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psychiatry residency

Location: Wilford Hall Ambulatory Surgical Center
Phone: (210) 292-5941

Vision

Excellence in psychiatry requires intensive training and experience in several distinct but related areas. We select outstanding physicians and provide them with a thoughtfully developed curriculum with a fundamental emphasis on assessment and treatment planning. It is also to develop skill in modern therapeutic technology and an awareness of the legal and ethical implications of our work. Supervision by outstanding faculty is always close at hand, but coupled with the responsibility and independence needed to develop leadership skills in psychiatry. Building around core clinical experiences with the full range of psychiatric disorders, residents have in-depth exposure to the ethical, psychotherapeutic, sociocultural, pharmacological and forensic dimensions of psychiatry. We strive to maintain the humanistic and scientific balance that makes psychiatry a unique specialty in medicine.

Education

The general psychiatry residency program is a combined military/civilian residency program ACGME accredited through the University of Texas Health Science Center at San Antonio. The civilian program director is responsible for the entire residency program with a military associate program director. The residency is a 4 year-program and is one of two such combined military/civilian programs in the Air Force. For more information, please visit the psychiatry residency website here.

Psychiatry Rotations

(Please see the UTHSCSA website for complete information; the following is meant to serve as a guideline.)

PGY-1 Rotations (total 12 months)

 

Primary Care (6 Months)

 

  • Inpatient Internal Medicine (2 Months)
  • Internal Medicine Outpatient WHASC (1 Month)
  • Emergency Medicine (1 Month)
  • Inpatient Neurology (2 Months)

Psychiatric Inpatient Units

 

  • Veterans Administration Inpatient Psychiatric Ward: Includes treatment of acute and chronic mental health conditions such as PTSD, Psychotic Disorders, Mood Disorders, Anxiety Disorders, Substance Abuse/Dependence, and Personality Disorders in veterans. Rotation also includes clinical experience in the Veterans Administration Psychiatric Triage. There, residents will learn about the evaluation, treatment, and appropriate disposition of psychiatric emergencies.

  • San Antonio Military Medical Center (SAMMC) Inpatient Psychiatric Ward: Includes treatment involving mostly acute mental health situations in addition to chronic mood and anxiety disorders. Residents often treat young patients during their first psychotic or manic episodes as well as basic trainees with suicidal ideations in the context of BMT. Other diagnoses treated can range anywhere from adjustment disorders to personality disorders or substance dependence/abuse.

  • University Hospital Psychiatric Inpatient Services: Residents are able to care for the underserved in this setting and treat mental health disorders in both young and older adults that often have problems related to new diagnoses or chronic, debilitating mental illness. 

PGY-2 Rotations (total 12 months)

 

Consultation/Liaison Psychiatry (4 months)


  • SAMMC: Collaboration with physicians on medical, surgical, neurology and Obstetrics/Gynecology (ob/gyn) services, topic-centered case conferences and reading seminars.

  • University Hospital and VA Hospital: Collaboration with physicians on medical, surgical, neurology and Obstetrics/Gynecology (OB/GYN) services, topic-centered case conferences and reading seminars.

Child and Adolescent Psychiatry, Outpatient (1 month)

Residents work in a variety of locations to treat children and adolescents. Several issues are addressed (not an inclusive list): Behavior Disorders, ADHD, Learning Disabilities, Mood Disorders, Anxiety Disorders, Psychoses, Abuse/Neglect, Family Therapy

 

Substance Abuse Psychiatry (1 month)

One month is dedicated to the developing knowledge, attitude, and skills necessary to evaluate, diagnosis, and treat common conditions in substance abuse patient with psychiatric and medical co-morbidities

 

Geriatric Psychiatry (1 month)

One month is dedicated to the developing knowledge, attitude, and skills necessary to evaluate, diagnosis, and treat common conditions in geriatric outpatients.

 

Advanced Inpatient Psychiatry (2 months)

Two months of the PGY-2 year are accomplished on the UH Inpatient Psychiatry unit. Rotation intends to build upon the skills acquired during the first year and to develop a more independent skill set in crisis management, medical evaluation of the patient, consultation with the emergency room. Rotation also has night float system whereby residents gain greater independence.

