As a part of PRMS’ ongoing commitment to behavioral health we invited Ulrick Vieux DO, MS, Psychiatry Residency Program Director at Orange Regional Medical Center in Middletown, NY, to be featured as our guest blogger this month.
As the founding Psychiatry Residency Program Director at Orange Regional Medical Center in Middletown, NY, I wanted to ensure that the residents who have entrusted us with their training would have a program that would expose them to opportunities that more established programs have for their residents. My mentors have always taught me that it is important to understand your strengths, but is equally if not more important to understand your weaknesses. Hence, a way that new programs can expose their residents to the breadth that the specialty of psychiatry has to offer is by establishing relationships with outside organizations. The local district branches of the American Psychiatric Association provide an excellent opportunity to provide support for residents. Our local district branch, the West Hudson Psychiatric Society, has provided an excellent service to our residency by making mentors available to our residents.
Two of our residents who have taken full advantage of the program share their experience here:
Eric Jarmon, DO, Associate Chief Resident:
Last year, when the residents in our program were informed that we would be starting a mentoring program with our local chapter (West Hudson Psychiatric Society of the American Psychiatric Association), I had a few concerns. As a second-year resident, I felt I had enough on my plate. Trying to juggle the demands of my rotations, in addition to the mandatory meetings with my two supervisors from our program, seemed like enough responsibility. A mentoring program on top of this seemed a bit extraneous to me. But with the strong encouragement from our program director, I felt I had little choice but to participate.
Last fall, the administrator for the West Hudson Psychiatric Society sent questionnaires for the residents to complete. The questions asked about both our personal interests and our professional interests specific to psychiatry, such as pursuing fellowships in sub-specialties including child and adolescent psychiatry, forensic psychiatry, addictions, and geriatric psychiatry. As the representative resident/fellow for the West Hudson Psychiatric Society, I collected the completed forms and sent them back to the administrator. Within a few weeks, each resident was matched with a mentor, usually an executive board member for West Hudson. Once matched, the resident mentee was responsible for reaching out to the assigned mentor to arrange for future meetings.
I had concerns about this matching process, too. I didn’t know who my mentor was going to be, and I wondered if we would have anything to talk about. The first meeting was via Skype. This initial contact felt like a meet and greet, each sharing personal experiences of how we ended up in Psychiatry. We also talked about interests and topics for discussion of future meetings. Personally, I had a pressing issue that I wanted to discuss: office politics. I dove right in talking about my situation and the frustration I was feeling. To my surprise, he had a similar experience and provided some very helpful insights. I quickly began to realize that I had access to a seasoned professional who had a wealth of knowledge and experience to share. It was also a relief to have such a resource who wasn’t affiliated with work. I didn’t have to worry about saying something that might come back to “bite” me later, which also made having a mentor advantageous.
Over the course of the next few months, my mentor and I went from meeting once a month to every 2 weeks. I usually make the drive from Orange County to Rockland County after work on Fridays to visit his office after work. Skype wasn’t quite as personable as meeting face to face, so we usually meet for lunch or later at his office. The agendas for our meetings are less structured now, since we have gotten more comfortable with each other. Sometimes our sessions include discussing a book on problem solving that I read for the first time and my mentor re-read from his fellowship. Other sessions may focus on cases that I am seeing on my rotations. Another topic of discussion has been private practice and documentation. As a resident, what better resource to have than someone who has been in private practice for several years and who also works as a consultant reviewing medical records? Again, I cannot emphasize enough what a valuable experience mentoring has been for me.
Other residents in my program haven’t been as involved with the mentoring program. I can certainly empathize with them; residency can be challenging, stressful, and time-consuming. Having another item on your plate that isn’t required can feel like too much. Like me, they probably had doubts about what mentoring would look like, what to say, or what topics to discuss. After the first couple of meetings, I realized the benefit of having a mentor far outweighs concerns about time commitment or travel. What my mentor has offered me is a fresh perspective on daily struggles of residency that I wouldn’t have from someone working within my program. Scheduling and making time to meet is no longer a burden now that I realize what an asset the experience has been. I find myself looking forward to talking to my mentor. Whether the topic of discussion is patients, getting along with co-workers, documentation, private practice, travel, or where to get my new bike fitted, I can only hope my mentor finds our meetings half as rewarding.
Stephanie Kuntz, DO:
I am in a fairly new psychiatry program and it has been one of the best experiences of my life. The faculty has been very focused on my education and has made the process of caring for patients much more straightforward. However, there are always those lingering questions about my management of patients: “Did I ask all the right questions I could have asked?” and “Did I establish that therapeutic relationship?” From career goals to patient care, I have had so many questions, that at times, the thoughts were overwhelming.
During my second year of residency, I received a questionnaire that asked about what I looked for in a mentor. I was asked what my interests were, what I would feel comfortable discussing, and even about the distance I was willing to travel to speak to my mentor. I filled out the form, sent it out, and continued to question my clinical decisions until someone reached out to me and told me that there was a mentor for me from the West Hudson Psychiatric Society. Then, we were able to build a relationship that provided the guidance I needed.
Through my experience with this mentorship program, I am truly fortunate to be one of the residents that has an attending to speak to regarding my career as a psychiatrist. I was paired with an attending who worked with children, adults, and within the forensic psychiatry field. We had initially met face to face to discuss what major topics to delve into for future meetings. After that, although we have not met in person, FaceTime has been a great way to speak to each other and enabled us to meet more regularly, despite the distance.
There are so many ways in which this mentorship has benefited me. For example, my mentor has guided me in developing a further understanding of transference-counter-transference with some of my patients. Because of my lack of experience, I would always wonder what I did wrong if a patient had manifested either overt or covert aggression during the session. I would also find myself feeling uncomfortable with a patient and not understanding the reason for that emotion. My mentor allowed me the time to take a step back and re-evaluate the situation in a safe setting. My mentor enabled me to determine that something the patient had stated had resonated with something in me. As my mentor explained it, “this is a way of having you feel what they are feeling, that they cannot express for themselves.” Because of my mentor, I feel that I can more effectively use my own emotions in a clinic setting in order to build a better therapeutic relationship with my own patients. Having someone take that time to process a case with me, from beginning to end, has been very beneficial.
In addition to patient interaction, my mentor has enabled me to make more sense of where I want to go in my future career as a psychiatrist. Working with my mentor has enabled me to take a step back from those general questions that seemed so overwhelming before and really think things through. Those questions have ranged from deciding on whether or not to work with a select population (I have finally decided on children and adolescents), to deciding the environment in which I want to work (rural vs suburban vs urban), to whether I want to work in a private practice, an inpatient hospital, or the outpatient clinic setting. This last point is undecided; however, I’ve learned from my mentor through his many anecdotes about his experience and his words of wisdom, that I have time to decide and that choices are not set in stone. My indecisiveness was always a concern before, but my mentor has enabled me to feel more comfortable with the unknown.
The West Hudson Psychiatric Society has been a great example of how mentorship/supervision from an attending outside of the hospital can be an asset to the next group of doctors coming into practice. Through my mentor, I have been able to build a wonderful networking relationship that provides guidance and clarity. His anecdotes have helped me to learn what I want my future in the field to look like, as well as how to more appropriately process my clinical cases using both my medical knowledge and my growing knowledge of therapy. Above all, I have learned that, as a resident, I do not have to go through this next phase of medicine on my own. My mentor was very supportive when I came to him with frustrations and with triumphs, and I will always be grateful for that.