For me everyday is different. I’ve never done only one thing or had just one interest, so it is no surprise that my present job, like the many that have come before it, is actually a bunch of different jobs daisy chained together in an unending variety of tasks. Research, administration, and teaching are the three main focuses of my present professional life. Though clinical care has played a large role in the past, for the past three years I have not provided direct patient care and chosen instead to pursue my care of patients through teaching and research.
A "typical" day, like Thursday, April 28, 2005, usually starts at 6:15 AM saying good morning and good bye to my youngest teenage son as he heads off to high school. This is followed by a 2—3-mile jog. A time to think and reflect on what lies ahead. A time to "work things out." Often I’ll scan over some notes for a manuscript or lecture before I head out the door so it can be "working in the background" of my mind as I run through my neighborhood. I love the morning for getting work done, but administrative expectations don’t always give me the luxury. However at least one morning a week I try to spend some time working on a manuscript, reading a paper, or preparing a lecture. Otherwise it’s a quick look at email to see what must be answered before work or what follow-ups I will need to do during the day. It always takes longer than it should to do this, so a very quick shower usually gets me out of the door and into the office with a short commute.
Work at VA in Washington, DC is interesting. As the Associate Chief of Staff (ACOS) of Education, I have two major roles, to oversee the 40 hours of annual mandatory education for all 1700 employees, clinical and non-clinical, and to watch over the training of over 800 residents, medical students, and other trainees who come to the VA in a given year, usually from one of our three medical school affiliates, Georgetown University, George Washington University, and Howard University. As the "ACOS of Ed" I manage the money put aside to send staff to professional meetings. I established a committee to oversee this duty and chair that committee. On this day, our 1-hour morning meeting is lively, as usual, as we discuss how to use the always limited resources. I’ve prepped for this meeting a few days ahead by reviewing all the requests and reading over the justifications, so I can advise the committee on how we might make a decision about what to pay and what to deny. Together, we as a committee have established policies and procedures that allow us to fund, in full, those who are presenting research from the VA at national meetings. It is gratifying to the committee, despite the tedium of having to review sometimes 50 applications in a single hour, to be able to support those who do work with veterans.
After this meeting, I usually have 1 or 2 hours to catch my staff of 10 up regarding projects on which they are working and to sign official documents. I don’t like signing things unless I understand them, so I usually need a thumbnail about what and why I am signing things. We have a weekly staff meeting on Tuesdays, but to get things done for the week, individual follow-up and problem solving are needed throughout the week. Even when I am out of town, I call in to check that projects are moving forward.
Thursdays are one of my split days, in which I also spend time as the director of education in the Georgetown Department of Psychiatry. This gives me the opportunity to both teach psychiatry and develop programs on psychiatric education for medical students and residents. In the position of Director of Education, I act as a consultant to the residency training director, the medical student training director, and the Chair of the Department to develop education programs within the department. I officially spend two half days a week at this job. This afternoon is a busy one with a meeting of the medical student education committee. I’m late as usual as I try to race between the two institutions and find a parking spot in Georgetown. I use the drive time to catch up by cell phone on genetic research issues and family matters with my husband. My husband and I have worked together and collaborated on research for the 25 years of our career. He presently has a complementary position to mine as the ACOS for Research and Development at the DC-VAMC.
The medical student training meeting addresses issues of teaching for first- and second-year medical students, as well as clinical rotations for all third-year medical students, and making enticing electives for fourth-year students in the hope that they will pursue careers in psychiatry. I wear two hats at this meeting since I also oversee the training of medical students in psychiatry at the VA, with the chief resident. There are discussions of what all doctors need to know about psychiatry and how we can keep and recruit medical students into psychiatry.
Following this meeting I grab a coffee with the Chair and have our weekly meeting. We discuss what is going on, not just in medical student education, but in residency education and the department in general. How are the residents progressing clinically, and how will we change their clinical and didactic rotations in the next year to improve their experience while still managing the finances of their training? We discuss adding more lectures for the PGY-1’s and combining the 3 and 4’s into a two-year continuum of lectures. For every meeting I go to, I have an agenda. Usually it is written out, either in my palm or on paper. This way I can make sure to cover all the items I need to touch on in an hour. I also take notes at every meeting to focus my attention and help me to organize my thoughts.
Also today, I’m meeting with a resident who is under a remediation plan. I spend about 30 minutes reviewing the evaluations received for the past week’s work and then meet with the resident for an hour to discuss progress, answer questions, and plan what needs to be done next. Together we document what has transpired during our meeting for the official record. Then it’s off to grand rounds from 4—5:30 pm. Today’s speaker is one of my colleagues in our psychiatric genetics research group. My husband meets me at grand rounds and we leave 30 minutes early, just as Q&A is about to begin, in time to grab our 17-year-old son and take him to dinner before his 4-hour SAT review course. We catch up on the day together and shuttle him off to class and linger at one of our favorite local restaurants to listen to a jazz singer until we pick him up at 10 pm. When we return home, I sit down to review last-minute manuscripts that arrived via email for the educational summit I’m attending the next day. I finally get to bed, as usual, between 11:30 pm and 12:30 am.
As I prepared this piece, I was forced to think of my life rather than just my jobs. As a dual-career couple that has worked together for our entire professional life, you could say, we work all the time. However, instead, I prefer to think of our academic and personal lives as one life experience, in dynamic equilibrium. If you do what you love and what interests you, then it isn’t really work at all!
Dr. Pato is with the ACOS for Education, DC-VAMC and Director of Education, Department of Psychiatry Georgetown University, Washington DC. Dr. Pato is also Professor and Co-Director Center for NeuroPsychiatric Genetics SUNY-Upstate-Syracuse, NY.