A Day in the Life for Psychiatry Residents

7:00 a.m. - Wake Up
I’m not much of a morning person, so I begrudgingly roll out of bed. I feed my cat Jinx, make coffee, and get ready to head to the unit by 8:00 a.m.

8:00 a.m. - Pre-Charting
I arrive on the unit and head to the workroom with the other interns, seniors, attendings, and medical students to begin chart reviewing before the treatment team meeting.

9:00 a.m. - Treatment Team
The whole team packs into a conference room to discuss patients and ensure that everyone is on the same page regarding plans of care. The unit at Methodist includes nurses, nurse techs, recreation therapists, chaplains, social workers, therapists, pharmacists, nutritionists, and more. This meeting truly epitomizes interdisciplinary collaboration.

9:30 a.m. - See Patients
Now it’s time to finally see patients! There’s a wide breadth of psychiatrically complex cases at Methodist. During my time on the unit, we’ve helped treat patients with Bipolar I and II, Schizophrenia, Schizoaffective Disorder, Borderline Personality Disorder, and more. Patients at Methodist also have the option to pursue ECT, and even as an intern, you can begin helping and getting trained in ECT.

11:00 a.m. - Table Rounds
After seeing patients, I meet with the attendings Dr. Patel and Dr. Withers, the medical students, and other residents in a conference room to discuss our patients and collaborate on care plans. If there’s extra time, we also discuss interesting cases or use the opportunity to review various topics in psychiatry.

12:00 p.m. - Lunch
We receive a meal stipend while at Methodist, so I pop down to the cafeteria for a quick bite. We’re encouraged to have lunch, but I prefer to eat quickly so that I can finish my work.

12:30 p.m. - Notes
Every resident’s favorite task: documentation! I spend the rest of the afternoon following up with patients, seeing new admissions, and documenting my encounters.

2:00 p.m. - Wrap Up
Most days at Methodist, we finish up around 2:00 p.m. I check with the team to see if they need any help, but if my work is done, I head home to Jinx (my cat).

2:30 p.m. & Beyond – Academic Activities
I try to read a few psych articles related to the conditions or medications we’re seeing on the unit each week. Because our schedule isn’t too time-intensive, this doesn’t feel like studying or a burden. I’ve also had the chance to resubmit an article from a project in medical school that was under review, as well as send an article to Psychiatric News, which will be published in the Residents’ Forum in November. These extra tasks don’t feel overwhelming, thanks to the great balance of time we have, even as interns.

4:30 to 10:30 p.m. - CIU Call Shift
We work about 25 call shifts throughout our intern year, notably only on weekdays. Call occurs at the Crisis Intervention Unit (CIU) at Eskenazi, a walk-in psychiatric emergency clinic. A social worker sees patients first, and if they are deemed eligible for inpatient admission, you assess them and staff with the attending on call. It’s a great way to see a wide range of psychiatric conditions and start practicing your independence, even as an intern.

Personal Time
I believe it’s vital to have a life outside of medicine, and it’s been great to rediscover hobbies that were set aside during medical school. I’m almost finished reading Venomous Lumpsucker and will pick up another weird dystopian sci-fi novel after I’m done. Running (albeit slowly) is also a passion of mine, and I’ve been consistently running five days a week throughout both of my blocks.

We get weekends off during our psychiatry rotations during intern year, so I’ve been able to visit my partner in Chicago, my dad near Fort Wayne, and hang out with some of the other residents at local spots in Indianapolis during my two blocks at Methodist. Dr. Patel and the program leadership genuinely prioritize health and wellness—I went to the doctor for the first time in years was able to take Jinx to the vet twice.

Overall, It’s surprising to say, but so far, my intern year has been a deeply fulfilling and even enjoyable experience. The opportunity to finally practice psychiatry has been incredibly rewarding, and the balance between work and personal life has exceeded my expectations. I’m only excited for what lies ahead!

