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SUNY Downstate Health Sciences University

Department of Psychiatry & Behavioral Sciences

A Day in the Life

A day in the life of a first year...

We spend a total of six months of our first year in inpatient child and adolescent psychiatry where we are exposed to three very different units. We also rotate through the Comprehensive Psychiatric Emergency Program and consultation-liaison, and a Board of Education Day Treatment Program. On Tuesdays we have fully protected didactic days.

My day starts at 8:00am on the Latency Inpatient Unit. I meet up with my patients before breakfast and see how they are doing. Community meeting is held at 9am which is another platform for patients to discuss any issues that they may be facing on the unit. Next we have morning rounds with the child and adolescent psychiatry unit chief, psychiatry residents, medical students, social work staff, psychologists, nursing staff, pediatric residents, psychology interns, social work interns, nurse practitioner students, and international medical graduate observers. I then walk with my patients to the hospital school across the hall. The school is affiliated with the Department of Education and provides an excellent opportunity to observe patients in a school setting. 

Book Club

While the children are at school we conduct family meetings, evaluate new admissions and discuss discharge planning. Since it is Wednesday, I attend the 12pm case conference with the Chief of Service. At 3:30pm on Fridays the fellows and residents lead medication groups where we provide the patients with psychoeducation on psychotropic medications. I have twice weekly supervision with two different attendings. I finish with my notes, meeting with new patients and conducting family meetings at about six and head home for the day.


A day in the life of a second year...

2nd YearAs second year fellows we have more control over our schedule. Second year is spread out into three major rotations; Outpatient, Developmental Evaluation Clinic (DEC) and Intensive day treatment (IDT) program at New York City Children Center in Brooklyn. Tuesdays are didactic days and comprise of classes starting at 8.30 am.

I start my day at the Developmental Evaluation Clinic, which provides multidisciplinary evaluation and treatment for children with developmental, intellectual, motor skills disabilities and autism spectrum disorder. A typical day on DEC starts at 9 am with a psychiatric evaluation of a new patient. After completing the evaluation, I discuss my findings and recommendations with my supervisor and come up with a plan. On other days on DEC, I observe speech evaluations by Speech and language pathologists, psychological testing by clinical psychologists and work with pediatric neurologist evaluating children and adolescents for neurological conditions. In the afternoon, I have outpatient clinic from 1-6pm. During this time I am able to maintain continuity of care for my clinic patients through different treatment modalities such as psychopharmacology and psychotherapy. Throughout the week we also have supervision with different supervisors for our Outpatient clinic and DEC patients. In addition to that, we have seminars on family therapy, parent training, brief psychodynamic psychotherapy and cultural psychiatry.

Currently, minor rotations are forensic psychiatry and pediatric neurology. On Monday afternoons I see patients at the Pediatric Neurology Clinic, which is a very enriching experience. On Thursday mornings I go to the court to observe forensic evaluations and court proceedings involving children, adolescents and adults. This provides a very exciting opportunity to work and learn with patients involved in the legal system.

AACAP MeetingAs a second year and one of the three chief fellows, my time is divided between clinical duties, scholarly work and chief responsibilities. This provides me with an excellent opportunity to work on my leadership skills. I work with other fellows and advocate for them while collaborating with the clinical and administrative staff of the institution.