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GWU Department of Psychiatry and Behavioral Sciences - Washington, DC
RESIDENT TEACHING
Psychiatrists face dual challenges during the coming decade.
Neuroscientists progressively elucidate neurobiological
processes that underlie each psychiatric disorder. These
discoveries press psychiatrists to understand brain
mechanisms of illness. On the other hand, psychiatric
disorders have proven to be brain disorders that are
exquisitely sensitive to the emotional and communicational
environments in which patients live. The emotional stressors,
shifting relationships, and cultural diversity of patients'
lives press psychiatrists to become ever more facile in using
dialogue and relationships therapeutically. The GWU psychiatry
curriculum trains residents to meet both of these challenges
capably.
The GWU psychiatry residency program prepares psychiatry
residents to practice in the urban and international
environments that characterize the Washington metropolitan
area. GWU psychiatry residents learn clinical approaches that
embrace the complexity of patients' lives in their family,
community, and cultural contexts. They learn biological and
psychosocial therapies within a broad and balanced
biopsychosocial curriculum. They draw from multiple clinical
perspectives and therapeutic traditions to tailor treatments
that address creatively each patient's concerns.
The GWU psychiatry curriculum emphasizes eight domains of
excellence:
Consultation-Liaison Psychiatry and Psychosomatic Medicine
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GWU residents are pictured with Dr. Jay Scully,
Medical Director of the APA.
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Consultation-liaison psychiatry at GW joins broad residency training in the inpatient and outpatient care of medically-ill patients with one of the nation’s oldest and most highly-regarded fellowships in Psychosomatic Medicine.
Consultation-liaison training for GW residents has a uniquely broad scope in its therapeutics for patients and families who bear medical illnesses over a span of time, from acute medical hospitalizations to outpatient clinics and home-based care. Residents are trained rigorously in psychiatric assessment and acute treatment of hospitalized patients on medical and surgical services. However, they also learn skills for care beyond the emergency treatment and crisis management during acute hospitalizations. Residents learn skills for helping medically-ill outpatients and their families to manage the human devastation that often accompanies illness, involving demoralization, grief, marginalization and loss of status, strained relationships, and burdens upon caregivers. They learn family interventions and train in collaborative family-centered care that mobilizes family strengths and competencies to build resilience. They learn how to incorporate patients’ religious and spiritual resources in clinical treatment. Lorenzo Norris, M.D., Director of the GWU Hospital Psychiatric Consultation-Liaison Service, and four full-time faculty who are ABPN board-certified in Psychosomatic Medicine teach and supervise residents.
Initial training in consultation-liaison psychiatry begins in the PGY-I year at Inova-Fairfax Hospital, where residents attend the Consultation-Liaison Psychiatry Service weekly clinical conference during inpatient rotations. In the PGY-II year, residents at Inova-Fairfax learn the role of psychiatric consultant on a geriatric medicine consultation team during their Geriatric Psychiatry rotation.
Core training in hospital-based consultation-liaison psychiatry occurs on the PGY-II Consultation-Liaison Psychiatry rotation at George Washington University Hospital. Residents conduct psychiatric consultations on medical and surgical services under supervision of faculty attendings. Readings in the psychosomatic medicine research literature and written examinations of clinical knowledgebase provide residents with a strong foundation in the psychiatric care of medically-ill patients. Residents’ diagnostic interviews are directly observed in formal evaluations by supervisors who mentor development of interview skills.
Advanced training occurs in the PGY-III year with psychiatric consultations to outpatient medical clinics and bedside psychotherapy with patients hospitalized for extended periods of time. PGY-III residents are assigned as year-long liaison psychiatrists to the Breast Cancer, Amyotropic Lateral Sclerosis, and Stroke Clinics where they provide outpatient psychiatric consultations and treatment. In the Epilepsy Program, they conduct psychiatric evaluations for presentation at the interdisciplinary Epilepsy Clinic. As a component of brief psychotherapy training, residents are supervised in bedside psychotherapy with hospitalized medical patients who are demoralized, grieving, or struggling to cope with the adversities of illness.
Residents with potential career interests in consultation-liaison psychiatry are encouraged to initiate clinical research projects that are mentored by consultation-liaison psychiatry faculty.
The GWU Department of Neurology has a close affiliation with the Department of Psychiatry. PGY-III Psychiatry residents attend the weekly Epilepsy Conference, where patients are presented multidimensionally from neurological, neurosurgical, psychiatric, neuropsychological, and neuroradiological perspectives. Neuropsychiatry and clinical neurosciences are taught in both PGY-II and PGY-III residency seminars.
