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A Day in the Life

Pierce-AndrewAndrew Pierce, MD

PGY-1

Background

Hi, I’m Andrew Pierce. Growing up as the son of a teacher and hospital administrator in East Tennessee I knew from an early age that I wanted to be a physician. I was enthralled with the complexity and pragmatism embodied by the science of medicine. I also saw how medicine could impact the lives of patients in powerful ways and the fulfillment that practitioners could subsequently experience. It wasn’t until the second half of my time at the Quillen College of Medicine that I found psychiatry to be a fascinating marriage of the art, science and humanity that drew me to this career. I often relate psychiatry to my first love, basketball. Both endeavors require knowledge and talent but a person cannot reach the pinnacle of performance without the ability to connect to other people on a profound level.

Why UF

My interview at The University of Florida was the first of 10 interviews that led me to crisscross the nation several times. I had every intention of leaving the southeast for a grand metropolis elsewhere in the country, but I found myself comparing every program I visited to UF and making the same conclusion each time.  UF – Psychiatry surpassed my expectations in all three of the categories I felt were critical for a program: ample resources, friendly people and a dedication to improvement.  We have new, modern facilities that allow us to serve our patient’s needs effectively (and in style) while providing a variety of clinical settings for residents to work.  Many programs across the country are struggling financially while UF is planning to expand the number of residency positions.  From the top down it seems every person I interact with is dedicated to making UF one of the top programs in the nation.  As residents we are encouraged to actively participate in shaping of our program and our input is truly considered when decisions are made.  Defining the standard of education, research and clinical experience is a primary goal for the program.  The greatest strength of the program in my opinion lies beyond the brick, mortar and mission statements however.  I was most impressed by the people I met at UF during my interview and my experience has only become more enriched upon becoming a part of this remarkable group of psychiatrists. I feel blessed to have found a home with colleagues and mentors who I consider more than just co-workers.

Typical Day’s Schedule

Oh, the life of a resident!  My days start around 6 am with a cup of coffee and a walk with my two dogs, Lola and Rufus.  I’m currently rotating on one of the UF Health Adult Inpatient Units.  I arrive around 7:30 and huddle with the medical students to plan for the day.  We have treatment team rounds before 8 which include nursing, case management, team therapists and administrative personnel.  The conclusion of this round table discussion triggers a coffee break.  Once we’re sufficiently caffeinated the attending, medical students and myself round on the members of our census.  Patient interviews, orders, planning and a free flowing dialog about patient care all take place during this time.  Our attendings make time to discuss teaching points as they arise throughout the day and learning is more discussion based than “pimping” based.  Once rounds are complete we break to finish the morning’s work and prepare for new admits.  The afternoons are spent admitting, interviewing and staffing new patients as they arrive and managing any problems that arise on the unit.  When not engaged in these activities we attempt to pass our knowledge on to the medical students rotating with us, catch up on studying or sit back and shoot the breeze.  We cover the ward until 5 o’clock and are usually ready to go home between 5 and 6.  Unless I’m on call, which happens about once a week, it’s free time until the next day after that.

How I Spend My Free Time

One of the best surprises I have had since moving to Gainesville is the abundance of things to do in the area and actually having the time to experience them!  I assumed I would be pressed squarely against the grindstone; however, I have found our work schedule challenging but totally reasonable.  I enjoy hiking in the area with my above mentioned pets and investigating the local eateries.  I meet most weeks with many of my fellow residents to grab a bite to eat, have a drink and mingle outside of the hospital and clinic.  On lazy weekend days I like to cruise yard sales and thrift shops with my significant other, Emma, and find furniture to refurbish in our makeshift garage workshop.  I’m looking forward to enjoying some of Florida’s more famous attractions.  Emma already has me on the hook for a trip to Harry Potter World, the program has arranged a canoe trip for faculty, residents and loved ones, and a beach plan is in the works!

Final Thought

Mark Twain once declared, “You may have a heart of gold, but so does a hard-boiled egg”.  Look for a program that’s more than lofty rhetoric and soaring self-praise.  Find a program that’s proud of what has been done but unwilling to rest on its laurels.  Find a program that helps you achieve your potential as a physician and a person.  Find a program that you can call home.  

