A Day in the Life of a Resident

• PGY-1
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• PGY-2
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• PGY-3
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• PGY-4

A Day in the Life of a PGY-1 Resident

Azeesat Babajide
My name is Azeesat Babajide and I’m a PGY1 resident.  I’d like to tell you a little about intern year and a typical day for me.  

Each day, I wake up at 7AM in my Washington Heights apartment.  I chose to live near the medical center for the sake of convenience, and I’m really enjoying the area’s vibrant culture!  I leave the house by 7:45AM and arrive at the Emergency Room around 7:50AM for rounds with my team at 8AM.  After that, I start seeing a wide range of patients who present with life-threatening accidents, initial presentations of chronic illnesses, and even primary care concerns.

Work in the ED is divided into 12-hour shifts.  For each shift, I’m on a medical team that consists of an attending, a senior resident (usually either a 3^rd year ED resident or 3^rd year internal medicine resident) and me, the PGY1.   As an intern, I typically assess patients on my own and decide which preliminary tests or imaging studies to order.  Then I present the case to the supervising attending and we further discuss and revise the history, exam, study results, assessment and plan.  The 3^rd year residents are also available and eager to help with brainstorming, medical procedures, or logistics planning.  These interactions with attendings and senior residents are wonderful opportunities for learning, and everyone is very friendly and quite enthusiastic about teaching.

During my time in the ED, I have not only learned about patient care in the emergency setting, but I have also learned a great deal about the health care system and the challenges many patients face in accessing care.   My role in the ED often requires coordination of outpatient services for those I see.  With so much to do, life in the Emergency Room is definitely a busy one, where the ability to multi-task will take you far. In addition, it is a rich environment for personal and professional growth. 

Next week I will finish my time in the ED and I will return to the neurology service, which I am looking forward to.  Intern year is divided into thirteen blocks which provide a variety of experiences in neurology, psychiatry, and internal medicine.  In total, I will complete 2 months of neurology, 4 months of psychiatry, 4 months of internal medicine, 1 month of emergency medicine, and 1 month of geriatrics.  Importantly, we also receive 1 month of vacation, split into 2-week blocks!  Of course, I’m also looking forward to beginning my psychiatry rotations and settling into my new role as a psychiatrist.  

All in all, I have truly enjoyed my intern year so far.  I have learned so much, but also realize that I have so much yet to learn.  With this in mind, I look forward to a challenging, yet rewarding first year as a physician at Columbia!

A Day in the Life of a PGY-2 Resident

Rachel Caravella
Hi! My name is Rachel Caravella and I am currently on the Consult-Liaison (C-L) Psychiatry Service and loving life as a PGY2 at Columbia.

My typical day starts at 7AM when I wake up and head outside to take my new puppy “Ruby” for a walk around the beautiful Fort Tryon Park near our apartment at 190^th street .  I chose to live in this quiet little area of Washington Heights , nicknamed Hudson Heights , because of its diversity, history, and community feeling.  I bike the 22 blocks to work  every day (rain or shine!), passing fellow residents strolling along the sidewalk, and arrive at the hospital around 8:15AM.  I round on several patients on whom I’ve been consulting: managing psychotropic medications and engaging in bedside psychotherapy.  At 9:45AM we have attending rounds, in which we present new cases, review plans for ongoing patient care and discuss the latest psychosomatic literature.   At noon, all the PGY2s convene for didactics – this month we begin classes on Suicidality, Schizophrenia, Neuroscience and Basics of Psychotherapy.   In addition to classes, we have weekly process group, Grand Rounds on Fridays, and other resident events scattered throughout the week.  This year is a bit of a reunion for our class and we are really enjoying working and laughing together, doing what we love.   My fellow residents are fantastic and I am so proud to be a member of such a dedicated, fun-loving, and hardworking bunch.   Afterwards, I spend the afternoons seeing new consults, mentoring 3^rd and 4^th year medical students, and attending special C-L lectures on topics like Hypnosis and HIV Psychiatry.  I end my day around 6:00pm with a relaxing bike ride home.

PGY2 is a big year for us because we learn the fundamentals of Psychiatry.  We build upon our experiences from intern year to think about the whole patient, body, brain and mind, as we work in a variety of inpatient, outpatient and emergency settings.  The year has a great mix of rotations including two inpatient Adult Psychiatry rotations comprised of 3 months on the Washington Heights Community Service and 2 months on the General Clinical Research Unit.  We also spend time on the C-L service, in the Comprehensive Psychiatry Evaluation Program (CPEP), and Intensive Outpatient Program.

At our program, we are training to be psychopharmacologists, psychotherapists, clinician-scientists, medical educators and Psychiatric community members.   We are guided by talented supervisors and supported by a wonderful administration.  I am delighted to be a part of this community and welcome any questions you may have about what life is like as a Columbia Psychiatry resident.

A Day in the Life of a PGY-3 Resident

Gaurav Patel
My name is Gaurav Patel, and I am a PGY3 resident.

