A Typical Week for a Third-Year Psychiatry Resident
Monday
I started the day with the gym and sauna — there are some nice gyms in the area, and we get a discount through Duke. I usually stretch and do some breathwork in the sauna before heading out.
The morning was an admin half-day — I scheduled one therapy patient, and the rest of the time was admin work and reading up on a topic related to one of my more complex med management cases. I grabbed lunch from Neomonde (their lamb kebab sandwiches are delicious), then drove out to Central Regional Hospital for a neuropsych half-day.
Central Regional is the state hospital that we rotate through as PGY2s and is really a unique experience. It’s about a 20-minute drive from Duke, and the view of Falls Lake never gets old — especially if I catch the sunset on the lake on my drive back home.
We typically see a new neuropsych consult, such as a possible movement disorder, new memory/cognitive concerns, atypical catatonia/mania or possible autoimmune encephalitis presentations. Dr. Ali is a phenomenal attending and teacher who has been helping me hone my neuropsych testing skills. At 3:30pm, he also leads MRI rounds, where we discuss an interesting case and practice reading the associated brain MRI. From 5 to 8pm, I moonlight at CRH for some extra income. My wife had made dinner (sushi bake), so we ate together and just relaxed for the night.
Tuesday
For my schedule, Tuesday, Thursday, and Friday mornings are med management clinics at Duke’s Behavioral Health Outpatient Clinic. Clinic starts early at 8am, so no gym today. Instead, I made coffee at home (beans from Crema, a local shop we like) and drank it on the balcony — the weather this time of year in Durham is perfect. The morning was packed with back-to-back med management patients. From 11am to 12pm we had our teaching session, today on personality pathology, led by an attending who had previously worked on a personality disorder unit.
The afternoon was Academic Half Day. From 12 to 2pm, there are either specialty track meetings, educational sessions, class meetings, or nothing scheduled. We are treated with delicious lunch—this week was from Alpaca and their Peruvian-style grilled chicken and Yuca fries were on point. Since nothing was formally scheduled, I caught up on work and hung out with some co-residents. From 2 to 3pm, we continued our psychodynamic/analytic series, and from 3 to 4pm, we had an outdoor lecture on ethics in psychiatry, focusing on involuntary commitment—a heavy but meaningful topic.
One of our co-residents brought a pie to share, which, along with the great weather, made the afternoon feel special. We wrapped up with our neuroscience series. I stayed late after Academic Half Day, catching up with a co-resident, then went home, finished notes from morning clinic, had dinner with my wife, and took a walk outside.
Wednesday
Wednesday is a full day at Changes by Choice, a private substance use clinic. I’m usually there 9:30 to 4:30pm, but my first patient canceled, so I took advantage of the time to go for a run and the sauna. Afterwards, I stopped by Mad Hatter for coffee and a pastry, where I bumped into a co-resident—always a nice surprise. Clinic was busy but good: mostly follow-ups, but I saw one new patient as well. I’ve gotten very comfortable managing suboxone and also have a few patients on long-acting injectable buprenorphine and naltrexone.
Clinic wraps up by 4:30pm. It’s about a 20-minute drive back home, and even in rush hour, traffic only adds five to seven minutes — amazing compared to DC traffic while I was in med school. After clinic, I walked over to my wife’s sand volleyball league game. Sometimes I join if they need extra players, but usually I just hang out and watch. There are a couple of sand volleyball leagues in the area, and they’re pretty laid-back.
Thursday
Med management clinic starts at 8am. I had no real quiet time at home this morning, so I kept the drive silent—no music, no podcast, just letting my mind wander so I could be more present with my patients. Each morning I work with a different supervisor, which has been invaluable—the breadth of perspectives sharpens my practice. Because we get many referrals from our inpatient unit, my patient panel is diverse: bipolar disorder, primary thought disorders, depression, trauma spectrum disorders, anxiety, eating disorders, autoimmune encephalitis, catatonia, and more.
The afternoon was one of my favorite clinics—Family Studies. We started with an hour of didactics on a family systems topic, then moved to live case work. I observed a co-resident through the one-way mirror while they received live supervision and feedback. Our first case was a couple, and the second was a family. Afterward, we came together as a small group to reflect and discuss—always one of the most engaging and practical learning experiences of the week. On the drive home, I called a friend from New York, then stopped at Anjappar for their chicken korma (saw an online deal and couldn’t resist—totally worth it). Enjoyed dinner with my wife and ended the night with some light reading from Tolin’s CBT book to prep for Friday’s therapy cases.
Friday
My reading list keeps growing with new recommendations, but recently I decided to reread/listen to The Autobiography of Malcolm X. I play the audiobook while getting ready in the morning, drinking coffee and commuting. The morning looked similar to Tuesday and Thursday: clinic started with a patient intake (about 1.5 hours) and then follow-up visits (30 minutes).
Friday afternoons are therapy-focused. I have a one-hour CBT case and a one-hour psychodynamic case, each followed by two hours of supervision (1 hour CBT, 1 hour psychodynamic). Afterward, I usually stay in clinic for another hour or two, finishing notes and tying up loose ends so I can start the weekend clear-minded.
This weekend, my wife and I decided to camp at Hammock Beach State Park. It’s about a two and a half or three-hour drive, and we arrived just in time to set up our car tent before quiet hours at the campsite.
Weekend
Saturday morning we walked around the campsite, then stopped by a local coffee shop before heading out for a long bike ride. Hammock Beach State Park is only about 15 minutes from Emerald Isle, which has a beautiful stretch of sand. Starting mid-September, bikes are allowed on the beach, so we rode along the shoreline, had lunch, and then drove back to Durham.
Sunday was slower: running errands, spending time at a coffee shop, and reading. On Sundays, I try to read therapy books to prep for cases—currently Cabaniss/McWilliams for psychodynamic, Wachtel for integrative therapy, Tolin for CBT, and Ghaemi for theory/philosophy/psychopharm.
Weekends vary quite a bit. About once a month I’ll visit family or friends in Richmond, VA. Before my shoulder injury, I would train Jiu Jitsu/Muay Thai at an MMA gym (many great MMA gyms in the area—some offer Duke discounts) or play pickleball with my wife and co-residents. When we’re feeling adventurous, we’ll take trips—the East of NC has plenty of beaches, the West has great hikes, and depending on the season we might even go snowboarding. Sometimes I’ll also pick up a moonlighting shift to keep my inpatient skills sharp and make a little extra income.
On quieter weekends, my wife and I like exploring Durham—new coffee shops (recent favorite is Assali, with baklava cheesecake, Biscoff cheesecake, savory pastries, and great espresso drinks), parks (Lake Crabtree at sunset is beautiful), and restaurants (favorites include shawarma from Albarraka, shiitake mushroom pizza from Mellow Mushroom, and Indian food at Lime & Lemon or Anjappar).
Read other Week in the Life narratives:
- Julia Tucker, MD, PhD (PGY1)
- Soji Ojo, MD, MPH (PGY2)
- Molly Fessler, MD (PGY3)
- Rachel Landrum, MD (PGY3)
- Carolina Nadal Medina, MD, MS (PGY3)