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Deepak Davidson, MDDeepak M. Davidson, MD

PGY – 2

My background:

I was born and raised in New York. I attended SUNY Binghamton for undergrad then Barry University in Miami,Fl for a masters and finally St. George’s university in Grenada, West Indies for medical school.  

Why I chose UF:

I chose UF because it is an outstanding training program, with great facilities and excellent teaching staff. I knew one of the residents from medical school and was able to get first hand knowledge about the program. My interview visit confirmed what I learned from my friend. The one thing that stood out for me was the camaraderie among the residents. I knew I wanted to be at a place where the residents found it enjoyable to be and got along with each other. UF exemplifies those characteristics. 

Typical day’s schedule: 

Currently I am on the Blue Team on the inpatient unit at the VA. This team generally sees patients with mood disorders. There is one resident for the team and I see at most 12 patients per day. Normally I get there in the morning and get the census from the nursing staff. I then log on to CPRS and quickly review my patients’ charts for updates. The attending and I will see new patients admitted overnight and then round on the patients already admitted.  As the resident, I am responsible for the care of the patient and also responsible to manage medical care if appropriate.  I liaise with the attending, case management, pharmacy and the nursing staff to formulate a treatment plan for each patient. This allows for treatment and facilitates discharge planning as well. As the resident I am responsible for the patients until 5pm.  After that all calls will be handled by the ward call resident. 

How I spend my free time:

I enjoy spending time with my friends and family. My wife gave birth to our first child this past April.  I usually like to relax and just hang out. I enjoy both playing and watching sports. Though I am a New Yorker at heart, I think Gainesville is a great place to live. 

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Melinda Hansen, MDMelinda M. Hansen, MD

PGY – 2

My background:

I was born and raised in Minnesota but was looking to migrate to sunny Florida as my family will be relocating here in the near future. I went to University of Minnesota, Twin Cities for undergraduate and St. George’s University School of Medicine in the West Indies.  

Why I chose UF:

When I came to UF I was amazed at the resources available to the residents to include a variety of fellowships as well as clinical and research opportunities in new state of the art facilities. I was particularly impressed by the amount of clinical exposure that I would get to include private and public settins as well as procedure based exposure to electroconvulsive therapy and transcranial magnetic stimulation. I was also very excited to gain early experience in outpatient psychiatry which is integrated into the program starting second year. I was most enthused by the warm welcoming I received from the residents at UF throughout the interview process and I felt that the residency program had a “family” like feel to it which was an important attribute.

Typical Day’s schedule:

Currently I am rotating at Shands Vista East inpatient unit which has 19 beds designated for patients with psychosis. In the morning we generally start rounding on the patients about 7am with the attending, nursing staff and medical students. During this time, we review the patient’s status, current treatment plan as well as discharge planning. Of the 19 beds, I am responsible for 9-10 of the patients and typically discharge 2-3 daily as well as admit 1-3 patients per day until 5pm. While the attending is ultimately responsible for the final treatment plan, I am generally permitted to make medication changes with his discretion. During lunch time, we generally have a lecture series on Tuesdays and Thursdays for 1 hour which we are currently using for PRITE review as well as Grand Rounds on Fridays. Additionally on Wednesday afternoons I have outpatient clinic from 2-5pm which allows for more diversity in my weekly routine and enables me to maintain continuity of care as I can continue seeing my recently discharged patients from the inpatient unit as well as take on a few psychotherapy cases. We also have psychotherapy group supervisory on Thursday afternoons which is a great venue to further explore some of our unique and challenging cases.

How I spend my spare time:

There are a variety of activities to get involved in throughout the year to include nature preserves for hiking, nearby springs for swimming with the mantees, cave scuba diving, and horseback riding as well as kayaking or sailing on the UF lake which is free to residents. Additionally, there are a variety of restaurants in the down town area with diverse cuisine and it is always a pleasure to take in a play at the Hippodrome theater. And of course if you are a fan of football, the Gator Stadium is always a popular destination to take in a game. As I have most weekends off, I also find it relaxing to take a drive to nearby St. Augustine beach, Tampa Bay area to visit the Florida Aquarium, and Orlando to visit the many theme parks to include my personal favorite Epcot Center with the food & wine festival.

