a day in the life

Hello (again) from Longwood!

First off, thank you again for coming to interview and seeing what our program has to offer. Hopefully, you enjoyed your time with our faculty and residents, because we all enjoyed meeting you!

We residents were brainstorming awhile about the interview process. Recalling our own interview seasons, it can be tough to remember all the details from each interview.  We put together some “Rotation Blurbs,” written solely from the resident perspective that provides a brief, but detailed, description of each rotation during the four years. Additionally, we wanted to send you some individual resident bios from members of each class to provide a picture of “A Day in the Life” of a Longwood resident. As you likely witnessed on interview day, our residents have widely varying interests, but all share an underlying passion for learning and patient care. It’s a pretty awesome place to train.

Please feel welcome to contact any resident or faculty member with additional questions that arise. It was our pleasure to meet with you, and we residents hope to work alongside you next summer.

Sara Brady, PGY3

Caroline Bader, PGY1

"Hi! I’m Caroline, one of the PGY-1s.  I've been loving the first half of my year so far as a Longwood Psychiatry resident!  I started off my year with 2 months of medicine at Newton Wellesley Hospital. It was definitely an intense way to start. The learning curve was steep, but I had a lot of support from the medicine residents (MGH residents), and I learned a ton over those two months. I was always treated equally to the other interns, never looked down on as "the psych person.” By the end, I felt like I was a medicine resident along with the rest of them. While the hours were long, the hospital was a really friendly environment to work in, and the level of academic teaching was very high. I felt like I obtained a solid base of medicine knowledge, as well as a framework for how to be an efficient and effective resident, all of which have helped me in my career as a psychiatrist already!

Currently, I'm rotating on the neurology consult service at the Brigham and Women’s Hospital. It's also been an amazing educational experience - learning from faculty and residents at one of the top Neurology programs in the country, with luminaries in the field leading our morning reports and noon conferences. I spend 2 months on the consult service, so I've seen breadth and depth of neurological presentations, started to think like a neurologist, and mastered that good ol’ neuro exam. I know that this will help me in my future career as well, particularly because I am interested in geriatric psychiatry which involves a lot of neurology. I also still get to participate in psychiatry didactics while I'm on this service.

Didactics for PGY-1s occur on Wednesday afternoons, and we are excused from all clinical duties starting at 11:45 AM on Wednesdays. It’s great! Our first class is always “On Becoming a Psychiatrist,” led by two psychiatrists, and it gives us the chance to informally process with each other the experience of being an intern and becoming a psychiatrist. I love it – it’s basically like group therapy, and can be very therapeutic and facilitates bonding with my co-interns. Then, we have a “Psychiatry 101” course where we learn the basics of interviewing, safety assessments, documentation, etc. The third class of the afternoon is our interviewing class, where one of the PGY-1s interviews a patient currently hospitalized on Deac 4 in front of the group, and we give feedback on how the interview went, and discuss the case. The last class of the day is our psychopharmacology course, which is taught very approachable and practical way. We all eagerly look forward to didactics afternoons, particularly because it’s a chance to see each other during the week!
It's been a great experience so far and I'm looking forward to the rest of my year!"

Lauren Morris, PGY2

Currently, I'm working on the adult inpatient psychiatry unit at Beth Israel Deaconess Medical Center, affectionately called "Deac 4.”  Here we treat patients 18 and over (up to 90+) for a range of affective and though disorders.  I generally carry 5-6 patients which means together with the attending I evaluate patients diagnostically and determine therapeutic inpatient plans which we transition to the outpatient setting.  We frequently have patients ranging from first presentations to care to patients needing ECT treatment and DMH services.  The team also includes a social worker, multiple nurses, occupational therapists, case manager and usually medical students, social work interns and nursing students.  We round together to see each patient as well as have a team meeting each day.  We have 2 chief residents who look after us residents to lead journal club, precept cases, observe interviews, and bring us cookies PRN!  Aside from my work on the inpatient unit, I am also carrying my first outpatient psychotherapy case.  We meet weekly at BIDMC's outpatient department in the Rabb building. I have weekly supervision with a senior clinician (who always meets me in the Longwood area) as well as check-ins with the outpatient chief resident whenever I need advice.  Each Wednesday is a protected day for didactic, during which we are learning the foundations of psychotherapy, advanced concepts in psychopharm, diagnostics and neuropsych.  We start our scholarly project in the PGY-2 year, for which I've paired-up with one of the child-adolescent attendings at Boston Children's Hospital, as I hope to over the next 3 years do a project in psychendocrinology in the adolescent population. Last but not least, while working on Deac 4 I have been preparing for my upcoming elective time in which I will be working in the Simmons College (undergrad school near Longwood medical campus) in the counseling center learning about the role mental health services play in college settings.  It's a busy but exciting year and very gratifying to be doing psychiatry on a full time basis.