The start of my second year has been very exciting for me. Now that required rotations (medicine, emergency medicine, and neurology) are out of the way, I just have psychiatry rotations to look forwards to. My current schedule is a three-month-long block that allows me free time to explore my areas of interest and have a better work-life balance. My current schedule has me at different sites throughout the week with two other co-residents. Each day, I am scheduled with a different provider.

Monday:  My week starts with a research day. At the start of the rotation, we discussed our area of interest and focused on research relating to that topic. I am currently interested in perinatal psychiatry, giving me a chance to data mine different research papers regarding postpartum psychiatry care. I will condense data mining is a little out of my comfort zone, but this has been an excellent opportunity to develop my research skills and broaden my knowledge regarding a future career interest.

Tuesday: Forensic Psychiatry Day. This has been the most eye-opening rotation for me so far. We explore the different aspects of the legal system, capacity, the ability to stand trial, and the nuance behind an insanity plea, which involves understanding the mental state of the defendant at the time of the crime and how it may affect their culpability. Our day usually consists of interviews with current patients in the Marion jailhouse or spending the day at the State hospital. As the second year has offered me more time to explore my areas of interest, I often find myself watching court cases on YouTube with a better understanding of  the intersection between psychiatry and the law.

Wednesdays and Thursdays: Palliative Care Cognitive Behavioral Therapy (CBT), where we get a chance to develop therapy skills. With CBT training on Friday, this has been an excellent way to practice what we've learned. So far, my therapy sessions have been one of the most rewarding aspects of my second year, as therapy was an essential element that drew me to psychiatry. After seeing our patients, we debrief with our attending and discuss ways to improve our interview skills, challenge and help patients, and note what therapy techniques were helpful for each patient.

Friday: Friday starts with CBT training in the morning, followed by didactics for the rest of the day. We once again get the chance to go over our palliative care patient's therapy session. Having Dr. Danielle Henderson and two other co-residents to bounce ideas off and learn from has allowed for a steep learning curve. The rest of the day often feels like hanging out with the rest of the psychiatry program. Lunch is provided to give us the much-needed boost to get through the next few hours of lecture.

We must not forget to add the start of being on call. These shifts, while they may sound daunting, are a crucial part of our training. They provide a great way to highlight (and remind myself) how much learning has happened so far! During these shifts, I am responsible for responding to urgent psychiatric issues that may arise in the hospital. Luckily, I can reach out to my co-residents and attend for support when needed.

Third year is an excellent time to build confidence in the outpatient setting. With a full year of outpatient clinics, you'll enjoy continuity in your work, allowing you to really see the progress your patients make. The best part is that you get to choose clinics that align with your interests, which makes the experience even more rewarding. You'll also deepen your understanding of psychopharmacology, rounding out the strong foundation you've built during the first two years. By the end of third year, you'll feel ready to step into a junior attending role in your fourth year. A typical day in my life as a third-year psychiatric resident at Indiana University School of Medicine is both demanding and rewarding. 
 
Monday 
My week kicks off on Mondays at Goodman Hall, where I work in the adult psychiatric outpatient clinic. Here, I encounter a wide variety of complex psychiatric cases, often complicated by significant medical comorbidities. The diversity of these cases challenges me to integrate my knowledge of both psychiatric and medical principles, pushing me to think critically and apply my training in real-time. 

In the afternoon, I shift my focus to psychoanalytic psychotherapy. These sessions are a crucial part of our training, as each resident is assigned to one patient for the whole year, allowing us to connect with patients on a deeper level and address the psychological aspects of their conditions. After each session, I staff with my attending, discussing the patient's progress and refining our approach. This collaboration is invaluable, providing me with insights and guidance that help me grow as a psychiatrist. By the end of the day, I feel a sense of accomplishment, knowing I've made meaningful strides in my patients' care.  