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Anuja Shah, MDAnuja S. Mehta, MD

Outpatient Chief Resident

PGY – 3

My background:

Undergrad: University of Florida, Medical school: University of Florida, Hometown: Orlando, Florida

Why I chose UF:

I chose UF because I was already exposed to the program as a medical student at UF. I was very impressed with the quality of the faculty and diverse training experience that is provided in this residency. My other reason was wanting to be near my family.

Typical day’s schedule:

As a third year resident, I have month long rotations. In addition to inpatient and C/L, I will do addiction, geriatric psych, child and community rotations this year. A typical inpatient rotation starts with rounds in the morning starting at 8AM, didactics at noon twice a week with grand rounds usually on Fridays and the afternoons consist of 2 half days of clinic, 1 hour of supervision and completing my notes on the unit. Residents interested in child fellowship can apply during Fall of this year. Third year residents take no call so my evenings and weekends are free. Moonlighting opportunities are available if you have a state license.

How I spend my free time:

I enjoy reading and spending time with my husband. Gainesville is a college town with plenty of outdoor activities which include canoeing, kayaking, tubing in the summer, movies, football games in Fall. I also drive to Orlando and Tampa which are both only 2 hours away to go to theme parks, shopping or visiting family.

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Vikram Vaka, MDVikram Vaka, MD

Outpatient Chief Resident

PGY – 3

My background

I was born in India and grew up in Ohio but I had always wanted to live closer to the ocean.

Why I chose UF:

UF “just felt right” of every program I visited. I was impressed by the diversity of experiences that residents are exposure to, the various fellowships offered, and the excellent facilities. However, I was most impressed by how friendly everyone I met was, how the residents got along well with each other and all had very positive things to say about their experience at UF.  The residents all had great camaraderie and had nothing but good things to say about how friendly and earnest the faculty were. This was most apparent to me when I witnessed the assistant program director, covertly pull a harmless practical joke on one of the residents as payback for a practical joke the resident had played on him earlier that day. The fact that the residents and attendings felt comfortable joking with each other in this manner really resonated with me.

Typical day’s schedule:

Currently I am on the Brain Stimulation Unit (BSU), an inpatient unit specializing in administering ECT. The day to day schedule varies a bit based on the specific rotation but as is true of many rotations here, I begin my workshift at approximately 8AM. At the BSU, a typical day starts with treatment team rounds during which the attending, resident, and nursing staff review all of the patients on the unit, discuss overnight issues, and make tentative treatment decisions. The attending, resident, and case worker then meet with each patient in the conference room. The resident is responsible for any admissions or discharges to the unit until 5pm at which time their shift ends.

One of the things I really appreciate about the program is that many of the attendings trust the residents and give them excellent autonomy regarding making the diagnosis, coming up with the treatment plan, and caring for the patient. The attendings and residents often make decisions about how best to treat the patient as a team. The attendings have the final say regarding treatment decisions, which acts as an important safety net. However, if the resident comes up with a reasonable treatment plan, many of the attendings will trust the resident’s plan and give them the go ahead. This autonomy that residents have, I find is invaluable in easing the transition from supervised training to individual practice.

How I spend my free time:

In terms of ways to spend your free time, Gainesville has a lot to offer regardless of where your interests lie. If you like nature there’s some beautiful nature trails, hot springs, lakes, caverns, a bat house and even an artificial rainforest populated with butterflies from all over the world. If you like art, there are several art festivals, various museums, and even a theater. If you’re a sports fan or like the night life, Gainesville is a university town so there’s certainly no shortage of either. The Gator games can be pretty epic and there are residents that like to have fantasy football every year. If you would prefer to get together with friends to play board games, video games or to watch a movie, there’s a few residents in every year that like do precisely that. And if you like traveling, Gainesville is only a 2-3 hr drive away from Orlando, Tampa, St. Augustine and Daytona which puts you within a short drive away from multiple beaches, and amusement parks (Busch Gardens, Seaworld, Disney and Universal all of which offer a surprisingly affordable annual pass for Florida residents). As for me, I spend my free time doing all of the above and every so often save up five vacation days to go on a nine day road-trip through Florida, driving from Gainesville to the Everglades, Fort Lauderdale, Miami, Key West, and back.

