My Path to Geriatric Psychiatry

My Path to Geriatric Psychiatry

By Dr. Reece Ramkissoon PGY5, University of Manitoba

When I began my psychiatry residency, the thought of specializing in geriatric populations was not something that came to mind. As an inexperienced junior resident, geriatric cases in the emergency department intimidated and frustrated me. I believed that age-related issues and diagnostically unambiguous cases would lead to an unsatisfying career.

This belief continued until my geriatric psychiatry rotation. My first patient was an 87-year-old woman with bipolar disorder admitted for a suicide attempt. She was charismatic and engaging; debunking my preconception that interactions with the elderly would be mundane. I enjoyed our daily interviews and we formed a strong therapeutic relationship which continued when I volunteered to follow her in long-term psychotherapy. I felt challenged adjusting to new themes of loss, end-of-life, and functional changes.

This rewarding experience was not limited to a single patient, but instead occurred repeatedly across the geriatric disorder spectrum and throughout my residency. On the consultation service, I enjoyed cases of managing neuropsychological symptoms of dementia, complex
capacity, and delirium. I no longer felt frustrated by geriatric patients in the emergency
department, and instead, sought out these experiences.

In many ways, geriatric psychiatry overlaps with internal medicine, palliative care, and neurology. This gives the specialty a uniqueness, which sparked my enthusiasm, and continues to grow in my current work as a geriatric psychiatry fellow at the University of Manitoba. My passion is nurtured by the supportive and highly invested attendings in this program. Discovering my interest in this field was a wonderful surprise. I now encourage other residents to not repeat my misjudgment and to be open minded to the exciting world of geriatric psychiatry.