Reflections on Tulane: my brief internship in Psychiatry there prior to Hurricane Katrina in August 2005

I was once a Tulane Psychiatry Intern. I transferred out of the program AFTER Hurricane Katrina devastated our city of New Orleans on Aug 29th, 2005, forcing me to leave my home state of Louisiana and their program, and to transfer into another psychiatry residency program in Massachusetts at Harvard. Nonetheless, I did perform 2 months of training with this spectacular program and would like to share my experience with you: A typical day for an intern such as myself consisted of arriving on the unit around 7:30am to pre-round on my patients, talk with the staff to see how things went during the evening and night prior. Afterwards, we (me and the Tulane medical students) would talk with the patients and write our notes. The Tulane medical students are very helpful with interviewing the patients, writing Progress notes, setting up appointments, etc. Around 9 am, we had group therapy, which the Intern conducted with a Psychologist. At 10:30am, my attending psychiatrist arrived, and he would inquire about the patients, we would update the charts, write notes, and interview the new patients admitted the night before from the Charity Hospital Emergency Room. We'd have lunch after of this. Between 1pm and 4pm, I would cover a few things that needed to be done (call the pt's family, set up appointments, talk some more with the patients, teach my medical students a certain topic via a lecture), then go home. It is really up to you when you left: it could be early or late, depending on your speed/efficiency. No one is breathing down your back, watching you or making you stay until a certain time. It is very, very laid back! The social service ladies and nurses are all fantastic and helpful, making your work very easy. The call schedule was terrific, probably the best in the country from what I've seen on other residency sites; it was q8-q10 the first year, beeper call the second year, no call for 3rd or 4th year. While on call, which is overnight, you were always with an Attending and a Moonlighter (passed Step 3, has a license and is usually in their 4th year). So, you were covered for very difficult cases. The call room was on the same floor as the Pscyh ER, which was convenient, and you were provided free meal tickets. We had a lot of lectures during the week, but thankfully not too many to keep you from getting your work done. It was protected lecture time; so one could actually step away briefly from patient care in order to attend to the lecture. Lastly, on Thursdays, twice monthly, we may have to go to the local courthouse and testify whether or not to keep a patient judicially committed to the hospital...it was a question of legal status for the inpatient. The experience was not too bad, but somewhat intimidating because it was in front of a judge and there were lawyers. Nonetheless, you had a lawyer, too, and a psychiatrist who testified with you/for your case. Teaching: The learning experience was actually superb. The Attendings were very knowledgeable in many areas of medicine and psychiatry. Moreover, all the teaching was upheld: rarely, if ever, was a lecture cancelled. Interns were asked to prepare small lectures to give to each other; so, we were given a topic out of a psychopharmacology text, and the next week, we gave a "lecture" about it. The Residency Director (Dr. P. O'Neill) presided over these lectures, and he gave additional information as well. The atmosphere was quite comfortable and benign. Again, the program is probably the most pleasant one around, and their is a very reassuring comraderie among the residents and the attending staff. The grand rounds on Friday were pretty good: lots of lectures on PTSD. There were always, always free lunches from pharmaceutical companies on those days, too. Atmosphere: Outside of work, every week there was a pharmaceutical-sponsored dinner at a 4 or 5 star New Orleans restaurant! We had valet parking, could choose any drink and any meal choice from the menu. The guest speaker was always some famous person in the field of Psychiatry from some big name university, and again, the atmosphere was pleasant. Conclusion: The positives are mentioned above: the staff, teaching and atmosphere are unsurpassable! The negatives would be the fact that FMGs in the state of Louisiana have to complete 3 full years of training before they can get a Louisiana license; therefore, an FMG would not be able to moonlight (make the big $$$) until he/she is a 4th year resident. Once you are in the middle of your second year of this program, you will already be prepared to manage ANY thing that comes your way in terms of psychiatry pathology! They prepare you very well, very early. All I can say is that the Tulane Psychiatry program was a gold star residency training site in New Orleans; but this is what is was like for us residents prior to Hurricane Katrina flooding our city and damaging so many of our buildings we worked in. I imagine that once the Tulane residency returns, it wont be much different than what I experienced and described above. In fact, it could get better or improved!