David Austin Finch, MD

A day in the life of a PGY-4 resident

Welcome to a day in my life as a PGY-4! As the academic chief for this year, my most active days are Wednesdays. First, I wake up around 5 am to check on my newborn, and then I try to go back to sleep – unless the cute baby cuddles overwhelm me. Regardless, around 7 am, I get up to work out, usually consisting of cross-training for Brazilian Jiu-Jitsu. By 8 am, I start the daily rhythm of showering, breakfast, and coffee. I almost always take my coffee outside, even in the winter – I can't go without sunlight in the morning! Around 8:45 am, I'll head to clinic. My wife and I moved to Bethlehem my first year of residency, so the commute is only about 5 minutes! 
 

At clinic, from 9 am to 11:30 am, I see a panel of medication management patients selected from my PGY-3 clinic schedule, as well as a psychodynamic psychotherapy case. I enjoy the variety of the patients I get to see in clinic, and because I have been following them since last academic year, the doctor-patient relationships have only deepened over time. I find psychotherapy particularly enjoyable. Every person is different, and crafting a therapeutic alliance, discovering where problems come from, and building a path forward are all intensely creative endeavors. I precept with my attending between each patient, running my clinical reasoning and plans past them for additional learning and feedback. 
 

By 11:30 a.m., I begin to switch gears from morning clinic to afternoon didactics. I quickly try to wrap up notes or inbox items and head over to the hospital, where I assist guest speakers and residency lecturers get set up for their lectures. From 12-1 pm, we have Grand Rounds or a case conference or journal club, followed by a meeting with my co-chief, Dr. Goykhman, and our program administration. We meet with our program director, assistant program director, and program coordinator every single week to discuss residency updates, brainstorm fixes to emergent problems, and prepare for recruiting & wellness events. 1:30-2:30 pm usually contains a lecture specifically geared towards our board exams or more advanced psychiatry topics relevant for clinical practice. I help lead board review from 2:45-3:30 pm – depending on how many residents are present or the study format, these times of board review may feel like a casual group study session or a full-blown competitive game show! From 3:45-4:30 pm, the whole residency meets with our program director and our program coordinator for group supervision, which is a blend of residency updates and discussions of challenging cases from everyone's rotations. This is a valuable time to interface with program leadership and also to troubleshoot cases with all the residency classes weighing in.
 

I get home no later than 5 pm after this full afternoon of facilitating didactics, board review, and supervision. Either my wife has prepared something amazing for dinner around then, or I may whip up something myself – the sensory experience of cooking feels relaxing after a very intellectual day. I spend time with my wife and baby, maybe verbally processing the day or watching something over dinner. The rest of the evening is usually some mix of quality time together, reaching out to friends/family via phone, or having some introvert time to just read and write before bed. In an ideal world with perfect discipline, I'd be asleep by 10 pm. But despite a day packed with good things, we do not live in an ideal world, and I'll normally let the day end sometime around 11 pm. And that's a day in my life as a PGY-4!