Tulane Home Tulane Shield logo linking to site home page

A Day in the Life

PGY-1

Jessica Zhang, MDJessica Zhang, MD

Our intern year is split up into the standard 6 months of psych, 4 months of medicine, 2 months of neurology. We spend our psychiatry months mostly between the psychosis unit at University Medical Center and the general psychiatry unit at VA. We also each do a month of consult-liaison psychiatry at Tulane Medical Center. Getting to rotate at different hospitals is a definite plus — we practice psychiatry in varied settings with different patient populations. We also work with a variety of smart, caring attendings, each with a unique style to learn from!

I’m currently rotating at the University Medical Center. It's the only safety net hospital in New Orleans, which means that the psychopathology can be fairly severe. I have learned so much from my patients and feel gratified and humbled to be a part of their care.

A “typical” work day for me might go something like this:
Arrive at the hospital around 7am. First stop: the resident lounge for free coffee and snacks! Then, I head up to the unit for nursing report. The nurses at UMC are wonderful, they truly are my eyes and ears. I can always count on them for additional insight into how my patients are doing. After I get the scoop, I do some chart checking and note-prepping. Then I pre-round on all of my patients and come up with a tentative plan for each of them. The attending comes in to round around 9-10am and we always round with a social worker, psychologist and nurse. Rounding is interactive and genial, it’s a great time for everyone to chime in and work together. I learn so much here everyday! After rounds, I grab some lunch from the cafeteria (they make a mean poke bowl!), then finish up by putting in orders and finalizing my notes. Each afternoon varies and I can be found doing anything from holding family meetings to going to court to leading group therapy sessions with our psychologist! At UMC, we often get out earlier than 5pm and have plenty of time to cook dinner, exercise, relax or explore the city! I love trying out different restaurants and spending time in city park or by the bayou. Some of my co-interns have joined a krewe or sports league in their spare time!

I am so happy to be doing my residency at Tulane. I feel very supported by my co-residents and faculty. I practice with enough autonomy to feel like a vital part of patient care. At the same time, I really feel like the upper levels and faculty have my back and are there to help when I don’t have the answers (which is, obviously, normal and expected as an intern!). All within the great city of New Orleans!


PGY-2

Ariana Koster, MDAriana Koster, MD

Hello! My name is Ariana Koster and I am a second-year resident. Having completed the required Neuro and Medicine training last year, I’m now able to delve completely into the world of psychiatry. Rotations this year offer more independence and we work in a variety of different settings including inpatient work, consults, community-based programs, clinics, and working in the ED.  

I’m currently working on a new Med/Psych rotation allowing us to develop skills caring for patients with both medical and psychiatric pathology. This is a great rotation for gaining exposure to some more unique and complex cases. My day usually begins around 7:30am with some chart-checking to see how my patient’s did overnight. After this, we meet in a multidisciplinary team to discuss patient care with nurses, social work, pharmacy, PT/OT, and other staff. I then check in with my patients and prepare for rounding. In the afternoon, once rounding is over, I finish up writing notes, discussing plans of care with my patients, call collateral, and tie up any other loose ends. Depending on my workload, I am usually done with this work between 4-6pm.

On Tuesday and Friday afternoons, however, we leave our clinical responsibilities early to attend didactics. On Tuesdays, all PGY levels attend a team-based learning activity. On Fridays, we attend grand rounds followed by lunch and lectures based on PGY level. This is a great chance to catch up with the other residents and decompress a bit from the week.

I work weekend shifts 1-2 times per month (much improved from last year!) These are either 11 or 24H shifts depending on how many people are scheduled to take call. On these days, I cover the Tulane ED any acute concerns for patients at Tulane Hospital or the VA.

In my spare time I like cooking, practicing yoga and spending time with my little Terrier. New Orleans offers so much to do in terms of places to eat and explore. I feel very supported by my fellow residents and am fortunate to be able to learn from such a committed faculty.


