The National Capital Military Psychiatry Residency Program is a unique and innovative military graduate medical education program in psychiatry. Four military medical institutions with traditions of excellence in graduate medical education have joined forces to form an integrated psychiatry residency program. Residents from these institutions consistently score among the highest in the nation on standard training examinations. A large number of graduates have gone on to distinguish themselves as national and world leaders in psychiatry. Walter Reed Army Medical Center (WRAMC), National Naval Medical Center (NNMC), Malcolm Grow U.S. Air Force Medical Center (MGMC), and the Uniformed Services University of the Health Sciences (USUHS) have integrated previously separate Army, Navy, and Air Force psychiatry residencies. After two years of affiliation between previously existing institution-based residency program, the integrated psychiatry residency officially began operation in July 1996.
The National Capital Military Psychiatry Residency is a four-year program designed to prepare uniformed services residents for the practice of general psychiatry in military and community settings. The program's mission is to train physicians to become effective psychiatrists in the variety of future roles they will fill, from military medical operations to multi-disciplinary mental health settings to primary care and other medical-surgical settings. Military Psychiatry and Psychiatry in Primary Care are two particularly strong areas of emphasis of the program. The program has more than fifty full-time faculty members, nationally known leaders in a number of areas of psychiatry, including psychopharmacology, psychoanalysis, neuropsychiatry, child and adolescent psychiatry, consultation-liaison psychiatry, military psychiatry, and psychiatry in primary care. In addition, there are more than forty part-time faculty members from other National Capital military institutions, Walter Reed Army Institute of Research, USUHS, and NIH.
Combined residency training opportunities are also offered by the program. Residents may accelerate their training in order to complete both general psychiatry and child and adolescent psychiatry training in a total of five years. In addition, there is a five-year combined psychiatry-internal medicine training program offered by the National Capital Military Psychiatry Residency and the Internal Medicine Residency Program at Walter Reed Army Medical Center. Graduates of this combined program complete requirements necessary for graduation from both residencies and for board certification both in general psychiatry and in internal medicine. There is also a combined five-year residency program in Psychiatry and Family Practice, utilizing this psychiatry program and the Family Practice residency program at Malcolm Grow USAF Medical Center.
Walter Reed Army Medical Center is the flagship medical center of the U.S. Army and has a rich tradition of excellence and leadership in military medicine and graduate medical education. WRAMC has one of the world's largest institutes of military medical research, the Walter Reed Army Institute of Research. National Naval Medical Center serves as "The President's Hospital." This flagship Navy medical center is across the street from the National Institutes of Health and shares a campus with the Uniformed Services University of the Health Sciences. Malcolm Grow U.S. Air Force Medical Center is on Andrews Air Force Base, an active military base that serves the President and members of Congress. Andrews AFB also hosts an Airlift Military Command wing and active duty and reserve Navy and Air Force training units. MGMC hosts both Psychiatry and Family Practice GME training, providing a rich environment for learning the practice of psychiatry in primary care settings. The Uniformed Services University of the Health Sciences is the uniformed services's own medical school and is the site for the residency's didactic courses, grand rounds, and is a center for military psychiatry research. USUHS medical students also rotate in the residency's participating institutions during their third and fourth years of medical school.
Potential
applicants are encouraged to visit the program if possible, or at least
talk to members of the Residency Training Committee by phone. Each participating
institution offers fourth year medical student elective rotations that
familiarize potential applicants with the advantages offered by this new
GME program. Applicants from the Army, Navy, Air Force, and Public Health
Service may apply to this residency in the same manner as to any other
military GME program, by designating the participating institution of his
or her service on the military GME application form.
Train military
physicians to become effective psychiatrists in the variety of future roles
they will fill, including military medical settings, multi-disciplinary
mental health settings, and primary care and other medical-surgical settings.
The National Capital Military Psychiatry Residency Program is one of a number of integrated graduate medical programs in the National Capital Area. These programs are part of the National Capital Consortium for Graduate Medical Education. The Consortium provides overall policy direction for the integrated GME programs (e.g., due process and appeals) as well as a structure for cooperative training among area military GME programs.
