A Day in the Life of a Resident
A Day in the Life of a PGY-1 Resident
Victor Pereira-Sanchez
Hi everyone! My name is Victor Pereira-Sanchez and I'm one of the PGY-1 residents here at Columbia! I started my intern year at one of the inpatient units, the Washington Heights Community Services of the New York State Psychiatric Institute. During this rotation we join multidisciplinary care teams to treat underserved New Yorkers with severe mental illnesses. Apart from learning psychiatric assessment and psychopharmacology, this rotation is a great opportunity to learn how to provide high quality, dignified, and culturally sensitive care while working in teams with nurses, social workers, occupational therapists, interpreters, and other professionals, teaching and mentoring medical students, and addressing the social determinants of mental health to help highly vulnerable, often non-English speaking individuals and families in their path to recovery.
I was blessed to rent a great apartment right across the street from work (less than a 5 minute walking commute!) through the hospital housing lottery available for incoming residents. I live there with my wife and son while we expect the birth of our second one, and I appreciate the enormous support this residency program offers for residents who are or want to be parents. Having my home so close to work is helping me stretch my sleep hours, have time for an energetic breakfast, and enjoy more time with my family, who often walks me to work and meets me at the door when I finish the day, and sometimes accompanies me during a brief lunch break. I currently wake up at 7 am and I come to work at 8 am. I typically start the day seeing the patients assigned to me, discussing their progress and plan with the attending psychiatrists, social workers, medical students, nurses and other team members. After lunch it is time to see patients if needed, talk to their families, and complete documentation and medication and lab orders.
My work day finishes around 4:30-5 pm, when I am eager to meet my family and take them to the park, to church, and back home for dinner and bed.
A Day in the Life of a PGY-2 Resident
Kimberly Sanchez
Hello everyone! I’m Kimberly Sanchez, one of the second year residents. I’m rotating through my block of Emergency Psychiatry and Overnight call. My CPEP (Comprehensive Psychiatric Emergency Program) late shifts were from 2 pm to 11 pm, allowing me to have a slow morning and breakfast at home. While in the CPEP, I evaluated patients presenting to the ED with acute psychiatric emergencies—first-episode psychosis, suicidality, substance intoxication, acute mania—and formulated diagnoses, medication recommendations, and disposition plans within hours. As a team, we decided who needed inpatient admission, who could go home with outpatient support, and who required medical workup first. In the CPEP, we were also responsible for participating on the BERTs (Behavioral Emergency Response Teams)— trained crisis response staff who de-escalate behavioral emergencies on the units—determining when medication intervention is needed and collaborating on patient safety.
I also just completed my week of DOC (Doctor on Call) for nights at NYSPI (New York State Psychiatric Institute), where I was the on-site psychiatrist receiving calls for medical and psychiatric emergencies, medication questions, behavioral crises, and acute patient concerns throughout the night. Before a night shift, I packed my dinner or grabbed food on my way to NYSPI. I brought a cozy blanket and my skincare products to make the on-call room a home away from home. During shifts with admissions, I began by reviewing the patient's chart and then conducted a psychiatric interview and a physical exam. I then discussed with the attending, wrote my notes, and completed the necessary paperwork for admission. Afterwards, I was able to rest and received calls throughout the night. After my night shift, I would get breakfast (an omelet at the Milstein hospital cafe), go to a workout class (Orangetheory), or have a self-care day/run errands.
A Day in the Life of a PGY-3 Resident
Lauren Gorfinkel
As a research-track resident, I have two days a week (Thursday and Friday) protected for research time for the entire year. The rest of the week is spent in the outpatient “Psychiatric Institute Residents’ Clinic” (PIRC), apart from Tuesday afternoons which are devoted to pizza and didactics. After years of working on research in the evenings and weekends, it feels amazing to finally have some real protected time!
