School of Medicine

General Psychiatry Residency

Julian Thorne, MD

Week in the Life of PGY-4 Resident, Julian Thorne, MD

MONDAY And…the 2nd week of PGY-2 has begun. Last week was the first week since orientation our whole PGY-2 year was back on-service and we spent the previous weekend catching up and having fun being back at full strength. I’m currently on an adult inpatient psych rotation at the University Neuropsychiatric Institute (UNI), our standalone psych hospital. This is one of my favorite rotations because you get a good mix of everything from mood disorders, psychosis, acute mania, and personality disorders all at once. Luckily, I made coffee this morning so I wake up around 6:50, grab a quick shower, and hop in my truck for the 20 minute commute to work. I quickly pre-round before meeting up with Dr. Lewis and my sub-I to start rounds on one of our acute units. We have a couple of new patients to see and my sub-I does most of the interview before I take over and wrap up. We all quickly discuss the case and come up with a solid treatment plan before we head off to another unit to finish up rounds around noon. We spend the next hour or two writing notes and discussing some teaching points with my sub-I which always leads to further discussion and an educational experience for both of us. While working on notes I run into multiple other residents and we end up talking about work-related and non-work-related topics. Our new class of “terns” (PGY-1 Residents) are just getting started and we have a good time getting to know each other, talking about some of the ins-and-outs of UNI as well as the excellent hikes in the area. We get lucky today and don’t have another admit so I pack up and head home for the day. My wife comes home a little later and we eat and catch-up before another PGY-2 resident, Dan, comes over to hang out. Dan and I spend the rest of the evening in my woodshop working on various projects and catering to my dog Brewster’s constant pleas to throw his ball. Most of our projects end in disaster but we learn how to not screw things up next time and some of it turns out alright. I’ve been working on woodturning bowls and it’s harder than it looks. Dan leaves and my wife and I wind down with our current favorite TV show (Handmaid’s Tale) and a glass of whiskey before we’re off to bed to start tomorrow.
TUESDAY This day is pretty similar to yesterday. I take a quick moment before I head to work to check on the beer I made that’s fermenting in my fridge to make sure things are going smoothly. I hope to serve some of it at a BBQ on the 4th with the rest of the residents. That being done I’m off to work again where we round and see our new patient who came in overnight. Today is Dr. Lewis’s last day on rotation so after rounds we take a moment to do supervision. We get so much 1:1 time with our attending’s that feedback is always poignant and I usually end up with more than a couple articles or books to read, both for psychiatry and for fun. While we’re doing feedback a code blue is called on one of our acute units. The nice (and terrifying) part of being a standalone hospital is that we get experience running the codes and stabilizing patients before deciding who needs to go to the ED and who is stable enough to stay. We run up to the unit and happen to be the first docs there and it turns out to be one of our patients who had an episode of syncope and currently has low pressures. This is my first code at UNI and I’m a little out of sorts with all the commotion on the unit. Dr. Lewis runs most of the code and our patient is responsive and responds well to our fluid bolus. Its most likely vasovagal syncope but we send the patient to the ED for a full work-up. After debriefing from the code we head back to Dr. Lewis’s office to finish feedback. I hang around UNI afterwards to chat with some other residents and check in with my med student before wrapping up and heading home around 4. Tonight is a chill night at home spent grilling and chilling with my wife in the backyard. We play some cribbage and it’s so warm this time of year we stay outside well after dark by our fireplace hanging out. It’s nice to unwind after a long day and we end up losing track of time and get to bed way too late.
WEDNESDAY Wednesdays are one of my favorite days of the weeks because it’s didactics day. We started out with resident meeting at 8:30. I like to show up a little earlier to talk to everyone as they show up. It’s fun for us to all be together as a residency once a week and I always learn a lot about rotations I will have in future years. In resident meeting we talk about a few announcements coming up and have some “shout-outs” before we break off for our class specific didactics. One of the PGY-4’s is doing a lecture on night float prep for us PGY-2s, a rotation we will all do 5 weeks of this year. We have a break for lunch and some of the residents from various years go to a local Thai place for some bomb curry and pad thai before heading back to UNI to wrap up didactics. Didactics ends at 3 today and I run home to grab a quick bite before meeting up with Dan to go fly fishing. Dan is an experienced fly fishing master who has been showing me the ropes and I’m still pretty bad. I get too excited every time I get a nibble and end up pulling to quickly or flinging the fish right out of the water, over my head, and back into the river. Dan laughs at me before landing yet another 18 inch monster trout. We wrap up a bit after dark, grab some spicy McChickens and head home.
THURSDAY Another day at UNI. I have a new attending today, Dr. Solzbacher, who I’ve rotated with before and know well now. I’ve worked with no less than 7 attendings in residency so far for about 2 weeks at a time and it’s helpful to see so many different styles. Rounds are efficient today as my med student and I know the patient’s well and can fill Dr. Solzbacher in. We have an interesting new patient who is convinced she’s dead (she isn’t) and discuss as a team whether management with ECT or anti-psychotics would be most appropriate. Rounds end at 11 and quickly do our notes before leaving the hospital around 1. We’re at census so I have the whole rest of the day to do whatever I want. Being from Montana, I mountain biked a little before coming to Utah but there are so many awesome trails here that I’ve gotten way more enthusiastic about it. I spend my afternoon up in Park City, just half an hour drive, getting out of the summer heat and sending some killer downhills. I only fell, like twice, so all in all a pretty good day. Afterwards another PGY-2, Christina, invites me and my wife out for a drink with her and her husband. We meet up at one of my favorite breweries, toss a couple back, and catch up before calling it a night. I’m a pretty big beer enthusiast and have been pleasantly surprised with the solid offerings SLC has.
FRIDAY Back at UNI again today and we start at 7 this morning to try to get out early. My med student is out today so I’m doing all the interviews today and writing all the notes for our 8 patients. It doesn’t take me too much longer than usual as I dictate my notes which takes a lot of labor out of charting. I spend some time researching salient topics to our patients that day. I often get distracted talking to other residents, ensuring our notes take us twice as long as they need to. I run home and grab a quick nap and clean up my house before having 4 or so residents over for a game night. Jackson, another PGY-2, brought over a new game which we all enjoyed. We hang out late into the night enjoying good beer and cocktails before everyone heads home. It was a good week and I hang out with my wife for a while after everyone leaves. Thankfully, I’m not on call tomorrow and my wife and I make plans to go for a hike before a local Taco Fest the next day.