The NCA Military Psychiatry Residency Program has an executive Policy Committee and a Curriculum Committee. The Policy Committee formulates policy for the residency program and monitors overall resident progress. The Curriculum Committee designs rotation objectives, coordinates courses, and plans residency review activities. The Policy Committee is comprised of the program director, on-site training directors of the four participating institutions, a senior faculty consultant, and the program housestaff president. The Curriculum Committee is chaired by the USUHS training director and includes the program director, training coordinators for each year of training, coordinators for key aspects of training (e.g., community psychiatry), a senior faculty consultant, and resident representatives. There are also training committees for each level of training. Each PG year committee is chaired by a faculty coordinator and includes faculty members from each service where residents rotate that year, as well as a resident representative.
The Program Director is full-time and includes the following responsibilities: resident appointments and assignments, administering and directing educational activities, coordinating training in each geographically separate institution, and providing written information to residents and applicants regarding financial compensation, liability coverage, and program policies. The program director also chairs the program's policy committee and reports on residency issues and problems to participating institution department chairmen. The program director reports to the executive officer of the NCA Military GME Consortium and coordinates with participating institution department chairmen via the USUHS Advisory Board. The participating institutions' on-site training directors are appointed by and represent department chairs of those institutions. Resident records are maintained at a central location and are the responsibility of the Residency Policy Committee. Individual clinical rotation evaluations will be coordinated by the Training Year Committee according to standards developed by the Policy Committee.
The Council of Psychiatric Residents is chaired by the housestaff president, who is responsible for administrative representation of all residents in the program on the residency policy committee. The housestaff vice-president serves on the residency curriculum committee. There are also Army, Navy, and Air Force chief residents, each of whom sit on one of the PG-year training committees. Resident officers are elected by vote of the residents' Housestaff Council. The residency program will, from time to time, with appointment by participating institution department chairs, form time-limited subcommittees and working groups to provide consultation on important issues needing review or work (e.g., annual retreat planning). Residents are represented on these appointed groups. The Council of Psychiatric Residents meets weekly during protected didactic time.
NATIONAL CAPITAL MILITARY PSYCHIATRY RESIDENCY POLICY COMMITTEE
Program Director (Chair); Thomas A. Grieger, LTC, USAF, MC, FS
Senior Faculty Consultant: Maria Esposito, M.D., COL, MC, USA (RET)
Training Director: Walter Reed Army Medical Center: George Brandt, M.D., MAJ, MC, USA
Training Director: National Naval Medical Center: Gerald Cohen, M.D., CDR, MC, USN
Training Director: Malcolm Grow U.S. Air Force Medical Center: Timothy Lacy, M.D., Co-Director, Combined Psychiatry-Family Practice Residency, MAJ, USAF, MC
Training Director: Uniformed Services University of the Health Sciences: Thomas A. Grieger, M.D., CDR, MC, USN
Training Director: Combined Psychiatry-Medicine Residency: Scott Joslin, M.D., MAJ, MC, USA
Training Director: PGY-2 Training Committee: Sandra Yerkes, M.D., CDR, MC, USN