I typically wake up at 7AM, which gives me time to walk my 1-year-old son to his nearby daycare before taking the C train to work.  After looking up and down the west side of Manhattan, my wife and I bought a condominium in Harlem because we could afford more space for our family, live amongst  trendy new restaurants and bars in a historic neighborhood, and enjoy easy access to the medical center (~30min commute) as well as activities downtown. We’re originally from St. Louis but we love New York and have found it to be a rather easy place to live.  I arrive at my office at NYSPI around 8:45AM and check my email.  From 9 to 12, I see patients for psychotherapy and psychopharmacology appointments, leaving time to write notes.   At noon we have our Psychopharmacology and Neuroscience class, which today is focused on the neurophysiological basis of deep brain stimulation.  After class, I catch up with my fellow residents and plan our next social outing. Then I return to my office for supervision with my child psychiatry supervisor, in which we review a video recording of a recent patient encounter.  My next hour is free, and I choose to work on the neuroimaging data that I’ve been collecting in my experiment on mapping the areas involved in visual processing in humans.  After another patient appointment, my workday wraps up at 5:15PM, which gives me time to pick up my son from daycare and enjoy playtime and a meal at home with my family before he goes to sleep.  I then spend some time with my wife before reading a research paper and going to sleep around midnight.

The PGY-3 year is focused on outpatient care, with separate supervisions in psychopharmacology, psychotherapy, substance abuse, child psychiatry, and cognitive behavioral therapy.  We meet our supervisors and our patients in our own offices.   In our PGY3 year, we learn how to run our own practices, which includes scheduling our patients at appropriate intervals and balancing our caseloads with different types of patients.  We also spend one morning per week at a public psychiatric clinic. The twelve PGY3s also cover the psychiatric emergency room at nights and on weekends, which works out to approximately 4 one-week night float blocks and five weekends over the course of the year.  In the emergency room, we learn to quickly and accurately diagnose and stabilize individual patients and to manage the flow of patients.  In addition to my patient duties, I’m on the research track, so I have two protected days per week of research time throughout the PGY3 year, which gives me ample time to collect pilot data for an NIH K-award and also to begin learning how to create a balance between my research and clinical work.

As you can see, the PGY3 year allows me to gain the experience of being an independent psychiatrist and researcher while also offering plenty of support through supervision and research funding.  I’ve been looking forward to this year for some time, and am already enjoying it!

A Day in the Life of a PGY-4 Resident

Matthew Erlich
My name is Matthew Erlich, and I am a PGY4 resident. On a typical day, I wake up at 6:30 AM, make espresso, and hop on the nearby subway. I live in Brooklyn and the commute is one train, one hour, an available seat, and a terrific time to read. I arrive at my office by 8a.m, where I am joined by a senior analyst for my 45 minute supervision in psychodynamic psychotherapy. At 9a.m., I'm off to the School of Public Health , an adjacent building to the NY State Psychiatric Institute, where I have 3 hours of seminars with the Public Psychiatry Fellowship.  I grab some lunch, come back to my office, check my messages, and do quick administrative tasks.  From 2 to 5pm I see outpatients in my office. Then I work for some time on my research, where I investigate the delivery of mental health services in the SMI population in NY State.  By evening, I’m headed home for dinner or to further explore New York City.  

Fourth year at Columbia is primarily an elective year, allowing senior residents to further explore areas of clinical and research psychiatry interest.  For me, this elective year has provided an opportunity to delve further into public psychiatry and mental health services research.   Through Columbia’s Public Psychiatry Fellowship and as a New York State Office of Mental Health Policy Scholar, I’m working at Columbia’s Division of Mental Health Services and Policy Research in an academic-public partnership project between Columbia University, New York State's Office of Mental Health, and New York State's Office of Alcoholism and Substance Abuse Services to assess the implementation of Medicaid fee-for-service administrative and management services to coordinate behavioral health services.  Public health is a real priority at Columbia , and the wonderful public sector clinical opportunities, didactics, and research options that are available here have really helped my interest in this area to blossom.

I also see outpatients, some of whom have been in treatment with me since my PGY2 and PGY3 years, in multiple modalities of psychotherapy (long-term psychodynamic psychotherapy, supportive psychotherapy, child psychiatry) as well as medication management. I am fortunate to have world-class experts in psychotherapy and psychopharmacology as my supervisors -- an incredible asset and a wonderful educational opportunity.  In addition to my outpatient experiences, the PGY4 class has three hours per week of didactic courses (many of which are relevant to career-planning and consolidation of knowledge), grand rounds, process group, and a weekly PGY1-4 resident lunch.

The PGY4 year has been a wonderfully consolidating and nurturing year, in which I feel myself becoming a confident and independent clinician. My interests in services research and public psychiatry have been able to flourish, as I have the elective time necessary to pursue these rich areas of career development more closely. Moreover, my commitment to clinical psychiatry and eagerness to soak up as much expertise as possible from Columbia is warmly encouraged here. Though I will be sad to leave this terrific program, the legacy of the PGY4 year will be its incredible preparation for a challenging and rewarding career in clinical-research psychiatry.