Shadowing A Psychiatrist

Thanks, @Cyberdyne 101. I’ll explore what opportunities there are at my local medical center and inquire there. Much appreciated!

I Shadowed Psychiatrists for a Month

Content Warning: this blog post contains mentions of drugs, substance use and abuse, mental illness, suicide, historical trauma and genocide (but please read on if you want to learn about my Winter Term project which wasn’t as scary or heavy as the content warnings might suggest)

In the Fall 2018 semester, trying to come up with a Winter Term project was a big source of stress in an already stressful semester. On paper, Winter Term sounds great: a month to yourself to pursue any project you want in the name of experiential learning! In practice, though, before this year, I wasn’t sure I actually liked the idea of Winter Term. There can be pressure (self-imposed or otherwise) to come up with a meaningful project, and the transition from Oberlin to Winter Term back to Oberlin can be jarring, at least for me. This attitude partly has to do with my experience last Winter Term. Last year, I spent the month at home teaching myself a lot of German, and while I did learn a lot during that month, I also felt isolated, lonely, and depressed. To be fair, I did a very bad job of getting out of my house, but most of my friends were out of town, and my parents and sister had work and school, so a lot of the time it was just me alone in my house with a neurotic German Shepherd foster dog as my only companion.

HOWEVER. This year, I have a renewed appreciation for Winter Term. I spent the month at home again, this time shadowing various psychiatrists affiliated with the University of New Mexico, where both my parents work (having connections is great). Since I’m majoring in psychology and want to go into mental health care someday, this past month provided me with a very unique opportunity to observe mental health practitioners in a way I initially didn’t think possible. I observed Telehealth clinics (remote therapy provided over video technology) and rode alongside psychiatrists from the Assertive Community Treatment (ACT) Team, a group of psychiatrists, nurses, psychologists, and social workers who conduct home visits for people with severe mental illness. I also did some supplementary reading: articles and parts of a developmental psychology textbook. If you want more details about what I did during this past month, I wrote a Winter Term specific blog that you can access here: https://rbiebers.wixsite.com/wt-2019

Besides being forced to leave my house, seeing an actual meth trailer on my first day of work (yay Albuquerque?), and interacting with strangers who know a lot more about mental health care than I do (every other student I shadowed with was a medical resident), this Winter Term gave me a lot of insights I didn’t expect to leave with, and was really rich and valuable for a lot of reasons. For one thing, as I’ve already alluded to, I was reminded about how effective experiential learning is. I have yet to take an abnormal psychology class in college, so there was a lot I didn’t know about mental illness in terms of diagnostic criteria. Because of this limitation, I’m sure there were things in the patients I observed that I could have looked out for but didn’t know to. That being said, learning about different mental illnesses by observing actual people was far more valuable than learning about disorders from a textbook. Textbook learning can be important but learning through observation meant that anything I learned stuck with me so much more. The things that I saw in the patients—their symptoms, their concerns, their ways of processing and their goals and desires—were so much more real, relevant, and memorable.

The other wonderful thing about my project was that it didn’t go in the direction I expected. What’s this, you say? Ruth is glad that something didn’t go EXACTLY to PLAN? Why, yes! It’s true! I value unexpected moments of learning more than I love my Google calendar! All jokes aside, I learned things this month that I did not expect to learn. So, while I did learn all about things like the Telehealth and ACT Models, and about psychiatric medications and conditions and disorders like Autism Spectrum Disorder, PTSD, depression, anxiety, schizophrenia, schizoaffective disorder, psychosis, etc., the most valuable thing I learned about was historical trauma.

One of the articles I read (by Maria Yellow Horse Brave Heart, a nationally renowned Native American scholar, who I had the privilege to meet) defined historical trauma as “…cumulative emotional and psychological wounding across generations, including the lifespan, which emanates from massive group trauma.”

Now, as a privileged white person who has never really experienced oppression, I am lucky that I didn’t have to know about historical trauma. I have never experienced its brutal effects. I got to learn about it from an outsider’s perspective and didn’t have to perform any emotional labor when I learned about it. Still, it made me really upset. I come from a state with a profound history of oppression, colonization, and genocide of indigenous peoples by Europeans (mostly Spaniards). I know about New Mexico’s past but before this Winter Term I wasn’t aware of this intersection of history and psychology. What I learned made sense, but it also shocked me; and it shocked me because I come from a place of privilege.