Training Director: PGY-3 Training Committee: Kevin Moore, M.D., LCDR, MC, USN
Training Director: PGY-4 Training Committee: George Brandt, M.D., MAJ, MC, USA
Housestaff President: Brian Grady, M.D., LCDR, MC, USN
NATIONAL CAPITAL MILITARY PSYCHIATRY CURRICULUM COMMITTEE
USUHS Training Director (Chair): Tom Grieger, M.D., CDR, MC, USN
Program Director: James R. Rundell, M.D., LTC, USAF, MC, FS
Senior Faculty Consultant: Maria Esposito, M.D., COL, MC, USA (Ret)
PGY-2 Committee Representative: Adam Lowy, M.D.(Civilian)
PGY-3 Committee Representative: Tim Lacy, M.D., MAJ, USAF, MC
PGY-4 Committee Representative: Cameron Ritchie,M.D., MAJ, MC, USA
Housestaff Vice-President: Staci Valenzuela, M.D., LT, MC, USN
Chair E. Cameron
Ritchie, M.D., MAJ, MC, USA
Inpatient
Psychiatry Sarah Kohn, M.D., Capt, MC, USA
Inpatient
Psychiatry Keith Caruso, M.D, LCDR, MC, USN
Partial Hospital
Sandra Yerkes, M.D., CAPT, MC, USN
Addiction
Psychiatry Shannon Miller, M.D, Capt, USAF, MC
Adolescent
Psychiatry Tom Fluent, M.D., LCDR, MC, USN
Program Director
James R. Rundell, M.D., LTC, USAF, MC, FS
Chief Resident
Rena Ferguson, M.D., LT, MC, USN
Chair Kevin
Moore, M.D., LCDR, MC, USN
National
Naval Medical Center Gerald Cohen, M.D., CDR, MC, USN
Walter Reed
Army Medical Center Donald Hall, M.D., MAJ, MC, USA
Child and
Adolescent Psychiatry Al Parambo, M.D., MAJ, MC, USA
Senior Faculty
Consultant Maria Esposito, M.D., COL, MC, USA (Ret)
Program Director
James R. Rundell, M.D., LTC, USAF, MC, FS
Chief Resident
John Kennedy, M.D., LT, MC, USN
Chair George
Brandt, M.D., MAJ, MC, USA
Community
Psychiatry Donald Hall, M.D., MAJ, MC, USA
Child and
Adolescent Psychiatry Steve Cozza, M.D., MAJ, MC, USA
Malcolm Grow
USAF Medical Center Edwig Plotnick, M.D., MAJ, USAF, MC
Program Director
James R. Rundell, M.D., LTC, USAF, MC, FS
Chief Resident
Staci Valenzuela, M.D., LT, MC, USN
PSYCHIATRY DEPARTMENT CHAIRS OF PARTICIPATING INSTITUTIONS
Walter Reed
Army Medical Center
Sandra Yerkes,
M.D. CAPT, MC, USN
National Naval
Medical Center
Michael Dinneen,
M.D. CDR, MC, USN
Malcolm Grow U.S. Air Force Medical Center
Molly Hall,
M.D. LTC, USAF, MC, FS
Uniformed
Services University of the Health Sciences
Robert J.
Ursano, M.D. COL, USAF, MC (RET)
COUNCIL OF PSYCHIATRIC RESIDENTS (1997-1998)
Housestaff
President:
Brian Grady,
M.D.
LCDR, MC,
USN
Housestaff
Vice-President:
Staci Valenzuela,
M.D.
LT, MC, USN
PGY-4 Chief
Resident:
Staci Valenzuela,
M.D.
LT, MC, USN
PGY-3 Chief
Resident:
John Kennedy,
M.D.
LT, MC, USN
PGY-2 Chief
Resident:
Rena Ferguson,
M.D.
LT, MC, USN
APPLICATION, SELECTION, AND APPOINTMENT PROCESS
GENERAL POLICIES:
Applicants to the National Capital Military Psychiatry Residency must be eligible for active duty military service or in the commissioned corps of the U.S. Public Health Service. Therefore, applicants must be U.S. citizens and have a command of the English language sufficient to facilitate accurate and unhampered communication with patients and teachers.
PGY-1 APPLICANTS: Applicants submit their applications and credentials to the Office of Graduate Medical Education in their respective military services. Army applicants must use the Electronic Residency Application System (ERAS). Help with completing the ERAS can be obtained by calling the Walter Reed Office of Psychiatric Education and Training (202-782-5989 or 7104). Navy and Air Force applicants submit paper applications through their respective services. Help with the Navy application process is available in the NNMC Psychiatric Education Office (301-295-2458). Help with the Air Force application process is available in the Malcolm Grow USAF Medical Center GME Office (301-981-6061). Students in the U.S. Public Health Service should contact the program director for more specific information applicable to their application process (301-295-9796).
