A Week in the Life (Jamie Courtland, MD, PhD)

A Typical Week for a Psychiatry Resident in the Physician-Scientist Track

Monday

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  Morning: I wake up around 6am and get ready for work. Mondays are my early clinic days. I’m doing an elective at the Treatment Resistant Depression (TRD) clinic at the Veteran’s Affairs (VA) hospital, and our TMS treatments start at 7am. I get ready, brew my coffee, and grab a quick bite for the short seven- to eight-minute drive to work. I see patients in the TRD clinic from 7am-noon, which usually includes a really interesting mix of modalities: two different TMS options (Magstim -figure of 8 coil and Brainsway -H coil), ketamine, ECT, and occasionally, some alpha stim sprinkled in. I’ve really enjoyed learning about the different interventional modalities and discussing the (sometimes minimal/burgeoning) literature with my attendings. I wrap up notes by noon and have lunch (usually outside for some sunshine!) before heading to my afternoon clinic.

• Afternoon: I head over to the Duke Autism Clinic by 1pm for the afternoon. From 1-4ish, Dr. Cho and I see patients (generally together) either via Zoom or in person for medication management. It’s been a great experience to gain more comfort with stimulants and complicated med regimens for a population that can at times be significantly more sensitive to medication adjustments. I also really appreciate Dr. Cho’s approach to treating the whole family system.

• Evening: Quick drive home, then decompress with my husband, Maury, and dog, Lily, on a long evening walk through the neighborhood. Occasionally I’ll also workout, but often I use Mondays as my day off from exercise. We have dinner and unwind with an episode of TV (British murder mysteries currently).

Tuesday

• Morning: I get up around 5:45am to get out for a nice morning run before work. Luckily, there’s about six miles of trails in my neighborhood, so I can lace up and trot out the door. I aim to be back by 7am and get ready to leave for clinic by 7:50am. My morning clinic is a quick five-minute drive away at a stand-alone VA office building. I see patients from 8-11am for medication management at the OOO VA clinic, which is focused on veterans that have served in the most recent wars (Iraq, Afghanistan, etc.). Therefore, the clinic skews towards younger veterans and tends to involve PTSD symptom management. I staff cases with my supervisor at 11:30am, and then wrap up notes before heading over to our in-person academics for the afternoon.

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  Afternoon: I drive seven minutes down the road to the main Duke campus for lunch (provided at Academic Half-Day!) and didactics for the afternoon. It’s always a highlight to catch up with my co-residents in person before classes start/in between each lecture. Once per month, my PGY3 class has process group (group therapy) at 5pm at the end of Academic Half-Day, as a continuation of the weekly process group we had as PGY1s.

• Evening: On my drive home, I call my parents. I head home for the evening and catch up with Maury over a dog walk and dinner. I either take some time to watch an episode of TV (or perhaps fall asleep on the couch while pretending to watch), or if my schedule looks busy the following day, sometimes I take some time to read up on my new patient intakes scheduled for the next morning. I head to bed by 10pm. 

Wednesday

• Morning: I get up around 5:45am to do a morning workout (lift or spin depending on my mood). I get ready for work, grab my coffee and a quick breakfast, and head over to my office at the main VA hospital campus around 8am (occasionally 8:30am if no one is scheduled for the first slot of the day). I see patients for med management from 8-11:30am, often including one, if not two, new intakes. I staff my patients with my supervisor from 11:30am-12pm. I grab some lunch outside on a picnic table if the weather is nice, and then head back to my office for the afternoon. Wednesdays are my full day the VA, which is a nice change from the rest of my week because I don’t have to shuffle between clinics half-way through the day. 

• Afternoon: I have a 1-2pm meeting with my VA treatment team (an interdisciplinary group of providers including psychologists, social workers, psychiatrists, and pharmacists), where we discuss difficult patient cases and/or treatment strategies. These have really helped me learn about all the various wrap around services available at the VA. Then I see two patients (one virtual, one in person) from 2-4pm for psychodynamic and supportive psychotherapy. I staff these cases my supervisor afterwards from 4-5pm. She’s been wonderful in helping me come up with effective therapeutic strategies, as well as reminding me each week to focus on self-care. I finish up notes after staffing. I’m still admittedly working on paperwork efficiency. I head home around 6/6:30pm.

• Evening: Usual routine of an evening stroll with Maury and Lily, which often feels extra needed after a packed clinic day. We have dinner, I do a little reading for my therapy cases the next day, then head to bed around 10pm. 