The Psychosomatic Medicine Fellowship at Inova-Fairfax Hospital/George Washington University has long stood as one of the nation’s major Psychosomatic Medicine psychiatry fellowships under the leadership of program director, Catherine Crone, M.D. and Inova-Fairfax psychiatry chairman, Thomas Wise, M.D. Over the past three decades, the fellowship has trained over 80 consultation-liaison psychiatrists while providing national leadership in development of psychosomatic medicine as a psychiatric subspecialty within the American Board of Medical Specialties. Over 300 research articles, clinical reports, and other scholarly works have been published by Inova-Fairfax/GWU fellows during training. Drs. Wise and Crone have served on the Council of the Academy of Psychosomatic Medicine and the American Board of Psychiatry and Neurology’s Psychosomatic Medicine examination committee. Dr. Wise has served as Editor-in-Chief of the journal Psychosomatics and is past president for both the Academy of Psychosomatic Medicine and the American Psychosomatic Society.
Cultural and International Psychiatry
The Washington metropolitan area is one of the nation's most
multi-ethnic regions, with as many as 180 countries and 100
languages represented in suburban Northern Virginia and
Maryland and District of Columbia public schools.
Complementing its diverse patient populations, the clinical
and full-time faculty of the Department of Psychiatry include
over a dozen teachers, scholars, and clinicians who are
internationally recognized for their expertise in
cultural psychiatry and international mental health services.
The GWU Department of Psychiatry provides the psychiatric
component of mental health services at Northern Virginia
Family Services, whose multilingual psychosocial programs
include the Program for Survivors of Torture and Severe
Trauma. GWU psychiatry residents study cultural
psychiatry during PGY-II and PGY-III seminars, learn therapies
for posttraumatic disorders, treat patients in clinics for
immigrants and refugees, and conduct asylum evaluations for
political refugees in the GWU Human Rights Clinic. GWU
psychiatry residents work in a community mental health center
at Gallaudet University with patients in the deaf and hard of
hearing community. Residents and faculty gather periodically
for an evening Cultural Psychiatry and International
Mental Health Interest Group.
GWU psychiatry residents have unique opportunities to
participate in clinical research on the role of spirituality
in mental health and in recovery from medical and psychiatric
illnesses. GWU psychiatry faculty have collaborated regularly
with the George Washington University Institute on
Spirituality and Health (GWISH) in educational programs that
assist physicians seeking to respond to spiritual needs of
patients in their provision of health care. The GWU psychiatry
residency was a recipient of a 2002 Spirituality and Medicine
Award and a 2006 Psychiatry Residency Curricular Award from
the John Templeton Foundation.
Child, Adolescent, and Family Psychiatry
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Drs. James Griffith (left) and Jeffrey Akman (center) meet with current and former GW psychiatry residents (L to R) Drs. Lydia Sit, Jacqueline Henschke, Sarah Birmingham and Lisa Catapano at the 2007 APA Annual Meeting in San Diego.
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Since its inception, the GWU Department of Psychiatry has been
nationally recognized for its focus upon children and
families. All child psychiatry faculty at the nationally
renowned Children's National Medical Center also hold joint
faculty appointments in our GWU department.
GWU psychiatry residents have more child and adolescent
training than most residents in American programs, up to four
months. This child psychiatry experience occurs early in
residency during the PGY-II year, which provides residents with a
realistic picture of career possibilities in child and
adolescent psychiatry before making a decision in the PGY-III
year to apply for fellowship training. From a third to a half
of GWU psychiatry residents complete child and
adolescent psychiatry fellowships.
An innovative family psychiatry curriculum in the PGY-III year teaches
residents how to integrate family interventions in general psychiatric practice,
how to conduct family-centered care for medically and psychiatrically-ill
patients, and how to aid individuals struggling to differentiate successfully
within their family systems by supporting elaboration of personal self while
preserving family relationships.
Mental Health Advocacy and Public Policy
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Michael Barnett, MD (right), his wife Laura Otolski, and Rep. Patrick Kennedy (D-R.I.) are shown with a copy of the National Resilience Development Act of 2003, a bill aimed at building psychological resilience in response to terrorism. A member of the full-time GW psychiatry faculty, During his PGY-IV residency year, Dr. Barnett helped write the bill as an American Psychiatry Association Freedman fellow on Rep. Kennedy's staff. |
Located a few blocks from the White House and State
Department, the physical proximity of GWU to the national
government, public policy institutes, and headquarters of
national professional and non-governmental organizations
provides unique opportunities to develop a career at the
interface of psychiatry and public policy. GWU psychiatry
residents can pursue a joint Psychiatry Residency/MPH Degree
in Mental Health Policy. The GWU School of Public Health and
Health Services (SPHHS) is the sole school of public health
based in the nation's capital. Department of Psychiatry
faculty collaborate with members of the nationally recognized
Center for Health Services Research and Policy in the SPHHS in
multiple areas.