Rashad Hardaway, PGY3

As a third year resident, my days are split between my community psychiatry rotation and long-term outpatient. Two days of the week, I am at the Massachusetts Mental Health Center, where I am rotating in the Continuing Care clinic. Here I work with a multidisciplinary team of psychologists, social workers, psychiatrists, and other allied health professionals to serve patients with chronic mental illness. In this six month outpatient experience, my role consists of managing medications, doing psychotherapy, and developing comprehensive treatments plans for patients. The other two days of the week, I see my long-term outpatients at the Brigham Psychiatric Specialties clinic, the outpatient clinic of Brigham and Women's Hospital. Here, I see a diversity of patients, many of whom have multiple medical comorbidities or issues within psychiatric subspecialties such as neuropsychiatry, traumatic brain injury, substance abuse, or women's mental health. Part of my caseload is psychodynamic therapy cases, part is cognitive-behavioral therapy cases, and some patient come for medication management. At the BPS clinic, we also provide outpatient psychiatric consultations and work with a multidisciplinary team that includes social workers, psychologists, psychiatrists, and trainees from multiple disciplines to provide comprehensive treatment plans for what can be complex and very interesting cases. Wednesdays are a protected day for didactics in the morning and time to work on scholarly projects in the afternoon.

Rebecca Allen, PGY4

As a fourth year resident, I am Chief Resident of the Psychiatry Consult Service at Beth Israel Deaconess Medical Center (BIDMC), one of two Chiefs on this service.  Every service has a Chief Resident position, and I love mine because I have the unique opportunity to supervise and teach first, second, and third year residents, as well as medical students. 

I spend four half days on the consult service. On Monday and Friday mornings I arrive at the psychiatry office in the BIDMC emergency department (ED) at 7:30am.  The second year resident, on night float, signs out to the intern who will be in the ED during the day, and it is my job to supervise this 30-minute sign out and teach or help when appropriate.  From 8am to 1pm on Mondays and Fridays my job varies a lot, but I am in charge of fielding consult requests from inpatient medical and surgical floors, triaging the urgency of these consults, and assigning which resident and attending will see the patients.  I also spend time working one on one with the intern in the ED, watching interviews and giving feedback, helping out with decision making and triage, and occasionally seeing a patient by myself when the ED is busy.  Every day from 1pm to 2pm the BIDMC consult service meets for rounds to discuss patients, and my Co-Chief and I take turns running these meetings.  On Tuesday after rounds the BIDMC consult service has didactics for an hour, and I organize these sessions, which are sometimes lectures and sometimes walk rounds when we all go see a patient together.

As Chief it is also part of my role to supervise and teach medical students and make sure they have a good experience on our service; we typically have two medical students per month.  I also volunteered to help teach a psychiatric interviewing course for 2nd year medical students, every other Tuesday afternoon during the winter.

Just like all other third and fourth year residents, I have part-time outpatient clinic, and for me that clinic is at Brigham and Women's Hospital.  I usually have between 4 and 6 therapy patients, who I see for an hour weekly, and a highly variable number of medication management patients who I see for 30 minute slots.  Every other Thursday I see an intake, a new patient, and decide whether the patient would be best served by myself, another clinician, or at another site.  On Thursdays after the intake I meet with my clinic team, which is an interdisciplinary group of attendings, fellows, residents, social workers, and both psychology and social work trainees, and we discuss new and difficult cases.  To learn therapy, I have three supervisors who I meet with one on one.  Two of these supervisors are for general or psychodynamic therapy and I meet with each of these two for one hour weekly.  The third supervisor is specifically helping me learn CBT, and I meet with her every other week.

My weekly schedule also includes didactics.  Monday evening, I am taking an elective 2-hour course on psychopathology taught by Dr. Mufson at the Brigham.  On Tuesday mornings we have didactics at the Brigham outpatient clinic from 9:30am-12pm, and often these are residents presenting on topics of interest; my own lecture is on sleep disorders.  Wednesday morning at 9am, I am taking an elective on forensics with Dr. Thomas Gutheil at Massachusetts Mental Health Center.  From 10am-2pm on Wednesdays, all the fourth years have didactics together.  One of our classes right now is "Transition to Practice," about career options, and another class is on health care systems.

Beyond the above weekly schedule, I've put together a research project on sleep and memory which will likely be ongoing through fellowship (I'm staying for the two-year neuropsychiatry fellowship at the Brigham), and I'm the Co-Chair of the Health Care Systems and Finance Committee at the Massachusetts Psychiatry Society, the local branch of the APA.  As part of that role, I run the monthly meetings, do the minutes, and write a monthly column for the MPS newsletter.

Overall, fourth year is diverse and flexible, and I am enjoying the variety of experiences I am able to have at Harvard Longwood.  Of course, the other three years were great too!