Michael Chen, MD
Psychiatry Resident Finds Value in Collaboration at LVHN
“The ability to communicate and collaborate with other services is crucial, and plays an integral part of being a resident at LVHN.”
The psychiatry program at LVHN provides a unique experience because we train at an academic community hospital with multiple campuses. Our psychiatric unit is located, and several electives rotations take place, at Lehigh Valley Hospital–Muhlenberg. Meanwhile, the consult service and several off-service rotations happen at Lehigh Valley Hospital–Cedar Crest. The combination of community and academic settings provides residents with a unique opportunity to learn how different hospitals function, and helps residents decide what kind of environment they will ultimately choose to work in after they complete residency.
The most unique aspect of my training is the individual attention and training I have been able to receive from my attending physicians. As residents, our primary goal is to train and develop to become well-rounded psychiatrists. As a result, attending physicians go out of their way to mentor, provide unique experiences and demonstrate different aspects of psychiatry. During the psychiatric inpatient rotation, aside from my typical duties on the unit, individual attending physicians have mentored me on how to run an electroconvulsive therapy (ECT) service, how to develop an efficient psychiatric emergency service and how to run an effective outpatient practice. The dedication of our attending physicians is the residency program’s strongest attribute.
During my consultation liaison rotation in my intern year, I grew to appreciate that psychiatry is the bridge between the health care system and patients with mental illness. Whether managing agitation or helping other medical services to treat psychosis, it became apparent that without adequate support, patients would be less likely to participate in their recovery.
One particular case that stands out was a consult for agitation. Nursing staff and other medical services were worried that the patient was getting more and more upset and was threatening to leave against medical advice (AMA). Psychiatry was consulted, and through a collaborative effort, a new medication regimen was initiated. A week later, I ran into the internal medicine resident who informed me that he was very grateful for psychiatry’s help and that the patient was now fully committed to his medical treatment and would be discharged soon. It was very rewarding to know that we were able to help the team with a patient who otherwise would have likely left AMA and may not have returned for follow-up care.
I believe that the most important aspect of residency is the training environment. It is imperative to factor in the morale of not only the residents in the program you are applying to, but also the residents from the other programs in the health network. Medicine is a collaborative effort, and you will interact with residents from other programs on a daily basis. I have quickly learned that your work flow is more productive and enjoyable when every member of the team feels appreciated and valued.
To be a successful resident at LVHN, it is imperative to be a team player. Along with your co-residents, your goal is to provide comprehensive care for all patients. You will share patients with other services like family medicine, neurology or surgery. The ability to communicate and collaborate with other services is crucial, and plays an integral part of being a resident at LVHN.
My name is Michael Chen, and I'm a PGY-2 in the LVHN Psychiatry Residency Program.
I am currently in my second of three months in the adult inpatient psychiatric unit. During our second year, we rotate three months in the adult inpatient psychiatric unit, three months in the psychiatry emergency room, two months in the adult partial hospitalization program, one month with geriatric medicine, one month with the toxicology service seeing patient with substance use disorders, and three months in the adolescent inpatient psychiatric unit.
My time in the adult inpatient psychiatric unit roughly follows this daily schedule:
I arrive on the inpatient unit at 7 a.m. Every third day I am in charge of following up on patients who needed to be physically restrained. I check in with the nursing staff to see if any patients are in restraints. If so, I perform face-to-face follow ups on these patients and determine whether the restraints need to be continued. I then review the charts of my follow ups and new patients until about 8 a.m. From 8 a.m. to 11 a.m., I round on my own patients and also assist any PGY-1 resident who needs help. Then, I meet with my attending to present my patients and update them on the management plan. After meeting with my attending, I meet with the case manager that works with all the residents and update her on the plan as well.
At this point, it is around lunch time and I eat my lunch. Normally, I grab lunch with the other psychiatry residents who are on campus. However, on a slow day we sometimes leave campus to pick up food and bring it back to the unit.
After lunch, a PGY-1 resident and me lead a psychoeducation group for patients on the unit. The topic of the group rotates between wellness, psychotropic medication awareness, and diagnosis awareness. Leading the group provides a unique experience to the resident. It allows the resident to interact with patients outside of morning rounds and to focus on different topics than are typically discussed at rounds (e.g. medication management and overnight symptoms).
Once the group is over, I help the inpatient team wrap up any loose ends. These responsibilities could include following up on patients in restraints or seeing new admissions that arrived in the afternoon. Typically, my day ends around 5 or 5:30 p.m. I then head over to my HIIT class at my gym. Other residents tend to use the free gyms on the hospital’s campus, but I found myself doing more socializing than working out at the hospital gym.
When I get home, I make dinner or go meet up with co-residents and neighbors at the local downtown bars and restaurants for dinner. I live in downtown Allentown where the majority of residents at LVHN reside, so it is very easy to find people to hang out with. After unwinding for some time, I typically screen the night notes about my patients and prep for another day at the hospital!