All PGY-III psychiatry residents complete a three-week
intensive Health Policy rotation that combines morning
lectures on health policy topics with afternoon field trips to
Washington sites where policies are made, ranging from Capitol
Hill to the Institute of Medicine. Residents with serious
interests in mental health policy and advocacy can matriculate
into the joint psychiatry residency/M.P.H. program. Two GW
psychiatry residents in recent years have been selected by the
American Psychiatric Association as a Jeanne Spurlock, M.D.
Congressional Fellow on the legislative staff of a United
States Congressman.
Jerrold Post, M.D., Professor of Psychiatry and Political
Psychology, offers interested psychiatry residents an
opportunity to complete a Master's Degree in Political
Psychology in the GWU Elliott School of International Affairs
under his mentorship.
The Jerry W. Wiener, M.D. Fund in Psychiatry supports an
annual lectureship in mental health advocacy and public
policy, as well as attendance at national conferences for
PGY-IV residents pursuing scholarly projects in mental health
policy and advocacy.
Community and Primary Care Psychiatry
GWU psychiatry residents learn how to conduct psychiatric
treatment on community-based interdisciplinary teams. These
include both primary care community health centers and
comprehensive community mental health programs for the
chronically mentally-ill.
Unity Health Care, Inc. is the major provider of primary care
medical services for working poor, immigrants, and homeless
patients in Washington, DC. Unity clinicians provide
medical care for 82,000 patients through 530,000 return patient
visits. Unity has a network of 29 neighborhood health centers that
include Women, Infants, and Children (WIC) Centers, specialty medical
clinics, mobile outreach vans for homeless and substance abusing patients,
medical services for the city jail, and medical and dental services for
homeless shelters. It provides medical and dental services for
the 1,350 bed Community for Creative Non-Violence Shelter, the
nation’s largest sheltered living program for homeless people.
PGY-III and PGY-IV psychiatry residents work on
interdisciplinary treatment teams alongside internists,
pediatricians, family physicians, obstetricians, and other
medical specialists treating psychiatric problems in Unity’s
primary care settings.
The McClendon Center is a District of Columbia Core Service
Agency that serves the needs of approximately 700 adults
diagnosed with serious and persistent mental illness. Its
individualized, multidisciplinary programs seek rehabilitation
of patients as persons, by fostering creativity, friendship,
stability, independence, emotional growth, and greater
participation in the community. The Center provides day
programming, case management, psychiatric care, and counseling
at two sites. McClendon Center is the only Washington, DC
community mental health agency with accreditation from the
Joint Commission on Accreditation of Healthcare Organizations
(JCAHO). PGY-III and PGY-IV residents learn community
psychiatry and mental health services delivery through their
work on McClendon Center interdisciplinary treatment teams.
Green Door, Inc. is a District of Columbia Core Service Agency
that provides community psychiatric treatment for patients
with severe and persistent mental illnesses. Since 1976, Green
Door has helped nearly 3,000 District of Columbia residents
move from institutions and homeless shelters, to lead
fulfilling, independent lives. Green Door has been recognized
nationally for the success of its program, which in 2007
achieved a remarkably low re-hospitalization rate of only 7%
among its patients. PGY-III and PGY-IV residents learn
community psychiatry and mental health services delivery
through their work on interdisciplinary treatment teams at
Green Door.
Woodburn and Mt. Vernon Mental Health Centers provide the core
mental health services for the Fairfax County Community
Services Board in Northern Virginia. PGY-IV residents acquire
advanced levels of expertise as community psychiatrists
through the Woodburn and Mt. Vernon programs.
Gallaudet University Community Mental Health Center provides
student mental health services for the nation’s only
university committed to education of deaf and hard of hearing
students. Deaf and hard of hearing adults in the Washington
metropolitan area make up approximately a third of Gallaudet
Mental Health Center’s patients. A PGY-III resident serves as
psychiatric consultant on Gallaudet MHC’s interdisciplinary
treatment teams via sign interpreters.
