Our PGY-3 looks something like this:
Starting patient load
-30 pharm transfers from prior residents
-2-3 new combined pharm/therapy patients + 2-3 carryover therapy cases from PGY-2 year
-2 child therapy cases
1-2 intakes per week, done w/ attending faculty
Panel by the end of the year is probably in the neighborhood of 75-90
Tons of supervision: 3 hours general/pharm supervision, 1 hour adult psychodynamic supervision, 1 hour child supervision, 1 hour group CBT supervision, 1 hour group dynamic supervision. I'm doing a little extra CBT supervision as well
In theory many of our patients are held on teams with collaborating social workers or psychologists, and in addition to this we've hired several case workers for both our general and specialty (ex. first episode, chronic psychosis) teams
In addition to the above we have some half days of the week in integrated care, homeless health, bridge clinic, etc.
WOW! You're so lucky. My PGY-3 was:
- One day VA clinic where you inherit all the cases from the previous PGY-3 + any new one or f/u they could cram in your schedule from a recently retired attending (whose primary drug of choice was Xanax for PTSD). These patients were not checked out with an attending unless you specifically ask to have them checked out. Then 30 minutes of
supervision at the end of the day, which was commonly useless b/c both you and the supervising attending just want to go home at the end of the day.
- Two days of clinic at the university hospital where you inherit all of the panel from a previous PGY-3 (minus the 30-40 easy ones they kept for themselves into 4th year) and do 1 new intake per clinic day. No separate supervision hours on these days, but you did have to check out every single patient and then briefly see them with your attending.
- One day of clinic at the local CMHC which was 2 new intakes per day + 11 follow-ups on the worst EHR you've ever used. No checkout on these days either, but the day ends with 30 minutes of supervision with a burnt out CMHC attending who commonly
supervised via saying "Ok, any questions today? No? Ok, see you next week!"
- One day of didactics (4 hours) + supervision (3 hours in afternoon: 2 hours psychiatry supervision, 1 hour psychotherapy supervision)
- No therapy patients allowed at CMHC, no exceptions. No therapy patients allowed at the VA unless you really, really fought for it, then they would allow 1 per day.
- As many therapy patients as you wanted allowed at university clinic, but "supervision" was highly variable based on which psychologist you were paired with.
Our third year definitely sounds worse on paper than it was in real life, but the experience as a whole was less than favorable and all but one of my classmates took an inpatient job after graduating. Looking back, I don't know what I would change about it other than having better psychotherapy supervision.