A Typical Week for Gregg Robbins-Welty, MD, MS
Hey everyone, welcome to Duke Med-Psych! I appreciate you taking the time to review what a “week in the life” is like for me and I’m hopeful it may be helpful in your residency decisions. I’m happy to discuss Duke, med-psych or things I talk about below via email or other means. Please feel free to reach out!
Monday
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Morning: I’m currently in my fifth year of med-psych residency, which is a combination of six months of medicine and six months of outpatient psychiatry. I am currently on my medicine half of the year, so I hope to give you an idea of what a week in the life is like! On Monday mornings, I’ll often wake up early and try and get a workout in before going to the hospital. I’m on the ‘Gen Med 12’ or med-psych service, so it is a full morning of chart checking, rounding, getting in orders, supervising interns and students – general patient care things! At noon there is “Med-Psych Conference,” so I’ll go and learn about a med-psych related topic or hear about an interesting case.
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Afternoon: After lunch/conference, we may get admissions or have other patient-care related things come up. Otherwise, just generally a work afternoon!
- Evening: I go home around 7pm, take my dog for a walk, and probably make something for dinner or go to a social function of some kind. Mondays are often my “I have to get some stuff done” nights, so I may work on a paper, poster, a “week in the life” write-up for prospective applicants, or something like that.
Tuesday
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Morning: I often work out in the morning and then drive to the hospital. I live close to the hospital, so it is an easy commute (about six minutes) and the parking at the hospital is free. More patient care, supervising, learning how to care for patients with comorbid medical and psychiatric issues on the med-psych service.
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Afternoon: A whole afternoon of academics and scholastic activities. This is something that you attend anytime you are on a psychiatry rotation or an outpatient medicine rotation. Gen Med 12, the med-psych service, technically counts as a psychiatry rotation for med-psychers!
I am part of the Clinician Educator Track (CET), and we have a 12:15 to 1:45pm meeting to learn about chalk talks, peer feedback, and creating learning objectives. From 2 to 4pm, the PGY4 psychiatry residents are learning about the finances of outpatient psychiatry clinics, and then from 4 to 5pm, we are learning about psychodynamic theories. As med-psychers, we are often on medicine or otherwise not on psychiatry rotations in the earlier years of residency, so I feel like this year I’ve had the chance to attend various PGY2, 3 or 4 psychiatry Academic Half-Day lectures to fill in the gaps that I may have missed over the last four years.
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Evening: Since we get out of academic half-day around 5pm, it is a great time to get together with some of my psychiatry resident classmates. A group of us might get together to go to the local sushi place and play Super Smash Brothers.
Wednesday
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Morning: Similar to days prior, I am probably getting a workout in in the morning and then I am heading back to the “Big Duke” hospital.
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Afternoon: I finish up seeing patients before noon and then I’ll drive five minutes up the road to my med-psych continuity clinic. Younger residents on the med-psych service don’t have clinic while on service, but the senior residents do. For the last three years, I did my primary care clinic through the regular VA primary care teaching clinic, but the last two years, I switched my primary care clinic to this med-psych VA clinic. It is primary care, but for patients with severe and persistent mental illnesses or mental health concerns that may affect their primary care needs. It is really a fun experience and feels like a capstone med-psych experience in many ways. Plus, I get to work closely with a med-psych faculty member who is doing collaborative/combined care. Would recommend!
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Evening: I am involved in several committees and other academic things through the departments of medicine, psychiatry and GME more broadly. So tonight, I have a 7pm Residency Council Meeting, where residents across the health system come together to discuss issues that can be brought to hospital leadership. After that, I take my dog for a walk, catch up on administrative work like emails, and get to bed early! Perhaps it is a Netflix kind of night.
Thursday
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Morning and afternoon: Thursday feels like a “regular work-day” on a gen med service. Probably a gym rest day, so I’ll sleep in a bit and get to the hospital ready for rounding and other patient-care responsibilities. I’ll likely go to the medicine noon conference. In the afternoon on Thursdays, I have a two-hour clinical ethics fellowship weekly seminar that I head over to. I feel really lucky that I’ve been able to complete a clinical ethics fellowship during my PGY5 year of residency. I plan to take the HEC-C (healthcare ethics consultant) credentialing exam in November. The med-psych attendings are so helpful and willing to supervise the interns while I am away for this short period. Then, afterwards, I am back on service with the team. I may give a chalk talk, teach/learn something, and/or tend to patient-care issues that come up.
