Current Residents

Tiffany Xie, PGY-1

My Background

Hello future psychiatrists! My name is Tiffany and I grew up in Carmel, Indiana just outside of Indianapolis. For college, I went to Indiana University in Bloomington where I majored in English and biology. After I graduated, I taught English in Taiwan to middle and elementary school  students on a Fulbright grant. I love crafts (I picked up knitting, ceramics, and quilting in medical school) and am trying to build a vegetable garden this year!

Medical School Experience

I went to the University of Chicago Pritzker School of Medicine and absolutely loved it. Volunteering for a free psychiatric clinic at a shelter for women who experienced intimate partner violence is what first sparked my interest in psychiatry. I’m most passionate about how we can expand psychiatric care to our most vulnerable patients, and my research focused on the intersection between housing access and health. Rotating in addiction medicine, palliative care, and family planning also made me interested in how psychiatry intersects with so many other aspects of medicine. I also got involved in medical education and designed my own elective focused on peer mentorship in my fourth year!

Why I Chose Washington University in St. Louis

I’m not 100% sure what I want to do with my career yet, so I wanted to go to a large program with a lot of opportunities to explore different aspects of psychiatry. WashU really impressed me with how the program empowers trainees to pursue their interests, whether it’s medical education, research, education, a clinical subspecialty, you name it! I was personally excited about research opportunities like PRREP, which is truly a unique opportunity to get funding for your research while in residency without having to be a part of a physician scientist pathway. I also like that the program emphasizes training you as someone who treats the whole patient, both medical and psychiatric concerns. I also did an away rotation in inpatient child and adolescent psychiatry at St. Louis Children’s Hospital and loved my experience working with the child faculty. Although I was initially nervous about whether a program that stresses autonomy meant a lack of support, I feel really supported by my co-residents and attendings and appreciate the emphasis on learning by doing!

Typical Day for a PGY-1

PGY1 is divided up into on- and off-service time. You’ll spend half the year on the inpatient Psych unit (“Pavilion”) at BJC, with a few possible weeks at another similar off-campus inpatient site. Pavilion days start at 7:00 with sign-out from the overnight resident and then prepping for mid-morning rounds. You pick up new patients overnight or do the full admission when they come up during the day. Patients on Pavilion tend to be fairly sick, and you’ll be busy learning about ECT, pharmacology, and involuntary treatments. Without a senior resident, you’ll be the physician testifying in front of the judge to detain and treat your patients, an experience that is equally exciting and humbling. On Pavilion nights, you cover all the in-patient teams to handle any emergencies (behavioral or medical) that come up. You also do any overnight admissions, staffing them over the phone with an on-call attending. On off service rotations, you function as the intern for the team (medicine, neurology, peds, or EM) and are fully integrated into the service. Overall, intern year here is truly a “learn-by-doing” experience where you are fully in charge of your patients’ care. Candidly, it’s a lot of work, and you need to be very mindful of fatigue, but it’s an experience that will give you confidence as a clinician early on.

Living in St. Louis

I did an undergraduate summer research program in St. Louis and my partner has lived here for the past 6 years, so although this is my first time officially living in the city, I’ve had a long time to get to know and love St. Louis! Coming from Chicago, the rent and cost of living is also really affordable. Everyone loves Forest Park and for good reason. I personally love biking around the park, having a picnic on Art Hill, going to free shows at The Muny, walking around the zoo and art museum, the list goes on…My partner and I started biking around the city about a year ago and it’s great to be able to see all the different neighborhoods (I love the historic brick buildings in Soulard, going to the botanical garden, Tower Grove Farmer’s Market, and trying out new coffee shops). More than the arch, I think that Ted Drewes is the city’s must-see attraction (the people watching is awesome, it’s a historic Route 66 attraction, and in the wintertime they sell Christmas trees in the parking lot!).

Thoughts for Future Applicants and Incoming Residents

My mentors in medical school always emphasized that medicine is hard, a marathon and not a sprint, and because of that it’s even more important to make sure you think about where you can be your best self while in residency training. It was really important for me to be near my partner and support system in residency, in addition to exploring all of the career goals I had. I feel lucky that I can have both at WashU. Best of luck and hope to see you soon!

Grace Posey, PGY-2

My background

Hi, psychiatry applicants! My name is Grace and I grew up in McLean, Virginia just outside of Washington, DC. For college, I headed down south to attend Wake Forest University where I majored in psychology with minors in biology and neuroscience. For my gap years before medical school, I mostly did neuroscience research and earned a masters in biochemistry and molecular biology from Tulane. To answer the ice breaker question you will be asked at almost every resident social on the interview trail… my fun fact is that I love animals and have fostered both dogs and cats before they found their forever homes. I plan to get involved with volunteering at animal rescue groups here in St Louis as well!

