PGY-1

The PGY-1 year in psychiatry serves as an introduction to the specialty and to medicine in general. The program has been conscientiously structured to provide incoming residents with a firm foundation in general medicine and the clinical neurosciences. As such, the year is divided into 6 months of psychiatric rotations, 2 months of Neurology, 2 months of Internal Medicine, a month in Emergency Medicine, and a month in Pediatrics. This allows our residents to be well equipped to manage and treat the varied pathology that we will be exposed to at the University of Louisville’s diverse academic environment.

The year starts with a rotation in Psychiatry. As an example, a resident may rotate at the University Hospital’s Inpatient Psychiatry ward, which is considered a rewarding educational experience. The medical treatment team consists of an attending, a PGY-4 resident, and either three PGY-1s or two PGY-2s. Each day begins with the residents pre-rounding on their respective patients, reviewing patient’s charts for any overnight events, and seeing any new admissions to the unit. Table rounds begin at 9 am, with the entire treatment team, which includes the clinical staff, social work, nurse managers, therapists, and other support staff. This allows residents to be informed and involved in all aspects of a patient’s care, and in the process residents learn systems based practice. Following table rounds the resident begins formal teaching rounds with the attending physician; and the day culminates with residents following up on notes, orders, and general daily patient care.

In addition to the responsibilities of each specific rotation, the program emphasizes didactic education and professional development. As such, residents attend weekly lectures and a weekly academic hour with the entire department. The topics of discussion range from current research, to psychiatry board review. In addition, residents cover one or two weekend shifts in the Emergency Psychiatry Service. This unique opportunity allows them to be introduced to patients with the highest level of clinical acuity early in our training. Overall, our program is designed to train well-rounded psychiatrists that can comfortably practice in today's ever-changing medical and mental health landscape.

When not in the hospital, the residents in our program enjoy an active social life and soak in everything that Louisville has to offer. Whether it is sports, rock climbing, musical concerts, festivals, hiking, culture, arts, theater, or cuisine; Louisville has everything and our residents and faculty are involved in every imaginable social and community activity. The University of Louisville Department of Psychiatry has a wonderful work-life balance, and residents are given the opportunities and support to develop personally, professionally, and academically.

PGY-2

A typical day in a life of a PGY-2 resident varies, depending upon the rotation. For example, a resident might be at 3N, the inpatient psychiatry unit at University hospital. They start the day with pre-rounding at around 8:00 am, then they go through the patient charts, marking any changes, and will then see the patients assigned to them. They typically carry around 8 patients as a PGY-2 resident. After pre-rounding, they go to the treatment team meeting at 9:00 am. The treatment team is made of physicians, residents, nurses, social workers, therapists and medical students. They go through each patient on the unit, share information, discuss any critical issues, and formulate a plan for the patient. They then round with the attending and medical students. After rounding, they work on the documentation, orders, and obtain collateral information. Depending on the day, they have different activities in the afternoon, which includes didactics, outpatient clinic or grand rounds. After that, they return to their unit and finish any pending work. The work day is usually done by 5:00 pm.

Weekend days are more relaxed. Residents feel as if they have more freedom, in the sense of when they want to start their day, as there are no treatment meetings on the weekends. Usually, they start the day a little early, round with the attending, and they get done fairly early. Regardless of what day of the week it is, the day is very relaxed. There is an ample support from other staff, students and attending themselves. There is a lot of learning, as well as teaching (to the medical students). They usually see very sick patients on the inpatient unit and they have an immense sense of satisfaction at the end of the day. 

Overall, residents comment that they are extremely happy that they chose this program to train in psychiatry. It offers excellent training, great work-life balance, and is located in an amazing city. 

PGY-3

As a 3rd year resident, most residents claim that life is pretty good! This year is dedicated to practicing in the outpatient setting. They rotate through four sites throughout the year: the VA, Seven Counties Services, Centerstone (Louisville's community mental health system) and U of L Ambulatory Care. One morning a week, they see their own long-term psychotherapy patients, which has been a very valuable part of training. Frequently, they have several patients that they have been following since the beginning of their 2nd year, and it feels special to them to grow with them as a psychiatrist. They discuss their patients with a long-term supervisor, who imparts techniques in various types of psychotherapy.

And example of this year, the resident will arrive at the VA Shively clinic by the 8:15 treatment team meeting. The physicians, as well as the nurses, social workers and support staff, discuss upcoming cases for the day. Then they see patients, making medication adjustments, based on clinical picture, and providing supportive psychotherapy. Most residents are amazed to see how much they have learned in the past 2 years at this point. After seeing patients, they discuss cases with their attending supervisor on site. The attendings are all very open, approachable and love to teach. They usually leave work by 4:00 pm for plenty of time to balance life outside of residency. 

PGY-4

During the fourth year, the residents are mostly completing electives and inpatient rotations. While on the inpatient unit, they get practice running the unit as if they were the attending. They supervise lower level residents, lead treatment teams with social workers, therapists, and nursing staff, as well as make treatment plans for patients, all while under the supervision of an the attending physician.