Life in Child and Adolescent Psychiatry: Shadowing Dr. Ambrose

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As a medical student, have you ever wondered what it is like to specialize in child and adolescent psychiatry? Meet Adrian Jacques Ambrose, AMA Fellow, MD, MPH, Child and Adolescent Psychiatrist and AMA Featured Physician “Shadow Me” Specialty Series, which offers direct advice from physicians on life in their specialties. Check out her ideas to help you determine if a career in child and adolescent psychiatry might be right for you.

The WADA Specialty Guide simplifies the specialty selection process for medical students, highlights major specialties, details training information, and provides access to association information. It is produced by FREIDA™, the AMA residency and scholarship database®.

Learn more with WADA about themedical specialty of child and adolescent psychiatry.

“Shade” Dr Ambrose

Speciality: child and adolescent psychiatry; administrative psychiatry.

Practice setting: Academic medicine, outpatient.

Type of employment: Hospital.

Years of practice: Four.

A typical day and week in my practice: As a night owl, I often marvel at the ability of my colleagues to take action at the first light of dawn. After crawling languidly out of bed, I brewed my tea and mentally, the caffeine went straight to the nearest adenosine receptors. A little more human now, I arrive at the office to start planning my administrative meetings for the day.

As a Medical Director, I spend approximately half of my time managing clinical practices, reassessing best practices, ensuring appropriate clinical growth, addressing clinical concerns of faculty and patients, and reviewing the fiscal footprint of our clinical services. The work is a beautiful patchwork of multiple moving variables, both explicit and implicit, and I often get lost in the state of flux.

During clinical days, I often practice a combination of adult and pediatric outpatient psychiatry and interventional psychiatry for severe and refractory mood disorders. The day starts pretty much the same with my trusty cup of tea, but often ends with a variety of Lego blocks and toy cars scattered around my office. For the work of interventional psychiatry, I provide and supervise personnel in intranasal administration of ketamine. One of my favorite ‘dad jokes’ to tell first-time patients is,’ We often put our noses where they are. To do belong ”- much to my team’s dismay.

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The most stimulating and rewarding aspects of child and adolescent psychiatry: The most difficult part of my job in psychiatry is often the invisible barriers of receiving mental health care for patients and providers. For some patients, mental health care is often an exception for their insurance plans. As a result, many drugs or even treatments are not covered, which highlights one of the fundamental problems of health inequity in our care structures.

Additionally, for some of my patients who are health care providers themselves, it is heartbreaking to hear their stories of how they have to maintain an “all is well” facade at work for fear of. be corrected or disciplined. In many states, license applications often ask about a history of mental health treatment, which not only stigmatizes the aspect of psychiatric care, but also isolates providers struggling with mental health issues.

On the other hand, the surreal experience of sharing some of the most intimate and personal aspects of our patients’ lives is sublime. It is absolutely a privilege to enter the innermost thoughts of patients and accompany them through many laughs and sorrows, disappointments and triumphs, as well as births and deaths. These stories and experiences made me realize how incredibly similar we are as human brothers and how incredibly resilient and creative we can be.

These moments are the most rewarding and unforgettable parts of the field. I wonder how different the world would be if we could hear each other’s stories and see the commonalities with each other, instead of our differences.

How life in child and adolescent psychiatry has been affected by the global pandemic: Fortunately, with the advent of technology, most of the work has shifted to the telehealth platform. Convenience actually works quite well for many patients.

The long-term impact of the pandemic on child and adolescent psychiatry: The pandemic has increased awareness of the prevalence of mental health problems. Mental health issues are not a moral failure or personal weakness, but rather, they are medical conditions that can be treated.

Three adjectives to describe the typical child and adolescent psychiatrist: Kind, compassionate, dedicated.

How my lifestyle matches or differs from what I imagined: One of the things I didn’t realize about psychiatry in medical school was how versatile and adaptable training can be. As a result, the lifestyle of psychiatrists can be as varied and tailored as they want. If you don’t want to take calls, you can have it. If you want to keep working more than 90 hours a week, you can have it. If you want to have a family and a career, you definitely can have it.

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Skills that any doctor-in-training should have for child and adolescent psychiatry, but will not be tested during the board exam: In psychiatry it is extremely important to have compassion. There have certainly been situations where I disagree with the patient’s choices or feel immensely frustrated with their behaviors. However, ultimately having compassion helps me understand that these patients are hurting and suffering, and that their frustrating behavior can be a form of communication.

A question that doctors in training should ask themselves before embarking on child and adolescent psychiatry: “How much do you want to understand each other?” It sounds a little facetious, but the training and clinical encounters really force us to understand each other better. As one of my beloved mentors said: “You are one of the diagnostic tools; do you know how to use this instrument effectively? It’s about learning who we are as individuals and what we bring with us into the psychiatric setting of clinical care. I didn’t expect to “turn the mirror inward”, but I am very grateful to have the opportunity to continue to learn more about myself and about life.

Books that any medical student interested in child and adolescent psychiatry should read: Instead of books, I would say keeping abreast of different political perspectives on contemporary events around the world is crucial in this area. Most of the time our patients read these same articles, and it is helpful to navigate the clinical setting if we can contextualize the news according to the specific clinical situation. I’m used to looking at different websites across the political aisle on a regular basis for their views.

Online resource students interested in child and adolescent psychiatry should follow: I would like to shamelessly promote the American Psychiatric Association program official blog. They do a phenomenal job curating relevant psychiatry news for all interested psychiatrists.

Quick insights I would give to students considering child and adolescent psychiatry: To borrow the eloquence of Mr. Fred Rogers: “As human beings, our job in life is to help people realize how rare and precious each of us really is, that each of us has something. something that no one else has – or ever will have. have – something inside that is unique at all times.

It’s the cornerstone of psychiatry, in my mind. Plus, you get paid to do it! If you wanna never to be bored in medicine, I would highly consider psychiatry.

Song to describe life in child and adolescent psychiatry: I have a weakness for the classics: “Here is the sunBy The Beatles.


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