A week in the life

Charlotte is an ST5 dual higher trainee in old age and general adult psychiatry based in South Yorkshire.
No one week is the same but here Charlotte describes a typical week.

Monday: 'There was time to listen to patients'

'I start off in a busy outpatient clinic where I meet patients who often attend with their families. They can have a mixture of diagnoses and concerns.

It’s important that when patients leave clinic we’ve established a mutual collaborative management plan.

I usually see one or two new patients then four or five follow ups.

I love how psychiatry gives me the opportunity to have longer appointments with patients in clinic so I don’t feel rushed or overwhelmed, and most importantly the patient feels listened to.

You also get to develop long lasting doctor-patient relationships. Giving a patient a new diagnosis such as dementia is life changing for both them and their families.

At times it can be difficult, but at the same time very rewarding to be able to help commence treatment and to be able to offer additional management in the community.'

Tuesday: 'Great team working'

'I spend the whole day completing MDT (Multi-Disciplinary Team) review between inpatient units.

Everyone is able to contribute suggestions; it truly is multi-disciplinary team working in action.

In psychiatry we have functional diagnoses such as depression and psychosis, and organic diagnoses such as Alzheimer’s dementia.

The MDT reviews are chaired by my clinical supervisor, the consultant; however, I also run the reviews with observation by my consultant to complete assessments for my online portfolio.

We start in the functional unit where patients are being treated for variety of non-organic diagnoses such as depression or psychosis.

Each patient attends the ward round, with family being invited. Unlike a traditional fast paced acute medical ward round, by reviewing patients in this way you get time to spend with them when they really need it.

In the afternoon we follow a similar model in the organic unit where patients are being treated for different types of organic conditions such as Alzheimer’s.'

Wednesday: 'So rewarding to see patients get better'

'I spend the day doing home visits various locations, from flats to farms and maisonettes to mansions.

South Yorkshire has plenty of urban and country areas meaning the drive and view are often varied! I’m not great with direction so my satnav is essential!

The best way to truly get to learn and know your patients is to seen them in their home environment.

Sometimes this is challenging and being able to recognise how much someone is or isn’t managing in their own environment is important to help you understand as doctor what triggered the initial symptom and why things have progressed.

Being able to interact with patients in their home environment has made me a better doctor and better psychiatrist.

It’s a great satisfaction to see someone initially on the ward and then back at home and watching them get better.'

Thursday: 'Privileged to share ideas'

'In the morning I attend my community team’s MDT meeting, in which we plan when patients need to be seen and by which member of the team.

We also discuss challenging cases members of the team are managing.

This allows us to work together to exchange advice, support and define the next stage in management.

I feel privileged to have support from so many different disciplines each with their own area of expertise.

In the afternoon I have an hour’s protected supervision with my clinical supervisor.

This happens every week no matter how busy I or they may be. I find this hour invaluable.

I can discuss cases, complete assessments for my portfolio, review how special interests projects are going or think about future careers plans. Mostly importantly I can define what we discuss in the time.

The remainder of the afternoon I teach medical students on variety of topics, usually for an hour a time. I will then complete any outstanding admin work.'

Friday: 'Opportunities to learn'

'As a higher trainee I’m entitled to do two non-clinical learning sessions per week. I choose to do both of these Special interest and research sessions on a Friday.

The sessions are great and have taught me skills I never thought I’d have the opportunity to learn.

For my research I’ve joined an existing study helping initially with patient recruitment then data analysis. I’m usually based between the memory clinic or the local university.

Having this session has taught me skills I never thought I’d have the opportunity to learn resulting in me being one of the authors on a now published paper, all within work hours.

In the afternoon I complete my special interest session. I’m really passionate about recruitment into psychiatry, so spend the time planning future recruitment events for both foundation doctors and medical students.

I’m also currently one of the Trent reps for the RCPsych Psychiatry Trainees Committee (PTC) and use this time to attend meetings at the College or work on PTC projects.'

A final word

'I finished on time (at 5pm) for all of these session bar one (not including my out of hours shift). My Multi Disciplinary Team meeting overran but that’s medicine!

It was recognised I had stayed late by my consultant who thanked me for my input and checked that I would be able to take the time back later in the week.'