Broad Training in the Psychotherapies
Residents commonly choose our program for its commitment to
psychotherapy training. While training in psychodynamic
psychotherapy has been central to the identity of the GWU
residency, GWU faculty have also made important contributions
to teaching and research in couple and family therapy, group
therapy, and brief individual psychotherapies. Outpatient
psychiatry training coordinates didactic seminars, weekly
supervisions, clinical case conferences, and monitored case
loads representing multiple approaches to psychotherapy,
including long-term psychodynamic psychotherapy, five models
of individual brief psychotherapies (cognitive-behavior,
interpersonal, solution-focused, motivational enhancement,
somatic trauma therapies), group therapy, and couple and
family therapy. Our residents become skilled clinicians who
employ a breadth of approaches through which language and
relationship serve as tools of healing.
The educational and research partnership between the
Washington Psychoanalytic Institute and the GWU Department of
Psychiatry provides residents with didactic teaching and
psychotherapy supervision by one of the nation's major
psychoanalytic faculties. Approximately a third of the
membership of the Washington Psychoanalytic Institute actively
teaches or supervises GWU residents and medical students.
Faculty from the Washington School of Psychiatry and the
Baltimore-Washington Psychoanalytic Institute also contribute
seminar teaching and clinical supervision. Selected residents
can pursue psychoanalytic training concurrently with
psychiatry residency.
The Daniel S. Prager, M.D. Lectureship in Psychoanalytic
Psychiatry has brought to our department such distinguished
leaders in psychoanalytic thinking as Drs. Hilda Bruch, Otto
Kernberg, and Glen Gabbard. Each year one or more PGY-IV
residents who show special aptitudes for psychodynamic
psychotherapy are selected as Prager Fellows, which provides
funded support for advanced studies or research in
psychoanalytic psychotherapy.
Medical Humanities
The GWU Medical Humanities Program, directed by Linda Raphael, Ph.D.,
Associate Clinical Professor of Psychiatry, is a vibrant component of the
GWU School of Medicine and Health Sciences. The Medical Humanities
Program offers interdisciplinary seminars and book groups for medical
students and residents that focus on the interface of literature, the arts, and
medicine.
Residents can pursue a formal graduate certificate program in "Medicine,
Culture and Society" in the GWU Columbian College of Arts
and Sciences. This interdisciplinary program provides an opportunity
health professionals to conduct intensive studies in literature, political science,
history, philosophy, anthropology, and sociology
(http://www.gwu.edu/~ccas/grad/medicine_society.html).
In addition, residents can pursue other graduate school studies in the GWU
Departments of Anthropology, Psychology, or other human sciences.
University tuition benefits provide deferral of most costs for graduate studies.
Integration of Pharmacological and Psychosocial Therapies
Clinical training in the psychotherapies and in psychopharmacology both are
grounded in neurobiological and social neuroscience perspectives
in our residency curriculum. Residents learn how to integrate
psychoeducation, psychosocial therapies, resilience-building interventions,
and pharmacological treatments into multi-modality programs
that target specific psychiatric disorders. A balanced emphasis
is placed upon treatment of psychiatric disorders and interventions that can
relieve suffering from such normal syndromes of distress as grief,
demoralization, spiritual crises, and humiliation from
stigmatization or social injustice. Emphasis is placed upon
the practical use of psychotherapy skills during brief
clinical encounters with medically-ill patients on the
psychiatric consultation-liaison service and with
pharmacologically-treated patients in community mental health
centers, supporting a humanistic focus upon each patient’s
well-being as a person.
Didactic seminars and clinical supervisions across each year
of residency teach principles of clinical psychopharmacology
and multi-modality treatment. Residents are expected to learn
how to use medications not only for symptom reduction in a
narrow sense, but also to open new possibilities for patients
to communicate effectively, to engage more fully in personal
and work relationships, and to sustain a robust sense of self.
This teaching is modeled in a monthly psychopharmacology case
conference conducted by Dr. Fred Goodwin, former director of
the National Institute of Mental Health. Dr. Goodwin
interviews a resident and his or her patient about ongoing
treatment, then directs a balanced discussion of
psychopharmacological, psychotherapeutic, and
lifestyle-modifying strategies to control symptoms and prevent
relapse.
PGY-I Year
The primary objective for the PGY-I year is the acquisition of
knowledge, skills, and professionalism necessary to practice
as a physician. This is a year in which a resident's
professional identity shifts from student to physician, and
navigating this transition successfully is the primary
concern. The PGY-I year curriculum provides a foundation of
knowledge and skills in internal medicine and neurology, as
well as a basic introduction to psychiatry.
Six residents enter the program each year as PGY-I residents.
They train in internal medicine (three months), emergency
medicine (one month), neurology (two months), inpatient
psychiatry at Inova Fairfax Hospital (four months) and
inpatient/emergency psychiatry at GWU Hospital (two months).