Tuesday 
I am on the research track, so I have protected research time on Tuesdays. As a research fellow in radiology imaging sciences, I work at the Imaging Center for Alzheimer’s Disease at Indiana University, one of the largest and most renowned centers for Alzheimer’s research internationally. My work involves studying the brain microstructural changes in patients with Alzheimer’s through analyzing MRI images. Our residency program provides robust support for research initiatives, offering ample opportunities to contribute to cutting-edge projects, which enhances my clinical training and deepens my understanding of neuropsychiatric care.  

Wednesday 
Wednesdays bring me back to Goodman Hall, where I spend the morning working in the addiction clinic. Here, I treat a variety of addiction psychiatry cases, working with patients navigating substance use disorders and related challenges. This experience is vital for keeping my knowledge of addiction medicine up to date, and it gives me the confidence to manage these challenging cases effectively. The hands-on experience I gain in the addiction clinic is something I truly value, as it allows me to apply evidence-based practices in real-world scenarios. In the afternoon, I transition back to the general adult clinic, where I oversee a broad spectrum of psychiatric cases, addressing various mental health conditions ranging from mood and anxiety disorders to more complex, co-occurring psychiatric and medical issues.  

Thursday 
I start my day once again at Goodman Hall, this time in the ECT/TMS clinic. My work here involves evaluating patients with treatment-resistant depression, determining their suitability for treatments like Transcranial Magnetic Stimulation (TMS) or Electroconvulsive Therapy (ECT). This aspect of my residency is particularly fulfilling, as it allows me to work with cutting-edge treatments that can significantly improve the lives of patients who have not responded to traditional therapies. 

In the afternoon, I continue my clinical responsibilities at the VA, delivering psychiatric care to veterans and addressing the distinct mental health challenges they face. 
 
Friday 
By the time Friday rolls around, it's a bit of a breather since the day is fully dedicated to didactics with protected time for learning. We start the morning with PGY-3 psychotherapy didactics, diving into different therapeutic approaches. Around noon, we gather for our weekly resident business meeting, where lunch is provided, and we catch up on updates from committees and sites. The meeting usually wraps up early, giving us a chance to chat and unwind with our co-residents. In the afternoon, we join the other residency classes for didactics, where we cover a variety of topics that change throughout the year. 
 
Saturday and Sunday 
Our weekends mostly free, with just three or four weekends a year where we're on call at Riley Children’s Hospital. Other than that, we have those days completely off, which gives us a great work-life balance—something our program really values. Many residents use those weekends to moonlight, while others take the time to relax, unwind, and enjoy their hobbies. Personally, I love cycling, so I often hit the trails around Indianapolis and the suburbs. 

Being a fourth-year resident is amazing!

Not only is it exciting to be wrapping up residency after years of training to get to this point, but also, we are able to essentially design our fourth year schedule according to our individual interests and goals. As I was still in the process of considering what type of psychiatrist I want to be eventually (outpatient, inpatient, consults…), I wanted to get all the experiences I could during fourth year to really help me decide. However, I really enjoyed outpatient clinics during third year, so I kept my clinic with Dr. Anup Deshpande on Thursday mornings. It is a general adult psychiatry clinic, so I get to treat adult patients from all seasons of life (various ages) with a wide range of diagnoses. As I had this clinic in third year as well, I’ve gotten to treat many of the patients in this clinic for over a year. It has been nice to experience the longitudinal care aspects of psychiatry where I often get to see my patients getting better and accomplishing their goals. Another integral part of third year that shaped the psychiatrist I want to be included learning psychodynamic psychotherapy in depth. The psychodynamic psychotherapy clinic involves seeing my patients once per week for one hour. I staff the patients with my attending after seeing them so we are able to really understand the deep rooted psychological aspects involved in their experiences. I’ve found this incredibly rewarding and it has positively  impacted all my patient interactions as I’m now able to incorporate some of those therapy skills into all my appointments. As it was such an incredible part of my learning during third year, I kept my psychodynamic patient going into fourth year and I added on another psychodynamic patient as well. I see them on Thursday afternoons. I have also incorporated an education track project in my fourth year related to psychotherapy. My objective with this project is to work with Dr. Danielle Patterson (our primary psychotherapy educator) and my friend and co-resident, Dr. Amanda Kaminski, in learning more about psychotherapy and finding ways to deliver what we learn to medical students or residents so they can use these skills effectively with their patients. I have time on Friday mornings to work on this psychotherapy education track project. Friday afternoons, we go to didactics where we meet with our co-residents, eat delicious food (I’m a vegetarian and they even have food that I can enjoy at didactics), and learn about various topics within our field. My Mondays, Tuesdays, and Wednesdays this year look different depending on the month. I like the variability in my week and throughout the year.
 
