Summer job as an apprentice doctor (amanuenssi) in Psychiatry: My experience

I got a summer job as an amanuenssi (apprentice doctor in Finland) for the August of 2026. This would be after I've completed 1,5 years of my medicine studies.

If you want to read more about the process of getting this kind of summer job, read this post.

Before the job starts (December-July)

A lot of the Spring I spent just waiting for updates and information about the job. You see, there's not that much concrete information on what the job is, what you'll need for the job, etc. That's why I decided to start writing down my experiences in this post; so others could have some sort of reference for what a summer job as an amanuenssi actually is.

I actually only got the job contract to sign in April, but I know others who only got it some weeks before the job started! So if you've got confirmation about a job, but no contract, don't worry. The doctors in charge of sending the contract have a lot of work and surprisingly (not), sending the job contract seems to fall low on the priority list.

I got a job at a HUS hospital, so my experiences are specific to those who will work at those hospitals. I received an invitation to an event in May for future HUS summer job workers. This event was supposed to be an "orientation" of sorts, what to expect, etc. In my experience, while the event was nice to attend, I didn't get much value from going. The advice was quite generic, and as someone who appreciates very specific instructions and advice, it didn't ease my anxiety too much.

It's normal to be anxious about your summer job. It certainly doesn't help that you have no idea what you're even going to do. All of that depends on which ward, which city, which specialty, etc. you'll be working on. Each one has its own learning goals, limitations and opportunities. It also depends on your willingness to learn. If you are very interested and seek out more opportunities to practice your skills, you'll also be granted more of them.

Basically, this is everything I knew of my job before starting. It's quite little.

In June I received an email that informed me more about the practical aspect of the job, but I think it ended up confusing me even more. The introductory "flyer" I got is a general one for all new employees at HUS. As you might guess, the process of starting a job at a hospital is wildly different for each type of employee. As an amanuenssi, you can't get a VRK-card (it's like a card for healthcare professionals to enter the different patient systems). Yet, the email I received did mention a VRK-card, so I was very confused for a while.

Roughly translated, the email said this:

"Keys and an access tag have been ordered for you, and the need for an employee ID card photograph has been registered.

You can collect the keys from the information desk at [hospital]. The opening hours are Monday to Friday from [time]. When collecting the keys, you must present either a photo ID or a valid photo employee ID card together with a VRK card.

When your employment ends, the keys must be returned personally to the key services office on the same day. If your employment ends after both the key services office and the information desk have closed, the keys must be placed in the grey key-return box located in front of the information desk. Keys must not be left at the workplace for someone else to return.

A photo employee ID card can be issued during the key services office’s opening hours when the photographer is present. Alternatively, photographs are taken by appointment on Wednesdays.

Appointments must be booked in advance by calling [number]. When booking, provide your name, job title, cost centre number, preferred language markings, and whether your employment is permanent or fixed-term.

The employee ID card must be returned to the key services office together with the keys when your employment ends."

I was a little confused about whether I was to get the keys before my job starts or on the day it starts, so I called the number. They told me that I should go get the keys either on the first day or the day after depending on the traffic at the service point. So that cleared something up... I think?

I know I'm not the only one who feels lost when it comes to the start of their employment at hospitals, especially during studies. It's pretty much what I hear from all of my friends and acquaintances: "I don't even know where I'm supposed to go and when"

My partner, who started his first summer job at a hospital in July, only got to know where to go and when a day before the start of his job.

I was told via email that the typical hours in the department to work are 8.00-16.45 mon-thu and 8.00-15.15 fri. I would be working in two wards: one with mood disorder patients, and one with psychosis patients.

To summarise, the timeline went like this:

December 2025: I sent an email to a chief physician about the possibility of a summer job

January 2026:

I received an email from her, urging me to email another physician
Got an email from the second physician, letting me know of the available spots
She told me to send the application through the official system
I was told I received the spot, and instructed to email yet another physician
Emailed this physician and was informed of the ward and details of my job as well as the working hours.

March 2026: Received an email about filling a personal data -form.

April 2026:

Received my job contract to sign
Got invitation to the orientation event for May

May 2026: Visited orientation event

June 2026: Received information about getting my keys and personal card

I won't lie, I was nervous throughout the summer because I wasn't sure how much I should know before going to the job. Therefore I studied in my free time in July. I used official websites for the information, like Käypä Hoito, which has guidelines and information about the different disorders and their treatment.

