your journey. My journey brought me to Indiana University’s Psychiatry Program, and I’m so happy it did.

On my interview day with Indiana University, I was amazed at how welcome I felt. The residents, faculty, and program coordinator made me feel at home. The department is supportive, and resident education and wellness are both treated as priorities. I was blown away by everything our program has to offer - diversity in clinical sites, research opportunities, and medical school education opportunities are some of the highlights, in my opinion. As a resident now, I feel like a valued member of a team, and am given the right balance of autonomy and support necessary to grow as a new physician.

We spend about half of intern year rotating through psychiatry services. The other half of intern year is spent off service - two months of neurology, one month of EM, and three months of IM.  The psychiatry months are split into various sites: two months at Methodist Hospital, two months at the VA, two months at Eskenazi, and one month at Riley Children’s Hospital. Eskenazi is the county hospital and acts as a safety-net for the underserved; we see many gravely disabled patients here. About once every 1-2 weeks while on psychiatry, we take an evening call shift in the Crisis Intervention Unit (CIU) at Eskenazi, which functions similarly to a psychiatry ED. Here, we learn valuable skills about triaging and assessing emergencies.

I believe it is a great strength of our program that we are allowed to train at such a variety of clinical sites, as the patient populations tend to vary greatly. It gives us the opportunity to see a wide range in diseases and acuity, and allows us to see how different units are structured. 

I’m currently on the inpatient psychiatry unit at Methodist Hospital. My day usually starts around 7:45 AM, when I arrive on the unit. I spend about half an hour chart checking my patients, then pre-round on some before 9 AM. From 9-9:30, we meet with the treatment team - physicians, nurses, the pharmacy team, therapists, and social workers - and get updates on the patients. We discuss our census, treatment plans, and discharge planning. From 11-12, we meet with the attendings and medical students, and discuss patients and interesting teaching points. The rest of my day is spent checking in on patients, writing notes, putting in orders, and calling families. Overall, my day has a fair amount of structure, with enough variation in day to day events to keep it interesting. No two days are the same, and there’s always something new to learn. 

Our program really values resident education, and on every Friday from 11-4, we have protected time for didactics and learning, regardless if we’re on or off psychiatry services. We also have a really great work-life balance! In my free time in the evenings and weekends, I like to do Pilates, go for walks, read poetry, and spend time with my fiance and friends. Overall, intern year has been amazing so far, and I can’t wait to see what the rest of the year has in store.