On a typical clinic day, I wake up around 8, arrive at PIRC around 9, and see patients into the late afternoon, including a nice lunch break in the middle of day. Part of our benefits include money for the NYP cafeteria and Starbucks, where -in my opinion- the food is actually pretty great, so I never need to pack lunch. In PIRC, I see outpatients of my own, whom I schedule myself, see every 1-4 weeks for medication management or different modalities of psychotherapy, and follow for 1-2 years total. I also write notes, and see different attendings one-on-one for supervision, in which I review my cases and receive feedback. The PIRC clinic time varies by day but is open from 9-7 most days.
On a typical research day, I like to start a bit earlier. For many years I did population-level research (think national surveys, health claims data, EMR data) on substance use disorders, but since starting residency became interested in applying these skills to research in women’s mental health. Right now, I’m working on a few projects I feel really excited about. I typically have 1-2 research related meetings per week (I feel grateful to have AMAZING mentors here who are ridiculously supportive). Depending on what I’m doing that day, I’ll try to wrap up earlier in the afternoon.
My evenings are almost always spent on long walks or jogs while talking on the phone with friends/family in other cities, eating dinner/hanging out with my husband, and watching YouTube.
Omid Cohensedgh
Hi everyone! My name is Omid, and I'm one of the PGY-3 residents here at Columbia. Most days, I wake up around 7 AM for a quick home workout and breakfast before walking to campus for my first patient appointments at 9. Our third year is almost entirely outpatient — this year I'm splitting time between the Adult Outpatient Psychiatry Clinic at New York-Presbyterian/Columbia (PB2) and the Psychiatric Institute Resident Clinic (PIRC), a free clinic at the New York State Psychiatric Institute operated under the NYS Office of Mental Health.
PIRC and PB2 give us exposure to different patient populations and care team structures. At PIRC, we carry our own patient panel and schedule independently, with weekly supervision for each treatment modality (psychopharmacology, supportive psychotherapy, psychodynamic psychotherapy, and addiction); diagnoses run the gamut, from psychotic disorders to mood and anxiety disorders to substance use disorders, across a range of acuity levels. At PB2, our work is primarily in the intensive outpatient program (IOP) model, seeing higher-acuity patients at least weekly to manage medications and assess and mitigate risk. IOP patients also see an individual therapist weekly and attend group therapy. A good part of our day goes toward collaborating with the broader care team, and we round daily at PB2 — a great chance to learn from co-residents' cases and talk through challenging clinical scenarios.
After work and on weekends, I like exploring NYC (I've lived here 12 years and I'm still discovering new things — ask me for recommendations!), hanging out with friends and co-residents (shoutout to weekly Wingspan nights with my residency besties), moonlighting in the CPEP, and catching up on reading and shows I've been meaning to get to.
A Day in the Life of a PGY-4 Resident
Mathew Brown
Hi everyone! My name is Matthew Brown, and I’m a PGY4. I typically start my day at 8 am and my first patient is usually at 9 am. I live in hospital housing in Washington Heights which allows me to walk over to the New York State Psychiatric Institute in about 5 minutes without feeling rushed.
This year, my schedule is a bit varied. I see patients in the Psychiatric Institute Resident Clinic (PIRC) for both psychotherapy and psychopharmacology predominately on Tuesdays and Wednesdays. My current patient panel is composed of patients who I worked with during my third year of residency; it's a wonderful opportunity to work with patients in a longitudinal manner. For the duration of the year, I have protected time on Tuesday afternoons to attend didactics. In September I will begin two of my fourth-year electives: the first is a psychopharmacology rotation at the Columbia University undergraduate campus working with college age youth on Monday and Friday afternoons from September until December. The second is a year long interventional psychiatry elective where I will see patients with treatment refractory psychiatric disorders on Thursdays at the faculty practice. The goal of this elective is to become certified in various modalities of interventional psychiatry including electroconvulsive therapy, ketamine, trans magnetic stimulation and psychedelics. Outside of my designated electives, I also moonlight in the Comprehensive Psychiatric Emergency Program (CPEP).
After work, my evening is normally spent working out at the gym, chatting with my friends and family, and watching TV (cartoons, anime, nature documentaries, and sports keep my attention).