SAMPLE SOP - PSYCHIATRY 2

"It is not the person who has too little, but the person who always craves more, that is poor."
-Ancient Chinese Proverb

Without peace of mind, happiness cannot exist. I have always tried to do what I felt was best for me, as well as those around me. My choosing Psychiatry as a career is no exception. I chose psychiatry because it is one of the only fields of medicine that delves into the more intangible elements of disease-the mental health disorders, which have always fascinated me.

I credit part of my early interest in mental health disorders to my grandmother who is the Director of one of the largest community mental health facilities in Chicago, Illinois, where I was born and raised. I attribute the remainder of my early interest in mental health disorders to my surroundings while growing up in Chicago. Due to my surroundings, I recognized the symptoms of depression long before I could put a name to it. I regularly found myself daydreaming about what I could do to help those around me even as a child and throughout my teenage years. You can imagine my further frustration when I discovered the stigmatism associated with mental illness in my community. Amongst African Americans, and in the United States as a whole, there seemed to be a negative view of people who have mental illnesses. Somehow their chronic illnesses were different from the other more commonly talked about chronic medical illnesses such as hypertension or diabetes mellitus. Yet despite this overbearing negative public opinion, my interest in helping those who are mentally ill only continued to grow. By the time I reached medical school I had no doubt I was going to be a Psychiatrist.

Admittedly, I wavered at times, due to the various pessimistic attitudes and comments of my peers, and at times, my mentors towards the profession. Also, during my Inpatient Psychiatry rotation in my third year of medical school, I encountered my first in depth experience in the field of Psychiatry. I went in to the rotation with dreams of Freudian Psychoanalysis sessions; I left with a reality check that shook me to my core. I quickly learned that the managed care industry, large randomized controlled pharmaceutical trials, and the need for faster modes of therapy had long ago replaced the eclectic treatment form I had dreamed of. What I saw were patients who were severely psychotic, suicidal, homicidal, or a combination of the former. Most of them stayed in the inpatient unit until they were stabilized and then discharged-usually 3 days. Although a much needed service, it was not what I had in mind for my career choice or myself.

As a result, I looked into the other fields of medicine, including Internal Medicine. Internal Medicine appealed to me because it gave me the opportunity to use most of the medical knowledge I was learning in medical school, including Psychiatry. There was a strange comfort in the well-defined diagnostic methods and treatments that I routinely encountered in my rotations, yet I found myself inquiring about patients' moods and dispositions even when it may not have been essential to the case. For example, after hearing how gastric esophageal reflux disease forced a severely obese patient to change their diet, I began to inquire about symptoms of depression in addition to the commonly asked questions in the review of systems. In time, I realized that I was "hard wired" for Psychiatry. I had no desire to "shake" my love of mental disorders-organic or otherwise, however I walked away from the other specialties appreciating the importance of maintaining one's general knowledge of medicine no matter what their specialty may be.

At the beginning of my last year of medical school I was accepted to the Asklepios International Telemedicine Consortium Fellowship in Germany. During my matriculation there I spent time working with Psychiatrists and Trauma Surgeons, and helping with the Telemedical research and testing of a new Global Positioning System based Emergency Medical Response technology for Southern Germany. The new response system allowed the paramedics to enter medical data and have it transferred real-time to the Emergency Physicians- who travel to the scene of the emergency and to the hospital. The software was also programmed to translate between English and German as an incentive for the United States Army to purchase the technology. While there, I discovered that Psychiatry was practiced in the same way overseas as it is in the United States, except equal emphasis was given to pharmaceutical and to non-pharmaceutical adjunctive therapies. Areas of therapy such as psychotherapy, art and music therapy were regularly used with all of the chronic patients. It was a welcome change to what my mind had begun to accept about the practice of Psychiatry.

I came to several realizations during my time there. I realized the importance of language proficiency in the practice of medicine both in the United States and abroad. I also became truly conscious of the importance research plays in the advancement of medicine, whether that research is clinical or technological. Most importantly, I revitalized my faith in Psychiatry and re-realized the important role it plays in the healing process. These realizations were the basis of my decision not to enter the National Residency Match Program in 2004. Instead, I decided to spend the year conducting research. I have had the opportunity to work on research in HIV/AIDS in minority women in Washington, D.C. The results of the research were presented at the July 2004 AIDS Conference in Bangkok, Thailand and published in the annals of the conference.

In early 2005 after "The Match", I spent time in Puerto de la Cruz, Tenerife, Canary Islands Spain in for Spanish language proficiency training, and to experience another facet of medicine abroad. My stay in was only for 2 months, as I had already had the opportunity to study Spanish in high school and undergraduate college. The nine weeks of linguistic-cultural immersion was adequate to push my Spanish-speaking ability to a medically functional level. I plan to continue my study of Spanish with a focus on medical Spanish to implement it during my Psychiatric career.

So how have research and traveling abroad play into my career in Psychiatry? I would ultimately like to work with the World Psychiatric Organization in some capacity in the future. Politics has always interested me; its role in the advancement of medicine has already been established worldwide. My other areas of interest include Disaster and HIV/AIDS Psychiatry. Eventually, I would like to participate in collaborative international research initiatives dealing with the acute treatment of Post Traumatic Stress Disorder, especially in war torn countries.

Then again, one does not have to travel to a foreign country; you can find a "war torn" atmosphere in almost any inner-city community in the United States. Eventually I would like to start multiple multi-service, multi-ethnic community based clinics in major cities around the United States. My aim is to have the clinics funded by federal and private grants and investments as well as by the other revenue they bring in. My goal is to provide the surrounding communities, especially those of underserved populations, with mental health care, primary care, complimentary and alternative medicine and social services. I had the opportunity to work in a clinic that was very much like what I have envisioned myself creating in the future. Yet, the clinic was founded to serve a very specific population and thus was limited in its spectrum of care.

I have undeniably cast my net of future goals very wide. However, I am already on my way to fulfilling my goals and dreams. I am currently a Post Graduate Year One resident at in the George Washington University Medical Center Psychiatry Department. While the busy work schedule of Intern year has not allowed much time for dream fulfillment, I have had the chance to start attending the Hospital Emergency Preparedness meetings. I truly view this opportunity as an honor because I am one of the few residents who attend these meetings. The prospect of jointly working on a Masters of Science degree in Public Health during my residency also represents another possible "stepping stone" along my path of goal fulfillment. Regardless of how my career development unfolds, over the years, I know I will significantly impact the vast morbidity that mental health disorders represent in the world today-in our country and abroad.