Both HPSP and USUHS students should receive standard application materials automatically from their respective military services. Each medical center in the program also has a GME Office, which can help provide necessary application materials if not received and answer questions. The residency program offices in each of the medical centers can also help with the application process. It is important to designate on the application form that acceptance for GME is desired at WRAMC for Army applicants, NNMC for Navy applicants, and MGMC for Air Force applicants, since integrated program assignment billets are managed by personnel offices in those medical centers. In the essay which accompanies the application explain that you desire appointment to the NCA Military Psychiatry Residency Program. If you have any questions about the application procedure, please call the Program Director, Dr. Rundell, at (301)-295-3294 or (202)-782-7104; or call the training director at one of the medical centers: Dr. Sullivan at WRAMC (202)-782-7104, Dr. Cohen at NNMC (301)-295-0847, or Dr. Lacy at MGMC (301)-981-5420.
APPLICANTS IN ADVANCED STANDING: Applicants for admission in advanced standing (PGY-II and beyond) follow the same procedures as applicants for PGY-I positions. Physicians are appointed for entry to the program at the second postgraduate year level only after a broad-based clinical year of accredited training in the United States or Canada in Programs in internal medicine, family practice or pediatrics; or after one year of an accredited residency in a clinical specialty requiring comprehensive and continuous patient care.
APPLICANTS FOR ACCELERATED OR COMBINED RESIDENCY TRAINING PROGRAMS: Applicants interested in accelerated psychiatry-child/adolescent psychiatry training or in combined residency training in psychiatry-internal medicine or psychiatry-family practice should contact the psychiatry program director (301-295-9796) for information about application to these programs.
INTERVIEWS AND ELECTIVE ROTATIONS
Personal or telephone interviews are required for admission to the program. Potential applicants are encouraged to arrange personal interviews whenever possible, though interviews may be conducted by telephone when a potential applicant cannot physically be present. If possible, medical students are also encouraged to arrange elective rotations in one of the participating institutions. These rotations provide a chance to meet the faculty and become acquainted with the residency program.
Applicants are interviewed by members of the faculty and resident staff of the residency program. Just before the joint service GME Selection Board in late November, the applications, credentials, curriculum vitae and applicant interview reports are examined by the Residency Policy Committee of the NCA Psychiatry Residency Program. The Committee ranks the applicants in an official "order of merit" list presented to GME offices of all three military services. The merit list is determined by many factors, including applicant training location preference, interview results, the applicant essay, medical school academic performance, and commitment to the philosophy and goals of the program. Final selection decisions are made at the Graduate Medical Education Selection Board held in late November of each year, in consultation with program directors from other military GME institutions offering psychiatry residency training.
When appointments are made at or beyond the PGY-II level, credentials and past training are documented so as to ascertain that the individual has met essential requirements for the first postgraduate year if that year was in an accredited psychiatric residency training program, or the requirements for entry at the PGY-II level if prior training was in a non-psychiatric program. Applicants for transfer from other psychiatric training programs must provide written documentation from the previous training program(s) as to past clinical training, performance and professional integrity. This documentation is always made a part of the resident's permanent training record. We ensure that all transferring residents will have progressive levels of clinical responsibility, avoid redundancy of clinical and didactic training, and meet our program criteria for the given PGY-I level of appointment as well as ultimately the criteria for graduation.
Upon selection and admittance to the residency, residents receive appointment as a captain in the Army and Air Force or as a lieutenant in the Navy and USPHS, unless prior military service mandates a higher rank. Residents report to their medical centers of primary assignment in late June for orientation to the residency program and to the medical centers in the area.
All four of the residency's participating institutions are located near the Capital Beltway. Walter Reed, National Naval Medical Center, and USUHS are within five miles of each other. Malcolm Grow is a convenient half-hour drive around the Beltway, against heavy traffic during rush hour.
WALTER REED ARMY MEDICAL CENTER
Walter Reed Army Medical Center (WRAMC) is the flagship medical center of the U.S. Army and has a rich tradition of excellence and leadership in military medicine and graduate medical education. Patients are transferred to WRAMC from around the world and receive the highest quality care from specialists and subspecialists in every medical and surgical field. WRAMC is the largest medical center in the Army and has the National Capital Area's adult inpatient psychiatry unit, as well as a partial psychiatric hospital, outpatient adult and child/adolescent clinics, a forensic psychiatry service, and a nationally recognized consultation-liaison service. The area's new 24-hour consolidated emergency psychiatry service will be headquartered at WRAMC. The outpatient mental health clinic sees more than 30,000 patients annually, the inpatient service admits more than 800 patients annually, and the consultation-liaison service evaluates more than 1,200 patients each year. Walter Reed is the home base for several Consortium post-residency fellowship programs in psychiatry, including child and adolescent psychiatry, consultation-liaison psychiatry, and forensic psychiatry. Walter Reed is also home to one of the largest military medical research facilities in the world, Walter Reed Army Institute of Research (WRAIR), as well as the Armed Forces Institute of Pathology, which houses extensive neuropathological collections.