Those who are victims of historical trauma exhibit a psychological and behavioral Historical Trauma Response (HTR). Some visible and related effects of HT on American Indian and Alaskan Native (AI/AN) populations include the following:

· AI/AN populations rank higher for health disparity than any other ethnic/racial minority in the United States

· Alcohol-related deaths are 5 times more likely for Native Americans than for white people

· Suicide rates among AI/AN groups are 50% higher than the national average

· AI/AN communities experience heightened depression rates, PTSD, interpersonal loss, unresolved grief, alcoholism and other forms of substance abuse, lower life expectancy, and so on.

I don’t want to fill this entire blog post with facts about historical trauma, because it could turn out to be very long indeed: but here is a link to the blog post I wrote about historical trauma on my Winter Term website.

So, TL:DR, I didn’t think I would learn about historical trauma during Winter Term, but I did, and learning about it was incredibly important because I know now that it is extremely important to understand my positionality and the culture and identity of any patients I might treat one day.

The three biggest take-aways from my project are as follows:

1. I feel affirmed in my career goal of working in mental health. However, shadowing psychiatrists this month has taught me that I would prefer to be a psychologist, not a psychiatrist. Managing medications and symptoms is very important, but I’m more interested in working on the deeper, more personal aspects of a person’s life or mental illness. Both careers are important and needed, but this Winter Term gave me some clarity about the direction I want to go in with my career.

2. I was reminded of the importance of empathy in the mental health care arena, and also of the importance of self-care on the part of the practitioner. Being a mental health practitioner is draining work mentally and emotionally and achieving balance and taking care of oneself while also taking care of patients is a tricky thing to navigate. This is something I will be mindful of if I pursue a career in mental health care.

And, number three, the most important:

3. I understand better the legacy of historical trauma and the importance of culturally informed and culturally sensitive health care. New Mexico in particular is a state with populations deeply affected by historical trauma. Despite living here my whole life, I didn’t have a good understanding of the lasting psychological effects of colonialism and genocide. But now I do. And while I am sure that I have only just begun to understand the true devastation of historical trauma, I have learned that understanding it, and practicing healthcare that takes into account the culture and identity of the patient, is paramount.

To sum it all up, I had a great Winter Term. It was hard at times, but I learned so much and this was a very special opportunity for me. This type of experience is what I imagined when I thought of ‘Winter Term’ as a prospie. Now that I’m here, I have a renewed appreciation for the value of Winter Term and I’m excited for Winter Terms to come.

With that, I hope everybody enjoyed their Winter Terms, and good luck with the Spring Semester!

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Is it possible to shadow a psychiatrist?

I’ve spoken with my local private practice psychiatrist about shadowing him and he basically said this: “I wouldn’t mind at all. but my patients might.” Basically, a yes, but it’s not gonna happen because of how confidential private practice psychiatrics can be. Psychiatry is one of the specialties I’m VERY interested in, but it hasn’t been as easy as shadowing my local internist, urologist or pediatrician. I feel like I’m hitting a brick wall here with psychiatry. Is there any way to maybe shadow a psychiatrist who works at the local medical center/hospital? If any of you have shadowing experience with psychiatrists before, how did you go about doing it?

cinnalyn

Full Member

I’ve shadowed a child psychiatrist previously and have been able to get some of my peers in to shadow her as well. Its just like any other shadowing where you sit in and observe the interaction, but its true that HIPAA is much more prevalent in that context due to how stigmatized mental illness can be. When I shadowing, the psychiatrist always asked the patient beforehand if they’d be comfortable with a student sitting in on their appointment. Most of the time they were okay with it but there were a few instances where I was left out because the patient wasn’t comfortable. I did have the opportunity to shadow a psychiatrist at my university’s hospital but because of class conflicts I was unable to attend.

Psai

This space for lease

Joined Jan 2, 2014 Messages 11,384 Reaction score 24,003

Just ask around. But think about it, would you want to be giving up your deepest darkest secrets with some random person in the room?

xnfs93hy

Full Member

Joined Jun 24, 2008 Messages 2,243 Reaction score 85

Just ask around. But think about it, would you want to be giving up your deepest darkest secrets with some random person in the room?