Medical School Experience

I went to the Tulane University School of Medicine and absolutely loved my time in New Orleans. Experiences like serving as a leader for a student-run clinic at a residential substance use treatment center for women and getting the chance to participate in neuroanatomy research reinforced my instinct to pursue a career in psychiatry. Additionally, working in an early intervention psychosis clinic for adolescents and young adults combined with opportunities to work on care teams that included attendings who specialized in women’s mental health, autoimmune disease, and addiction helped me gain a better insight into the complexity and sheer breadth of the field. Psychiatry is such a cool specialty, and it stood out to me because of the truly unique and impactful way you can make a difference in the lives of not only your patients, but potentially their entire network of loved ones! 

Why I Chose Washington University in St. Louis

WashU truly impressed me the most out of the psychiatry programs I was fortunate enough to interview with. It was clear from speaking with the current residents at open houses and then with faculty during interview day that trainees at the program are empowered to do anything/everything they are inspired to pursue – whether it’s research, influencing policy, leadership preparation, and/or incredibly strong clinical training! The emphasis that the program places on serving as a physician first and psychiatrist second – in other words, maximizing your ability to effectively treat medical and psychiatric concerns simultaneously for the best possible patient care – is exactly what I was looking for. I also just feel incredibly supported and welcome by everyone I’ve met in our department. 

Typical Day for a PGY-2

PGY-2 is the “survey year,” so almost every month is something different. The PGY-2 residents spend one block on each rotation with the exception of consult-liaison rotation which has two blocks. On rotations such as consult-liaison, I work a typical workday of 9:00am-5:00pm. On other rotations such as research selective, I have more free time for independent study, supervision, and self-directed learning. One PGY-2 block is an overnight call rotation from 5:00pm-8:00am, covering emergent floor and emergency department consults. The inpatient and emergency rotations have given me experience in helping to decide acuity and need to admit versus discharge, have exposed me to a great variety of psychiatric pathology and medical co-morbidities, and are continuing to build on my experience as an autonomous and confident clinician. As a PGY-2, residents start having weekly supervision to discuss cases, readings, and process experiences, and there is a big emphasis on becoming more independent during the second year. There are also a variety of outpatient rotations including clinics specializing in eating disorders, neurocognitive disorders, interventional psychiatry (ECT, TMS), and addiction psychiatry. These rotations allow residents to explore specialty interests, experience continuity of care, and to practice psychotherapy

Living in St. Louis

Having only ever lived in the DC area or more Southern states, I was honestly nervous about trying something new in moving to the Midwest. But, to say that I was pleasantly surprised by St Louis and everything it has to offer would be an understatement! The city has a serene feeling to it and incredible green spaces including the famous Forest Park. I also thought that the food scene in New Orleans was unmatched, but STL definitely gives it a run for its money! 

Thoughts for Future Applicants and Incoming Residents

Really take into account what current residents at each program have to say about their class! It’s a green flag when someone earnestly tells you that the best part about their experience is their co-residents. My co-interns are some of the best people I’ve ever met, and I’d choose WashU every time knowing I’d get to grow into the best psychiatrist I can be with such smart, compassionate people! I also participated in couple’s match and highly recommend taking note of which programs take a special interest in seeing you succeed in that endeavor during (and before) the application process.

Lucy Yao, PGY-3

My background

I’m from the northern suburbs of Chicago, and I am the daughter of two Chinese immigrants: an acupuncturist and a caregiver for the elderly. Growing up, I spent a lot of time drawing/painting and being a big nerd (Science Olympiad was my jam). During my time in undergrad at the University of Illinois at Urbana-Champaign, I began to delve into my interest in this mysteriously complex organ our brains call the brain. I majored in Molecular and Cellular Biology with a focus in neuroscience. Before medical school, I took a gap year and worked as a waitress, a tutor, and an emergency department scribe. I watched as psychiatric patients boarded in the emergency department for sometimes weeks while waiting for placement at a hospital with a psychiatric unit, and as those same patients returned with a psychiatric exacerbation shortly after their hospitalization. That experience was my first exposure to the serious need for better mental healthcare in this country.

Medical School Experience

I went into medical school as a very undifferentiated student. I volunteered at the student-run clinic, as a crisis counselor with Crisis Text Line, and at the local conservatory. As I went through my clinical rotations, I noticed that I was always intrigued by patients’ psychiatric diagnoses, something that I did not consistently experience with other pathology. In full transparency, I was also strongly considering internal medicine, and I almost dual-applied. I used the beginning of my fourth year to dive into rotations in both specialties and really tried to imagine what the day-to-day would be like. Ultimately, I knew that I would feel more fulfilled treating someone’s depression than their heart failure. It was also important to me that I could potentially help advance whatever field I ended up in, and the thought of contributing to neuromodulation or personalized medicine research in psychiatry was too exciting to ignore.

