The first year of residency focuses on giving a broad view of clinical settings in psychiatry, while mixing in a few Internal Medicine rotations. So far, I have already rotated on service for neurology, emergency medicine, hospitalist night float, forensic psychiatry and adult inpatient psychiatry. Each rotation is four weeks of deeper focus on a specific area. Through all rotations we have Thursday didactics where we learn more about specific psychiatry topics (mental status exam, working with agitated patients, competency vs capacity). I like this integrated approach because it gives me an opportunity to see areas of medicine like neurology and emergency medicine through the filter of psychiatry, rather than as a medical student where the focus was putting yourself only in the mindset of the specialty you were rotating through.
I chose the Spokane program for many reasons, most importantly family. I have family in Spokane, Coeur d’Alene and Priest Lake. My family is very important to me and living close gives me the opportunity to visit more frequently and to continue volunteering and participating in a community I have been a part of for a long time now. I do not have human children (I have 2 lovely fur-children: Potato and Koda), but a few of my siblings do, and this is a great area for families. There is something to do outside regardless of the season, and the cost of living is not too expensive. I feel that I have ample time for work-life balance right now, which is not something every PGY1 can say!
Wake up at 6:30 AM and feed my fur-children and make myself coffee. Currently I am working at Eastern State Hospital, so I leave around 7:30am to get to Medical Lake by 8:00am, to be screened for Covid19 before entering the building and joining my team for morning report. We discuss any major events, changes or requirements for any of the patients on our ward. Then we meet with patients to check in on medication side effects, significant events, and sometimes to just see how they are feeling. In the adult inpatient ward I am currently working, we have a few patients who have been on service for more than a year. The focus is on setting the patients up for success for their discharge, so the attending and I work with a multi-disciplinary team to focus on whole-person wellness. Depending on the workload for the day, I will leave anywhere from 2pm to 5pm. On the days that I get to leave a little earlier, I spend a few hours studying for Step 3, studying topics that came up during the day on the wards, or preparing for didactics. I thoroughly enjoy reading scientific publications pertaining to neuropharmacology, and my early afternoons provide a good time for this pursuit. About 6:00pm I separate from my scholarly and work life to focus on family. My partner and I have dinner together every night that we can. I have a passion for knitting and gardening, making my evenings pretty labor intensive but rewarding. I currently have 2 indoor nursery areas of the house and 2 outdoor garden areas, which require daily attention and maintenance. My knitting I fit in between activities or while watching TV in the evenings.
Wednesday evenings, I volunteer with a local group that functions like Meals on Wheels for families with kiddos in a large section of downtown Spokane. The organization makes dinner four nights a week and helps to disperse the dinners and food donations from the local food bank to children scattered across about 2 square miles. We recently hit our 1000th meal delivered, and it seems like every week we have the honor to help provide nutrition and smiles to more and more families.
I start my day the same way as the other weekdays, but on Thursdays we have didactics from about 1pm to 5pm. I leave Eastern State Hospital around noon and arrive at Sacred Heart with enough time to get a snack. We have a generous food stipend at Sacred Heart and I miss the food available there when I am on rotations that are not located on the Sacred Heart campus. The Thursday didactics always starts with an hour long private meeting with only residents and a faculty member for the purpose of allowing us an opportunity to discuss tough cases we have seen, or air any grievances we might have concerning hospital practice or the program in general. Having this designated and protected time has made me feel that my voice is heard if I have concerns, and gives me and my co-residents time to work through big events. After this we have faculty presentations and workshops on a large variety of topics. I find the topics we cover to be relevant and helpful.
My current rotation allows weekends off! There are few things I love more than a protected weekend. I value my time with my family and for self-care very highly. I need time to clean, be creative, see family and friends, play with the dogs and exercise. The days on inpatient psychiatry can be pretty cerebral, so I like having weekends to focus on being relaxed and recuperating. So far most of my rotations have not infringed on my precious weekends, only a Saturday here and there. Late summer in Spokane has so much to offer: huckleberry picking, floating the river, axe throwing, gorgeous you-pick-yourself fruit orchards, wine/beer tasting rooms, mini-golf and camping. My weekends oscillate between being jam-packed with activities and being relaxation-focused in a hammock in the forest. In a few months the winter sports will open up, and my co-residents and I are excited to get some skiing trips in over the weekends.
Overall I’m pretty pleased with my work-life balance and my professional development. My last rotation had 10-hour shifts at odd hours, but never more than 5 days in a row so even then I still had enough time to take care of myself. Please feel free to contact me with any questions about the program, Spokane, or in-residency self-care tips!
