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Hi everyone, I’m Michaela, a second year psychiatry resident here at Tufts Medical Center! I am originally from Sweden, but my family moved around to Southeast Asia, New York, and finally Texas. I went to college at Austin College (the Kangaroos), majoring in ceramics and biology. I spent much of my free time in the art studio, leading the environmental group (the piles of red solo cups that were non-recyclable in that city still haunt me), working at a national park, and doing outdoor ecology research. I then went to medical school at UT Southwestern in Dallas and completed the dual MD-MPH program. I loved my public health courses and felt they complimented the medical education well (and were a nice break from memorizing). I was one of those people who loved every rotation, but was drawn to psychiatry for the personal connections. I appreciated the many gray areas in psychiatry, and being able to function as “the tool” rather than relying on diagnostic tests. I also helped run a free clinic for underserved communities and did research in trauma psychiatry working with Oklahoma City bombing survivors.
After four years, I matched in Boston, and I’m glad I did for many reasons. We have amazing proximity to outdoor activities! I spend much of my free time camping, hiking, skiing, and doing water activities with my dog. I have found plenty of free time to live my best life and travel on weekends. Our residency is also quite social, and we love to visit local restaurants and play games. I’m also on a casual kickball team with some other residents!
I commute on the train ~20-30 minutes and show up around 8:00 am to run the list with my co-resident and our medical students. The students help with pre-rounding so it gives us an opportunity to teach and to be more thorough with our patients. We then see any follow-ups from the days before and any new consults from overnight. After that we hold the pager and see consults throughout the morning. If we have questions, the Consult Liaison (CL) Attending, Dr. Manuel Pacheco is on site and always available to help guide us. This gives us the opportunity to learn how to develop our own formulations and plans. There is usually plenty of time to teach students, socialize with the team, and grab lunch before rounds. We are consulted for a variety of different questions, so it keeps things interesting. For example, we get asked to help with determining capacity, managing delirium and/or agitation, and optimizing outpatient psychiatric medications for medically ill patients.
Rounds with Dr. Pacheco start at 1:00 PM. We run the list with him, staff new consults, and discuss our preliminary plans for the patients. Dr. Pacheco is extremely enthusiastic about teaching and doing what’s best for the patient. After table rounds, we go on walking rounds with him throughout the hospital. Our C/L service is well-known in the hospital for taking up all the hallway space with our team of residents and students. After seeing our patients with Dr. Pacheco, we sit down and discuss specific cases. Then it’s time to finish notes.
On a typical day, we sign out to the overnight resident at 6:00 pm and I am home with my dog by 7:00! We have didactics on Wednesday afternoons and get delicious food delivered (recently it’s been Mediterranean, Indian, sushi, burritos, yum!). Didactic time is protected for all residents. As a second year, I also have my own outpatients that I schedule throughout the week, and my co-resident covers the service during those times. I usually see outpatients for 1h hour appointments about 2-3 times per week. I also take 24-hour call, 2-4 times a month and my co-resident will cover the service alone when I am post-call. This program provides a lot of autonomy, and I have noticed so much growth in my confidence and knowledge in just one year!
My name is Kat Han and I’m currently a PGY3 at Tufts Medical Center. A little bit about me…I was born in Mississippi, but moved up north when I was 10 and grew up in Cheshire, CT (about halfway between New Haven and Hartford). I went to college at the University of Connecticut, where I double-majored in English and Molecular and Cell Biology. I became a huge college basketball fan and lifelong lover of huskies. I also discovered a love of ballroom dancing and jujutsu (but don’t ask me to do both at the same time!). After graduation, I decided to stay in Connecticut and attended medical school at the University of Connecticut. I initially thought I might become a pediatrician, but after my psych rotation, I found that I never wanted to leave the inpatient psych unit. I never gave up on my dream of working with children though and am now applying for child and adolescent psychiatry fellowships with the goal of working in inpatient child and adolescent psychiatry.
Outside of work, I love hiking, cooking (I semi-regularly update a food blog), traveling, and playing with my two extremely fluffy cats, Rory and Shakira. I love exploring new areas of Boston, which is super walkable and often feels more like a collection of distinct neighborhoods than a traditional city. Despite growing up a couple of hours outside of New York City, I’ve always felt more attached to Boston for its beautiful outdoor spaces and more laid-back feel. That same laid-back, down-to-earth vibe and friendliness is what also drew me to Tufts MC.
Here’s what a typical day looks like for me! Of course, this is anything but a typical time so instead of seeing patients in my own office, I am seeing patients at home over zoom or on the phone. Just imagine that when you’re here as a PGY3, things will be back to normal.
9:30 am – 1:00 pm: Outpatient psychiatry and medication management appointments. I sneak in a brunch/lunch sometime in here as well. I’m a night owl, so I tend to see patients later in the morning and finish up later in the day. Since we do our own scheduling at Tufts MC so I can tailor my schedule to my own preferences.
1:00 pm – 3:00 pm: General psych intake clinic with Dr. Paul Plasky: This is all held over zoom these days, but it runs remarkably smoothly. For this weekly clinic, I see a new patient seeking to establish care with outpatient psychiatry. It’s usually Dr. Plasky, another resident, one or two medical students, and me in the room with the patient. I love watching how Dr. Plasky approaches a new patient and quickly establishes a rapport with them while obtaining a comprehensive history. Afterwards, we discuss a formulation and plan moving forward. We invite the patient back to ask some more questions and discuss the plan together. If we agree that the patient would benefit from outpatient treatment, I will work with them going forward. I currently follow around 30 outpatients, but we have various specialty intake clinics with different outpatient attending physicians throughout the year, which will give me a larger and more diverse outpatient case load over time. I’m especially looking forward to my child and adolescent intake clinic next month.
3:00 pm – 5:30 pm: Outpatient psychiatry and medication management appointments. I usually have one patient after intake clinic. The rest of the time is spent finishing up notes or taking care of other administrative tasks. On other days, I have supervision during this time. Seeing each of my 2 supervisors once per week is really the highlight of my week, since they help me see different perspectives on my patients, understand the art of outpatient psychiatry, and give me guidance on how to approach my outpatients when I’m not sure what to do.
After work, I typically go for a run, cook and relax for the night. On weekends, if I’m not traveling, I try to spend one day at home just relaxing with my husband and the cats and one day downtown with friends. About once every 14 days, I am on call and spend my post-call day running errands and then relaxing at home.
I usually see outpatients from my continuity clinic weekday afternoons. I’ve had great experiences discussing therapy dynamics twice a week with my 2 outpatient supervisors. One of the things that I most enjoy about supervision is discussing my own counter-transferences in therapy, which has helped me to understand my own interpersonal dynamics. Tufts MC is a psycho-dynamically oriented program, however, the diversity in teaching and practice helps residents develop their own therapy style. The diversity among my own mentors has been greatly beneficial to my academic growth.
The PGY4 year has a flexible schedule that allows one to read more, research, and participate in whatever scholarly activities one so chooses. It’s also important not to forget self-care! I’m currently working on being involved more in teaching both residents and medical students and I have been working with my supervisors to gain more experience in cognitive behavioral therapy (CBT) and supportive psychodynamic therapy. I have often heard the saying, “bloom where you are planted” with which I relate, as my experience in Boston has been transformative and enlightening overall.