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

Joanne Chang
My name is Joanne Chang and I am a PGY-1 resident, currently finishing up my final week on a four-week Addiction rotation. I’d love to share my experiences as an intern working and living in NYC.

On a typical day, I wake up by 7:15 am allowing me time to enjoy a leisurely breakfast. My apartment is situated within a couple of blocks from the subway, grocery stores, Riverside Park, and fantastic restaurants. After a 30 minute commute, I arrive at Columbia Eastside at 9 am, and discuss a write-up from a recent intake with an attending.

By 10 am, I’m ready to co-lead a 2.5 hour group therapy session for five to ten patients. During the 15 minute break, I discuss each patient with my co-leader, a psychologist. The group setting enriches my psychiatric training, allowing me to see psychiatric conditions expressed in interesting and unexpected ways.

At 12:30 I grab a quick bite to eat and join the staff meeting, where we discuss both existing patients and new intakes. I conduct directly supervised initial intakes with the attending, which is a great chance to hone my interviewing skills, develop techniques for establishing an alliance with my patient, and establish a multi-axial diagnosis, assessment, and plan.

From 2-4pm, I co-lead substance abuse group sessions with an attending. This is a wonderful opportunity to learn CBT for substance abuse in a group setting. Each week I attend different 12-step meetings (Alcoholics/Narcotics/Methadone Anonymous); through these, I’ve grown to appreciate the challenges inherent in the recovery process.

On Wednesday, I meet with an addiction psychiatrist for individual supervision to discuss various topics like managing alcoholism in a primary care setting and employing various modalities of treatment, including CBT, motivational interviewing, and medications. Afterwards, I head over to the NYSPI and reconvene with my co-residents for three hours of didactics. We learn subjects ranging from urgent psychiatry to psychotherapy. I look forward to these days because it is a chance for me to check-in with my colleagues and swap stories about our rotations.

Next week, I am off for two weeks of vacation, then am onto the medicine floors. Though the year has only just started, I know that I will be challenged in ways I cannot anticipate. I look forward to embarking on a demanding and enriching year, which will undoubtedly enhance my development as a psychiatrist.

A Day in the Life of a PGY-2 Resident

Uju Obi

Hi everyone. My name is Uju Obi and I’m a PGY2 resident. Each PGY2 resident rotates through the Psychiatric Emergency Department (CPEP), Eating Disorders Unit, Washington Heights Community Service, Child Day Unit, Mobile Crisis and Electro-convulsive Therapy Block, and the Consult-Liaison service. I’m currently finishing up my rotation in the CPEP.

I arrive at work a little before 8am to grab some coffee before rounds, which generally lasts from 8am-9am. During this time, the third-year overnight resident presents the new patients who came in overnight and updates us on patients we have been observing for up to 72 hours. We discuss whether the patient should be admitted, discharged, or held for further observation. After rounds, I decide which patients I would like to see. I love having the flexibility to choose from the great variety of patients, with mental health issues ranging from substance intoxication, acute mania, psychosis, major depression with suicidality, and those who just need to talk to someone to help sort out life’s psychosocial stressors. The CPEP is an interdisciplinary setting, with attendings, social workers, nurses, residents, and technical staff. Each has an important role in making the environment efficient, effective, and a warm learning atmosphere. After I see one to two patients in the morning, it’s usually time to break for lunch and our daily didactics.

This is a great time to see all my co-residents in one place, to do quick check-in to see how people are doing, to crack jokes and to catch up. Didactics usually run for 1-2 hours and then I head back to the CPEP to see patients until my shift ends at 5 pm. Depending on the day of the week, I may be the short-call doctor-on-call (DOC). The short call’s DOC role is to help manage emergencies and help admit patients to the 4 inpatient units we rotate through from the hours of 4:30-7:30pm before the night float gets in. This is a great opportunity to see patients that I have previously admitted and interact with the nursing staff who I will be working closely with over the next 3 years. So far, I’m having a blast as a 2nd year resident doing the work that I have always wanted to do and learning a ton at the same time!

