Suddenly being on call became a more serious task. At the University of Iowa, the resident on call fields question from each of the psychiatry wards, sees patients in the ER, and answers calls from patients. This seemed like a daunting and somewhat overwhelming concept at first. I was relieved to find out that the first four calls at the University are "training calls" with a senior resident present to help you figure out the system. By the end of my fourth call, I was still nervous, but I knew I could handle it. Of course it helped my confidence to know that someone to help is always only a phone call away. Between the R3/R4 resident on back-up call, the chief resident, and the staff on call, I found I was far from alone. I was told by one of the senior residents that after awhile you actually start to enjoy call and the challenge of it all. I'll admit, I'm still waiting for that to happen. In the meanwhile, I am becoming more certain of myself with each night on call."

"Handling the challenges of Monday through Friday on the ward is something different. On call you make sure the patient is stable and then let the next provider, their outpatient psychiatrist or the primary team on the unit, take it from there. And then you realize one day after call that you're on the primary team. Suddenly you need to figure out a way to get this person better -- to get them back to their life. Of course, your attending is right there with you. Every attending I've worked with at the University of Iowa has been an excellent teacher and has provided their own perspective and insight regarding how to manage the patients. For instance, my attending that first day explained why he preferred antipsychotics with fewer side effects to start off with. In addition, just like on call there are plenty of other residents to bounce questions off of -- usually there's one sitting at the desk across from you. Whether it's proofreading your first set of commitment paperwork or showing you where the nearest cafeteria is, my fellow residents have not only helped me a great deal, but also become my friends."

"I've been amazed at what an emotional roller coaster the first year of residency can be and I've discovered that having a good support system is vital. The emotions attached to seeing someone who came in suicidal 3 days before leave with their families are wonderful. The emotions you feel when a patient is being admitted to your service at 4:50pm on a Friday night are equally strong (but not usually as positive.) I've found myself scratching my head in frustration one day and laughing about the problem with the other residents the next day. The friendship and camaraderie that I've experienced at the University of Iowa has made this year more than memorable - this year has been a wonderful experience."

Jennifer
PGY-1, 2004-2005