During the six months of PGY-I psychiatric training, residents
learn to diagnose and treat the major psychiatric disorders.
They gain competence in managing crises and treating acute
episodes of illnesses with a range of psychotropic
medications. They learn how to conduct inpatient family
meetings that engage families in preventing relapse and
countering stigma. They learn how intervene in psychiatric
emergencies, such as threats of suicide or assault upon others
or refusals to accept needed medical treatment. PGY-I residents are
introduced to the concepts and principles of clinical psychiatry in 8 – 12
hours per week of didactic seminars and clinical conferences
during their four-month Inpatient Psychiatry rotation at
Inova-Fairfax Hospital, in addition to clinical supervision at bedside.
Inova Fairfax Hospital, located in Falls Church, VA, is a
950-bed regional medical center whose Department of Psychiatry
is nationally renowned for its leadership in
consultation-liaison psychiatry and psychosomatic medicine.
The 30-bed psychiatry inpatient service provides acute
psychiatric patient treatment for a patient population with
high medical co-morbidity that reflects the enormous ethnic
diversity of Fairfax County and Northern Virginia. PGY-I
residents train 4 months in the Inova Fairfax inpatient
psychiatric services.
The GWU Inpatient Psychiatry Unit is an 18-bed acute treatment
unit in the 380-bed GWU Hospital, Washington's newest and most
technologically-advanced hospital. The illness acuity, high
medical co-morbidity, and dual diagnoses that characterize its
patients reflect its downtown Washington setting. A two month
PGY-I rotation integrates training in Emergency and Acute
Inpatient Psychiatry in the GWU Emergency Medicine Department
and 6-South Inpatient Psychiatry Unit.
PGY-II Year
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PGY-II Year Seymour Perlin, MD, former director of Residency and Training and Emeritus Professor of Psychiatry and Behavioral Sciences with James L. Griffith, MD, Director of Psychiatry Residency Training. |
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The PGY-II residency class is expanded to eight residents each
year through admission of an additional resident who has
completed a PGY-I year in primary care medicine or a different
psychiatry residency. PGY-II residents each week attend a
half-day of didactic seminars and conduct outpatient
psychotherapy under supervision. Residents learn about group
processes experientially through a year-long weekly T-Group.
During the PGY-II year, residents treat children and
adolescents at Children's National Medical Center for two to
four months. At Inova Fairfax Hospital, they train one or two
months in addiction psychiatry, including both inpatient and
outpatient treatment programs. A one or two month rotation in
Geriatric Psychiatry at Inova Fairfax Hospital involves both
geriatric team consultations for hospitalized patients and
community nursing home consultations with a geriatric
psychiatrist. The Inova Fairfax Partial Hospitalization/Bridge
Program rotation provides one or two months training in
partial hospitalization and acute aftercare treatment of
psychiatric patients recently discharged from the hospital. An
inpatient rotation at Northern Virginia Mental Health
Institute focuses upon treatment of severely-ill psychiatric
patients with psychotic, mood, and personality disorders
requiring 30 to 90 days hospitalization.
Residents completing the PGY-II year acquire an extensive
knowledge of psychiatric disorders that includes all major
DSM-IV diagnostic categories for children, adolescents, and
adults. They gain competence in pharmacological treatments
through an intensive year-long weekly seminar in clinical
neurosciences and psychopharmacology. They learn how to
conduct family meetings for hospitalized patients that
emphasize psychoeducation, relapse prevention, and the
countering of stigma against psychiatric illness. They learn
skills for supportive group therapy with inpatients. They
complete the first level of training in long-term
psychodynamic psychotherapy through seminars, weekly
supervision, and psychotherapy cases.
Children's National Medical Center provides training in
inpatient treatment, with resident rotations on both the child
and adolescent units. Residents work on interdisciplinary
inpatient teams where they conduct family evaluations and
family therapy.
Northern Virginia Mental Health Institute (NVMHI) is the
public psychiatric hospital serving the suburban counties of
Virginia. Residents at NVMHI learn to work on
interdisciplinary treatment teams in the emergency assessment,
acute intervention, and stabilization of acute psychoses,
severe mood disorders, dissociative disorders, and other
severe and chronic mental illnesses in a broadly multi-ethnic
patient population.
PGY-III Year
The PGY-III year is devoted to outpatient psychiatry.
