With her dual training, Dr. Jenkins provides compassionate, evidence-based care to some of California’s most critically ill children.
The AAMC (as part of our Specialty Perspectives series) recently sat down with Dr. Jenkins to discuss her unique path to child psychiatry. Learn more about Dr. Jenkins' work below.
Can you describe your work?
I am a Canadian-trained child psychiatrist and Associate Professor of Psychiatry at the University of California, San Diego. My clinical work is mainly in the field of pediatric consultation-liaison psychiatry, which is a big term for saying that I am the psychiatrist who sees kids who are admitted to the hospital for other medical reasons.
What attracted you to child psychiatry?
I was always very interested in science and chemistry. So, when I finished high school, I took the opportunity to do an undergraduate degree in pharmaceutical sciences, which at the time allowed you to work clinically as a pharmacist. In that role, I started doing research in medication and psychopharmacology. I got exposed to psychiatry and neuroscience really early in my undergraduate training. And I had the benefit of having been part of a healthcare team already and understanding how best to work with people that bring different skill sets and the disciplinary team we all hear about.
After my pharmacy degree I was able to work for a year, which I mention because medical education is so expensive. I know that's a big barrier for a lot of people in thinking through how they are going to support themselves through their medical education.
I didn’t know that I was going to be a psychiatrist when I went to medical school. I knew I loved neuroscience, but I really was someone who loved every aspect of medicine. I found myself doing consultation-liaison psychiatry, which is a very specialized area of psychiatry that interfaces very much with medicine. I was working with pediatricians and surgeons every day. Then, I did my psychiatry rotation. I loved my colleagues and the people I was working with. I'd find myself invigorated every day when I'd get home from working with psychiatric patients and thinking about their illness and how to help. It was a natural fit. So, I matched into adult psychiatry.
I was working with severely ill people with mental health issues and a cross section of addiction, mental health, and also a population with HIV. I did a lot of interviews with people who shared how things had gone wrong for them very early in life. About their early trauma. About how they'd had a really negative experience with mental health early on in their life that deterred them from getting other help. As I was hearing these stories, I kept thinking, I wish I'd met you earlier. I wish I met you when you were 15 or 16. Maybe there were things that we could have changed with their trajectory. And so, I worked myself backwards and made the switch to become a child psychiatrist. And I couldn't be happier.
Can you describe a typical workday?
No two days are the same for me, which is the amazing part of my job. It never gets dull. On clinical days, I’m working at the hospital. I usually start by meeting with my team, which consists of medical students, fellows, social workers, psychologists, and nurses. We review the list of patients that we are going to be seeing that day. Then we break apart and go meet with different patients. Sometimes other doctors will call us with consults and patients for us to see. We usually regroup at some point in the afternoon and put all of our heads together to come up with treatment plans and recommendations.
I also have leadership responsibilities outside of my clinical day. I oversee a psychiatric emergency room and I teach. So, a lot of days I have other types of meetings where I’m discussing program development or giving lectures. My work really varies depending on the day of the week.
What parts of your job do you find most challenging? And what parts do you find most rewarding?
One of the most challenging things when working with children is navigating the complex health systems and social systems, like the different school districts and all of the different people that are in children's lives. Second, access to timely, properly trained mental health professionals for youth and children can be a struggle. So, making sure that, especially for my work in the hospital, when children leave my care they're connected with somebody to continue their support can sometimes be a challenge. The third piece would be in my job, the stories and the work that I do can take a toll emotionally. I have to make sure that I have good tools and supports and am working with a good team to help with that piece of the work.
On the other hand, children are remarkably resilient and recovery is the goal with child psychiatry. We get to see children do so amazingly. And that gives me hope for younger generations. Working with kids can be a super fun way to spend your day. It's a little different than a lot of other specialties because you might be playing, drawing, or doing something else outside of the norm. The other piece is supporting parents and families, which is a huge part of the work as a child psychiatrist. My job also lets me work with trainees. I get to work with medical students and fellows and help inform the way they're going to practice.
Can you share a case you found especially rewarding?