 

Psychiatric Electives (3 months)

Three months during the PGY-2 are dedicated to resident-selected, program approved experiences in psychiatry. Electives completed by residents include   medical education, research, process improvement, patient safety, military unique activities (e.g., AMP course). 

 

During your PGY-2 rotations, you will pick up individual psychotherapy patients and learn the basics of psychotherapy. By end of PGY-2 year, you should have three individual psychotherapy patients (approximation)

 

PGY-3 Rotations

 

This all-outpatient year emphasizes continuity of care, allowing long-term psychopharmacological and psychotherapeutic treatments.  Two days a week are spent at two or more of the following sites (not a complete list):

 

  • WHASC Outpatient Mental Health Clinic

  • Veterans Administration Hospital Outpatient Psychiatry Clinic

  • Veterans Administration Psychiatric/Primary Care Clinic (Prime)

  • University of Texas San Antonio Outpatient Psychiatry Clinic

  • Center for Healthcare Services

  • University of Texas Health Science Center San Antonio clinic

    • One- half day per week will be spent at a local Child and Adolescent outpatient psychiatric clinic.
    • Addition half day per week will be dedicated to elective activity.
    • Long-Term Psychotherapy Experience
  • One-half day equivalent

    • Three to five weekly individual therapy patients
    • Lead a weekly insight-oriented psychotherapy group

PGY-4 Rotations

 

Teaching Administrative Psychiatry "Junior Faculty"  (4 months)

Residents will perform two 2 month junior faculty-administrative faculty rotations on the inpatient or consultation services at UH, VA, or SAMMC. Further development of independent practice skills, leadership skills for management and coordination of patient care teams, and administrative management skills are goals for these rotations.

 

Forensic Psychiatry (1 month)

One month is dedicated to the developing knowledge, attitude, and skills necessary to evaluate, diagnosis, and treat common conditions in patients found in forensic settings.

 

Advanced Community Psychiatry (1 month)

PGY-4s will engage in a one month rotation at the Transition Care Clinic (TCC). This ambulatory setting serves as an outpatient referral source for patients dispositioned from emergency medicine, inpatient psychiatry, and medical/surgical units as an intermediary between crisis management and longterm, ambulatory care. PGY-4 residents further develop their clinical and administrative management skills through working within a multidisciplinary team. A secondary goal is for the PGY-4 resident to master their leadership and supervisory skill-set of junior residents in an ambulatory setting.

 

Ambulatory Selective (2 months)

PGY-4s will engage in a one month rotation at the Transition Care Clinic (TCC). This ambulatory setting serves as an outpatient referral source for patients dispositioned from emergency medicine, inpatient psychiatry, and medical/surgical units as an intermediary between crisis management and longterm, ambulatory care. PGY-4 residents further develop their clinical and administrative management skills through working within a multidisciplinary team. A secondary goal is for the PGY-4 resident to master their leadership and supervisory skill-set of junior residents in an ambulatory setting.

 

PGY-4s will engage in residency approved selectives, with emphasis on outpatient treatment. These selectives include telepsychiatry, intensive outpatient program (IOP), and the VA Polytrauma Center rotations. Residents will develop further attitude, and skills necessary to evaluate, diagnosis, and treat common conditions in patients found in these outpatient/ambulatory settings

 

Electives (4 months)

These electives moves provide residents with the freedom to pursue areas of interest and explore career choices.

 

  • Supervised Treatment:  Long-term and short-term psychotherapy patients throughout the year (one half-day equivalent per week in this setting).

Call

 

Call should be interesting and educational, as well as required. The department tries to make call responsibilities meaningful, but at the same time at a frequency which will not interfere with other education opportunities or the ability to have quality time away from work. Please refer to UTHSCSA website for more information about call in the context of ACGME duty hour changes that will be implemented with 2014-15 academic year. Call duties are performed at SAMMC, UH, and UV hospitals

 

Leave

 

Military residents receive 30 days paid leave per year; however, program day leave is as follows. Program days do not include weekends or holidays.

 

  • PGY-1 10 program days

  • PGY-2 15 program days

  • PGY-3 15 program days

  • PGY-4 15 program days

Seminars

 

All residents attend weekly half-day seminars plus a weekly Psychiatry Grand Rounds on Tuesday afternoons.

