Travis Alsky, DO, PGY-3

Monday 

  • Monday Morning: I wake up to bright rays of light pouring into the window—the scintillating Arizona sun is alerting me that it is, in fact, Monday. There is a wonderful contrast between dark and light in Tucson, lending to a well-preserved sleep/wake cycle. Tucson is a designated dark-sky city, meaning there is restriction on the amount of light pollution and artificial light structures due to the surrounding observatories. I’m able to fit in a cross-training workout prior to arriving at the clinic at 8 a.m. The PGY-3 year is the start of our outpatient experience. We get our own office and a great deal of autonomy. In my experience, the outpatient year is a particular highlight of the program due to the amount of didactics time, personal one-on-one supervision, and an extremely high-quality psychotherapy experience. I see a few follow-ups in the morning and then eat lunch on our clinic patio—a rustic cage-like structure suspended in the sky—very unique!
  • Monday Afternoon: We have five supervisors in total during PGY-3. Our program’s first two years prepare you to be able to function independently, and we see patients on our own throughout the week. The time spent with one’s supervisors is a time to reflect on patients’ care, add to the treatment plan, and learn in a one-on-one setting. I meet with Dr. Singh for one hour supervision. My first intake of the week is right after this. An intake is a new patient to the clinic and a new patient added to my panel. There is a good mixture of pre-existing patients and brand-new evaluations. After the intake, I head home around 5 p.m.
  • Monday Evening: At home, I meet up with my wife and two dogs (Welsh Corgis). I spend time practicing guitar—mostly working on some jazz/fusion improvisation. The rest of the night my wife and I hang out. We watch an Anime, Vinland Saga, and later do some reading.

Tuesday

  • Tuesday Morning: I get to the Whole Health Clinic by 8 a.m. The whole health clinic is a Banner-affiliated clinic that I spend a half day at on Tuesday mornings for the entire year. This clinic serves individuals with low-income and AHCCCS insurance. I work with Dr. Lam here and we see patients together; there’s a lot to learn in outpatient psychiatry, and I probe Dr. Lam’s brain about psychopharmacology in between patients. He feeds me journal articles just as a nurturing parent bird would feed its fledgling chick, soon preparing to take flight on its own.  
  • Tuesday Afternoon: I head back to our main clinic at Banner University Medical Center South for psychotherapy supervision at 1 p.m. I meet with both my CBT and psychodynamic psychotherapy supervisors. There is a significant focus on psychotherapy in the PGY-3 year. Progress is slow in learning this new language, but each step-forward is rewarding. I have a patient to see after this via our clinic’s telehealth platform. I finish up notes, emails, voicemails, etc., and get ready to leave around 5 p.m.
  • Tuesday Evening: I get home, greeted by Corgis. I spend a bit of time checking in on our garden. My wife and I have been working on our gardening skills, and this year our garden is incredible! The weather in Arizona allows for one to garden year-round. I get to working on some music—a consistent practice schedule has been a mainstay of my wellness (buzzword) in residency.

Wednesday

  • Wednesday Morning: I get a cross-training workout in in the morning and get to the clinic around the same time as usual to see a few follow-ups in the morning. It’s a great day as my standing desk was installed! I meet up with some of my co-residents for lunch on our sky-cage patio prior to didactics beginning—great views and conversations. 
  • Wednesday Afternoon: Wednesday afternoons, from noon onward, are designated didactic time throughout all four years in our program. A notable lecture of the day was on the basics of CBT for insomnia from Dr. Rodriguez, an expert in sleep psychology. After this, we have a lecture on psychodynamic psychotherapy with Dr. Pritchard—some of the best teaching I’ve ever experienced. Lectures end at 5 p.m. and we all head home.
  • Wednesday Evening: It’s monsoon season, which is a big deal in Tucson. The late summer months are transformed by surprise lightning and quickly evolving skyscapes of clouds. This summer has been a little drier than the past two, but there has still been a lot of great storms. My wife and I walk our dogs once the storm calms down. Later in the night, we convene and make plans for some travel later in the year.

