A Day in the Life of a PGY-3 Resident

Tobias

My background

Hi, my name is Tobias and I am a third-year resident in adult psychiatry at Yale. I’ve been living in Connecticut for most of my life, so staying here for my psychiatry residency has been a very enjoyable and comfortable experience. I went to Wesleyan University as an undergraduate to study psychology and then went on to the University of Connecticut School of Medicine. Here at Yale I’ve just finished serving as one of the two co-presidents in the Psychiatry Residents Association (PRA), a group comprised of all of our psychiatry residents, acting as an advocate for my fellow residents and liaison between the residents and administration.

Why I chose Yale

I was originally looking to move to New York for residency after spending so many years here in Connecticut for college and medical school. Yale was my last residency interview and I thought my rank list was all set with the New York programs. Then I came for my interview here and loved it, so I had to do some rearranging.

I chose Yale because I felt it was the best balance of everything I was looking for in a residency. I wanted a program with a multitude of training sites to ensure a diversity of patients and patient care experiences (we train at the Connecticut Mental Health Center, Yale-New Haven Psychiatric Hospital, the West Haven VA, and Yale University Health Services). I also wanted a program that had an association with a psychoanalytic institute to strengthen and balance my psychotherapeutic training (many of our psychodynamic instructors come from the Western New England Psychoanalytic Institute and we can take elective courses there as a resident). Lastly, I was interested in learning more about forensic psychiatry, so I wanted a program with a strong forensics fellowship, which we have here.

My schedule

In our third year of training, our work is entirely outpatient with overnight calls taking place every 10-12 days in the psychiatric emergency room. For our outpatient training, we can request to be placed at either the West Haven VA (which sees veterans with a wide variety of ages, races, and diagnoses), Yale University Health Services (which treats Yale undergraduates with psychotherapy and psychopharmacology), or the Connecticut Mental Health Center (serving the uninsured and chronically mentally ill of New Haven).

I chose to work at the Connecticut Mental Health Center due to my interest in working with the chronically mentally ill and those mentally ill patients intertwined with the criminal justice system. I have my own office and see patients individually for psychotherapy and med management. I spend 80% of my time working with patients, meeting with supervisors (we are assigned individual supervisors for psychodynamic therapy, CBT, brief therapy and med management), and attending weekly didactics. The other 20% of our time is made available for electives (research, clinical, or academic).

Life as a third-year resident

A typical day for me involves getting up around 6:00 AM to go to the gym prior to work. I don’t like getting up that early, but I feel good starting my day knowing I’ve already gotten something accomplished. I get to work around 8:30 AM and spend the rest of my day involved in a variety of activities. A large percentage of my time is spent seeing patients for psychotherapy, med management, or a combination of the two. I also spend time meeting with my supervisors to discuss individual cases. I usually get done between 5:00-6:00 PM and head home for the day.

What I really enjoy about the third year is the autonomy you get in molding your own schedule! You get to decide when you see patients, for how long, and how often. It really gives you the opportunity to help craft your patient’s treatment with them. The other great aspect of creating your own schedule is that you can build in time for your additional interests (thanks to the 20% elective time our program guarantees). Right now I devote one morning a week to either working on my forensic research project or getting some clinical experience working in the court clinic learning how to do competency to stand trial evaluations. I have also carved out one afternoon a week to be free from patient care responsibilities so that I can take classes with the forensic psychiatry fellows!

Where I live

I live in a neighborhood of New Haven called East Rock. It is outside of the downtown area and it is a very residential area where a lot of graduate students and other programs' residents live. Housing is mostly multi-family homes where each floor of a 2-3 story building is its own apartment. I love it in East Rock because I’m close enough to the downtown area where I work to get there quickly when I need to (a 5 minute drive or a 10 minute shuttle ride), but it doesn’t feel like I’m living in a city. The neighborhood has lots of wonderful coffee shops, cafes, and markets to eat at, and it’s a great place to walk our yellow lab!

My favorite New Haven restaurant

My favorite New Haven restaurant is Caseus. It’s a French bistro and cheese shop in the East Rock area with the best macaroni and cheese I have ever had in my life! They also have a cheese truck that sets up shop in the downtown area and makes a mean grilled cheese, so if you see it, make sure you stop and get one!

Final thoughts

Although New Haven sometimes gets a bad rap as far as cities go, I’ve loved my time working and living here and wouldn’t trade it for anything. It’s not New York or Boston, but it’s a wonderful small city with plenty of restaurants, culture and amazing events associated with Yale University.

I’d also say that as far as Residency Program Directors go, you can’t do any better than Robert Rohrbaugh. I’ve been amazed during my time here, particularly while working with Dr. Rohrbaugh as PRA co-president, how thoughtfully and carefully he listens to the residents’ thoughts and concerns and makes adjustments to the program based on this feedback. He puts his residents first and that is a wonderful quality to have in the person running your training program!