Atypical day in the life of an academic psychiatrist is an oxymoron. There is nothing typical about any one day, as each day presents new and different challenges. And if by chance you believe that a workday is nine to five, forget it! As I tell the residents who are on-call when they see me leaving my office late at night, "Being a resident/student is relatively easy. Your schedule pretty much has a finite structure and there is a boss (me) who protects your time." But I also tell residents as well as medical students and residency applicants that academic psychiatry is exciting, not just because each year we learn new information about the function of the brain and the mind but that being a psychiatrist allows us to engage in many different roles simultaneously. The roles of +clinician (biologic and psychotherapeutic), educator, researcher, and administrator complement each other, thereby producing not a dilettante in several disparate areas, but a complete, competent, well-rounded expert.

Although I wear many different hats each day, director of education and training and president of the American Association of Directors of Psychiatric Residency Training (AADPRT) are my main identities. As director of education and training I am administratively responsible for our general (adult) psychiatry residency training program, four fellowship programs, and our medical student clinical rotations (approximately 180 students per year). Fortunately, each fellowship program has its own director and I have a director of medical student education who is also the associate director of residency training who works with me.

My day begins at 7:45 A.M. when I spend one-half hour reviewing and answering e-mails and messages from the previous day. This is followed by one or two patients. My clinical practice is predominantly insight-oriented psychotherapy. As I do not have any hospital clinical responsibilities, my faculty practice augments my salary and provides income for my department.

Approximately 2 hours per day are devoted to what I consider direct resident or medical student education. This includes individual psychotherapy supervision, didactics (I teach a weekly interview class, a course in supportive psychotherapy, and various lectures to medical students), individual appointments with residents (progress/evaluation meetings, planning individualized resident programs/electives, and career path meetings with senior residents), individual mentorship meetings with medical students, and monthly meetings with each class of residents. Of course, there are unplanned meetings, such as the resident who is depressed as a result of going through a divorce and needs referral to a therapist, the resident who is pregnant and now must discuss a schedule change to accommodate her new needs, or the resident who has to be placed on academic probation and have a special remediation program developed. These hours need to be wedged into the workday.

One of the things I have learned during my 20-something years as a training director (yes, I am one of those surviving dinosaurs) is that since I do not run all the divisions of my department, I depend daily on every department head and administrator for the smooth functioning of the services where my trainees work. Therefore, 1 hour per day is devoted to the various types of meetings that enable an education program to function successfully. There are meetings with supervisors to discuss progress of individual residents, service chiefs to improve clinical rotations, faculty to develop the didactic curriculum, junior faculty to develop their academic careers, my staff (associate residency director who is also director of medical student education, fellowship directors, chief residents, and residency coordinator/secretary). Finally, last and probably most important are meetings with the Department Chair. As an academic psychiatrist, and in my case a director of education and training, you are always going to be in a position of middle management. Years ago I was told, "Your success as a middle manager will depend on you keeping your boss's boss's foot off of your boss's neck." This was terrific advice. So meeting with my chair is key to both finding out what pressures and constraints he is under as well as gaining his support for my endeavors.

Another hour a day is filled with committee meetings, including departmental (i.e., Psychiatry Executive Council, Space Planning Committee, Electronic Medical Records Committee, Core Competency Committee), hospital (i.e., Graduate Medical Education Committee, Library Committee, Building Committee—we are building a new psychiatric hospital), and medical school (i.e., Medical Student Curriculum Committee, University Senate meetings). And of course there is the issue that meetings beget meetings. As an example, the Graduate Medical Education Committee generates subcommittees such as the House Staff Housing Committee, the Departmental Internal Review Committees, and the occasional House Staff Disciplinary Review Committee. Although most of the work of these committees is essential for the operation of the medical school, hospital, and department, I sometimes wonder if my father knew that I spent time debating whether the house staff and the hospital budget would be better served by giving either free food or a monthly food allowance check; he might ask for a refund for the money he spent on my medical school tuition.

At the present time, very little of my workday is involved with direct research endeavors. Yet time is spent organizing research education for the residents and the Stanley Scholars Research Training Program for medical students.

Sometime during each day, I duck into a phone booth and, like Clark Kent, I come out as a different persona. Now I am the president of AADPRT. During the last 10 years I have devoted a portion of every workweek to this wonderful organization. Whether it is developing the Train the Trainers Program for our members, functioning as the liaison to other national organizations, or deciding if the organization can afford fried shrimp hors d'oeuvres at $2.50 per piece for our cocktail party in Puerto Rico, this position involves some of my time every single day.

My typical workday ends with 4 to 5 hours of clinical practice, some nights as late as 9:30 P.M. Of course, like the weather, there are seasonal changes in my academic life. Twice a year I hold retreats for my house staff and faculty. This takes a fair amount of planning as does the yearly house staff graduation. Each Spring, I am busy organizing rotations, didactics, and supervision schedules for the upcoming academic year. And then there is that huge endeavor called resident recruitment. From September through mid-February, reading applications on the Electronic Residency Application Service (ERAS), setting up interview schedules, interviewing applicants, and meeting with the interview/admissions committee is an added priority of the workweek.

Finally, there is the weekend. When else would there be time to prepare new curriculums and presentations, read journals, and write articles such as this one? So, the typical workday for this academic psychiatrist is long, stimulating, challenging, and very rewarding.