NATIONAL NAVAL MEDICAL CENTER
National Naval Medical Center (NNMC), often also referred to as "Bethesda" or simply "Navy," is "The President's Hospital." Located in Bethesda MD, this flagship Navy hospital has more than 200 beds. Patients are referred from around the world. NNMC not only houses the medical center, but also the National Naval Dental Clinic, Naval School of Health Sciences, and the Health Sciences Education and Training Command. National Naval Medical Center is relied upon by the Navy for operational support. NNMC staff serve on teams which deploy on the USNS Comfort, a large hospital ship. In addition NNMC supports deployment operations such as post-disaster medical care, refugee care, and Antarctica activities. As a major teaching hospital, NNMC receives patients from all parts of the world. The medical center is across the street from the National Institutes of Health and shares a campus with the Uniformed Services University of the Health Sciences. In addition to psychiatry residency training, NNMC sponsors a full spectrum of primary care and specialty training programs. National Naval Medical Center has the NCA's inpatient adolescent psychiatry unit, an adolescent partial hospital, an innovative outpatient psychiatry clinic, and a combined consultation-liaison/emergency psychiatry service. NNMC psychiatrists serve on a Special Psychiatric Rapid Intervention Team (SPRINT Team), which deploys immediately when military operational psychiatric issues arise in wartime and peacetime environments.
MALCOLM GROW U.S. AIR FORCE MEDICAL CENTER
Malcolm Grow U.S. Air Force Medical Center (MGMC) is located on Andrews Air Force Base, an active military base that serves the President of the United States and members of Congress. Andrews AFB houses Air Force One and the fleet of presidential and diplomatic aircraft. MGMC is a 200 bed facility closely involved with base activities. For example, Malcolm Grow provides medical care for the many Special Air Missions which are deployed to and from Andrews AFB. There are active Navy and Air Force training units as well as a wing of the Airlift Military Command. The medical center supports one of the largest military aeromedical evacuation hubs in the world. Accordingly, patients from all over the world pass through and receive care at MGMC. Malcolm Grow has the National Capital Area's inpatient addiction psychiatry unit, dual diagnosis unit, and partial substance related disorder treatment unit. MGMC is a primary care community medical center, and has a large family practice training program. The consultation-liaison service provides an effective interface between psychiatry and family practice inpatient and outpatient clinical and teaching activities. Much of each resident's experience in psychiatry in primary care occurs at MGMC, where psychiatrists and psychiatric residents work directly within the family practice clinic.
UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES
The Uniformed Services University of the Health Sciences (USUHS) has the military's own medical school (F. Edward Hebert School of Medicine). USUHS is the source of much of the residency's teaching, lecturing, and supervising faculty, and is a center for military psychiatry research. USUHS has developed a world-wide reputation for expertise in effects of psychological trauma, military families, the POW experience, the Gulf War "Syndrome," HIV-related neuropsychiatric phenomena, women in the military, and toxic/contained environments (e.g., chemical and biological warfare protective garments and structures). USUHS medical students rotate at all the residency's participating institutions and are supervised by psychiatry residents. The residency program places a high priority on teaching residents to be effective teachers from the earliest rotations of the residency. USUHS is also the home of three post-residency psychiatry fellowships: military psychiatry, traumatic stress disorders, and addiction psychiatry.
OVERVIEW OF CLINICAL ROTATIONS
PGY-1 ROTATIONS
(13 Four-Week Rotation Blocks)
PGY-2 ROTATIONS
(13 Four-Week Rotation Blocks)
PGY-3 ROTATIONS (10 Half-Days per Week Based at One
Site)
PGY-4 ROTATIONS (13 Four-Week Rotation Blocks)
SUMMARY OF DIDACTIC TRACKS, COURSES AND SEMINARS
Each didactic track organizes several courses into overall areas of emphasis consistent with goals and objectives for each training year.
