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PGY-4 Spotlight

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PGY-3 Clinical Rotations:

  • South Bay Guidance Center county clinic for severely mentally ill patients in the community, high TAY and Spanish-speaking population

  • Survivors of Torture International clinic providing psychiatric care to asylum-seeking patients, most with PTSD

  • Women's Reproductive Mental Health elective treating mostly perinatal mood and anxiety disorders

  • College Mental Health Program elective working with UCSD students

  • Vista Balboa Crisis House which provides respite care for patients in crises who do not require inpatient admission

  • Psychodynamic therapy cases at the UC San Diego Outpatient Psychiatric Service (OPS)

  • San Diego Youth Services working with at-risk youth including those struggling with homelessness and LGBTQ issues

Average weekly hours:

  • Least 35, Most 45, average 40 hrs/week

  • Community track has call only one holiday per year, averages only 1-2 hours of work; otherwise, no inpatient call!

Get to know Al

Background & Education:

I grew up in the Chicago suburbs, went to college at Washington University in St. Louis for psychology/Spanish and division III track and field and returned to Chicago for medical school at Rush University. Driven by a lifelong desire to live in California and a specific interest in community psychiatry, I moved to San Diego!

Career Goals/Interest within Psychiatry:

  • College Psychiatry - Beginning residency, I planned to pursue child and adolescent psychiatry (CAP) and enjoyed my one-month inpatient child and eating disorders rotations in PGY-2. I joined the San Diego Academy of Child and Adolescent Psychiatry (SDACAP) chapter for local networking and the national American Academy of Child and Adolescent Psychiatry (AACAP). Through this network I learned about college psychiatry and joined a mentorship group, which has helped me refine my career interest to transition age youth (TAY). I have decided not to pursue CAP fellowship and am open to discussing the nuances of that decision making process.
  • Community Psychiatry Track - this has provided me with the opportunity to work in diverse settings and extensive learning about interdisciplinary teamwork, health systems, cultural competence, advocacy, and the daily use of the biopsychosocial model.
  • Psychotherapy - I am part of the San Diego Psychoanalytic Center fellowship which offers monthly lectures and mentorship with experienced local analysts during PGY-3 and 4 years. I have had 8 different psychotherapy cases throughout residency (CBT, complicated grief therapy, psychodynamic therapy). I also participate in my own personal psychotherapy; the program offers one year of free therapy during residency.
  • Typical Week

    AM: I sleep in! Then meet my friend for a trail run at Iron Mountain. This is one of my favorite routes for running or hiking that is only a 35 min drive away, ~5 miles with a rewarding view. On our way home to we stop at Pannikin coffee for a latte and a muffin.
    PM: Chill night doing food prep and watching Curb Your Enthusiasm.

    AM: I typically wake up at 6:30 then head South to Chula Vista for a full day at South Bay Guidance Center, 9-5. This is the longest commute of my week, from La Jolla to Chula Vista, and is against traffic, only 25 minutes with some great ocean views. I have 2 peers and we take a lunch break together. 
    PM: After clinic, once per month I assist with the UCSD Free Clinic which is a medical student-run free community clinic where psych residents can volunteer to teach medical students in patient interactions. On a night I don’t have Free Clinic, I might go for a bike ride through Torrey Pines, one of my favorite parks.

    AM: Starting the day setting up my home office for the Survivor's of Torture International clinic, which is currently all virtual. I am learning how to provide trauma-informed, culturally competent care. This morning I meet with patients who speak Arabic, English, Spanish, and Haitian-Creole.
    Noon: Eating lunch and reviewing my afternoon patients. I am fortunate to be able to walk to my afternoon Women’s Clinic in La Jolla. I have a small caseload of women and enjoy getting to know them and having more frequent follow-up. From 4-5 we have excellent didactics on women’s reproductive mental health. 
    PM: Swim at the local Jewish Community Center pool, a nice, affordable gym that’s easily accessible in La Jolla close to the VA. Afterwards celebrate taco Tuesday, fish tacos abound and are the perfect meal for a pescatarian. Some favorites include Taco Stand and City Tacos.

    AM: Walk over to the College Mental Health Program situated next to the UCSD campus and shadow a psychiatrist or therapist for a few patients. It’s nice to experience different teaching styles and a focus on lifestyle treatments as well as psychopharmacology. Afterwards, we engage in one hour of case discussion which may include discussion of OCD, ADHD, substance treatment, etc. 
    Noon: Meeting my psychodynamic supervisor for 45 mins to discuss my therapy cases. This is my favorite meeting of the week! Afterwards I’ll drive downtown ~15 mins to the crisis house, listening to a Spanish Podcast like NPR's Radio Ambulante to keep my language skills fresh. If I have time, I will eat my lunch in the grass in Balboa Park. Then I head in to the crisis house, where I see 1-2 patients. When we are on call in the hospital we often send patients here from the ED.
    PM: Run club at Milestone Running store. Sometimes there are up to 60 people, all ages and abilities. We do runs through a hip neighborhood called North Park. When I first moved here this is how I met new people!

    AM: Didactics day! Lectures range from a Jeopardy-style "Mind Games" competition between the residents and faculty to psychopharmacology talks by Dr. Steven Stahl. After the first lecture, the residents separate by class; last week the PGY-4’s learned about cardiac consequences of psychotropics.
    Noon: I have personal psychotherapy during the lunch hour, since PGY-1. The program leadership helped me find a therapist and appointment time that fits in my schedule. We receive one year of free psychotherapy provided by the program, if you choose to participate. Since I am in the Community Track, we have a full day of didactics including group supervision of interesting cases. This week we had a lecture on the infrastructure of the San Diego County behavioral health system. 
    PM: Time to decompress from all the Zoom, going for a walk with my partner or reading on our patio. I’m currently working through “The Body Keeps the Score” (purchased with my academic funds). 

    AM: Seeing my psychotherapy cases. 
    Noon: Treat myself to a Poke bowl for lunch. Working from home with San Diego Youth Services where I get 90 minutes for an intake with a teenager. It’s great to have this amount of time with a patient. Volume is low so if I don’t have patients, I use this time to do work on my senior project.
    PM: I’m usually done with work by 4 PM and might meet my classmates at a local craft brewery like Modern Times.  

    AM: Have coffee, grab my wetsuit and get ready to surf! A group of co-residents and I took lessons intern year and this is one of our favorite ways to decompress, typically at Scripps Pier, Del Mar, or Ocean Beach. Sometimes we see dolphins! When we finish we pick up some acai bowls for breakfast. Chores and groceries in the afternoon.
    PM: Live music, anything from jamming with my partner at home to seeing a big performance. Recently rocked out to Tramped by Turtles at Humphrey’s by the Bay. After a weekend of fun and sun, ready to rinse and repeat the week!

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