 

  • First-year seminars include ethics, interviewing, diagnosis, basic psychopharmacology, other biological therapies, substance abuse, introduction to psychotherapy, and group therapy.

  • Second-year seminars address diagnosis and treatment of psychiatric disorders, childhood development, and advanced psychopharmacology.

  • Third-year and fourth-year seminars build on those of the first two years and address special content areas such as geriatric psychiatry, ethics, system negotiations, special psychotherapies, and specialized areas of biological psychiatry and forensic psychiatry.

Supervision

 

The transition from student to professional is necessarily abrupt but invariably rewarding. Proper supervision can ease the passage, maximizing both educational benefits for the resident and the therapeutic benefits for the patient. At each stage of training, residents rely on experienced professionals for guidance. The demands made upon the residents' personal sensitivities as well as their clinical abilities are considerable and remain as challenging throughout psychiatrists' careers as they are during the first months of training. As residents gain experience, perceiving more complex problems and formulating more sophisticated questions, the degree and form of supervision needed varies accordingly. Supervisors provide continuity, a stable source of advice and reference, and a fresh point of view when change is in order.

 

1.  Training directors oversee the educational experience of the residents to ensure an appropriate mix of the various components; recommend appropriate reading material; review evaluations with the residents; assist in solving problems and in selecting elective activities; and help the residents design the most appropriate courses to take in the pursuit of personal and professional objectives. Clinical supervisors work with residents at each clinical rotation to assist with patient care issues as well as professional development.

 

2.  Clinical supervisors work with residents at each clinical rotation to assist with patient care issues as well as professional development.

 

3.  Psychotherapy supervisors are assigned to each resident to assist in the logic, application, and integration of techniques used in psychotherapy. Residents follow selected patients over a prolonged period to assist in developing treatment skills and an understanding of the psychodynamics which cause behavioral reactions.

 

Opportunities

 

Research

Residents may participate in ongoing research with faculty. Additionally, residents may choose to participate in a designated research track, which includes one day of protected time for research during the third and fourth years of residency. The faculty members are eager to develop research experiences for interested residents.

 

Program Evaluation

Psychiatry training is conducted in a state of measured flux -- residents, patients, the body of knowledge to be mastered -- all change continuously. Regular and candid evaluation is crucial to the success of the program. Residents are provided formal feedback every six months in addition to feedback provided during and at the end of each rotation. Both faculty and residents appraise clinical sites, supervision and seminars. The feedback allows studied adjustments in the program.

 

Residents' Program Evaluation Conference

A distinctive feature of the training program is the annual two-day workshop and retreat organized by the residents. The house staff meets to discuss and evaluate various aspects of the residency training program and to formulate recommendations for changes, which are later submitted to the Residency Education Committee. Another equally important function of the meeting is to create an atmosphere conducive to personal interaction and communication among residents. The retreat is held off campus.

 

Faculty/Resident Retreat

The faculty and residents hold a one-half-day retreat in the spring of each year at UTHSCSA. Small groups, composed of faculty and residents, discuss program-related issues and consider adjustments to the program. Each small group reports to the group as a whole, allowing for further discussion.

 

Residents' Noon Conferences

The residents have weekly conferences at which lunch is provided. During the meetings administrative issues are discussed and clarified, complaints are addressed, and special announcements are made. Resident Clinical Case and Morbidity and Mortality Conferences are presented at these meetings. 

 

Funded Temporary Duty (TDY) Conferences

There are opportunities for residents to go on conferences and present their research in addition to attending the annual American Psychiatric Association annual meetings (if funding available). If funding is available, board review courses and the psychiatry board exam can be covered for PGY-4 residents. Due to the current economic climate, funding is not guaranteed.

 

Social Gatherings

 

  • Hail and Farewell for incoming and graduating residents

  • Resident Picnic in July

  • Local social outings during the year are scheduled by the resident program social representatives

patient services

 
 
  
Medical Appointment Line:
210-916-9900
 
 
Secure Messaging

Nurse Advice Line

JBSA Sexual Assault Response and Prevention

JBSA SAPR Hotline: 210-808-7272
DoD Safe Helpline: 1-877-995-5247

Chaplain Services: 210-292-7373

 

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