charlotte is a double st5 senior trainee in adult aging and general psychiatry based in south yorkshire. no week is the same, but here charlotte describes a typical week.
Monday: ‘there was time to listen to the patients’
‘I started in a busy outpatient clinic where I meet patients who often attend with their families. they may have a mix of diagnoses and concerns.
It is important that when patients leave the clinic, we have established a collaborative management plan.
I usually see one or two new patients and then four or five follow-ups.
I love how psychiatry gives me the opportunity to have longer appointments with patients in the clinic so I don’t feel rushed or overwhelmed, and more importantly, the patient feels heard.
You can also develop lasting doctor-patient relationships. giving a patient a new diagnosis as dementia is life changing for both them and their families.
It can be difficult at times, but at the same time very rewarding to be able to help start treatment and to be able to offer additional management in the community.’
Tuesday: ‘great teamwork’
I spend all day completing the mdt (multidisciplinary team) review between inpatient units.
In psychiatry we have functional diagnoses such as depression and psychosis, and organic diagnoses such as Alzheimer’s dementia.
mdt reviews are chaired by my clinical supervisor, the consultant; however, I also run reviews with my consultant’s observation to complete my online portfolio assessments.
We start in the functional unit where patients are being treated for a variety of non-organic diagnoses such as depression or psychosis.
Each patient attends the ward round and the family is invited. Unlike a traditional fast-paced acute medical ward round, by checking on patients this way, you get time to spend with them when they really need it.
In the afternoon we follow a similar model in the organic unit where patients are being treated for different types of organic conditions such as Alzheimer’s.’
Wednesday: ‘so gratifying to see patients improve’
I spend the day visiting homes in various locations, from flats to farmhouses and duplexes to mansions.
South Yorkshire has many urban and rural areas, which means driving and views are often mixed. I’m not good with steering so my satnav is essential!
The best way to truly learn and get to know your patients is to see them in their familiar environment.
This is sometimes a challenge and being able to recognize how much someone is or is not managing in their own environment is important to help you as a clinician understand what triggered the initial symptom and why things have progressed.
Read more: What is Buprenorphine? | SAMHSA
Being able to interact with patients in their familiar environment has made me a better doctor and a better psychiatrist.
It’s a great satisfaction to see someone initially in the room and then back home and see them improve.’
Thursday: ‘privileged to share ideas’
‘in the morning I attend my community team’s mdt meeting, where we plan when patients should be seen and by which team member.
We also look at difficult cases handled by team members.
This allows us to work together to exchange advice, support and define the next stage in management.
I feel privileged to have the support of so many different disciplines, each with their own area of expertise.
In the afternoon I have an hour of protected supervision with my clinical supervisor.
this happens every week no matter how busy we may be. I find this hour invaluable.
I can discuss cases, complete evaluations for my portfolio, review how special interest projects are going, or brainstorm future career plans. more importantly, I can define what we discuss at that time.
The rest of the afternoon I teach medical students on a variety of topics, usually for an hour at a time. I will then complete any pending administrative work.’
Friday: ‘opportunities to learn’
‘As a senior trainee, I am entitled to do two non-clinical training sessions per week. I choose to do these two research and special interest sessions on a Friday.
The sessions are great and have taught me skills I never thought I would have the opportunity to learn.
For my research, I joined an existing study that helped initially with patient recruitment and later with data analysis. I usually work between the memory clinic or the local university.
Having this session has taught me skills I never thought I would have the opportunity to learn, which has made me one of the authors of a published article now, all within working hours.
In the afternoon I complete my special interest session. I’m very passionate about recruiting in psychiatry, so please take the time to plan future recruiting events for both foundation physicians and medical students.
Currently, I am also one of trent’s representatives to the rcpsych psychiatry trainee committee (ptc) and use this time to attend meetings at the university or work on ptc projects.’
one last word
‘I finished on time (5pm) for all but one of these sessions (not including my after-hours shift). my multidisciplinary team meeting went overboard, but that’s medicine! my consultant recognized that I had stayed late, thanked me for my input, and checked that I could make up the time later in the week.’