Fp-psych(ese)! My favorite new word (aka neologism!)

Time flies by quickly- I am now a third year resident: I am almost half way done with my training! I remember the beginning of my first year of residency: orientation during July, a month of inpatient psychiatry and inpatient family medicine in September. And, then, all of us (or almost all of us, fp-psych residents) left together to attend the Medicine- Psychiatry conference in Chicago (www.assocmedpsych.org). This year, the med-psych conference is 9/30-10/1, in Chicago, and almost (all) of us are going to it, except Matt.

I remember it took me a few months during my first year to "switch", so to speak, between being on a  family medicine rotation to a psychiatry rotation and vica versa. I, first and foremost (like any intern quickly learns their first few months) had to learn a new hospital system (putting orders, who to consult etc), and then also two systems in two different departments. For example, when a patient is transferred out of inpatient psychiatry, a discharge summary is needed. When a patient is transferred from inpatient family medicine to another service, there is no need for a discharge summary. Imagine how confused I was, when I switched from inpatient psychiatry my first year, to inpatient family medicine, writing unnecessary discharge summaries! It sounds funny to remember this now, but at the time, it was NOT funny to me after wasting time writing discharge summaries! I learned to check with other fellow residents about "technical" details (thats what I like to call them!).  

During second year, I learned to feel comfortable with belonging to two worlds, two groups of people, two departments. It also meant having more friends, more people to hang out with and more social events! I also learned how to be on my own track of self-study, compared to peers in categorical training (family medicine and psychiatry), who felt to me were 6 months ahead of me (which they were, but I was also ahead of my peers in other spheres of knowledge, whether it be family medicine or psychiatry). Starting second year, I also started to see patients at the Counseling and Health Promotion clinic (CHPS), where I began  learn to do psychiatric evaluation/diagnostics and medications checks, a year ahead of my psychiatry categorical peers. And in CHPS, I also am able to ask about medical issues that may complicate my patient's mental health. This gives me another dimension into understanding the patient's world and integrating family medicine and psychiatry after finishing my intern year.

By now, being a third year resident, I feel more comfortable in my skin. The best way I can explain it- it is like being bilingual, and I like speaking fp/pscyh(ese). This is what I call it! For example, when being on inpatient family medicine service, it becomes second nature to me to pick out some psychiatric details/medicines that may not have been noticed or asked. It also becomes second nature that when rounding on inpatient family medicine, that I can answer psychiatry questions that may come up. On the flip side, when I am on psychiatry consults/calls/inpatient psychiatry, it is also second nature for me to assess the medical needs for my psychiatric patients and bring to attention medical issues that may have been missed before.

Check out the upcoming medpsych conference and medpsych association: http://www.assocmedpsych.org/.

More to come soon!

--Nesrin