My first day of work

I arrived early, because I take the train. I was told to be there between 8-8:15. I was there before 8 and there was no doctors there yet!

I basically arrived, asked the secretary where the room was that I was told to go in, went to try the door (it was locked) and waited outside the door. A lovely nurse saw me waiting outside the door and asked me what I’m waiting for. I let her know I’m there for my first day of being an amanuenssi. She showed me to the break room and I waited there for some minutes. I introduced myself to a few nurses, and a doctor, who then showed me to the doctors room. She admitted that she didn’t know I was coming (fair enough, I think she just came back from vacation).

In the doctors room I got to know two of the student doctors, who happened to be from RSU. All the staff here are super nice and were very welcoming to me. The chief physician who was supposed to be there was elsewhere, probably busy with something, so the doctors told me to come with them to the morning meeting, after which they could help me get the work clothes and keys, etc. The morning meeting was at 8:30. Basically, it was just 30 minutes of the nurses and doctors and other staff together planning the schedule for meetings with the patients today. Like, the nurse would say a patients name, and a doctor who wanted to meet with them asked whether a time (e.g. 10:15) would be fine for a meeting. This kind of scheduling needs to happen, because each of these meetings with a patient has both a doctor and a nurse in the room.

After this the chief physician (who actually was in the meeting) asked one of the student doctors to help me get work clothes and keys etc. So we did just that. She was super sweet and showed me around everywhere and repeated the directions many times without me asking, so I would remember. The place was a bit of a maze.

Most of my day was actually spent in the doctors room. There I can read the patients records and information of the treatment and just get familiar with the system. Nothing is really expected of me, and I can kind of just do what I feel comfortable and confident doing. Whenever a doctor was going to a patient meeting, I asked whether I could join, and I always could. Only one time I went and the patient said she didn’t want a student in the room so I just went back to the doctors room to read more. It happens!

In the meetings I don’t do much. Some of the meetings are super short, maybe even just some minutes long. Some of the patients have been there for quite a while so the doctor and psychologist only need to ask some basic questions about suicide risk, psychosis, medications, and such. Some meetings might be longer to get a more full picture of what’s going on. It all depends on who’s doing the interview, what kind of patient it is, what the plan for the patient is and many other factors.

The patients are all very different. Many of them have more chronic mental health struggles, substance abuse history and struggles with money, housing and such. That makes all the patients cases very complex, and the team taking care of the patient is very big. There’s doctors, nurses, social workers, and psychologists taking care of the patients. I work in the adults ward, so there are patients from only 18, all the way to older patients. Many of the patients have impaired ability to deal with day-to-day life so there’s also a social worker to help with basic things like applying for benefits, explaining the next steps of treatment in outpatient care, and so forth.

There’s two wards: one for patients with schizophrenia-type illnesses and psychotic symptoms, and one for patients with mood disorders such as bipolar disorder or depression. But of course patients are not that clearly divided into two, so there’s some overlap.

Many of the patients have a lot of diagnoses and therefore extensive medication lists, so there’s a lot of learning to do! But luckily I’m not expected to know anything, I personally have just studied about frequently used medications and I end up asking about them from the doctors from time to time.

The doctors really appreciate any questions you ask and opinions you bring forth. So honestly I might just ask “why are you using this medication if so and so…”, it really teaches a lot.

The wards are closed, so the patients can’t really just come and go as they please. If they’re there with a referral for observation or treatment against the patients wished, they can’t go outside alone. They’re accompanied by a nurse. Sometimes they can’t even go outside, only to the inside-yard-thing? I don’t know what to call it…

The doctors are all so nice. Both of the student doctors told me that I can follow them, and once I get confidence with time, I can start asking questions myself and interviewing the patients independently with them as support. I hope once I see enough interviews I’ll feel confident!

I was warned a lot about this field being very rough and difficult. And while that might be true on some aspects, I don’t feel any way toward the patients other than the desire to help them. I hope that when I start interviewing patients, I can help them feel heard.

We all went to eat together during lunch time. The team is super nice, we all go eat together and talk about life and everything. My colleagues are super sweet people.

A lot of my day was just spent sitting in the doctors room, reading the patient files, getting to know how patient texts are. On my second day of work I actually got to write two patient texts. I found it really nice actually! It’s really nice to write a comprehensive text of what happened in the meeting so that other doctors can know in the future what is going on with the patient.