PGY-3

Ahmed Siddiqui, MD

Hey! I’m Ahmed and currently a third year resident. I’m really enjoying third year because of the variety of things I do day-to-day. Ultimately, I think I’ll be practicing outpatient Psychiatry in a community clinic so this year has been a great preview. I have a set schedule in which I split my days into mornings and afternoons. My typical day starts either at 8:00 AM or 8:30 AM and I am working out of Tulane Medical Center and the VA. On Monday mornings, I have VA ambulatory mental health clinic for follow-ups. In the afternoons, I continue my day at VA AMH for new intakes. I’m treating mostly depression, bipolar spectrum, anxiety, and PTSD. I love being able to provide my VA patients with a comprehensive treatment plan that may include therapy, group therapy, behavioral activation activities, yoga, etc.

On Tuesday mornings, I have my therapy clinic at the VA. I carry approximately 2 patients that I see on a weekly basis. My VA therapy supervisor is psychoanalytically trained which gives me a great perspective on analyzing cases. On Tuesday afternoons, I’m in didactics from 1-4PM which includes the great opportunity to attend lecture series at the New Orleans Psychoanalytic Institute.

On Wednesday, I have my outpatient clinic at Tulane Medical Center. I really like my Tulane clinic because we have a great list of internal and community referrals to pick new cases from. I model this clinic on how I think I’ll practice eventually. I pick cases that interest me or what I would like to follow long term in therapy. My therapy supervisor at TMC is both CBT and psychoanalytically trained which lets me hone my skills in both schools of thought. On Wednesday afternoons I partake in group supervision in which my co-residents and I discuss a “case of the week” with an attending.

On Thursdays, I run group therapy at the VA for patients with chronic mental illness. In the Spring, Thursday mornings will be allotted entirely to telepsychiatry. On Fridays, I return to TMC clinic for med management and psychotherapy patients. And on Friday afternoons, I attend grand rounds and third year didactics. All in all, I really enjoy the variability in my day-to-day schedule with a chance to treat a wide breath of patients and illnesses.


PGY-4

Cecilia Webb, MDCecilia Webb, MD

Hey y'all! My name is Cecilia Webb, and I am a fourth-year categorical psychiatry resident. It feels great to be starting fourth year, as it is our most flexible year in terms of scheduling, with a wide array of electives to choose from in order to really sharpen our skills before heading out into the world! My clinical interests lie primarily within outpatient psychiatry, so I have been able to build my schedule to reflect that. My week consists of a combination of VA medication management clinic and psychotherapy clinic, Tulane Behavioral Health Clinic, Gracehouse (an outpatient substance-use disorder treatment facility exclusively for women), and didactics.

My typical day starts around 7AM, I wake up, have breakfast, and go on a nice neighborhood stroll with my roommate (who also happens to be my sister) and our dogs. I then head to my clinic at Tulane (TUBC) for my first patient at 8:30. What I love about TUBC is the freedom to make the clinic your own. We have a growing list of internal and community referrals from which you can build your patient census and really tailor your clinic to your interests. I am interested in both psychotherapy and medication management, so I have 4-5 weekly psychotherapy patients along with a handful of med management-only patients. I meet with my supervisor weekly to discuss my cases, which allows me to feel both autonomous and supported in this clinic. Additionally, I have a great office (with a window!) that I have had so much fun decorating and really making my own. I really believe that my TUBC clinic gives me a true glimpse into my future practice, which makes me even more excited for life after residency!

I wrap up at TUBC around noon, have lunch, and then head over to the VA for my outpatient med management continuity clinic starting at 1PM. Here, I see the patient panel that I built in my 3rd year clinic at the VA, which is great because I have really gotten to know these patients over our past (virtual) year together. I primarily see depression, anxiety, and PTSD within this clinic, and I find it very rewarding to support our veterans not only through medication management but also through supportive psychotherapy that I can usually squeeze into our 30-minute visits. Another great feature of the VA is the accessibility of other services to complement medication management, such as manualized psychotherapy (CBT, DBT, etc), yoga, tai chi, behavioral activation, anger management classes, and a variety of other groups. I truly feel empowered by the degree of comprehensive care I am able to connect veterans with through the VA. I generally finish this clinic around 4PM, and then I head home to enjoy the city with my sister and our dogs.

I have lived in New Orleans since starting medical school at Tulane in 2014, and there are still new restaurants, festivals, and events around the city for me to experience. Although we can sometimes be quite busy in residency, there is no other city I would rather be in for my training, because there is simply so much to do and explore when I do have time off! I am very excited to see the city become its vibrant self again as we find our new normal beyond the pandemic.