Thursday

• Morning: Usual wakeup time of 5:45am to get a workout in and get ready before heading to the VA for our resident didactic seminar at 8am. I see my CBT therapy patient at 9am, then have a few meetings (CBT didactic seminar and CBT supervision) before logging onto Grand Rounds virtually while having lunch. 

• Afternoon: I head over to our Family Studies clinic for an afternoon lecture at 1:30pm, followed by two, hour-long cases in the afternoon where I am the therapist for one and observer for the other. Family Studies is a unique therapy experience where we work with either a couple or a family. For example, my case consists of a family with three kids and two adults. A large focus is learning how to work effectively with all the family members in the room. I have a supervisor and a team of other residents and psychology graduate students watching my session behind a one-way mirror, providing real-time feedback as needed. 

• Evening: I am usually pretty drained after Family Studies, so I often come home, eat some dinner and melt into my couch for a few hours before going to bed. If I’m feeling invigorated, I’ll go out to my vegetable garden and tend to my tomatoes/pick anything that the deer have managed to miss to add to our dinner, followed by the inevitable couch melting. 

Friday

• Morning: Friday is my research day (I’m on the physician-scientist track). I often give myself an extra half-hour of sleep on Friday mornings, then get out for a morning run. I come home, get dressed, and am sometimes treated to a fancy flat white coffee courtesy of Maury. I either head to lab in person or log on to a Zoom meeting with my research advisor by 9am. Right now, part of my research is conducive to remote work, which is a big shift from when I used to do animal research in my PhD. I am working on a project analyzing differences in executive function and sensory processing in autistic children with or without comorbid ADHD and anxiety. To do so, our lab uses a variety of modalities, including neurophysiological data (ex: EEG, eye tracking), caregiver reports, and clinical interviews/observational studies.  In meeting with my advisor, we discuss my progress on a manuscript and some recent data analyses. I then spend some time working on editing my manuscript and/or debugging code for my EEG analysis.

• Afternoon: I have a weekly EEG analysis meeting where everyone from the lab working with EEG data comes together to troubleshoot issues in the analysis pipeline. Afterwards, I take a break for lunch. If I’m working remotely, I usually try to enjoy lunch outside on the deck with Lily before heading back in to continue writing/coding for the rest of the afternoon. If I’m in the lab, I try to catch up with Diana, one of the other PST residents who’s also working in the same lab. 

• Evening: Friday nights vary, but often include either going out to a restaurant for dinner or catching up with friends for the evening. Maury and I are pretty big foodies, so we love sampling the restaurant scene. We decide on Krill, a great Southeast Asian restaurant in downtown Durham, conveniently located next to one of our favorite breweries, Ponysaurus. Afterwards, we debate ice cream options (The Parlor vs. Two Roosters vs. Simon Says Dip This), and Maury chooses Simon Says Dip This. We head home, take Lily out for a quick stroll, and head to bed.

Saturday

Most weekends during PGY3 I don’t have to work, other than a few weeks of call per year. On weekends I am free, I usually try to spend one weekend day socializing and one resting/catching up on the basics, like laundry. Maury and I have a tradition of starting our Saturdays with Isaac’s bagels (we are both HUGE bagel fans, and until a few years ago, bagels were sorely missing from the Triangle food scene…fortunately Isaac’s opened during the pandemic and we’ve been supporting them ever since). Later, I call up one of my co-residents, Andres, and plan to meet up for a run. Afterwards, he, Maury, and I lounge by the pool for the afternoon. We decide to go out again for dinner and settle on one of our favorites, Little Bull, a Mexican-influenced/new American restaurant. 

Sunday

I sleep in a bit, then get up and take Lily on a long leisurely morning walk. We see lots of wildlife, including multiple herds of deer, birds (including a heron by the lake!), bunnies, and of course, lots of squirrels. I spend the rest of the day getting some exercise, planning groceries/meals for the week with Maury, catching up on laundry, tending to the yard/garden, and generally enjoying the sunshine. I call my parents and a few friends scattered across the country to catch up. By late afternoon, I’m ready to put my feet up. Maury cooks dinner while I spend an hour prepping for Monday’s clinics. After cleaning up, I head to bed to start the next week. 

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Read other Week in the Life narratives:

• Lizbeth Leapo, MD (PGY1)
• Cameron Blount, MD (PGY2)
• Andres Fuenmayor, MD (PGY3)
• Lara Thibodeau, MD (PGY4)