All didactic courses are taught during half-day blocks at the Uniformed Services University of the Health Sciences. Courses designated as "seminars" are usually taught at one of the clinical sites. Attendance at courses and seminars is mandatory and staff physicians cover clinical duties of residents during their attendance period.
TRACK 1: THE BRAIN AND THE MIND
2101,3101,4101 Grand Rounds, PGY 2-4 42 Hours/yr= 126
2103,3103,4103 Resident Process Group, PGY 2-4 42 Hours/year=126
2110 Orientation to General Psychiatry 19 Hours
2131 Growth and Development 24 Hours
3111 Overview of Neuroscience 25 Hours
3121 Psychodynamic Theory in Clinical Practice 10 Hours
3131 Overview of Child Psychopathology 19 Hours
3141 Classics in Psychodynamic Psychiatry 18 Hours
4111 Review of Clinical Neurology 8 Hours
4121 Human Sexuality 6 Hours
TRACK 2: APPROACH TO THE PATIENT
2111 Basic Principles of Psychiatry 38 Hours
2201 Psychological Assessment Methods 5 Hours
2202 Interviewing Skills Seminar 20 Hours
2211,3211,4211 Psychiatry Morning Report Seminar 80 Hours
2221,4221 Inpt. Psychiatry Treatment Planning Seminar
44 Hours
2222 Inpatient Psychiatry Case Conference Seminar 36
Hours
2223 Substance Abuse Seminar 6 Hours
2224 Adolescent Psychiatry Inpatient Seminar 6 Hours
2231 Emergency Psychiatry 7 Hours
2233 Inpatient Group Psychotherapy Course 11 Hours
2225 Inpatient Group Psychotherapy Seminar 100 Hours
2234 Principles of Hypnosis 7 Hours
2251 Supportive Psychotherapy 5 Hours
2252 Biopsychosocial Formulation and Treatment 10 Hours
3201 Couples and Family Psychotherapy Course 10 Hours
3202 Outpatient Diagnostic and Case Planning 48 Hours
Seminar
3221 Brief Psychodynamic Psychotherapy 10 Hours
3231 Cognitive Psychotherapy 10 Hours
3241 Outpatient Group Psychotherapy 14 Hours
4232 Consultation-Liaison Psychiatry Case Seminar 14
Hours
4233 Geriatric Psychiatry 6 Hours
4261 Behavioral Therapies 7 Hours
4271 Advanced Psychotherapy Techniques 16 Hours
TRACK 3: THE HEALTH CARE SYSTEM
1301 Orientation to the Integrated Psychiatry Residency
4 Hours
2301 The Psychiatric Ward Milieu and Organizational Psychiatry
10 Hours
3301 Health Care Economics 10 Hours
3311 Orientation to Child and Adolescent Psychiatry 4
Hours
4341 Ethical Issues in General and Military Psychiatry
4 Hours
4351 Evidence-Based Medicine 12 Hours
4361 Preparing for Psychiatric Practice 4 Hours
4371 Preparing for Board Examinations 6 Hours
TRACK 4: COMMUNITY AND MILITARY PSYCHIATRY
1401 Orientation to Military Psychiatry 2 Hours
1411 Combat Care Casualty Course 100 Hours
2402 Orientation to Military Administrative Psychiatry
I 5 Hours
3402 Orientation to Military Administrative Psychiatry
II 5 Hours
3403 Military Medical Field Exercise: "Bushmaster" 50
Hours
4401 Orientation to Community Psychiatry 2 Hours
4411 Military Studies 7 Hours
4412 Military Medicine 3 Hours
4413 Military Psychiatry 17 Hours
4441 Sociocultural Issues in Psychiatry 10 Hours
4451 Overview of Forensic Psychiatry 11 Hours
NIGHT CALL
Night call, including coverage of emergencies presenting
in the emergency room and on the inpatient wards, is an integral part of
training. Frequency of night call differs in each year of residency training
but decreases each year. In the PGY-I year, the frequency of night call
is determined by the particular service to which the resident is assigned,
but is never more frequent than one night in three. From the PGY-II through
the PGY-IV year, there is a decreasing frequency of night call, so that
the PGY-II residents, who are assigned to wards in the hospitals, cover
most of the night call. PGY-III, and PGY-IV residents, who have diverse
assignments, many of them out of the hospital, cover night call infrequently.