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Evening: I get off around 7pm. One of the hobbies I really enjoy is playing music, and I have found a cohort of people (both residents and non-residents) who share that interest. So, several friends come over around 7:30pm and we play music later than we probably should. This is a good chance to see friends and maintain my hobby.
Friday
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Morning: Last day of the gym this week – phew! Back up early, to the hospital, rounding and caring for patients.
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Afternoon: Today I have my psychiatry continuity clinic, so I’ll leave Duke University Hospital around noon. They just built a beautiful behavioral health building with a psych ED, inpatient unit, and outpatient services, including an ECT suite, over at Duke Regional Hospital. I have my own office there when I’m there on Fri afternoons—pretty nice! I see new and return patients all afternoon. The attendings in this clinic are really great, and the last half hour of the afternoon (4:30 to 5pm) is “supervision” and teaching. Our own med-psych interim program director, Nicole Helmke, often has some good clinical take-home pearls for the residents in clinic in the afternoons. Given that I am one of the med-psych chief residents, we often use this opportunity to discuss issues in the program or plan a social gathering for the residents/faculty.
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Evening: I’ll leave the hospital and have been trying to do things with my free weekends that the senior years of residency have afforded. I’ve been trying to travel, go to conferences, or do other things that I might not have had time for in the earlier years of residency. I might catch a flight, or drive to the mountains or the beach (each about three hours away). Or, if I am staying local, I really have enjoyed the Durham food scene. I may go for wine and American food at Bin54 or Omakase at M-Sushi. I may also do drinks or another fun group activity with co-residents, depending on what everyone is doing.
Weekend
I’ve really been enjoying having weekends off as I’ve progressed in my residency. As above, I’ve been spending a lot more time travelling, doing weekend trips, catching up with friends that I haven’t seen in some time (thanks, Covid … and residency.). If I am staying in Durham, I’d probably get up early, find coffee, check out the Durham Farmer’s Market, get brunch with friends, and/or take my dog to the lake. In the afternoon, I’m likely to go to a friend’s house for a cookout or go to another good local restaurant for date night. I’ll be the first to admit that when I have a weekend off, I’ll usually spend at least some of that time moonlighting to earn extra money. Med-psychers are allowed to do both medicine and psychiatry moonlighting. My personal favorite of the many options is to carry the admissions pager for the state psychiatric hospital in Butner, NC. I’ll spend the night (8pm to 8am) at the psychiatric hospital, likely do one admission, and still get plenty of sleep. The extra money makes a huge difference!
If I am not staying in town, I love that Durham has easy access to both the beach (approximately two hours away) and the mountains (approximately 2.5 to 3 hours away). I spend many weekends at music festivals or events in the area or in surrounding Tennessee and Virginia.
At the end of a weekend, I always meal prep for the week. I like to cook, so I have been experimenting with recipes! I’ll catch up on emails, read something related to medicine or psychiatry, and do something hobby-related.
Number of work hours per week: 55
I chose Duke because ...
… I was excited about the combined medicine and psychiatry program. I thought doing a combined internal medicine and psychiatry residency fit well with my career interests (geriatrics, palliative care, caring for the underserved), and I felt like I fit in well when I interviewed here. I have really enjoyed my time in the Duke Med-Psych program, have met incredible mentors and colleagues, and would chose it again. I was also excited about the idea of relocating somewhere that was closer to the hobbies I enjoy, like playing bluegrass music!
My favorite thing about Durham is ...
… the lifestyle! I live in a nice-beyond-my-payscale, three-bedroom house with a garage and fenced yard that is five minutes from the hospital on a resident salary! It is hard to beat the convenience and cost of living here.
My favorite thing about Duke is ...
… my co-residents! I work with such a supportive, friendly and inspiring group of people. The medicine, psychiatry, and med-psych residents are all remarkable people, and I enjoy spending time with them inside and outside the hospital.
My advice to prospective residents is ...
… to pick a program that fits you and your needs. There are more places than one that will give you a great clinical education. My recommendation is to train somewhere that pushes and supports you to be the best you can be, while also encouraging your life outside your clinical work and the hospital. Duke has been that for me.
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