During the 6 months of my Child and Adolescent outpatient rotation, every day has its unique schedule and unique educational experience. However, my most challenging day of this particular rotation tends to be Thursday, due to the variety of tasks I am required to perform.
The alarm clock sounds at 5:30 a.m., and I arise to prepare myself for an early morning workout followed by the daily routine of preparing myself for work. I set out to leave by 8:00am in order to be at work by 8:30 a.m.; however, the day would not seem right without a "good-bye" and an "I love you" from my husband amid a flurry of barking from my pet.
I arrive at the Diagnostic Preschool Program between 8:30 a.m. and 8:45 a.m. This program includes a maximum of six children ranging between three and 5 years of age. The various diagnoses during my rotation include oppositional defiant disorder, mixed expressive-receptive language disorder, mental retardation, and parental-child relational problems and others. This experience helps by allowing me to have hands-on experience with the emotional and behavioral problems that a parent may report during an interview session and the importance of clear communication in alleviating some of the problems. I learned the proper way to administer a structured therapeutic setting, while providing the appropriate behavioral interventions. With this experience, I was able to develop an understanding of the parents, enabling me to work with and help them maintain their parental role and create a less stressful home environment. The learning experience would not be complete without the necessary paperwork, which is completed after the children have been picked up by their parents.
At noon, I prepare for the psychopharmacology lecture series, which is provided by various board-certified psychiatrists and is continued throughout the first year of fellowship. This 1 hour and 15 minutes of lecture time, in addition to the 4 hours of lecture time on Wednesday mornings is protected, which guarantees no schedule conflicts and assures the development of a strong psychiatric fund of knowledge. We are provided with the selected readings pertaining to the lectures beforehand. I attempt to have the majority of the articles read, which usually involves staying up late the night before. However, I am not always successful in having the assigned readings completed. I use every possible free minute before the lecture to finish the articles that I was unable to complete the night before.
Conveniently following the psychopharmacology lecture, I set out for the medication management clinic. This clinic provides challenging cases for medication management and allows us to be thoroughly involved with a multidisciplinary team. The team includes a child and adolescent board-certified psychiatrist, two child and adolescent fellows, a psychology intern, a licensed masters of social work (L.M.S.W.), and a social work intern. The team meets prior to the scheduled appointments to discuss the clients for the day and the goals of treatment. This clinical experience allows for the assessment of new patients, the development of treatment plans, and the ability to follow patients for at least a 6-month period. In some cases, I was able to participate in the Individual Education Plan (IEP) meetings and school conferences. This allowed me to see the battle parents may face in attempting to obtain assistance for their children with a psychiatric diagnosis. I developed an understanding of the responsibilities in managing a clinic and the importance of developing time management skills. Good time management skills aid in the fluency of the clinic and demonstrate respect not only to the clients and their families but also to the office staff.
At the University of South Carolina, as an upper-level resident, the on-call experience is a moonlighting opportunity, so, it is optional. It is an overnight on-call experience at an inpatient psychiatric facility. My exposure to this experience will begin in March 2003 and will allow me to enhance my skills as a psychiatrist, specifically in areas of crisis stabilization.
My day ends as it began. I am greeted by my husband and my hyperactive pet. In going into medicine, specifically Psychiatry, an important part of my learning experience was to find what helps me maintain a healthy balance between my physical and mental health. For me, this obviously has been the love and support of my husband, my family and being able to stay spiritually grounded. In addition to my training at the University of South Carolina Psychiatry Program, these factors have done nothing but enhance my abilities as a psychiatrist in the making.