I, personally, would be all right with a student in the room. I’m very liberal when it comes to stuff like this; however, I could see where people would feel very uncomfortable with a student in the room.

xnfs93hy

Full Member

Joined Jun 24, 2008 Messages 2,243 Reaction score 85

I’ve shadowed a child psychiatrist previously and have been able to get some of my peers in to shadow her as well. Its just like any other shadowing where you sit in and observe the interaction, but its true that HIPAA is much more prevalent in that context due to how stigmatized mental illness can be. When I shadowing, the psychiatrist always asked the patient beforehand if they’d be comfortable with a student sitting in on their appointment. Most of the time they were okay with it but there were a few instances where I was left out because the patient wasn’t comfortable. I did have the opportunity to shadow a psychiatrist at my university’s hospital but because of class conflicts I was unable to attend.

When you were shadowing and sitting in on appointments, was this in a private practice setting?

Catalystik

A Gimlet Eye

Joined Sep 4, 2006 Messages 35,391 Reaction score 15,357

I’ve spoken with my local private practice psychiatrist about shadowing him and he basically said this: “I wouldn’t mind at all. but my patients might.” Basically, a yes, but it’s not gonna happen because of how confidential private practice psychiatrics can be. Psychiatry is one of the specialties I’m VERY interested in, but it hasn’t been as easy as shadowing my local internist, urologist or pediatrician. I feel like I’m hitting a brick wall here with psychiatry. Is there any way to maybe shadow a psychiatrist who works at the local medical center/hospital? If any of you have shadowing experience with psychiatrists before, how did you go about doing it?

Ask about group counseling sessions and psychiatrist-led support groups, where your presence is more likely to be tolerated.

xnfs93hy

Full Member

Joined Jun 24, 2008 Messages 2,243 Reaction score 85

Ask about group counseling sessions and psychiatrist-led support groups, where your presence is more likely to be tolerated.

Catalystik

A Gimlet Eye

Joined Sep 4, 2006 Messages 35,391 Reaction score 15,357

Ask the psychiatrist you know. He may be aware of ongoing such activities at an inpatient setting and could give you a contact. Alternatively, get your active clinical experience in a psych unit (hospital or VA), get to know folks, and the rest will follow.

WillburCobb

I am the pull out king

Joined Aug 20, 2010 Messages 1,958 Reaction score 2,076

You could look for a job as a psych tech, BHT, psych CNA, or whatever other may call it. I did this for over 2 years on a child/adolescent unit and a PICU. I was also able to line up shadowing through it beings I was an employee and was able to build a relationship with the Drs. I worked with frequently. Also, while shadowing in other settings (ER, primary care Dr.) I wasn’t allowed to follow on any psych cases.

kittykattat

Meow

Joined May 11, 2013 Messages 380 Reaction score 312

If he said its not going to happen in private practice, try to look in community settings. I shadowed a psychiatrist who volunteered her time at a clinic for the homeless. It was extremely interesting and I never once had a patient say no when the doc asked if I could sit in on the psych eval.

cinnalyn

Full Member

When you were shadowing and sitting in on appointments, was this in a private practice setting?

It was private practice. I think the fact that it was child psychiatry made it easier for me to shadow because it was mostly the parents calling the shots as to whether or not to let me in on seeing their ADD child get their meds. Comparatively, the teens seemed much less comfortable with an extra set of eyes in the room.

SixStringPsych

Full Member

I was able to shadow a psychiatrist at a large academic child psychiatry practice. They had rooms set up for residents/fellows to observe first time evaluations fitted with a one-way mirror. Only certain undergrads who took certain courses at my school were able to sit in on these, but you might want to ask around at your nearest large academic hospital because they might have this set up for their residents/fellows as well.

NickNaylor

Thank You for Smoking

Joined May 22, 2008 Messages 17,395 Reaction score 9,124

You’ll likely have great difficulty seeing therapy if you have any interest in that because of the inherently personal nature of it. For things like medication management visits and routine follow-up, though, I imagine you shouldn’t have any difficulty. It’ll depend on the attending and the patient’s preferences.

