For Residents

Career Choices: Community mental health in an urban/public setting

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Editor’s note : Career Choices features a psychiatry resident/fellow interviewing a psychiatrist about why he or she has chosen a specific career path. The goal is to inform trainees about the various psychiatric career options, and to give them a feel for the pros and cons of the various paths.

In this Career Choices, Cornel Stanciu, MD, talked with Mufida Wadhwania, MD. Dr. Wadhwania is an adult psychiatrist practicing in an urban/public setting in metro Atlanta, Georgia, at DeKalb Community Service Board. She manages a variety of uninsured and underinsured patients in an outpatient setting.

Dr. Stanciu: What attracted you to practice community mental health in an urban-public setting?

Dr. Wadhwania: A high portion of the population here has no health insurance, and hence there is a great need in the community. The psychopathology severity is high, so one can see a wide range of disorders. One can also build on the skill to pull together resources, such as linking patients to community resources and patient assistance programs, finding food banks, and finding ways to secure stable housing. There is continuity of care, and when a staff member leaves the agency, patients are linked to the next provider in an adequate time frame so that the patient’s quality of care is not compromised. The new provider is also given notification so that he or she is aware of the transfer of the patient and is able to review the chart in advance.

Along with medication management, we also provide psychotherapy. We utilize a single electronic health record (EHR) throughout the agency and we are able to contribute to changes in the EHR to make it more user-friendly. We have monthly journal club meetings and meetings with other staff members to review and discuss the progress of our organization. There are also numerous online resources through which we can keep ourselves updated with current research and earn CME. Some of the providers at our agency have academic affiliations, and hence there are opportunities to teach medical students and residents who rotate at some of our sites.

Dr. Stanciu: What are some of the more prevalent disorders you encounter?

Dr. Wadhwania: We see a wide range of disorders, such as affective disorders, schizophrenia, and comorbid disorders, specifically comorbid substance use disorders. So we encounter a high number of chronic mental illnesses.

Continue to: What are some challenges in working with this population?

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