Department of Psychiatry

Penn Behavioral Health

PGY1

Daniel Barron, MD, PhD

Daniel Barron

"I moved to Philadelphia in June and rent an apartment in the Filter Square area.  This part of Center City is convenient because it is in between Pennsylvania Hospital on 8th and Spruce (East) and the Hospital of the University of Pennsylvania/Presbyterian Hospital /VA medical center (West) and allows for multiple modes of transportation to the various clinical sites we rotate at. I started my PGY-1 year on the Mood inpatient service at Pennsylvania Hospital, which is a 1 month rotation. Here is a sample day of inpatient psychiatry at Pennsylvania Hospital (Mood, 6 Spruce):

I wake up around 6:30AM. I get myself ready, then have a cup of coffee while I quickly scan patient's charts in Epic. I look for overnight events or nurses notes, so that I am aware of any acute changes in my patients. I leave the apartment around 7:20 and catch the bus, arriving at the hospital between 7:45 and 8:00AM. I greet other team members including nurses and medical students, then print a patient list. I look to see if there are any new patients to the floor and read their emergency psychiatric evaluations. Around 8:15, I start pre-rounding on existing patients and find how they are feeling. Around 9AM, Dr. Leight, the attending on the service, arrives and we begin interviewing new patients as a treatment team (including Dr. Leight, myself, the medical students, and the psychologists). At about 10:30AM, we have treatment team which also includes the social worker, charge nurse, and occupational therapists. Here , we present the new patients and review the existing patients, updating the plan in regards to diagnosis, medication adjustments, and dispositional planning. Depending on the time, we may interview 1 or 2 existing patients again as a team or have a family meeting with patients to clarify new issues or changes. At about noon, Dr. Leight leaves the unit and I get to work putting in orders. Once all the orders are in, I will break for lunch -- usually the cafeteria or a food cart. In the afternoon, I call collateral and write my notes. Invariably, questions and issues will arise: orders need to be changed, pharmacy wants to clarify medication dosing, family wants an update about a patient, its time to give medical student feedback, etc. Prioritizing tasks is one of the biggest new challenges as an intern! On a typical day, my work will be done by 4:00 or 5:00pm and I will sign out and head home. I might elect to finish some notes at home or work on discharge summaries but for the most part I will be done with my work. Then, I'm free to relax with some dinner, video games, and television. 

About 1 day every work week during rotations at Pennsylvania hospital, I will be on "Admitting Clinician Call" which means that I need to put in admission orders for new patients to Pennsylvania hospital floors. This means I will stay at the hospital until 6pm--the other services at PAH will sign out their patients to me as they leave for the day. I might get called by the nurses about issues with patients on the floor--typically minor issues but occasional more serious medical complications--and I will need to see the patients and follow up. I will also get called about new patients arriving to the floor. I briefly see those patients and then put in admission orders so they will be comfortable for the night until their treatment team staffs them in the morning. At 6:00PM, I head to the Crisis Response Center (CRC) across the street which functions as a psychiatric emergency room. From 6-10pm, I help the treatment providers with emergency assessments, as well as handling any issues that come up on the inpatient floors. This makes for a long day, but gives a tremendous variety of learning opportunities.

Now, in my second month as a PGY-1, I am on the VA consult service, with Dr. Bleier and Dr. Devon as attendings. On this service, the day is totally different and variable depending on the number of types of consults we get called about--but generally spans from about 8AM to 5:30PM (with no additional call during the week). "


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