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A Day in the Life of a Psychiatry Resident

Reflections from a Day in the Life of a PGY-1

My day begins around 6:00AM when I get up to take my dogs out for a walk before heading to the hospital for my emergency psychiatry shift. During my drive, I listen to my favorite new albums each day. I arrive for my shift and am greeted by the warm smell of coffee and the bustling hospital hallways. It is 8AM and I am ready to review my patient’s charts.

The clock strikes 8:30AM and I am ready to join the treatment team including attendings, nurse practitioners, social workers, and students among others. The team is extremely supportive and encouraging every step of the way. We head to the ED to see our patients where we interview people during crisis moments. After the interview, we decide the next steps for our patients. This usually involves obtaining collateral and discussing the case with my attending. I enjoy working with my attending in a one-to-one ratio on this rotation.

12:00PM arrives and I dig into my favorite lunch from the cafeteria, usually sushi. After lunch I review some clinical pearls from earlier this week. 2:30PM arrives and it is time to head home before answering service begins.

By 5:00PM I am home for the day with my pager in hand. I am ready to answer pages that come in from now until 8:00AM. I usually settle into a movie or play with my dogs in the backyard around this time. At 8:45PM I receive my first page. A patient is feeling suicidal and is unsure what to do about it. I call the patient and we decide the best thing to do is head to the emergency room for treatment. I remember feeling nervous about answering these calls earlier in the year but feel supported with my PGY3 backup being just a phone call away. Finally, I doze off feeling satisfied I know more about treating patients than I did yesterday.

My Intern year in Psychiatry has been exciting, challenging, and fulfilling. I feel more confident as the days go by and am thankful for the ample opportunities to continue developing with each rotation to come. I love working with the senior residents and the faculty. Their endless mentorship and support they offer along the way has made all the difference in my journey.  

- Joe Piks (he/him)


Reflections from a Day in the Life of a PGY-2

The day kicks off at 6:45 AM when I wake up, ready to embrace whatever challenges lie ahead. After a quick shower and a light breakfast, I set off for the hospital, usually arriving by 7:45 AM. As the city of Cleveland slowly comes to life, I’m already deep into my day, reviewing patient charts and gearing up for what’s to come.

By 8:00 AM, I’m fully immersed in morning rounds—a cornerstone of the day where our team gathers to discuss patient cases. This is where the magic happens: collaborating with attending physicians and fellow residents, we dive into each case, dissecting the complexities, sharing insights, and formulating a comprehensive plan of care. It’s a dynamic, fast-paced environment where every voice matters, and every decision has a direct impact on patient outcomes.

The rest of the morning is where I see follow-up patients, document notes, and communicate treatment plans with the consulting team. Each encounter is a blend of medical knowledge and human connection—whether it’s reassuring a patient who’s struggling or fine-tuning a treatment plan to better meet their needs. The morning flies by, fueled by the diversity of cases and the constant drive to deliver the best possible care.

Afternoons are when things really get interesting. I switch gears to see new consults, and this is where the full scope of psychiatric care comes into play. I encounter a wide range of conditions—delirium, psychosis, mood disorders—all in patients who often have complex medical histories. These cases require me to dig deep into my training, think critically, and adapt on the fly. It’s challenging, but it’s also incredibly rewarding to help patients navigate these tough situations.

On select evenings, I take on the call shift at the VA hospital from 5 PM to 8 PM. These shifts are a true test of everything I’ve learned. I’m responsible for triaging patients in the emergency department, making critical decisions about whether they need admission or can be safely discharged, and covering both the inpatient unit and the CL Service. It’s during these hours that I’ve learned to trust my instincts, sharpen my decision-making skills, and stay calm under pressure. The experience is invaluable—it’s a crash course in adaptability and resilience.

But residency isn’t just about work; it’s also about finding balance. Most evenings, I prioritize my physical and mental health by heading outdoors—whether it’s a run through one of Cleveland’s beautiful parks or a leisurely walk to clear my head. And of course, I indulge in the city’s food scene whenever I can. Cleveland has some fantastic spots, and I’ve made it a mission to find the best pizza around.\

PGY2 is a pivotal year in residency—challenging, yes, but also immensely fulfilling. It’s a year of growing independence, where you start to feel the weight of responsibility, but also the thrill of making impactful decisions. Yet, through it all, there’s an incredible support system in place—from your fellow residents who quickly become your second family to the program’s leadership who are there to guide and encourage you at every step.

Every day, I’m not just learning the art and science of psychiatry; I’m becoming the physician I’ve always aspired to be. The blend of rigorous training, diverse clinical experiences, and a supportive, enriching environment makes this journey truly enjoyable and fulfilling.

- Cole Bergeron (he/him)


Reflections from a Day in the Life of a PGY-3

One of the very biggest advantages to PGY3 life is having call behind you. This frees up time for returning to hobbies, developing new interests, and moonlighting. With some friends, we started a weekly Dungeons and Dragons campaign that’s still going strong. I was also able to build time into my schedule to account for the reading I was doing on psychedelic therapies and research through a certificate program in California. Signing up for a few moonlighting shifts each month put a little extra money in my bank account and helped me develop independent clinical decision-making in a way that has been a huge part of my clinical growth. Also, with some planning, there was enough flexibility in my schedule to plan several trips throughout the year to conferences and to visit friends out of town.

