This summer I am interning as a research volunteer at Bergen Regional Medical Center
(BRMC) in the Research & Education Department of the Behavioral Health Division. My role is
to assist psychiatric residents with the research they are conducting, and I am currently involved
in three research projects under the guidance of a second-year resident, Dr. Muhammad Khan.
It has been an interesting couple of weeks, especially with getting started and figuring out my
roles and responsibilities in such a huge facility.
Established in 1916, BRMC is the largest hospital in New Jersey with 1,070 beds. With a huge
nursing home facility and a variety of inpatient and outpatient services, including Behavioral
Health, Acute Care, Addiction Treatment, and an entire division under the jurisdiction of the
Bergen County Jail, BRMC treats a diverse patient population. Within Behavioral Health, there
are numerous subspecialties including child/adolescent, geriatric, forensic, and emergency
psychiatry.
I have a long history of involvement at BRMC. My mother has been a physician here for about
15 years, and throughout my childhood, she would bring my younger brother and me into the
Long-Term Care Units around the holidays to sing to the patients. I volunteered in Long-Term
Care at BRMC extensively throughout high school, working mainly with dementia patients. And
as an EMT, I have brought a number of patients to the emergency department.
I became involved in this particular internship through my mother. I had asked her if there were
any research/internship opportunities available at BRMC, and she spoke to various members of
the Psychiatric Residency Program to determine if and how I could get involved.
The interview process was a very low-key course of events. I came into the interview with the
Chief Resident, Dr. Waseem, nervous and unaware of what to expect. My nerves turned out to
be unnecessary as all Dr. Waseem really wanted to do was to ensure that my goals would mesh
well with the aims of the psychiatric research program. We also talked about how my
background in HSSP would help me in this position. She told me about the different kinds of
projects the residents do at BRMC and what my role would be once I got started. Right away, I
knew that this internship would be a great way for me to learn more about psychiatry and figure
out if it was something I wanted to continue with in the future.
I am particularly interested in psychiatry and mental health because it shows how different
factors, such as socioeconomic status and the environment, contribute to a number of health
problems. It is also important to consider the role mental health plays in non-mental health
conditions. Often, psychiatric issues are not given as much weight as other medical conditions,
and they are attributed to a person ‘just being crazy’. It is important to acknowledge that a
mental health issue is just as ‘real’ or ‘valid’ as something like diabetes. I hope that this
internship will offer me a way to spread this knowledge, or at least show me how I can go about
doing this in the future.
There are a handful of other research volunteers working with residents this summer, and nearly
all of them have already completed medical school and are looking to apply for residency. Due
to the competitive nature of psychiatric residency programs, these medical school graduates are
strengthening their residency applications with psychiatric research. BRMC provides a great
environment for individuals looking to go into psychiatry due to the large and diverse patient
population that is treated here. One of the aspects of this internship that can be kind of
frustrating is not being allowed to have any kind of patient interaction for the sake of safety and
patient confidentiality. In my mind, it would be much easier to contextualize the research I am
doing and draw some kind of deeper meaning by understanding more about the patient as a
person as opposed to a set of symptoms and diagnoses.
I am looking forward to so many aspects of this internship, particularly: (1) learning more about
the previous research relating to the patients I am focusing on throughout the course of the
summer, and (2) learning about the changes to treatment due to the enactment of the
Affordable Care Act. BRMC reaches a patient population that other hospitals in the area have
no way of treating due to the breadth of psychiatric services available at BRMC that cannot be
found in the surrounding area. BRMC has served patients of lower socioeconomic status for
many years prior to the ACA through the New Jersey Hospital Care Payment Assistance
Program (Charity Care Assistance). This program insured low-income individuals who had no
health insurance, inadequate health insurance, or were ineligible for private insurance of
Medicare/Medicaid. It is currently still in use for patients who are not eligible for coverage under
the ACA (i.e., undocumented immigrants).
The Behavioral Health Division at BRMC is known for independent research projects by
psychiatry residents and medical students, as well as clinical trials. I am currently working on a
project regarding the effect of antipsychotics on fetal development. My role is to find journal
articles relating to this subject and write summaries of them. Once this is done, Dr. Khan can
determine whether or not there is sufficient evidence supporting the safe use of antipsychotics
in pregnant women (i.e., minimal incidence of fetal abnormalities). He can then use this
information to determine whether or not to administer antipsychotics to a pregnant patient with
schizophrenia who is experiencing severe psychosis. While it can be tedious and sometimes
frustrating to read article after article looking for information relating to the administration of
antipsychotics during pregnancy, it is nice to know that this information is going to help
someone who is already suffering from schizophrenia and has a fetus to take into consideration
as well.
One of my favorite parts of this internship is attending research meetings, held every other
Friday afternoon. The residents present their research progress to Dr. Hossain, the Chief of
Behavioral Health Ambulatory Services and Adolescent and Child Services, and Dr. Rahmani,
the Research Chief. These meetings are such an interesting way to learn about different
patients and the considerations that must go into treating them. For example, one of the
residents talked about a patient he was seeing who has severe Obsessive Compulsive
Disorder. This patient has tried just about every medication under the sun with no success. The
resident is interested in trying electroconvulsive therapy for this patient, as it has been seen to
have some success. However, the issues that come into play are that ECT is not available at
BRMC and the patient does not currently have health insurance. It is fascinating to see how the
other residents and doctors use their own experiences at BRMC and other facilities to offer
different options for getting this patient ECT.
In regards to what I am doing as a research volunteer, I have a timeline of approximately four to
six weeks during which I will find and summarize articles relating, after which there will be a
poster presentation and/or journal article submission. I am excited by the prospect of being able
to share what I have been learning with a wider audience. After spending countless hours
researching and writing, I cannot wait to disseminate what I have learned and see how this
knowledge has the potential to affect the treatment of schizophrenia in pregnant patients.
As an HSSP major, this internship draws on my understanding of how different factors, both
genetic and environmental, contribute to mental illness. It also offers a new way to understand
how health policy impacts the care patients receive. I find myself trying to analyze what I
learned in American Health Care in the context of a hospital that has been serving underserved
populations for decades before the ACA, and to see the differences between the ACA and the
NJ Charity Care program. I am hoping to learn more about these differences to see how the
ACA has benefited the patient population that BRMC reaches. I am also looking forward to
learning more about different aspects of psychiatric care and the considerations that must go
into making treatment choices. I also foresee understanding a lot more about the interplay
between health policy and the day-to-day operations within BRMC.