PGY 4: A Day in the Life with Thomas Beesley
The fourth year as a general psychiatry resident is seemingly the home stretch. This year has a lot of freedom in terms of scheduling and planning the experiences you may wish before we either head out into the workforce or pursue a fellowship. Having such autonomy has allowed me to cultivate new skills while building on those developed over the past three years. At this point in my residency, I essentially craft my own curriculum. The program genuinely empowers me to make this final year an opportunity to explore my interests and make every effort to ensure I meet my personal goals.
Having just finished 12 consecutive months of outpatient clinics as a PGY-3, I knew that this year I wanted to have a lot of variety in my schedule to ensure I get additional experience in a number of practice settings that will help solidify looming employment decisions. In order to do this, I chose to break my year into two blocks, one block being inpatient and the other being more of a hodgepodge of clinical experiences. During my first block, I decided to take two months and dedicate them to inpatient psychiatry at Eskenazi Hospital. During this experience, I serve as a “junior attending” where I oversee first-year residents and essentially manage an entire inpatient treatment team. So far, this has been an incredible experience and has allowed me to further develop my personal style as a provider.
During the second block (the remaining 10 months) of my final year, I will be partaking in a number of clinical experiences depending on the day of the week. One of these experiences will be a psychotherapy clinic to better develop my skills as a therapist. In addition to this, I will have an outpatient clinic working with individuals with chronic mental illness through Eskenazi Midtown Community Mental Health Clinic. Other days of the week I’ll get to experience emergency psychiatry working at the Crisis Intervention Unit at Eskenazi Hospital and even psychiatry consultations at IU Health University Hospital.
The most unique part of my fourth year is actually an expansion of an interest I developed during my third year. During PGY-3, I worked in an integrative care clinic which exclusively served the homeless population of Indianapolis. During this experience, I developed a passion for serving this population of individuals. A component of this clinic was going out into the community and working with a homeless outreach team. This year, I chose to expand my presence on this same team, allowing me to work with some of the most vulnerable individuals in the community who happen to be homeless. Often times, during outreach, we’ll end up under a bridge doing a psych evaluation, at the downtown library following up on a housing application or maybe even on a welfare check at a homeless camp. In addition to this experience, I also will be spending a half-day working with a different subset of the homeless population at the Indianapolis Veterans Domiciliary.
If all of this wasn’t enough, I also realized this year I wanted to be more active in medical student education. So, one day per week, in addition to my other clinical experiences, I developed and am leading a “coffee and cases” series. During this experience, third-year medical students on their psychiatry rotation bring in cases they’ve seen and, together, we discuss them in a small group format. This student-driven discussion group has been a beneficial addition to IU School of Medicine’s psychiatry clerkship.
As you can see, the fourth year of residency really provides the opportunity to put the past three years into perspective. Call responsibilities are minimal during this year, which allows one to have plenty of time to spend with friends and family, pursue hobbies, job search or moonlight if desired. This may be the homestretch of residency, but in reality, it’s really just the beginning of something much greater and I feel like I will be more than ready to enter the next stage of my career after these four years of training.
Learn more about a residency in Psychiatry at IU School of Medicine.