Telepsychiatry, TMS & Women’s Mental Health: Victoria Starner, PA-C, CAQ-Psych

Origin Story

Victoria Starner didn’t start in psychiatry. She began in outpatient pediatrics, transitioned during the height of COVID into a fully remote psychiatric practice, and built her confidence through structured mentorship. Today, she works on-site in a New York practice offering TMS and Spravato while focusing on ADHD, anxiety, and women’s mental health. Her story reinforces one truth: it only takes one connection to build a career in psychiatry.

How She Got Here (and Why Mentorship Made the Difference)

Strong foundation: Victoria completed a psychiatry rotation in PA school — an opportunity not every program offers.

First role: Outpatient pediatrics.

The transition: In 2021, she joined a small private psychiatric practice in Maryland during COVID, practicing fully remotely.

What made it work:

• Three months of structured onboarding

• Psychiatrist joining initial visits and introducing her to patients

• Warm handoff model

• Close mentorship from an experienced psychiatric PA (Carol Smith)

“Mentorship determines confidence.”

That gradual exposure allowed her to safely build skills in psychiatric interviewing, medication management, and telepsychiatry workflows.

Telepsychiatry Done Right

Victoria practiced telepsychiatry for four years.

Benefits she observed:

• Improved access to care

• Higher appointment retention

• Flexible scheduling for patients

• Reduced commute barriers

What made it sustainable:

• Clear supervision structure

• Strong provider collaboration

• Defined communication channels

Telemedicine wasn’t just convenient — it expanded psychiatric access while preserving quality.

Expanding into TMS and Spravato

Victoria recently transitioned to an in-person role in New York at a practice offering:

• Transcranial Magnetic Stimulation (TMS)

• Spravato (esketamine)

Her role includes:

• 40-minute monitoring visits during Spravato sessions

• On-site patient support

• Collaborative management alongside four psychiatrists

This shift reflects a growing trend in psychiatry: neurostimulation and rapid-acting treatments are becoming more integrated into outpatient psychiatric practice.

Clinical Interests: ADHD, Anxiety & Women’s Mental Health

Victoria is particularly drawn to:

• ADHD across the lifespan

• Anxiety disorders

• Women’s mental health

She highlighted the importance of:

• Recognizing PMDD vs bipolar misdiagnosis

• Educating patients about menstrual cycle-related mood changes

• Supporting pregnancy planning and peripartum care

• Providing validation in psychiatric diagnosis

“Sometimes the diagnosis itself becomes the treatment.”

Accurate labeling and education can reduce stigma and empower patients — especially women whose symptoms are often dismissed.

What She Actually Uses (and Recommends)

Core resources:

• Stahl’s Prescriber’s Guide

• Psychiatry & Psychotherapy Podcast (David Puder)

• Peer mentorship

Her advice for new PAs:

• Network intentionally

• Ask about onboarding structure

• Clarify supervision expectations

• Seek out experienced psychiatric providers

• Trust your medical training

“Every new grad feels nervous — but you will figure it out.”

Practice Design & Career Longevity

Victoria works a four-day schedule with extended shifts, prioritizing:

• Provider collaboration

• Team culture

• Professional tribe-building

• Personal interests (dance, movement, community engagement)

Her background in dance influences how she speaks to patients about movement — focusing on joy rather than rigid exercise prescriptions.

“Make movement fun.”

Whole-person psychiatry starts with whole-person clinicians.

Shareable Takeaways

• A pediatrics-to-psychiatry transition is possible with mentorship.

• Telepsychiatry can be high-quality and sustainable.

• Structured onboarding builds confidence in new psychiatric PAs.

• Women’s mental health requires diagnostic nuance and validation.

• Psychiatry careers are built through connection, not perfection.

Connect with Victoria

Instagram: @torstarner

If you enjoyed this conversation, catch the full episode of Mindset Matters and share it with a PA considering a career in psychiatry or exploring telepsychiatry, TMS, or women’s mental health.

Because when psychiatric PAs support each other — we expand access, confidence, and impact.