Codie Vassar, MD
I just recently finished my 6 week rotation in the Psychiatric Emergency Room (PCS) located at the Milwaukee County Mental Health Complex and am transitioning to the Inpatient Psychiatric unit at the same location. This has been an excellent start to my intern year as I am able to see the flow of patients from the Psych ER to the inpatient service. This is what a typical day in my life as first year resident looks like.
- 7 a.m.: Wake up, shower, get dressed, prepare my lunch; all without forgetting anything or being late! All made easier with Salsa music.
- 8-9 a.m.: Arrive at work, review notes from the night before as well as any labs to prepare for rounds. Check for any new admissions. Discuss with the 3rd year medical student any questions they may have before rounding with Dr. Singh.
- 9-11:30 a.m.: See patients. Typically start with any patients being discharged, then follow up patients, and lastly new admits. This is the most interesting part of the day as you can observe drastic changes in patients’ presentations. This is also an excellent opportunity to improve your interviewing skills under direct supervision. I really enjoy seeing how patients respond to medications and improve over the course of their inpatient stay.
- Two days a week I am part of an interdisciplinary team with social workers, occupational therapists, and nurses from 9:30 a.m. to roughly 10:15 a.m.
- 11:30-12:15 p.m.: Staff patients with my attending. This is an excellent environment to learn in. The attending physician Dr. Singh is an excellent teacher and really engages you as a colleague. This will allow you to better understand difficult psychopathology, become more efficient and knowledgeable in pharmacology, pharmacodynamics, and pathophysiology. I recently become certified to prescribe Clozaril/Clozapine which has been incredibly valuable. This is also an excellent time to learn about the different resources available to patients in the Milwaukee area.
- 12:15-1:15 p.m.: Lunch Time. I usually bring my own lunch from home, but if I ever forget there are plenty of places close by if I need to run and get something (Froedtert/Children’s/City Market).
- 1:15-4 p.m.: Finish notes and orders. Accept any new admissions. Manage any pressing issues that come up on the floor. I also use this time to go over any unique findings or pathology with the medical student and try to teach about a new topic every day. I am usually done by 4:30 p.m. and head home.
Once I get done for the day I head home and start my other job. I am married and have a 2-year-old son at home that can be quite a handful! Outside of residency, I serve as an Officer in the WI Army National Guard as well as serve on the Residents as Educators (RAE) Committee and Under-Represented in Medicine Resident Committee.
Amanda Liewen, MD
The second year is challenging and exciting as we transition to outpatient practice. I rotate through three clinic sites (the VA, 16th Street Clinic, and the resident-run Center for Psychotherapies at Columbia St. Mary's).
I wake up around 6 a.m. (plenty of "snooze" time built in) to arrive to clinic by 7:45 a.m. Mondays are spent at the VA, where I start by seeing vets with PTSD. I really enjoy this clinic, especially our multidisciplinary supervision, where we team up with psychologists to discuss a holistic plan for our vets. The afternoons are spent in the Geropsych clinic, a challenging but educational experience as I’m becoming more comfortable with managing medically complicated cases. I have the honor of spending Tuesdays at 16th Street Clinic, a Federally Qualified Health Center that primarily serves Spanish-speaking and underserved patients. I think this is tied with psychotherapy clinic as my favorite rotations so far.
Our department has Grand Rounds on Wednesday morning; we also meet with our CBT supervisors and have didactics. The second half of Wednesdays, Thursdays and Fridays are spent at CSM for psychotherapy clinic. I’ve really enjoyed learning about psychodynamic psychotherapy, which is our focus at this clinic. There’s a lot of autonomy this year, as I see 12 patients at this clinic weekly and staff them during weekly supervision with a local psychoanalyst (where I present my process notes for my therapy cases) and a psychiatrist (for med management). With my more flexible schedule, I’ve been finding lots of time to read about the fascinating world of psychotherapy.
Outside of work, I enjoy hanging out with my fellow residents, exploring Milwaukee’s restaurant scene, and taking advantage of the outdoor space. I love Milwaukee’s bike trails, being close to the lake and renting free canoes and kayaks at the urban ecology center! When it’s snowing, I also like renting cross country skis. There’s always a festival going on in Milwaukee, so I’m usually trying to find some live music or interesting food or drink on the weekends. My real favorite, though, is biking to the local beer gardens or finding the best cheese curds with my friends and co-residents.
Satish Shashidhara, DO
After a year of outpatient clinics, we return to more varied rotations and experiences this year, spending time on the inpatient unit, psychiatry consult services, in the psychiatric emergency department, as well as continuing on with some of our long-term psychotherapy patients. Certainly, a bit more nomadic in nature this year, but I appreciate the change of pace.