Residents gain competence in long-term psychodynamic
psychotherapy through a sequence of seminars, weekly
supervisions with two different psychodynamic supervisors, and
psychodynamic psychotherapy cases. In addition, they learn how
to conduct focal psychotherapies utilizing a range of models
for brief psychotherapy, each with seminars, supervisions, and
assigned cases:
- Cognitive-Behavioral Psychotherapy, focusing upon treatment of anxiety and mood disorders;
- Brief Psychotherapy, adapting methods from narrative, solution-focused, interpersonal, and cognitive-behavioral
psychotherapies to outpatient psychiatric treatment;
- Motivational Enhancement Therapy for Substance Abuse, an evidence- based brief psychotherapy for outpatient treatment
of alcohol and substance abuse.
- Somatic Trauma Psychotherapy, which emphasizes psychoeducation about post-traumatic symptoms, mindfulness practices, and somatic cognitive-behavioral methods to reduce severity of post-traumatic and dissociative symptoms.
Family therapy, group therapy, and outpatient
psychopharmacology are also taught with seminars, weekly
supervisions, and assigned cases. PGY-III family/couple
therapy training emphasizes family interventions and
family-centered care for patients with chronic medical or
psychiatric disorders. Each resident conducts a weekly group
therapy with supervision throughout the year. Each resident
meets weekly with a clinical psychopharmacologist who
supervises medication treatments. Residents learn not only how
to implement these outpatient therapies in office settings,
but also how to design and implement outpatient psychiatric
services that integrate these therapeutic modalities with
psychoeducation and resilience-building interventions.
The PGY-II consultation-liaison psychiatry rotation is
supplemented by advanced PGY-III training in
consultation-liaison psychiatry that focuses upon bedside
brief psychotherapy with medically-ill inpatients and
outpatient consultation to stroke, amyotropic lateral
sclerosis, and oncology medical clinics. PGY-III
residents rotate monthly journal club presentations for
discussions led by Fuad Issa, M.D., Clinical Professor of
Psychiatry and Chair of the Virginia Hospital Center Dept. of
Psychiatry.
PGY-III residents each complete a three week full-time
rotation in health policy in the GWU School of Public Health
and Health Services. Mornings are devoted to lectures by
national experts who cover a broad scope of topics in
healthcare and public policy. Field trips occur in the
afternoons to a range of sites where health policy is
formulated or implemented, including the Institute of
Medicine, the U.S. Capitol Congressional Office Building,
National Institutes of Health, Washington “think tanks”, and
public systems of healthcare within Washington. Residents
conclude the rotation with group presentations of policy
analyses on major health policy issues to the Deans of the GWU
School of Medicine and the School of Public Health and Health
Services and other invited discussants.
The PGY-III year is intensely supervised by a broad range of
different supervisors representing each of the outpatient
therapies. The Chief Resident monitors resident case loads to
ensure that each therapeutic approach is appropriately
represented. PGY-III residents typically conduct:
- 2 - 4 hours weekly of long-term psychodynamic psychotherapy
- 2 - 4 hours weekly of brief individual psychotherapy
- 1.5 - 3 hours weekly of group therapy
- 2 hours weekly of couple and/or family therapy
- 1 - 2 hours weekly “split-treatment” psychopharmacological treatment with patients treated in the psychotherapy clinic of the GWU Doctoral Program in Professional Psychology
- 8 - 10 hours of diagnostic psychiatric evaluations and psychopharmacological treatment on interdisciplinary treatment teams at neighborhood health centers and community mental health centers in the District of Columbia
PGY-III residents spend approximately 8 hours weekly in didactic
seminars and clinical case conferences and 7 to 9 hours weekly
with supervisors representing each of the different outpatient
therapies
PGY-IV Year
Residents in the PGY-IV year focus on their special career
interests while continuing supervised outpatient therapies.
The PGY-IV year is broadly flexible in order to best
facilitate each resident's career trajectory. Residents who
enter a child and adolescent psychiatry residency or other
approved PGY-IV fellowship can do so with all general
psychiatry residency requirements completed by the end of the
PGY-III year. One PGY-IV resident is selected to serve as
Administrative Chief Resident at GWU Medical Center. Other
options have included training and research fellowships and
advanced clinical training with special patient populations or
treatment programs. In addition to primary administrative and
clinical assignments, PGY-IV residents select specific focal
areas of outpatient psychiatry in which to develop special
expertise.
Through an affiliation between the National Institutes of
Mental Health (NIMH) and the GWU Department of Psychiatry,
selected residents can complete PGY-IV requirements with a
year of full-time research at the National Institutes of
Mental Health. Residents also can pursue graduate studies in
a variety of George Washington University Columbian campus
and GWU School of Public Health and Health Sciences departments.