My days usually end at around 15:30. I could leave earlier, but I’ve opted to stay at work to write some patient texts.

I’ve found it super useful that I wrote notes about medications before work. That’s honestly been the most useful notes I wrote. I most likely will always know the diagnosis of the patient already, and just need to be part of the treatment planning. So I definitely recommend writing down notes about medications, like side effects, dosage, uses, commonly used with medications, etc.

Why do patients come to the ward?

There’s a few reasons patients come to the ward, and it can be quite well summarised to this:

There’s an acute risk to either their health or another’s because of them (e.g. suicide, violence)
The patients mental health disorder will get significantly worse if not treated in the ward and
Outpatient care is not enough

Simply put, a patient might be a risk to themselves or others, and perhaps they don’t realise it or aren’t motivated to recover in outpatient care. These could be patients in active psychosis (often paranoid psychosis where they believe someone is out to get them) or ones recovering from a suicide attempt or plans of one.

The goal of the treatment in the ward isn’t to heal these patients, but to get them out of the acute-risk state. Often this is done by updating their medications, therapy, and getting them a treatment contact to outpatient care.

So oftentimes, a patient might still be suicidal, but aren’t actively planning on it anymore, and they’re let out. Sometimes this might feel harsh, but it’s true that it’s not the job of the ward to get the patients healthy. It's to get them healthy enough to continue treatment in the outpatient clinic. This way other patients in more dire need of ward treatments have the spot available for them in need.

The patient meetings

So what actually happens?

I will ask a doctor when they’ll have their next meeting. Maybe it’ll be like 20 minutes away and then I’ll read up on the patient so I know who they are and why they’re there. Then, we will go together to the nurses room to get the nurse who is in charge of the care for this patient. Together, we all go to a meeting room with the patient. There will usually be 4 of us in the room. Either I’ll introduce myself as a student or the doctor will, and if the patient doesn’t agree with me being there, I’ll of course leave. This only really happened once.

In a meeting I typically will write down notes about the things that are said, or the way the patient is (dressed, affect, etc.). These notes I will use to write the patient text after. Later on, I’ll also contribute to the conversation by asking questions. I don’t do much else at the moment. I just listen empathetically.

I find these meetings the best part of my job. I have loved hearing about these patients situation. That maybe sounds bad, but I mean that I really care about what they’re saying, their situation and I’m genuinely intrested in them. I think that’s super important if you’re considering psychiatry. This field isn’t only symptoms of an illness, it’s usually something that has deeply affected their life and their ability to live it.

After a meeting, a few times I’ve discussed with the doctor about the medications, asked about them and they are always super nice and tell me about them.

What kind of patients did I see

I saw a big variety of patients. Many people in psychosis due to different reasons. Some might have schizophrenia, some schizoaffective disorder, some maybe have psychotic depression. They all present with similar symptoms but have important distinctions. I saw many manic patients as well, as it is the season for mania for many with the bipolar diagnosis (mania often starts in the summer when there’s more light).

Many patients had poorly treated schizophrenia. Schizophrenia and other such disorders often come with poor commitment to medication. This is partly due to how the disorder affects the motivation in a person, and partly due to patients not feeling the need to take the medication.

The patients are very often cooperative. And even when not, usually they’re still very calm. The few that aren’t, are put in an isolation room where they won’t be able to participate in the wards activities.

The wards have different activities that they do together. Three times a week there’s a dialectal behaviour therapy (DBT) group session. I got to participate once and it was very nice! We were all participating, learning to be more in the present and how to stop being controlled by anxiety and bad mood. I think DBT is super useful to everyone, not just people with psychiatric illnesses. I personally read books on it just to learn the skills for myself…

Many patients are also very kind and treatment-oriented. They often don’t want to be sick and want some help for it. They just may struggle to keep up with treatment, which is unfortunate.

The mood ward had a lot of patients with BPD and depression. Most BPD patients have a pretty similar presentation: suicide attempts, self harm, unstable home life and relationships. Many patients with BPD attempt suicide in a "safe" way multiple times. It sounds backwards, but it’s true. Often they’ll call or text someone ahead of time and let them know that they’re about to go commit suicide. Then police go pick them up, and they’re brought to the ward. It’s very unfortunate, because BPD is not as straightforward to treat. DBT is usually the standard for treating BPD and it has proved successful in treatment to the point that a large portion of patients will not meet the diagnostic criteria for BPD in a 10-year follow up. The problem is, that many BPD patients do not want to participate in DBT.