The following table summarizes ranges of frequency of night call in the
hospital per month in each year of residency training as defined by the
Residency Policy Committee:
MINIMUM MAXIMUM
PGY-1 2 10* (*10 times a month while in
MICU)
PGY-2 3 5
PGY-3 2 4
PGY-4 1 3
Residents have, on average, at least one day in seven
free of hospital duties at each level of training. PGY-2 - PGY-4 residents
have weekends off when not on call. When a resident is on call, a faculty
psychiatrist is always available for consultation and assistance.
ANNUAL LEAVE:
PGY-I: During the first year, a resident is authorized
14 days leave. A leave form can be obtained from the Intern Director or,
for psychiatry residents, from the Psychiatry Departments in each of the
three medical centers. The Attending Physician of the Service to which
the resident is assigned during the requested leave period must initial
the form. The Site Training Director then signs the form authorizing the
leave after the Attending Physician initials the form. The secretary or
enlisted department administrator in each medical center's Department of
Psychiatry processes the form for Psychiatry Residents. You must obtain
a copy of the form before you go on leave and complete the appropriate
boxes when you return from leave.
PGY-II to PGY-IV: During the second to fourth years, a
resident is authorized 30 days of annual leave and up to five days of educational
permissive TDY. Leaves should be planned well ahead of time, and must have
the approval of the service chief for whom you will be working at the time
of the leave. A limited number of residents will be allowed to be on leave
at any one time, so it is wise to discuss leave plans with fellow residents
to avoid conflicts. The Site Training Director must approve all leaves
for residents, and this approval will be contingent upon the resident being
in satisfactory status in his work and training program. It is customary
to plan leave in 1-week increments.
COMBINED AND ACCELERATED RESIDENCY TRAINING
There are opportunities for residents to pursue combined and accelerated residency training within the National Capital GME Consortium. In the past there have been residents who have obtained dual board certification in psychiatry-internal medicine, psychiatry-neurology, psychiatry-family practice, and psychiatry-child psychiatry. These individuals generally pursued individual tracks leading to dual certification. In cooperation with other NCA residency and fellowship training programs, there are now specific, well-structured, and board-approved combined or accelerated residency training programs in the National Capital Area in general psychiatry-child/adolescent psychiatry, psychiatry-internal medicine, and psychiatry-family practice. Further details about these unique programs may be obtained from brochures and handbooks that describe them, as well as by contacting the combined/accelerated program's directors or co-directors.
ACCELERATED PSYCHIATRY-CHILD PSYCHIATRY RESIDENCY TRAINING
By carefully constructing the PGY-1 through PGY-3 years
of the general psychiatry residency, it is possible to begin child and
adolescent psychiatry training during the PGY-4 year. By the end of the
PGY-5 year, graduates are eligible to attempt board certification in both
general psychiatry and child\adolescent psychiatry. This combined training
program is one year shorter than sequentially completing a general psychiatry
residency then a two-year child and adolescent psychiatry fellowship. Residents
may make a decision to pursue accelerated psychiatry-child/adolescent psychiatry
training at any time during the first three years of general psychiatry
residency training. For questions, contact the child/adolescent psychiatry
program director at 202-782-6855.