SUPERVISION
Our residents often point to the quality, variety,
availability, and amount of clinical supervision when asked
their primary reason for selecting our program for training.
Our large faculty of clinical supervisors drawn from the
talents of the Washington psychiatric community is the most
valued resource of our department. Together with our full-time
academic faculty, they provide excellent supervision of
residents' clinical work with children, individual adults,
couples, groups, families, social networks, and people in
crisis. Few residency programs can offer a comparable program
of psychotherapy supervision that balances training in both
the brief focal therapies and long-term psychodynamic
psychotherapy.
PGY-I residents are provided each week with clinical
supervision by the medical director of the inpatient
psychiatric unit, plus a faculty member from the full-time or
clinical faculty who focuses on specific skill areas for
inpatient psychiatry.
PGY-II residents at Children's National Medical Center,
Northern Virginia Mental Health Institute, Inova Fairfax
Hospital are supervised by GWU clinical faculty on the staffs
of each hospital. In addition, each resident meets each week
with a psychodynamic psychotherapy supervisor who supervises
their first outpatient psychotherapies.
PGY-III residents typically have six to seven hours weekly of
individual and group clinical supervisions, as detailed above.
Each resident meets for an hour weekly with each of two
long-term psychodynamic supervisors, a group therapy
supervisor, a psychopharmacology supervisor, one or two brief
individual psychotherapy supervisors, a supervisor for clinical
work with couples and families, and group supervision for
bedside psychotherapies in GWU Hospital.
PGY-IV residents continue long-term psychodynamic
psychotherapies with supervisors selected as appropriate for
the number of cases. Other supervisions are organized as are
appropriate for the clinical and administrative duties of the
resident.
CURRICULUM
A didactic curriculum of seminars and clinical conferences
parallels residents' clinical work. Teaching occurs in small
groups where intimate dialogues are possible. Seminar leaders
come from both the full-time academic faculty and voluntary
faculty, many of whom have distinguished national reputations.
In general, seminar leaders employ multiple teaching
modalities— lectures, live interviews of patients and
families, videotaped interviews, and case reviews. Depending
on resident feedback and changing trends in psychiatric
education, modifications are made each year.
PGY-I
PGY-I
(All weekly, bi-weekly, and monthly PGY-I seminars at
Inova-Fairfax Hospital are taught in a repeating cycle during
each four-month Inpatient Psychiatry rotation)
The Perspectives of Psychiatry
Tom Wise, M.D.
Emergency Psychiatry
Anjuli Jindal, M.D.
Evidence-Based Psychiatry
Michael Sheridan, ScD
Psychopathology
Alex Isaac, M.D.
Psychodynamic Psychiatry in Clinical Practice
Ross Silverstein, M.D.
Topics in Psychology
Philip Andrews, Ph.D.
College Mental Health
Roy Stefanik, D.O.
Community Mental Health
Anjuli Jindal, M.D.
Family Therapy Conference
Francis Andres, M.D
Psychiatry Clinical Case Conference
Robert Johnson, M.D.
Psychosomatic Medicine Case Conference
Catherine Crone, M.D. and Thomas Wise, M.D.
Journal Club
Various Faculty
Psychiatry Departmental Lunch
(weekly)
The Psychiatric Diagnostic Interview
Julia Frank, M.D.
(Two sessions in July at GWU Hospital)
PGY-II
Clinical Neurosciences and Psychopharmacology
James Griffith, M.D. with Invited Faculty
Weekly during July – June
Emergency and Consultation-Liaison Psychiatry
Lorenzo Norris, M.D.
Weekly during October – November
Medical Ethics
Richard Blanks, M.D.
Weekly during August – September
Medical Anthropology and Sociocultural Assessment
James Griffith, M.D.
Weekly during October - November
International Psychiatry and Mental Health Services
Amir Afkhami, M.D., Ph.D.
Weekly during December – January
Addiction Psychiatry
Suena Massey, M.D.
Weekly during August
Forensic Psychiatry
Richard Ratner, M.D., Glenn Miller, M.D., and Richard Blanks, M.D.
Weekly during July – September
Patient Assessment and Case Formulation, Interviewing
Techniques, and Psychodynamic Issues
Steve Rosenblum, M.D. and Cheryl Collins, M.D.
Weekly during July – October
Introduction to Psychodynamic Psychotherapy
John Zinner, M.D.
Weekly during November – April
Common Factors in Psychotherapeutic Change
Julia Frank, M.D.
Weekly during January
Early Childhood Development: Typical and Signs of Atypical
Development
Jean Thomas, M.D.
Weekly during January – March
T-Group
Skip Gump, D.Ed.
