Day in the Life of a UCSF Doctor – Psychiatry Resident Physician

Day in the Life of a UCSF Doctor – Psychiatry Resident Physician


[music] Hey, I’m Petey Kass, I’m a third-year
Psych resident at UCSF and this is the day and the life. So right now we’re walking to
work, It’s 8 a.m on a normal San Francisco summer day. I’m on in-patient Psych rotation,
so I’ll be seeing all patients who are admitted to our in-patient Psych unit. A little more
acute, patients who are a little sicker than what you’d see normally in out-patient setting
and uh, you never know what the day is gonna bring so, we’ll see. Alright, so Dr. Kass,
walk us through what a normal day is like for a Psych resident. So, Psych is practiced
kinda in two separate settings, there’s an in-patient setting and an out-patient setting.
So right now I’m going to the in-patient Psych unit, there’s also Consult Psychiatry, which
is where you’re working with Psych patients who are on the medical side of things. And
so when I’m on the in-patient unit essentially I get in at 8, I round all my patients, I make
changes to their treatment plan, I kind of go to rounds with our team of nurses and attending
and then I sort of just deal with the acute stuff that comes up during the day. And then
this is an interesting day ’cause at noon I’ll actually go to my outpatient clinic,
where I see patients who are just coming into the office to see me for a half-hour appointment.
And those patients are a little less sick, they’re a little higher functioning and generally,
you get an opportunity to do more like the Psychotherapy stuff with them. So this is
a fun day ’cause I get to do kinda both parts of Psychiatry. [music] Alright, so it is about
noon right now, Petey, can you walk us through what happened today? Yeah, so I got two new
patients this morning. The first was a guy I actually knew, a middle-aged guy with schizoaffective
disorder, who I took care of a couple of weeks ago and then he got discharged and stopped
taking his medications. So he came back with pretty bad auditory hallucinations and delusions
about thinking he was God. So kinda we spent the morning trying to get him restarted on
his medications and coming up with sort of a discharge plan that would keep him safe
for when he gets out of the hospital this time. And then I met another patient who uh,
is a younger guy who checked himself in last night with increasing depressive symptoms
and thoughts of wanting to hurt himself. So it’s really just getting collateral information
and seeing what we could do to help this guy feel better. Alright, so, what’s next? So
this is actually one of the few medical fields we get a lunch break, so right now it’s noon
and I don’t have to be back at work till one and that’s because at one O’clock I start
my out-patient clinic, which is uh, a clinic that I’m in once a week. Where I have a panel
of patients that I take care of just like kind of a regular out-patient doctor. And
they come to see me every 2 to 12 weeks depending on the patient. So I’ve got a full load this
afternoon of interesting people to take care of. [music] Alright so, it is now 4:30, Petey
just got out of clinic. Petey, walk us through what clinic was like today. Yeah, so I saw
a couple of patients, I had a new patient who I saw for a first visit uh, who was sort
of hearing voices and had a little bit of paranoia. So we diagnosed him with schizophrenia
and got him on a treatment plan for that and hopefully it works. And then I saw a patient
who I’ve been taking care of for a couple of months now who was pretty depressed and
is doing a lot better. So like it’s one of those rewarding cases where you see people
get better. And then my last patient ended up canceling, so here we are half-hour earlier
than I thought we’d be. Nice, so we hear about schizophrenia a lot in pop culture, can you
explain to the viewers what that is? Yeah, so I think what you hear a lot is like schizophrenia
and multiple personality disorder, which is kind of the complete opposite of what it is.
Schizophrenia is a disorder where people end up having a combination of hallucinations,
where they’re sort of seeing or hearing things that aren’t really there and delusions, beliefs
that aren’t actually true. So believing they’re God, believing they can talk to God, believing
they’re a superhero. And obviously for having these kinda severe thoughts and – and – and
seeing things, visions it really affects your function and your ability to work. So these
people are kind of the sickest patients we see and need the most treatment. Alright,
so I’m not – I’m not quite used to this because it’s 4:30 and it’s sounds like you’re done
for the day. Yeah, Psych life, I mean, we did a lot of work, we helped a lot of people
but we don’t need to be here till 8 so uh, the day is over, notes done and I get to go
home. Let’s do it. Yeah. So residency life is a lot different than being a med student,
what are some things that you wish you knew before you started residency back as a med
student, or even as a pre-med student? Yeah, so Psych is actually a much more diverse field
than I ever thought it was. You end up, you – there’s geriatrics, there’s forensics, there’s
addiction, there’s child. So it’s not just seeing patients on an in-patient Psych unit
and I think the nice thing about Psychiatry is, it gives you the freedom to change careers