I took a couple of months this year to do a neurostimulation rotation. This involves doing ECT (on Mondays and Wednesdays) and TMS (following up with patients on Tuesdays and doing set ups on Wednesdays). This rotation involves working with Dr. Jonathan Withers, Dr. Michael Metrick, and Dr. Susan Conroy. The days typically start around 9 a.m.  It’s been exciting to add neuromodulation to my list of skills and see the ways these can improve our patient’s lives. I also love that I can work with multiple attendings as the more people I get to learn from, the amount I learn grows exponentially.
 
I am spending two months on psychiatry consultations at the VA. Our attending is Dr. Michael Bridges and we generally have multiple residents (often psychiatry, but other specialties as well including neurology and dermatology) and medical and pharmacy students on the team. There is also a psychopharmacologist and PA on the team. They are a very fun and kind group of people to work with. The days on this rotation start around 8:30 a.m. Some days are busier than others with regard to number of patients, and this is nice as it often gives us time to learn from one another or do deep dives/lectures about psychiatric topics that are relevant to our patients or our interests at a given time.
 
Part of being a fourth year also means that you get to practice being an attending! In fact, all fourth years have to spend time in a junior attending role on an inpatient unit. I am going to be spending a couple months on the Methodist inpatient psychiatric unit (with Dr. Aimee Patel and Dr. Jonathan Withers) and the VA inpatient psychiatry unit (with Dr. Hillary Davis and Dr. Yena Choi). These teams are great, and most of our attendings actually did their training here! As we do these inpatient rotations as interns, I’m excited to go back now as a more seasoned physician. It will be exciting to work with psychiatry interns and other learners on these rotations. It will also be a nice change of pace from clinic given the higher acuity of care needed on these units.
 
As I live in Avon, IN, and there is an IU hospital very close to me (IU West), I also chose to spend a couple of my fourth year months doing psychiatry consults at IU West. Here, I will work with Dr. Sara Culleton, who was actually a consult fellow when I started residency. I’m looking forward to seeing how consults work at a new hospital and working closer to home.
 
Given that many psychiatry patients struggle with sleep, I also decided to do a sleep medicine rotation during my fourth year of residency. I would like to sharpen my skills in addressing sleep concerns to ensure that I am optimizing my patients’ health psychiatrically and physically.
 
A common experience in residency is learning a lot. However, it also involves learning what you don’t know or where you can improve. As I wrap up residency, I am excited to do a psychopharmacology rotation with Dr. Ott, a psychopharmacologist. This rotation is a month long and I will be doing it with several of my co-residents. We will virtually pick topics that we would like to learn more about and Dr. Ott will help us do deep dives into these pharmacologic topics so we can be prepared as we enter the attending world.
 
Fourth year involves a wide range of experiences and opportunities, so it’s been very exciting. The attendings are kind, helpful, and accommodating. My co-residents have become my best friends. While I think it is important to work and learn in residency so we can prepare for our attending jobs, having work life balance was also super important to me. I did not ever feel that my life outside of psychiatry was stifled by my work. In fact, I feel my life is enriched by it. Although I have the schedule above, I’ve always been able to find time to exercise, care for my dog (Baloo), and have lunch. I’m also afforded time to job hunt and interview, plan a wedding (I’m recently engaged), and travel. I feel so lucky that I got to come to residency at IU.