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Turner_AnaAna Turner, MD

Chief Resident

PGY – 4

My background:

I grew up in Florida and left to go to Washington College in MD for undergrad, but quickly learned to appreciate Florida weather and returned to UF for Medical School. I had my first child in between my 3rd and 4th year of medical school, Olivia, and then had Joey during intern year! I’m expecting my third child now, and will be the first to attest to how great Gainesville is for family life.

Why I chose UF:

Even before attending medical school I had always planned on doing outpatient child psychiatry, so I chose UF for it’s great fellowship program and the location for my family. However, it turned out that both outpatient and child psychiatry are not at all what I like the most, so luckily I’ve been able to experience a great General Psych training program along with all the other fields within psychiatry with UF’s fellowship programs in Forensics, Addictions, Child & Adolescent, and rotations within Geriatrics, Community, Emergency, C/L, Sleep Medicine, Pain Medicine, and tons more.

The other main reason I picked UF was the residents. I spent time with many of them as a medical student at UF, and they were always cheerful and fun, and I have noticed this has been true of all of our residency classes throughout my stay here. When you are working in a stressful field it is so important to enjoy working with those around you, and UF has not disappointed me!

Typical day’s schedule:

My 4th year is a little different that others in my class simply because I have the added administrative role of being one of the chiefs. Luckily I have a great co-chief, an amazing group of residents, and a wonderful training director, so it hasn’t been too different from my classmates (other than all the meetings…). I have a few “selective” rotations left to complete to meet my ACGME requirements, but otherwise have fulfilled most of my inpatient and ER requirements so I get to focus on completing rotations I’ve always wanted to try or dedicate time to my APA Fellowship in Community Psychiatry, writing, and studying for the Boards. We complete all of our call in years 1 and 2, so other than administrative duties my nights and weekends are free, unless I want to moonlight at our inpatient unit on weekends to help pay for family trips or other major expenses for the home (available to PGY3s and 4s). I mostly start my day at 8am and end clinical duties by 5pm.

What I like best about being a PGY4 is the independence we have from our attendings to truly get a “transition to practice” experience. I run inpatient services as if I’m the attending, and most of my clinic patients I’ve been following for almost 3 years now, so I can really treat them thoroughly. I spend one half day a week in clinic, and I have a handful of therapy patients that I’ve had for 3 years, others that we’ve finished CBT or other therapy treatments that I continue to follow for medication management, and if I have an opening I can offer to follow up an inpatient in my clinic as a new patient. We have a large number of “specialty” clinics that I’ve been able to experience, in particular I worked with our Women’s Health expert in the prenatal psychiatry clinic, and our Movement Disorders experts in the Deep Brain Stimulation clinic, so I feel I’ve had a really well rounded training experience.

I try to volunteer regularly at our Helping Hands Clinic, a free clinic with multiple services, with psychiatry being run by UF Psychiatrists 4 nights per month, and has been a great experience throughout residency to learn about treating “the whole patient,” which isn’t always just about medication. I also have supervision 1-2x per week to help me evaluate my therapy cases, find strategies to deal with problems I’m facing, or even get advice for my upcoming job search.

How I spend my free time:

My free time is spent with my husband, 4yo daughter, and 2.5yo son. We love all of the festivals, theme parks, and outdoor experiences that the area has to offer, and make day trips to the beaches on both coasts or around Florida to visit extended family. I also just love hanging out with my friends from residency or other groups I belong to in town. I can go outdoors year-round, and even though it’s hot during the summer months there are plenty of water parks (free or theme parks) to make it bearable. We love all the state parks and have tried to visit as many as possible around the area, and also try to make it to a few college or professional athletic events throughout the year, Go Gators!