COMBINED PSYCHIATRY-FAMILY PRACTICE RESIDENCY PROGRAM
The National Capital Military Psychiatry Program and
the Family Practice Residency Program at Malcolm Grow USAF Medical Center
currently offer combined residency training that allows residents to fulfill
requirements for graduation in both general psychiatry and family practice
over a five-year period. This program currently accepts Air Force, Army,
and USPHS applicants but has a proposal before the Navy to accept Navy
applicants. The current status of that proposal may be learned by contacting
Dr. Timothy Lacy (301-981-7186). Combined training commences during the
PGY-1 year, though applicants are also accepted for combined training at
the PGY-2 level. The program can train up to five combined residency trainees
per academic year. This exciting program is the first of its kind in the
military health care system, and will provide a steady flow of psychiatrist-family
practitioners who will be invaluable in GME programs and military medical
care facilities around the world. For more information about this combined
training program, please contact William Sykora, M.D. (301-981-3786), or
Timothy Lacy, M.D. (301-981-7186), the combined program co-directors. The
curriculum for this combined program includes the following rotations:
PGY-1 1 Inpatient medicine 2 Inpatient psychiatry 13 four-week 1 Emergency medicine 1 Consultation-Liaison psychiatry rotations 1 Inpatient family practice 1 Inpatient neurology 2 Obstetrics 1 Outpatient neurology 1 Inpatient pediatrics 2 General surgery
PGY-2 2 ICU/CCU 6 Inpatient psychiatry 13 four-week 1 Inpatient family practice 1 Addiction psychiatry rotations 1 NICU/outpatient pediatrics 1 Psychiatric partial hospital 1 Outpatient pediatrics
PGY-3 2 Inpatient medicine 6 Outpatient psychiatry 13 four-week 1 Obstetrics rotations 1 Family practice procedures 1 Geriatric medicine 1 Orthopedics/sports medicine 1 Gynecology
PGY-4 1 Inpatient family practice 7 Outpatient psychiatry 13 four-week 1 Family practice management rotations 1 Ophthalmology 1 ENT 1 Urology 1 Dermatology
PGY-5 1 Homeless clinic 1 Inpatient psychiatry 13 four-week 1 Emergency room 2 Consultation-Liaison psychiatry rotations 4.5 Family practice electives 1 Community psychiatry 1 Inpatient adolescent psychiatry 1.5 Psychiatry elective
---------------------------------------------------
COMBINED
PSYCHIATRY-INTERNAL MEDICINE RESIDENCY PROGRAM
The National Capital Military Psychiatry Program and
the Internal Medicine Residency Program at Walter Reed Army Medical Center
currently offer combined residency training that allows residents to fulfill
requirements for graduation in both general psychiatry and general internal
medicine over a five-year period. This program currently accepts Army applicants
but has proposals before the Navy and Air Force to accept applicants from
those services too. The current status of those proposals may be learned
by contacting Dr. Scott Joslin (202-782-6075). Combined training commences
during the PGY-1 year, though applicants are also accepted for combined
training at the PGY-2 level. The program can train up to five combined
residency trainees per academic year. This exciting program is the first
of its kind in the military health care system, and will provide a steady
flow of psychiatrist-internists who will be invaluable in GME programs
and military medical care facilities around the world. For more information
about this combined training program, please contact Scott Joslin, M.D.,
combined training director, at (202)-782-6075. The curriculum for this
combined program includes the following rotations:
PGY-1 3 Inpatient medicine 2 Inpatient psychiatry 13 four-week 1 Ambulatory medicine 1 Consultation-Liaison psychiatry rotations 2 Medical ICU 1 Inpatient neurology 1 CCU 1 Outpatient neurology 1 Emergency medicine
PGY-2 2 Inpatient medicine 6 Inpatient psychiatry 13 four-week 1 Ambulatory medicine 1 Addiction psychiatry rotations 1 Medical ICU 1 CCU 1 Oncology
PGY-3 2 Inpatient medicine 6 Outpatient psychiatry 13 four-week 1 Medical ICU 1 Psychiatric partial hospital rotations 1 Emergency medicine 2 Medicine subspecialty
PGY-4 2 Inpatient medicine 6 Outpatient psychiatry 13 four-week 1 CCU 0.5 Addiction psychiatry rotations 2.5 Medicine consults
PGY-5
2 Inpatient medicine 1 Inpatient psychiatry 13 four-week 3 Medicine subspecialties
2 Consultation-Liaison psychiatry rotations 1 Medical ICU 1 Community psychiatry
1 Medicine elective 1 Inpatient adolescent psychiatry 1 Psychiatry elective