A Day in the Life of a PGY-3 Resident

Enrico Castillo
My name is Enrico Castillo, and I am a PGY-3 resident. My typical day starts at 6:30am in my apartment, surrounded by wonderful restaurants, coffee shops, grocery stores, and Central Park. After a leisurely breakfast, a short, 15-minute subway ride gets me to the hospital by 9am.

In the morning, I sit down in my own office, check my voicemail and then settle in to see a couple of patients. A senior psychoanalyst visits my office to provide weekly psychodynamic psychotherapy supervision, followed by a child psychiatrist to supervise my child and adolescent cases. After our lunch-hour didactics, which we have daily, I head back to my office to see patients in a variety of modalities—CBT, psychodynamic psychotherapy, supportive psychotherapy, and medication management. I am out of the office by 5:30pm, giving me time to cook dinner, go to the gym, or explore the city.

Our PGY-3 year is entirely outpatient. In addition to the Residents’ Clinic, we spend one morning a week in a Columbia-affiliated public psychiatry clinic, seeing a diverse population of patients with serious and persistent mental illness. We can also choose from 3 tracks—research, psychopharmacology, or psychotherapy—giving us protected time in our week to develop our interests. I have one full day a week devoted to my research project, evaluating a clozapine educational initiative sponsored by the NY State Office of Mental Health and writing a review article.

My year so far has involved a lot of personal growth. I am developing my own style as a therapist and my identity as a psychiatrist. I am learning how to thrive as an independent clinician and also beginning to think about my future career, with personal interests in cross-cultural psychiatry, public psychiatry, and psychodynamic psychotherapy. I was fortunate to receive the APA/SAMHSA Minority Fellowship, and hope to use this opportunity to develop expertise in cross-cultural psychiatry, particularly Asian-American mental health. Amidst all of this personal growth, I have never felt alone. I have found my peers, staff, supervisors, mentors, and teachers to be very supportive, compassionate, and dedicated. I have been incredibly impressed by the breath of expertise and resources that Columbia has to offer its residents.

A Day in the Life of a PGY-4 Resident

Carl Fisher
I’m Carl Fisher, a fourth-year resident. The beauty of this mostly elective year is its variety. I’m happy to say that there’s no typical day in my schedule.

Twice a week I see outpatients in our residents’ clinic, in treatments ranging from twice-weekly psychodynamic psychotherapy to medication management. Between patients I have supervision. These expert clinicians are the heart of our outpatient training. This year, one of my supervisors is an accomplished playwright, another writes literary non-fiction, and a third is an expert in hypnosis. The days are never boring, and I’m given space to develop as an independent clinician while still being well supported. The resident community is great too, and it’s always reenergizing to be around people as curious, passionate, and genuine as my classmates.

Other days, I get more time to work on writing and research. My primary academic interest is in ethics and law, but I dabbled in other fields first, and it’s clear that residents are welcomed across all research divisions in the psychiatry department. I’ve been amazed by the opportunities for mentorship and serious scholarly work here, and it’s been a privilege to learn from and work with some of the leading thinkers in the field.

The main Columbia campus is also just a brief shuttle ride away. This Fall, I’m teaching a weekly seminar for graduate students in the Masters in Bioethics program. Because I’m interested in forensic psychiatry, I’ll also be taking several courses in the law school on policy, legal philosophy, and psychology of law. And the flexibility of our schedule allows for great clinical experiences too: later in the year I’ll be doing a “junior attending” month on a prison ward in a psychiatric hospital.

I’m very happy to be training at Columbia. The fourth year exemplifies the great combination of scholarship and solid clinical training that has been present throughout the whole residency. Largely because of these great experiences and wonderful people, I’ll be staying at Columbia after residency for a fellowship in Psychiatry and the Law.