Patients in the wards are varying levels of sick. All (or at least most) are in need of psychiatric ward treatment, but some are worse off than others. Some have had their diagnosis for over 10 years without proper treatment. Some haven’t even been diagnosed yet, but have been living with symptoms for years. It all varies.

The last weeks

With more confidence, with certain patients I was allowed to ask some questions and interview the patients. Every patient is very different. Some hide their true feelings and thoughts so you have to take into consideration how you ask the questions. Sometimes, you can’t take only the patients word for it. At times you’ll have to judge based on what they say, how they say it and their body language.

As the weeks progressed I definitely started feeling more connected to the patients. It’s very easy to feel sympathetic towards the patients as their circumstance is often not ideal. Some evenings I would even research medication and diagnoses on my own time to suggest different treatment options.

As an amanuenssi, you don’t have the responsibility of making decisions or telling the patient the treatment plan. Sometimes it feels limiting. In a way, I would like to do more for the patients. Sometimes I believe I would know how to motivate the patient better. But then again, confidence is the highest at the beginning of your learning. Psychiatric patients are often very sensitive and just one thing you say might change the course of their treatment. You say one thing wrong: They might become treatment resistant. They might never trust you again.

Obviously, it’s a lot of pressure. That’s why often the doctors end up saying less and asking more. Only in situations where the patient is refusing medication or boundaries need to be drawn, might the doctors say something. But with psychiatric patients, the goal is to make the patient want the treatment. If you force someone to take a medication, they might take it for the duration of the ward period. But at home, they’ll very likely stop taking it. Then they’ll come back to the ward, less trusting of doctors this time around. So there’s a lot of factors to consider.

The staff

The staff at my hospital was super nice. They are all very welcoming and eager to help. I asked the head nurse if I could follow the nurses one day, and she very kindly organised it for me! It was super nice to get to know the nurses and see what really happens in the ward. In many ways not a lot really happens at the ward itself. It’s kind of how it’s designed to be. The ward had very little triggers that could affect a persons mood.

The doctors were super nice to me. I followed one of the student doctors a lot for three weeks. I would go to all her meetings and write a lot of the texts for her. It taught me a lot. Following the same patients for an extended period meant I could really see the patients wellbeing improve with the right treatment. It really is crazy how much a persons situation can change in a short amount of time with the right medication.

One patient case that stuck with me went as follows. I’ve changed some information about the case to make it less specific for this patient. This patient came to the ward with very strong anxiety and panic states. They couldn’t get anything done at home and would just lay in bed all day. They had kids. The doctor had tried a few medications from a certain medication group with the patient. The patient was convinced that every medication was giving them strong side effects, ones that aren’t typical of the medication. It was suspected that they might be psychosomatic symptoms. But of course, telling a patient that they’re making up pain and other symptoms is not really the way to go. The patient had a tendency to think catastrofically and to ruminate on their wellbeing. Our ward’s psychologist summarised well for the patient what their symptoms appear to be, in order to help the patient break this cycle of rumination. Regardless, after this the patient strongly rejected their new medication. On the next appointment, I took a lot of the things the psychologist said to the patient and re-emphasized how important it would be to commit to this treatment plan, try a new medication and *not* google the side effects. This way we can build the patients trust toward the care system. Another doctor had suggested to us another medication (from another medication group) to try with the patient, since they were so against this previous medication group. With this support from different groups of professionals, the patients symptoms improved significantly and we were able to send her home the next week.

Our ward’s psychologist also told me that when a patient goes to a private psychiatrist, they get treatment only from this one psychiatrist. But when they go to a psychiatry outpatient clinic on the public sector, they are treated by a team of professionals. This gives the patient very large-scale help. At the ward, the patient is seen by doctors, nurses, psychologists, sometimes even nutrition therapists or functional therapists.

Will I be doing psychiatry again?

Definitely. My experience in psychiatry has been eye-opening. I’ve gained so much understanding about psychiatric illness and how it really affects the patients. I’ve also learned a lot about different systems that are in place to help these people.

In the future I might be publishing a guide of what to study for psychiatry internships in order to get the most out of them!