Sent from my iPhone using Tapatalk

Womb Raider

Full Member

Joined Aug 20, 2013 Messages 3,490 Reaction score 3,079

I feel your pain. I really wanted to shadow cosmetic plastic surgery but found out pretty quickly that wasn’t going to happen haha.

xnfs93hy

Full Member

Joined Jun 24, 2008 Messages 2,243 Reaction score 85

I’ll ask around and see what I can come up with. It’s too bad that surgeons and psychiatrists are so difficult to shadow, because those are where my interests fall.

xnfs93hy

Full Member

Joined Jun 24, 2008 Messages 2,243 Reaction score 85 Is it the same story for when you want to shadow a surgeon (any kind)?

Cyberdyne 101

It’s a dry heat

Joined Sep 16, 2013 Messages 4,541 Reaction score 5,933 Is it the same story for when you want to shadow a surgeon (any kind)?

I was fortunate enough to shadow a surgeon at a hospital that’s renowned for low infection rates and I just needed to demonstrate that my immunization and PPD was up to date. I guess this varies from hospital to hospital, but I was in an academic setting in which the surgeons often have visitors (other than residents and fellows) to observe.

I don’t think your everyday surgical patient will mind because they are under anesthesia. So it seems that asking the surgeon should suffice. But I guess, if Arnold Schwarzenegger needed a heart valve fixed, you’d have a difficult time observing that procedure.

Cyberdyne 101

It’s a dry heat

Joined Sep 16, 2013 Messages 4,541 Reaction score 5,933

I’ll ask around and see what I can come up with. It’s too bad that surgeons and psychiatrists are so difficult to shadow, because those are where my interests fall.

I can see why shadowing a psychiatrist would be difficult, but I’m pretty sure you can find a surgeon to shadow. As I mentioned before, those in academic settings should be more welcoming of students. Also, it may help to volunteer in a surgical setting. For example, some hospitals offer opportunities in wards for patients that just underwent surgery. Or if there’s an orthopedic hospital nearby, you can inquire there. If you’re luckily enough to shadow an ortho surgeon you can see quite a few procedures in a day (unless it’s spine).

And in terms of psych, I’m not a med student yet, but I’m pretty sure that it is a required clerkship so you’ll have enough opportunities to explore it in med school.

xnfs93hy

Full Member

Joined Jun 24, 2008 Messages 2,243 Reaction score 85

Thanks, @Cyberdyne 101. I’ll explore what opportunities there are at my local medical center and inquire there. Much appreciated!

Cyberdyne 101

It’s a dry heat

Joined Sep 16, 2013 Messages 4,541 Reaction score 5,933

Thanks, @Cyberdyne 101. I’ll explore what opportunities there are at my local medical center and inquire there. Much appreciated!

One more thing. I got my shadowing opportunity at an insanely prestigious ortho hospital (I couldn’t believe it) because I asked one of the surgeons questions about stuff he published (and I was genuinely interested in the material). That “pathway” worked out well for me. Obviously, ppl have come across such opportunities through different means, but regardless, reading a few papers can only benefit you. You might stumble upon something that you’ll want to pursue in the future.

EMDO2018

Membership Revoked

Joined Oct 8, 2013 Messages 1,885 Reaction score 1,271

Just ask around. But think about it, would you want to be giving up your deepest darkest secrets with some random person in the room?

mrh125

Membership Revoked

Joined Aug 4, 2013 Messages 2,371 Reaction score 620

As someone who has often shared the company of a psychiatrist very often, either the psychiatrist would have to really really really like you and/or be in a less one-on-one setting and even then you would expect to be kicked out of the office a lot. There are a lot of things that are shared that nobody would feel comfortable having an undergrad student just sit there and watch, even with HIPAA that isn’t much of a security blanket. I almost asked my psychiatrist once, but I just know I wouldn’t want to go down that path.

There’s times I feel uncomfortable opening up to my psychiatrist about things I deal with because it can be daunting and intimidating, imagine what it would be like with a third wheel in there. Even with the third wheel just kicked out it’d be very hard for some patients not to be shaken by that. A lot of patients have to fight to have their issues not exposed everywhere and need the privacy because with that exposure comes all sort of discrimination and stigma.