The Big Life of a Shrink

April 21, 2010
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Erika S., a.k.a. Mom, just graduated from medical school and is in her first year of residency of studying psychiatry. It is a four-year program and she is almost finished. Erika specifically wants to work with patients who are struggling with drug addictions.
Q: Could you describe a typical day at work?
A: A typical day at work involves me going to a meeting first thing with all the doctors and the doctor who was on call overnight and we discuss an interesting case about patients that come in to the emergency department overnight. The on-call doctor talks about what was the patient’s problems and the reason why they came into the emergency department for help. They talk about the medicines they’re on, their social support, their living arrangements, and their previous treatments if they have any. Based on that information, the team starts a list called a differential diagnosis. From there the attending physician who is in charge of the meeting discusses strategies we can use to prescribe an accurate diagnosis and helps us with our knowledge of therapy and medications to make a treatment plan for the patient. Of course these meetings are for education and what we decide may or may not be what their treating physician might do. After the meeting we break into teams and go to the computers and look up nurse’s notes on what happened with the patients overnight to see if they had any problems. We then meet with our team physician and tell them what’s going on with the patients, we discuss their progress and decide whether or not to make any changes to their medications or their treatment plan. We do this meeting with the nurse, the social worker, and the therapist who are assigned to the patient. After that we go see each patient on our list talk to them, ask them how they’re doing, and ask them if they have any questions for us. Then we meet with the team again and adjust our plan as necessary. The rest of the day is spent updating patient records and writing notes, ordering tests, or changing medication. We sometimes take phone calls with family members and other doctors too.
Q: What advice would give young adults who are considering a job in this career?
A: make sure you want to do that more than anything else. It takes a lot of money, a lot of time, and a lot of hard work. You have to give up fun stuff for a long time and miss some family events and miss some times with your friends in order to do your job. And you always have to keep reading and keep learning to stay on top of the newest information.
Q: What would you say the hardest part of your job is?
A: Being on call for 30 hours, having to stay up and take care of patients and their needs when you haven’t had any sleep and the phone keeps ringing and the pager keeps going off and you have to keep working. That all ends when I end residency though and become an attending and actually that all gets better next year because this year I have to do that every 5 days and next year I’ll only have to do it every 10 or 12 days. And when I get in my fourth year of residency, I don’t have to do that at all.
Q: What surprised you when you first started this career?
A: How much I liked it. I knew I would like it, but liking it helps the hours go by faster.
Q: In what ways are your current job and your dream job when you were in eighth grade different?
A: It’s the same. Well, in eighth grade, I knew I wanted to be a doctor, I did not know I wanted to be a psychiatrist. I thought I wanted to be a pediatrician. The career is the same, but the field is different.
Q: What would you say the American dream is?
A: For a lot of people, the American dream is having a family, a big house, nice cars, a good job, and lots of vacations. For me, the American dream is a happy family and good health.
Q: Describe your first day at your job.
A: My first day at my job was on internal medicine and all of a sudden I received 4 patients to take care of and they had a bunch of medical problems and I was so scared to make the wrong decisions. Plus I had to figure out how to use the computers, where to find stuff, who to talk to and make a new friend. It was scary but exciting.
Q: What was the most interesting/exciting incident that ever happened at your job?
A: I can’t say because it’s confidential, but I meet a lot of very interesting people.

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