Weekly (90 minutes) during July – June
Psychiatry Journal Club
Fuad Issa, M.D.
Monthly, July – June
Epilepsy Conference
Sam Potolicchio, M.D.
Weekly during July - December
PGY-III
Brief and Supportive Psychotherapy
James Griffith, M.D.
Weekly, July – June
Somatic Trauma Therapy for Posttraumatic and Dissociative
Disorders
James Griffith, M.D.
Weekly,
August – September
Clinical Psychopharmacology
Dan Lieberman, M.D.
Weekly during July – June
Research in Psychiatry
Lisa Catapano, M.D., Ph.D.
Weekly during April – June
Ego Development and Object Relations Theory
Joe Jeral, M.D.
Weekly during April – May
Group Therapy
Barrie Seidman, L.C.S.W. and Jerrold Post, M.D. with Invited
Faculty
Weekly during July – September
Cognitive-Behavioral Psychotherapy
Andrew Molchon, M.D.
Weekly during October – December
Interpersonal Psychotherapy
Stuart Sotsky, M.D.
Weekly during April – June
Motivational Enhancement Therapy for Substance Abuse
Daniel Lieberman, M.D.
Weekly during October – November
Consultation-Liaison Psychiatry
Lorenzo Norris, M.D. and Invited Faculty
Weekly during January – May
Reproductive Psychiatry
Lisa Catapano, M.D., Ph.D.
Weekly during March
Social Psychology of Stigma
James Griffith, M.D.
Weekly during October
Psychiatry and Spirituality
Anjali Dsouza, M.D., James Griffith, M.D. and Invited Faculty
Weekly during March – April
Apology, Forgiveness, and Reconciliation in Clinical
Psychiatry
Steven Wolin, M.D.
Weekly during November - December
Political Leadership and the Psychology of Terrorism
Jerrold Post, M.D.
Weekly during April - May (every other year)
Psychopharmacology Case Conference (monthly)
Frederick Goodwin, M.D.
Monthly, July – June
Psychotherapy Case Conference (7 times per year)
Presented by PGY-III and PGY-IV Residents and Clinical Faculty
January – June
Outpatient Medical Illness Conference
Lorenzo Norris, M.D. and Invited Faculty
Weekly during September – May
Psychiatry Journal Club
Fuad Issa, M.D.
Monthly, July – June
Health Policy Rotation
Fitzhugh Mullan, M.D. and Invited Faculty from GWU School of
Public Health and Health Sciences
Three Weeks Full-Time, October or March (half class per
semester)
PGY-IV
Advanced Clinical Psychopharmacology
Daniel Lieberman, M.D.
Weekly during July - June
History of Psychiatry
Amir Afkhami, M.D., Ph.D. and Julia Frank, M.D.
Weekly during August – September
Introduction to Couples Therapy
James Griffith, M.D.
Weekly during September
Emotion-Focused Couples Therapy
James Griffith, M.D.
Weekly during November – December
Human Sexuality
Jeffrey Akman, M.D. and Invited Faculty
Weekly during July – August
Mock Boards Examinations
Michael Rankin, M.D. with Invited Faculty
April - May (Individually scheduled with residents)
Political Leadership and the Psychology of Terrorism (every
other year)
Jerrold Post, M.D.
Weekly during April – May
The Role of Literature in Psychiatric Practice: The Life and
Writings of Primo Levi
Sam Goodman, M.D.
Weekly during January – February
Apology, Forgiveness, and Reconciliation in Clinical
Psychiatry
Steven Wolin, M.D. and James Griffith, M.D.
Weekly during November - December
Transition to Practice Seminar
Amir Afkhami, MD, PhD, Joe Jeral, MD and Invited Faculty
Weekly during April – May
Psychopharmacology Case Conference (monthly)
Frederick Goodwin, M.D.
Monthly, July – June
Psychotherapy Case Conference (7 times per year)
Presented by PGY-III and PGY-IV Residents and Clinical Faculty
January - June
RESIDENT TEACHING
Medical student teaching is an important component of the GWU
psychiatry residency. The GWU School of Medicine provides
strong medical student education in the behavioral sciences,
and 8% to 10% of the GWU graduating class enter psychiatry
residencies each year. During each residency year, our
residents provide lectures, clinical supervision, and
mentoring for third and fourth year medical students rotating
in our clinical services and training sites. Our senior
psychiatry residents lead discussion groups with third year
medical students following lectures in the medical student
curriculum. Psychiatry residents can also pursue elective
training with Dr. Julia Frank in advanced educational methods
for teaching and supervision. |