Why I Chose Washington University in St. Louis

WashU had everything I was looking for in a program. I wanted to be in an academic environment surrounded by colleagues and supportive faculty who were also invested in lifelong learning. I knew that WashU would provide access to abundant resources, diverse clinical experiences, excellent teaching, and faculty mentorship that would allow me to figure out exactly what kind of psychiatrist I want to be when I grow up.

If there was one thing that was made clear on interview day, it’s that WashU emphasizes autonomy. While I wanted a program that would challenge me, I was concerned that this was code for a lack of support. I’m happy to report that that is not the case at all. All of the faculty and senior residents have been incredibly supportive through this learning curve.

WashU also stood out to me because of its R25-funded PRREP program. Unlike other research programs, it’s designed so that anyone with an interest in research, regardless of past research experience (I only have a history of basic science research in undergrad), can test the waters. You are not locked in and can decide to quit at any point if you find out that you actually cannot stand research.

Typical Day for a PGY-3

Our third year of residency is completely outpatient and is divided between the child psychiatry clinic, the resident clinic, and a community mental health clinic located in downtown St. Louis. We see a wide variety of patients throughout these three experiences, and are able to appreciate practicing in different outpatient settings. Since the onset of COVID-19, all three sites have increased utilization of telemedicine, allowing patients to access care and providing residents with exposure to practicing telepsychiatry.

This year provides residents with excellent exposure to patients of all ages and various psychiatric disorders. For the resident and community mental health clinic, we autonomously run our clinics with minimal, yet sufficient, supervision. The child psychiatry clinic has more oversight provided by a child psychiatry attending who sees all of the patients with the resident. The day typically starts between 8:30-9:00AM, and most of the mornings are dedicated to didactic lectures. In the afternoons, I work at my assigned clinics and see 1-2 new intakes and 3-4 follow ups. 

On Monday, Tuesday, and Thursday afternoons, I work in the resident clinic seeing adult patients with a variety of disorders which have–at some point in their course–required psychiatric hospitalization. On Wednesday afternoons, I work in the child psychiatry clinic, where I see toddlers, children, teenagers, and young adults with various diagnoses including mood disorders, anxiety disorders, autism, intellectual disability, ADHD, disruptive disorders, and developmental delays. Midway through the year, we switch child psychiatry clinics, allowing us to work with a different attending and in some cases see a different patient population. On Friday afternoons, I work at the community mental health clinic, where I see a wide variety of severe mental health diagnoses including schizophrenia, bipolar disorder, personality disorders, and substance disorders. There, I am a part of team of people including community support specialists, therapists, and nurses who work to provide patient centered care. The work day is usually completed by 4:00-5:00PM allowing time to prioritize errands, hobbies, and relationships.

As a third year resident, I no longer work weekends or holidays, which is a huge boost to work/life balance. Many of the residents moonlight, doing emergency department psychiatry consults for extra money. On a weekly average, moonlighters have one 5pm-11pm shift where they alternate seeing consults with the PGY-2 on call resident and one nightfloat shift where they are on-call overnight at home and are only called in to help if there are enough open consults. Residents are able to moonlight during their PGY3 and PGY4 years. 

Living in St. Louis

In all honesty, when I was ranking my programs, I considered WashU’s location to be one of its “cons.” Having lived in Chicago for almost my entire life, I was wary about moving to a smaller city like St. Louis. If I could go back in time, I would tell myself not to even worry about that! I live in a plant-filled apartment in the Central West End with my two cat children and a cherry shrimp colony. It’s about a 7 minute drive to the hospital or a 25 minute walk when I’m willing to brave the weather. This unassuming city has several cute neighborhoods to explore, lots of free/cheap events, abundant greenery, and a diverse food scene. As much as I love Chicago, I must admit that living in a smaller city during residency has its advantages including the low cost of living and the lack of aneurysm-inducing traffic.

P.S. for anyone who loves tropical houseplants like me, the Climatron at the Missouri Botanical Garden is an absolute dream.

Thoughts for Future Applicants and Incoming Residents

Intern year will be emotionally and physically taxing no matter where you go. Your support system and the culture of your program can make or break your experience. Virtual interviews make it much more difficult to get a true sense of the ~vibes~ of a program. My biggest advice would be to reach out to multiple residents to chat about the program so you can get more data points. I got invaluable information about some programs that I wouldn’t have known otherwise.