Thursday

  • Thursday Morning: I get up early again to get a workout in before getting to the clinic. I have one of my long-term psychotherapy cases scheduled in the morning. As mentioned before, we are fortunate to have a lot of great guidance and instruction in this area. One of our most celebrated lecturers is Dr. Pritchard, who delivers our first 10:30 a.m. lecture this morning. We have psychotherapy didactics from 10:30 a.m. to 4 p.m. every Thursday—a huge highlight of the outpatient curriculum. Most of these are delivered by master therapists, Dr. Pritchard and Dr. Lane.
  • Thursday Afternoon: After lunch, we start back up in our continuous case conference series, broken into groups with either Dr. Pritchard or Dr. Lane. Here, we take turns presenting some of our long-term psychotherapy patients. The next lecture is Dr. Lane’s year-long course on Time-Limited Psychodynamic Psychotherapy—where Dr. Lane presents a more structured, problem-focused iteration of psychodynamic therapy that still primarily draws upon understanding a patient’s developmental history and maladaptive patterns. After this, we have group psychotherapy lecture where we review footage from the continuous therapy group that we take turns leading.
  • Thursday Evening: I leave for home after our lecture ends at 4 p.m. It’s nice to be on a more regular schedule this year. Tonight, my wife and I decide to listen to an audiobook of one of our shared favorite books from childhood, “A Wrinkle in Time.” We also ate dinner before this, a very healthy choice.

Friday

  • Friday Morning: I wake up early to keep the routine of getting a cross-training workout in, and I get to the clinic at 8 a.m. My first follow-up patient in the clinic is one of my long-term psychodynamic therapy patients. I then have a few telehealth appointments prior to lunch.
  • Friday Afternoon: My supervision with Dr. Curry begins at 1 p.m. on Fridays. Dr. Curry is out this week, but luckily, we spent a lot of time talking the previous week. I especially value his supervision due to his integration of philosophy, integrative psychiatry, and trauma-focused care into his approach and understanding of psychiatry. He will also recommend approximately 3.5 books per hour of conversation, so I must make sure a pen is always in hand to keep up with the ever-growing list of things to read. Since we aren’t meeting this week, I take time to catch up on notes and prepare for a new intake at 2 p.m. It’s pretty cool to feel confident enough to work independently but also have this time to grow into a more adept and skillful psychiatrist.
  • Friday Evening: I head to my friend’s house to hang out for a bit after work. It was a productive week, and it is nice to have a full weekend off ahead of me.

Saturday

I wake up roughly around the same time on the weekend as to ensure there is minimal deviation from my sleep-schedule—a necessary ingredient for mood and overall well-being. I have a guitar lesson with my jazz/fusion instructor via Zoom, something I’ve been happy to start up with again. I hang out with my wife the rest of the day and we later go to a local concert. The Tucson music scene has grown quite a lot since the times of COVID and before. There are a lot of great venues in town including (in my order of favor) the Rialto Theater, 191 Toole, the Hotel Congress, and the Fox Theater. Phoenix is also not too far away and has a preponderance of great shows as well.

Sunday

Enchanted from a great time with some great bands last night, my wife and I decide to go hiking with our dogs at Catalina State Park. The rest of the day we hang around the house. We tend to the garden and harvest tomatoes, Malabar spinach, habaneros, and many eggplants. For some reason this year, nature decided we would become eggplant farmers—no complaints about this! We also have some giant watermelons growing—which I was skeptical about when initially planting. It’s time to start planning for the fall planting. This time, we will be obtaining seeds from a local group called, Native Seeds/SEARCH, an incredible organization that seeks to preserve more unique species of edible plants from the greater southwest region. Industrialization has led to a staggering narrowing of plant diversity in our food sources; Native Seeds helps one rediscover local variants and diversity one’s garden and home-made meals as a result. Life in Tucson is pretty awesome and having time to explore the unique cultural/local aspects has added a sense of charm and connection to my time in training.