I chose to organize my PGY4 year around clinical education, research on structural inequities, and the care of patients with severe and persistent mental illness. I split my time between my small outpatient clinic (2 half-days a week, about 30 patients), PGY4 didactics (1 half-day a week), numerous research/quality improvement projects (3 half-days a week), the Blake 11 inpatient med-psych unit Co-Chiefship (2 half-days a week), and the Community and Public Psychiatry Chiiefship (2 half-days a week). My week has a lot of variety, including leading a journal club, helping to staff our clozapine clinic, leading a group in the local shelter, running meetings at the Department of Mental Health, staffing admissions on the inpatient unit with interns, leading process rounds, and lots and lots of writing and presenting research results. I chose two clinical- and education-heavy Chiefships, so I still end up doing lots of direct patient care and I oversee about 12 rotators at any given time (4 med students, 4 interns, and 4 PGY2s). I also teach the PA students in a local program as a contracted instructor, and I occasionally teach the PGY3s and PhD interns during their longitudinal community clinic and jail rotations. I’ve also recently organized our psychiatry COVID lecture series and helped to organize the mental health response at our 500-bed COVID field hospital for unstably housed patients.
I lead a research team of about 8 residents and attendings investigating the role bias plays in treatment outcomes throughout our department. Our primary goal is to identify inequities in acute psychiatric care and propose evidence-based interventions to address these. Areas of interest include how we help patients suffering from agitation, how homeless patients access care, and how we use the involuntary commitment system to force treatment. This work also allows me to serve as an educator in a different sense (e.g. leading the junior residents on my research team and presenting my results to allied health providers and administrators).
My call burden is now very light: about two overnight shifts a month at MGH seeing consults in the ED and on the floors (usually for safety, capacity, or agitation evaluations). I won’t have any call after March, so that I can get ready to transition to practice. The next step for me will be finding a faculty job after graduation where I can keep teaching, serving patients, and studying systems.
On a personal level, I'm a North Carolinian who had no exposure to New England prior to residency. I grew up in Charlotte, went to undergrad at the University of Alabama where I studied biochemistry, and then went straight into medical school at UNC. I was pretty nervous about the potential culture shock of moving up North and living in a big city. In fact, I had only visited Boston once before I moved here for residency, and that was for my residency interview! My wife and I have absolutely loved our time here. The people, both inside and outside the hospital, are incredibly nice, and I found it super easy to find a community with so many diverse people and opportunities. The summer is beautiful and there is always something to do on the weekends. I've spent a lot of weekends hiking and camping in New Hampshire, checking out new restaurants in Chinatown and Fenway, and spending time with my co-residents. I really can't emphasize enough how incredibly kind, friendly, and fun my co-residents and faculty are. They are definitely the best part of our program.