I also found it surprisingly difficult to create my rank list. I thought that there would be a clear best choice, but there were multiple places where I thought I’d be happy, and they each offered slightly different things. I debated each pro and con; I even created an Excel spreadsheet with weighted equations that calculated a composite score for programs based on factors that were important to me. While these are certainly very important decisions to make, you only have limited control over the outcome and it may turn out to be an unexpected outcome. Just remember that no matter where you end up, you will receive quality training and have the privilege of making a profound impact on people’s lives in their darkest times. Best of luck and hope to see you soon!

Kat Wrobel, PGY-4

My background

I’m a proud Minnesotan, shaped by summers spent on the lake, countless trips to the Mall of America, and shopping at the original Target (a true local rite of passage). I went to a small liberal arts college in the Midwest, where I majored in Biochemistry and Molecular Biology, minored in Psychology, and was lucky enough to serve as captain of the Swimming and Diving team—a role that taught me a lot about leadership and resilience. My path to medicine was deeply personal: I was inspired by my own experience as a patient going through spinal fusion surgery, which gave me a firsthand appreciation for compassionate care. That, along with my time working as a medical scribe during and after college, really solidified my desire to become a physician.

Medical School Experience

I moved to Chicago to attend Rush Medical College, where I was drawn to the school’s strong emphasis on community service and health equity. During medical school, I took a dedicated research year to participate in the Medical Research Scholars Program at the National Institutes of Health in Bethesda, MD, where I focused on epigenetics and children with ADHD. As I progressed through my clinical rotations, I found myself increasingly drawn to patients facing mental health challenges. It was during my Psychiatry rotation that I discovered a deep sense of purpose in connecting with patients, hearing their stories, and engaging with the evolving field of psychopharmacology. These experiences solidified my decision to pursue a career in Psychiatry.

Why I Chose Washington University in St. Louis

As a fourth-year medical student, I had the opportunity to complete a sub-internship at WashU, where I quickly developed a deep appreciation for the autonomy offered by the Psychiatry program. This autonomy, combined with the exceptional support from program leadership and attending physicians, encouraged me to engage consistently with psychiatric literature and research, while also honing my clinical decision-making skills from the very beginning of my residency. Beyond the academic aspects, I was drawn to the strong sense of camaraderie both within and between classes, which made my time at WashU truly enjoyable and meaningful. Additionally, WashU’s diverse patient population and comprehensive exposure to a wide range of psychiatric disorders aligned with my desire for a program that provides both breadth and depth in training.

Typical Day for a PGY–4

The PG-4 year is very flexible compared to prior years with lots of free time and options to pursue research or individual interests. While many residents choose to maximize their research time, some are more clinically oriented, taking electives such as Toxicology, Outpatient Interventional Psychiatry, ECT, or Forensics. The required clinical rotations include 2-3 months of Consult Supervision and 1-2 months of Inpatient Supervision, depending on the year and number of residents in the class. I also attend resident lectures on Tuesday and Thursday mornings throughout the academic year, outpatient clinic 3-4 afternoons a month, and personal supervision twice a week. In addition, 4 months of the year are dedicated to working on a research project. Moonlighting is also available to residents who are interested in earning extra money by helping with Emergency Room Consults.  

Living in St. Louis

The hospital is located in the Central West End, a neighborhood I’ve really come to love. It’s where many residents live, thanks to the walkability, great local restaurants, coffee shops, grocery stores, and easy access to Forest Park—which is perfect for a quick walk or weekend outing. I live in The Grove, just a short drive away, and enjoy exploring nearby neighborhoods like Tower Grove South and The Hill, each with their own unique vibe and hidden gems. St. Louis has truly surprised me—it’s a very livable, mid-sized city that still feels manageable while offering plenty to do. On weekends, I often check out local farmer’s markets, catch a concert, or spend time at the Missouri Botanical Garden. It’s been such a pleasant surprise discovering how much this city has to offer.

Thoughts for Future Applicants and Incoming Residents

The application and interview process can be exhausting, especially when you’re trying to get a true sense of a program virtually. While it’s certainly not required, if there’s a program you’re especially interested in, I highly recommend considering a sub-internship there—it gave me a much clearer picture when I did mine at WashU. The best advice I can offer is to pay close attention to how residents support each other through the challenging times, and how the program responds when life throws unexpected difficulties your way—whether that’s a serious illness, a surgery, or a personal loss. Also, don’t underestimate your gut feeling about a program. Psychiatry is a dynamic and growing field, with amazing opportunities and the potential for strong work-life balance. I’m genuinely excited for you during this next chapter and hope to see you virtually soon!