We asked a few residents to provide applicants with a window into their lives.
Intern year can be exhilarating and at times a bit terrifying, but overall, it is so much better than being a med student! The year is a mix of psych and medicine rotations, where each rotation is about 4 weeks long. The off-service rotations are typical like internal medicine, emergency medicine, neurology (inpatient and eventually outpatient) and psych rotations are adult inpatient, consults, addiction medicine consults and geriatric psych out at the state mental hospital (Eastern)! The day to day expectation can differ a little depending on what service – example medicine (house staff) is typically 6:30 AM – 5:30 PM six days a week, where psych rotations can look pretty different depending on inpatient vs consults and how sick the patients are (sometimes caring for 5 really sick consult patients can fill a whole day like 10 relatively straightforward consult patients). Often on psych rotations, interns get to the hospital around 7 AM and work until late afternoon or evening, five days a week. The call requirements in my opinion are really manageable – no overnight shifts or overnight call, no solo weekend shifts (only two training weekend shifts). “Short call” is about once per week 5-8ish PM where interns and a senior psych resident do additional psych admissions or consults.
One of the best parts is that every Thursday is protected, even when on the off-service rotations! On Thursdays, interns all come together for didactics and T-group which is probably one of my favorite things about this program! It is essentially a peer-support group where the residents come together for an hour to process the wins and the hardships of adjusting to residency, or to talk about literally anything we want (no faculty from the program is present). This really helped me connect with my co-residents and learn about them as a person outside of the hospital – even when we are on totally different rotations!
As a second-year resident, there is much less jumping around between different rotations, but there are some new adjustments. Basically, all the time is split between inpatient psych and consults (psych or addiction medicine) with outpatient psych and therapy clinics as the new adjustments. Usually, I will be on the same core rotation (inpatient or consults) for several weeks at a time which is nice continuity. Then one-half day a week I do therapy, and one-half day a week we have didactics and T group. Every 5 weeks I do outpatient psychiatry, and I am building a panel of my own patients. It is super nice to only do psychiatry rotations now.
It is fun to act in a senior role as PGY2 for the interns and take more responsibility for patient care. There is a big emphasis on learning psychotherapy starting R2 year with supportive psychotherapy, CBT and intro to psychodynamic therapy, and luckily there is also a lot of support to learn all these modalities.
The biggest shift in third year comes with transitioning to outpatient psychiatry clinic! Most of the time is spent in the ambulatory setting focusing on a few different clinic settings where each “clinic” is typically one-half day per week. I have three half-days of outpatient psychiatry (directs), one half day of outpatient addiction medicine in our Recovery Clinic, one half day of Collaborative Care, one half day of psychotherapy, one half day for outpatient child psychiatry, and of course we still get one half day of protected didactics. Basically, all of these are at the Spokane Teaching Health Clinic (so even though they are half days, I am not travelling or changing locations) or at the hospital for didactics. There is one off campus half day at Gonzaga University where we do psychotherapy for the college students at Gonzaga University which is really fun. The university is only a 4 min drive from our clinic. Third year is also great because you start to get some flexibility and choose a selective. Selective options are to do outpatient or inpatient rotations!
Fourth year of psych comes with significant flexibility geared towards your interests in psychiatry! There are also great learning opportunities to start building skills that will translate into attending-hood like doing a block of Junior Attending (it’s so much fun working as an attending with my fellow co-residents!) There is a lot of support from the program as well to start building resumes, CVs, information on board prep and job searching which is super useful as graduation nears!