Depending on the day (and rotation), I’m usually up by 7 a.m. depending on how many times I hit the snooze button, which still gives me ample time to get ready and head to work. This month, I’m working at the partial hospitalization/intensive outpatient (PHP/IOP) program at Columbia St. Mary’s Hospital on the East Side/Downtown Milwaukee, so my day generally starts around 8:30 a.m. In addition to leading group therapy and education sessions, I also head up to the PACU to get some ECT experience a few days of the week. Monday afternoons are reserved for my psychotherapy continuity clinic, where I continue to see patients with whom I began to develop a therapeutic relationship last year. Wednesday afternoons are protected time, with Grand Rounds and didactics over by the Tosa Health Center. One of the most rewarding parts of the PHP/IOP rotation is recognizing how comfortable we become with individual therapy and how that confidence carries over to group therapy as well. On this rotation, my day finishes around 3:30 p.m. and I spend the remaining afternoon/evening playing tennis, going to the gym, or reading something psychiatry related before getting way too comfortable in front of the TV. Our class is very tightly knit, so chances are I’ll be grabbing dinner or hanging out with one of my co-residents at least a couple of times a week. After I finish up this month, I’ll be heading to Rogers Memorial Hospital for an eating disorders rotation, where I’ll get to work in a residential as well as an inpatient setting. The rest of the year is spent on inpatient wards, the consult-liaison services, the psychiatric emergency department and various locations for addiction psychiatry experience. Outside of residency clinical duties, I sit on the MCWAH Housestaff Health and Welfare Committee, am currently mulling over my academic project, and will be moonlighting at two different places this year.
But enough about academics. While I certainly appreciate all the educational opportunities afforded through our program, I also love everything else Milwaukee has to offer. Wisconsinites make the most of the summers, with countless summer festivals including some must-sees such as Summerfest and the WI State Fair, various beer gardens, Brewers’ games, outdoor theater and musical performances taking place all over the city. In the winter, I’m a big fan of going to various coffee shops to read and relax or bars to watch the Packers or Bucks (though as a native Floridian, I’m still looking for places that have the Tampa Bay Bucs’ games on...).
Our third year is ripe with opportunity to grow academically and professionally, but we also have plenty of time to take part in the hobbies that are important to us. I’m looking forward to the rest of the year and am sure it will help me figure out how I want to shape my career in psychiatry.
Jill Sorby, MD
Every day begins the same at 6am with a hot shower and a strong cup of coffee. Once my 4 boys (9, 3, 1.5 and 7 months) wake up it’s a mad dash to get everyone ready before my husband leaves to take them to school/daycare and I rush out the door to get to clinic on time. During my 4th year I am one of the chief residents and I have a longitudinal schedule so each day looks a little different.
Monday: Mornings are neurology clinic at the VA. We have a unique program in that we do part of our neurology requirement in the 4th year with the idea that it will help us study for boards. So Monday mornings I am a neurologist diagnosing migraines, treating essential tremor and brushing up on post stroke treatment.
Afternoons are in the IMHAC (Immediate Mental Health Access Clinic) at the VA where I see veterans on an urgent basis for a variety of mental health concerns. I never know what the afternoon will bring.
Tuesday: Mornings I spend in an integrated care clinic where we see patients of the internal medicine docs right in their primary care clinic. The best part is that it is only 1.3 miles from my home.
In the afternoon, I rotate with a local ACT (Assertive Community Treatment) team. I spend my time collaborating with case managers who help me take care of patients with chronic mental illness. It is a true privilege to work with these individuals and learn a little about their lives. I even get to go on some home visits for the patients who have the most difficulty getting to clinic.
Wednesday: Mornings are didactic time, which I love. I get to spend time with my classmates and learn about a variety of topics that will be helpful to my career. So far this year, highlights include curriculum vitae preparation and suboxone training.
In the afternoon, I head to Columbia St. Mary’s where I supervise intake appointments in the psychotherapy clinic. It is really fun to get to supervise a superb class of residents and learn a little about a lot of patients.
Thursday and Friday: I see my own psychotherapy patients, many of whom I have seen for over 2 years. A unique feature of our program is that our second year is the outpatient year so we have a longitudinal therapy experience for up to 3 years. Some Thursdays I have meetings with the PGY2s that I supervise in clinic. I have psychotherapy supervision on Thursday evenings and I try to sit in on the PGY2 didactic time. We have some pretty fantastic psychoanalysts giving our lectures so I am trying to get a bit more education in before I head off into the “real world.”
My weekday evenings are all about the same – dinner, homework with my 9-year-old, baths, stories, snuggling my babies and bed. If I’m luck my husband and I have a moment together at the end of the night to take it all in. We live a full life and a great part of that for me is the MCW psychiatry residency.