This may sound very corny, but I love my job and feel very fortunate to be able to do what I do!! I am in the Department of Psychiatry, University of Michigan, where I am clinical professor and associate chair for education and academic affairs and Director of the Psychooncology Program at the University of Michigan Comprehensive Cancer Center. I am also President-Elect of the American Psychiatric Association (APA). I have a 14-year-old daughter, Erica, and a 26-year-old daughter, Alissa, who just finished law school. My husband, Arthur, is a very busy clinical cardiologist—we have been married for 31 years. My life is quite busy and very full!
My gestalt on developing an academic career has been to "follow the leader". I have been lucky to have had excellent mentors who have steered me in wise directions. In turn, I try to be a mentor for others. The clinical educator track has been an excellent vehicle for development at the University of Michigan. I have been able to move up professionally, doing what I like to do—teaching and seeing patients; doing scholarship in my clinical area, psycho-oncology; and being rewarded for involvement in national organizations. What I like to do best professionally is helping medical students and residents with their own career trajectories, assisting them with their ideas for projects, and trying to facilitate their successes. I very much enjoy this part of my work and value this aspect of academic life.
t1 is an example of a typical day/week for me. Mornings are taken up by personal tasks. I have always driven my kids to school so having some flexibility in the morning as to when I need to be at work has been key. Sometimes I do so many errands in the morning, that by the time I get to my desk, I feel like I have worked a whole day!
Clinically, I usually try to see and fit in patients around meetings, conference calls, etc. I am an outpatient consultation liaison psychiatrist who sees cancer patients. Most of my patients are very flexible about appointments, and so it affords a lot of latitude about scheduling. I travel at least once every 2 weeks for meetings related to APA or other organizations, so I am pretty busy clinically when I am in town. I average about 12—15 patients each week, of which two are new evaluations. An evolving part of my job is supervising a supportive/expressive group psychotherapy at our cancer center. Groups thus far include primary breast and a metastatic women's cancer group. On a day-to-day basis, my inspiration truly comes from patients. I realize it may sound melodramatic to say, but ever since I was in high school, I wanted to be a psychiatrist for cancer patients. So, on a daily basis, I am humbled and am cognizant of how lucky I am to be living out my dream. Hokey but true.
There are a lot of administrative and programmatic meetings that I attend or chair each day—education, psychooncology, departmental meetings, etc. I am also in charge of our continuing medical education programs so I try to attend our weekly grand rounds and other major conferences. Because I work at the cancer center, I also try to attend some of those conferences as well.
Answering e-mail is a big part of my day. Sometimes I do email while I am dictating or on the phone, just to get through it all. I hardly ever do email at home. I do not do clinical work with patients by e-mail, except in very, very rare instances. Unfortunately, I don't explore the Internet very much—not enough time.
I am also involved with several different research projects, mostly in the area of psychooncology. Almost all the research I do is with residents or postdoctoral students. I find it fun and rewarding to try to get trainees involved in clinical research. In fact, I am on an Institute of Medicine Committee on Incorporation of Research into Psychiatry Residency Training. We have been meeting approximately every 2 months in the last year, and we are kept busy writing and reviewing various papers in the interim. Our study should be completed by the Fall 2003.
As examples of the research we are doing here, a third year psychiatry resident is leading us on the "determination of the level of pain and anxiety experienced by women undergoing the ductal lavage procedure." I am also doing a project with another physician who has completed a radiology residency and finished a surg-onc fellowship. She and I worked on a training module for mammography residents on how to deliver bad news. There are also weekly supervision and group meetings with our collaborators.
In terms of education and F1, for many years I taught a biweekly Introduction to the Patient Course with the Chair of Family Medicine, University of Michigan, to first-year medical students. I also teach a didactic lecture on consultation-liaison psychiatry to third-year medical students about every 3 months, a course to third-year psychiatry residents on medication backup and primary care psychiatry, depression and cancer to oncology residents, and grand rounds and other continuing medical education activities at national and international meetings. We have large and highly regarded residency programs in adult, child and adolescent, forensics, substance abuse, and geriatrics—a National Institute of Mental Health (NIMH) funded research track—clinical educator track; postdoctoral training program, social work internship program, and a very dedicated medical student education program in psychiatry. In order to provide regular oversight, I chair a monthly education council meeting and attend other regularly scheduled education meetings such as monthly/biweekly resident selection and evaluation and try to meet with the education directors as needed. With such a diverse and rich education program, it always feels like we are preparing for an internal review, Residency Review Committee (RRC) visit, departmental review, medical school curriculum change, etc.
Evenings are very hectic. The phone is ringing, homework needs to get done, dinner, etc. … This is probably the most difficult time of day, especially because I am so tired. I can't do anything productive such as read or write. One of the tough things is that there are a lot of conference calls that seem to be getting scheduled for the evenings. In addition, I just finished the ELAM program (Executive Leadership For Academic Women), where we had computerized virtual discussions every other week on Monday evenings. I try to do a lot of my work for outside organizations at night or on the weekend—reviewing APA Review of Psychiatry manuscripts (which I co-edit with another physician); minutes of meetings, etc.
Things I don't do well—read journals. There is a HUGE stack of journals near my desk. Once they get to the ceiling, I come in on a few Sundays and read. I can't seem to write or do my academic work during the workweek—e.g., review papers, edit, etc. I have to come in on the weekends to do that. I find it is very quiet to come to the office, as opposed to doing work from home—less intrusions from the phone, less excursions to the refrigerator, etc.
A critically important ingredient is having an excellent assistant who makes everything work for me. There is a high level of organization necessary—I cannot say enough wonderful things about my assistant. My department chair and colleagues are all superb and make it a pleasure to collaborate over clinical cases, educational endeavors, and research.
Other essentials in enabling me to enjoy and do my work are having excellent child care, a loving and supportive family, and wonderful friends. We have an excellent child care assistant who is extremely reliable, dependable and thoughtful. With my travel schedule and my husband's demanding and unpredictable clinical schedule, we could not manage without having such help. My daughters and husband are also very easy about what to expect for dinner and such. Everyone pitches in and we try to make it all work. I am also extremely fortunate to have a great group of friends who are genuinely caring and loving.
In sum, there are probably things I would like to change—more time to play tennis, read, and definitely more time to be with family and friends. I do feel extremely lucky being able to provide clinical care to my patients and having the kind of doctor-patient relationship that I have; teaching such wonderful medical students, residents and other trainees; being able to do clinical research in a very nurturing environment; and feeling supported by my colleagues, family and friends. See t1. .