A resident is a physician who has graduated from medical school and is continuing his or her intensive training in a specific field of medicine.  All residents start their first year of residency known as “interns”.  Interns do the brunt of the work in patient care; it is a year designed to become proficient in general medicine.

Year I
As a psychiatry intern, I spent four months working internal medicine at the Veteran’s Administration Hospital (VA) and the county hospital known as Denver Health Medical Center (DHMC).  I treated inpatients in critical care and on general medicine floors.

I spent two months working in the emergency department of DHMC treating patients for all sorts of medical emergencies including women in labor and victims of severe trauma.
I spent two months on an inpatient drug and alcohol treatment and detoxification unit, one month in an out-patient medical clinic, one month on a child inpatient psychiatry unit, one month in the psychiatric emergency department (all at DHMC), and one month on the neurology service at University Hospital and the VA.  I was on call approximately one every four nights for the year.

The hours I worked during the intern year were average for an intern at the time; 80-110 hours per week.  The idea behind this intense year is to treat as many people as possible for medical problems.  It is an amazing experience where one learns just how much they are capable of doing.  This year really ingrained the “medical model” of treatment into me.  The knowledge of general medicine that I obtained serves me well in treating individuals and in working with physicians in other fields.

Year II
The second year of residency began the intensive psychiatric training.  I could also now be referred to as a “resident” instead of an “intern”.  This is a matter of prestige.  I worked on inpatient locked and unlocked psychiatric units.  I was part of a team that treated up to 10 inpatients at a time.  This was a busy year.  It was invaluable in learning how to diagnose psychiatric conditions and integrate medical and psychiatric treatment; I handled most of the medical problems of the inpatients as well as their psychiatric problems.  I was on call once every four nights for the year, admitting new patients over night and handling any psychiatric and medical emergencies that occurred.

Year III
The third year was focused on out-patient treatment.  I built a list of patients that I worked with over the year.  This was at a busy clinic run by the University of Colorado.  I was supervised (as I was in the second year) by instructors and professors of psychiatry on every case.  This was the year I learned how to build relationships with patients and work with them over a long period of time.  I also had eight hours of classes every Wednesday.  We covered a vast array of topics related to psychiatry.  Each area was taught by a professor or psychiatrist who was considered an expert in that particular subject.  I began my psychotherapy training this year, covered in some classes and with supervision.  This was continued each of the remaining years as well.  I was also still on call about once per week.

Year IV
This year could be considered my fourth year of residency or first year of my child and adolescent psychiatry fellowship.  A fellowship is basically a sub-specialty training that involves research and/or teaching and high intensity exposure to a specific field with LOTS of patient hours; in this case, child and adolescent psychiatry.   I was back on inpatient psychiatry units, at DHMC and The Children’s Hospital in Denver.  We had approximately six hours of lectures per week.  As for the second year, I worked on a team that handled 6-8 inpatients at any given time and was supervised by an attending psychiatrist.  In some ways this year felt like another internship with how busy it was, and in learning how to care for children.

Year V
This was my most satisfying year of residency.  I was the co-chief resident which meant that I did some administrative work, teaching, and team-building.  I continued my clinical out-patient work and honed my psychotherapy skills with weekly one-to-one supervision with a psychoanalyst.  I also initiated a research project regarding the evaluation of children and their care-givers in the emergency setting.   I did school consultation and in-patient consultation for children with medical problems having psychiatric issues.

Summary

I started medical school in the fall of 1995 and finished my residency training in June of 2004.   That comes out to four years of medical school followed by five years of residency and fellowship training.  It was a grueling time but left me well-prepared to begin my career as a child, adolescent and adult psychiatrist.