Throughout the week I’d wake up, make a coffee, and spend a minute with my dogs. If I was working virtually from home, they stayed with me. If I was going to an outpatient clinical site I dropped them at doggy daycare on my way to work. My patient population and clinical focus varied day by day. On Mondays I spent my time reading, seeing psychotherapy patients, and undergoing therapy supervision. On Tuesdays, I worked in perinatal mental health at a community clinic. Wednesdays were a mix of didactics, independent study, meetings (supervision, committees, chief resident duties), and psychotherapy. Thursdays were spent on medication management at the VA before seeing a final psychotherapy case and heading home. On Friday I attended psychotherapy didactics before having Child clinic. Some days my dogs got an extra walk after work, but some days I crashed on the couch to play video games or watch a movie.

It took time to adjust to the occasionally frenetic pace of clinic, but I enjoyed developing longitudinal relationships with patients and appreciated seeing their clinical improvement and getting to know them better over time. Towards the end of the year, it became clear to me just how much both my patients and I had grown and developed throughout our work together.   

- Tobias Squier-Roper, MD (he/him)


Reflections from a Day in the Life of a PGY-4

Mondays: ~6:30 am Kalispera (my German-Australian shepherd) announces that it's time to walk. After a short stroll around the neighborhood, chart check on the weekend's new CL patients, make breakfast, and bike to Main Campus for a morning of senioring on the consult liaison service. Once I'm there, Dr. Brandstetter makes sure that I get to see the patients I find most interesting. I give junior residents feedback on their notes, practice staffing patients from the weekend, and read up on interesting cases. Around noon, I bike back for lunch and another walk before seeing a patient (ideally two) for therapy in the afternoon. In the evenings I cook, train/entertain Kalispera, and head to hot yoga.

Tuesdays: ~6:30 Kalispera sounds the walking alarm. If the weather cooperates, my psychotherapy supervisor and I try to meet in the woods nearby for dog-inclusive psychotherapy supervision. On a trail or on the phone, we discuss my psychotherapy patients, and I have plenty of time left over to see 1-2 psychotherapy patients. Around noon, I hop on my bike and head to Walker, where I senior at the BHI consult clinic. I see patients who need short-term psychiatric help, staff with an attending, and then hear about and discuss other resident's cases in supervision from 4-5. Some Tuesday evenings I schedule one hour of psychotherapy to free up one of my half-days that's technically for psychotherapy.

Wednesdays: I drop Kalispera off at doggie daycare before biking to 8 am didactics, which go until noon. From there, I head to the Women's Mental Health Clinic, where Dr. Reed has reassured me it's ok to arrive kind of sweaty from biking. There's also a shower available, which is unusually biker-friendly! I see pregnant and paripartum patients, staff them with Dr. Reed, take mental notes about how his great patient rapport, and discuss articles/book chapters that Dr. Reed has assigned. At five pm I'm usually done with notes and ready to bike home.

Thursdays: When the academic year starts, I will see Oberlin students virtually, from the comfort of my couch. Since the academic year has not yet started, I've been enjoying slow Thursdays in the woods with my dog, reading, and cooking.

Fridays: I'm at didactics from 8-12, and then I spend the afternoon working on scholarly projects. This involves a lot of reading and writing-- Friday afternoons are my designated time to work on quarterly essays for OPPA's psychiatric newsletter. This flexibility in my schedule has also been helpful for finishing CL fellowship applications, scheduling interviews, and working around the schedules of psychotherapy patients.

Weekends/evenings: Since my first three years made me a very efficient note-writer, I almost never have to spend evenings or weekends working on notes! I have the option of moonlighting for extra cash, which is both financially and intellectually incentivizing. I probably average about two 12-hour weekend shifts and two 6-hour weeknight shifts/month.  That still leaves plenty of time free for weekend trips, evening workouts, and catching up with friends!

- Olivia Dahl (she/her/ella)


Additional Reflections from a Day in the Life of a PGY-4

The great thing about the fourth year of residency in our program is that it's highly customizable, consisting mostly of elective time, allowing each resident to pursue clinical and research experiences they prefer. I served as chief resident for education and research during my fourth year and consistent with my ambitions for a future research career in academia, I utilized most of my time for research, scholarly work, teaching and administrative work. My clinical responsibilities consisted of Resident Psychotherapy Clinic, in which I followed weekly with my two long-term psychodynamic psychotherapy patients, and the FIRST clinic, devoted to patients with first-episode and early psychosis. The elective rotation at FIRST clinic did not exist previously, and I had created that elective given my clinical interest in that patient population. This is another instance of how the program is willing to create new experiences for the residents if they do not already exist.

I utilized my research time by collaborating with researchers in the department. I became the principal investigator of a patient survey study in the psychiatry inpatient and community outpatient setting investigating how the experience of psychiatric hospitalization impacts subsequent trust in the outpatient psychiatric provider, and forthcomingness about psychiatric symptoms such as suicidal thoughts. I became involved in a clinical trial of pioglitazone use in bipolar depression and conducted secondary analysis of research data from clinical trials in the department. I used further scholarly time to work on a manuscript on the subject of philosophy and psychiatry.

I was enrolled in the Leadership in Medical Education (clinician educator) track of the residency, and my educational project consisted of a didactic course on the philosophy of psychiatry, which I had developed and taught to the psychiatry residents in the program. I also utilized my educational time to develop a didactic series for PGY4s: neuroscience for psychiatrists.

I found this mix of clinical, research, scholarly and administrative work highly rewarding and plan to seek this in my future career. I am very glad that the flexibility of the program allowed me to be so productive.