There is one case that I always share from my inpatient child psychiatry unit, which has been a big focus of my clinical work. We had a youth who was admitted for almost a year for psychosis and a diagnosis of schizophrenia. For anybody familiar with the system, to be admitted for a year to an inpatient facility is a pretty difficult thing. The youth was very, very sick. And it was a case where a lot of people would have thought that maybe the outcome wasn't going to be so good. It was a very challenging situation. But remarkably, the youth was discharged and we got updates that they are doing exceptionally well. They've graduated high school, they're working, and just really couldn't be doing better given they received proper care and treatment and nobody gave up on them. I like to share that as a case that even when things seem overwhelming or complicated, there is so much hope in working with young people.
What previous experiences have helped you most in your current role?
As a psychiatrist, living life really is one of the best informers. But before I went into medicine, I was a pharmacist, so I had the benefit of being another type of healthcare worker. And I worked in a methadone maintenance clinic, where we would dispense methadone to people who are struggling with addiction and substance use. That was definitely a role that helped me lose any type of judgement and be accepting of where people are. That experience very much informed my practice.
I was also a summer camp counselor for kids with cancer and their siblings. It was a very specialized type of summer camp experience, but it instilled my passion for working with kids. It was really helpful to work with them in a completely different type of role where a lot of the focus is on fun. I still pull on some of those experiences.
Lastly, I am a parent. My kids are my constant teachers. You don’t have to be a parent to be a good child psychiatrist. But in my perspective, it certainly helps and I definitely bring the skills I've learned from them to the office.
What’s one thing you wish somebody would’ve told you before going into psychiatry?
I wish that I had been told more about how hearing stories of trauma everyday will affect you. The stories that we hear are incredibly difficult. Lots of abuse, loss, trauma, critical illness. It is so important to have a very intentional system for managing that and taking care of your own mental health - having good supervision or a support group that you can talk to about difficult cases and being aware of that aspect of our work. I am lucky because I work in academic medicine, so I have teams built in everywhere. I think that really needs to be viewed as an essential aspect of our work in child psychiatry.
How would you describe someone who would excel in a career in psychiatry?
If you’re someone who is really curious about people, likes to be challenged, and able to tolerate uncertainty, this is the field for you. In psychiatry, no day is the same. It’s never boring. You also have to be patient and a good listener – someone who doesn't feel that you have to fix everything immediately. Of course, you have to have a strong interest in science and neuroscience as well. That goes without saying. But I think that kind of marriage of science and humanity is a perfect fit for a lot of people in medicine.
Are there any resources that focus on your field that our audience should be aware of?
The American Academy of Child and Adolescent Psychiatry is an amazing organization that I'm a member of myself and very actively involved in. And they have a whole medical student resource area for students who are interested in the field. I couldn't recommend a better place to start.
If you have any interest in child psychiatry, the Journal of American Child Adolescent Psychiatry would be the best landing place for anybody who's got an interest in the field. And then of course, there's a lot of amazing psychiatrists on social media sharing about our careers and our day-to-day. Following a few of us might give you a little taste of what working in child psychiatry is like.
Is there any advice you’d like to share with premeds?
When people learn I'm a child psychiatrist, I often hear “oh, that must be so hard” or “that must be such a difficult job.” But, on the contrary, I'm probably one of the more hopeful and optimistic people, especially when it comes to young people, because I have the benefit of seeing the recovery and resilience of the kids I work with. I definitely don't want anybody to be discouraged from the career, even though there are aspects that are difficult because it is just the most incredibly rewarding thing.
For premeds who are specifically interested in child psychiatry, I always recommend three things. Spend as much time as you can hearing people's stories. Take advantage of opportunities to shadow people within mental health to get a sense of what the day-to-day is like. And, learn as much of the science that you can, but also the human side, the psychology – what family support can look like, social environments, and different cultures.
Last, I’d like to let premeds know that psychiatry is flexible. I think that's one of the most amazing things. You can work in so many different settings. You can do inpatient or outpatient work. You can work somewhere for 10 years and switch to another place. There is a ton of longevity as an area of practice in medicine.
To learn more about Dr. Jenkins’s work, follow her on Instagram.