a lot. So you could do geriatrics, you could do a little bit of consult, you can do a little
bit of addiction and in Psychiatry, you’re never really stuck. You can always kind try
something new and it’s one of the more flexible fields of medicine. Petey, why did you choose
Psych? So when I got to med school I thought I was gonna be pediatrics, I wasn’t like sure
of it and when I did my Psych rotation I just sort of fell in love with the field. It’s
basically like a primary care field, so you get to see a lot of different types of people
with a lot of different types of illnesses. You get to help people who have pretty debilitating
illnesses get better and get their life back. And I think for a lot of med students, by the
time you’re done with med school you don’t wanna do more 88 to 100 hour work weeks. You
wanna have a life, you wanna have hobbies, you wanna be able to see your friends and
Psych provides that as well. So, it’s kind of the perfect plan between work and wellness.
Why UCSF for residency? So I think it’s a – it’s kind of a complicated answer, there’s
a lot of reasons one is that UCSF is a great academic institution. It’s known worldwide
for its research and its clinical abilities, people come from all over the world to our
Psych clinics. Um, there’s three training sites, there’s a VA at County Hospital and
an academic center so we see a lot of different types of patients. I really have always loved
San-Francisco and always wanted to live here so that’s kind of an added benefit. And there’s
just kind of a lot of cool people doing cool things here, so I knew I would get to try
a lot of different things and figure out what I wanna do with the rest of my life. [music] Alright Dr. Kass, so if you could give our viewers one piece of advice to either pre-meds
or medical students, what would that be? I think it would be don’t pigeonhole yourself
to one specialty, I think there’s a lot of fields out there that people don’t know about
before med school and that you don’t try until you get to med school. And some of the core
rotations once you’re in med school, don’t include a lot of things. So I think you just
keep an open mind, try a lot of things. If you want more advice on this, I actually wrote
a blog post about choosing a medical specialty on the med school insiders’ blog, so you
can check that out. But I just think there’s a lot of fields out there that are great and
super interesting that people don’t know about till they get to med school. I didn’t know
I was gonna do Psych, I’d never heard about kind of what Psych was like, so I changed
my mind from pediatrics and I’ve never regretted it. Nice, so why did you decide against peds
and why did you choose Psych instead? Yeah, I think I don’t wanna like bad mouth peds
there’s a ton of good things about it like there’s nothing more admirable than helping
kids. I just on my peds rotation decided it wasn’t – It’s kind of listening to kids chests
and listening to kids stomachs that kind of made me feel fulfilled and diagnosing their
medical illnesses. Uh, it was talking to them and getting to know them and seeing kind of
more about their developments and their anxiety and their depression that I found really appealing,
so I think child Psych for me was a more fulfilling career. While someone else may find the kind
of the medical side of pediatrics more fulfilling. Interesting, and you know as someone who ended
up deciding on plastic surgery, was surgery ever in your realm? I actually loved surgery,
I actually did plastic surgery in med school and – and absolutely loved it. And I – I did
really well- You don’t have to just say that for the camera. No, no I – I actually tell
my wife every once in a while that I should have been a plastic surgeon, so it comes up.
And I think there’s a lot of cross-over, like both fields are very invasive, your patients
have to trust you to let you cut them open, but they also have to trust you to share their
trauma history and their development history and their family history. So I think there’s
a lot of cross-over. At this point I’m super happy with my career and I think the schedule
offers me kind of what I want more than a surgical schedule and I think the time to
sit down and talk to patients is – is pretty rewarding for me but that you don’t have in surgery,
’cause you have to spend a lot of time in the OR but I definitely see why there are
a lot of people out there who are choosing between surgery and Psych, they – they’re
not as different as they seem. Interesting, very well said with the invasive thing, I
never thought of it that way. Petey, it was awesome having you thank you for showing us
a day in the life of a Psych resident, where can people learn more? Yeah, thanks for coming,
thanks for hanging out in my lovely over-priced San Francisco apartment. Uh, I’m actually
one of the advisors from medschoolinsiders.com so you can find me there. I’m also one of
the blog contributors so you can see my articles including the one about how to pick a medical
specialty, and you can also follow me on Instagram. [music]

One thought on “Day in the Life of a UCSF Doctor – Psychiatry Resident Physician”

  1. Thanks for watching and shout out to Dr. Kass! Check out our other video we uploaded today! https://youtu.be/irp5ghCVNAM

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