Education & Training

Thank you for your interest in the psychiatry residency training program of the George Washington University Department of Psychiatry and Behavioral Sciences.  Our GW residency has many strengths, including a dedicated full-time and voluntary faculty of enormous breadth and depth, exceptionally strong affiliate institutions including a nationally recognized children's hospital, and most importantly, a talented group of committed and caring residents.  Our GW residency offers a broad range of experiences with heterogeneous populations of patients representing the diversity, multinational character and enriched scientific resources of the Washington, D.C. metropolitan area. Through our longstanding affiliation with the Children's National Medical Center, we consistently attract applicants with a strong interest in child and adolescent psychiatry. Our affiliation with INOVA/Fairfax Hospital in Northern Virginia provides a range of outstanding training opportunities for residents and one of our nation’s oldest and most highly recognized fellowships in psychosomatic medicine. The Department continues to collaborate with the GWU School of Public Health and Health Services, the only school of public health in the nation's capital. We are one of the few programs in the country where psychiatry residents can complete an MPH degree during their residency program. Lisa Catapano, MD, PhD and Lorenzo Norris, MD Associate Directors, Psychiatry Residency Program Through our affiliation with the Washington Psychoanalytic Institute, PGY-IV residents are eligible to begin psychoanalytic training during residency. Through our affiliation with the NIMH, we offer those interested in a biomedical research career an opportunity to take their PGY-IV year at the NIMH.  Our four-year Global Mental Health Track is unique among our nation’s psychiatry residencies. The GWU Hospital, which opened in August 2003, is the first new hospital to be built in the District of Columbia in over twenty-five years. Its twenty-bed psychiatric unit, highly regarded emergency department, and med-surg units form the core of our inpatient psychiatry, emergency psychiatry and consult-liaison experiences. The heart of our identity has been our longstanding commitment to humanistic psychiatry.  A trainee in our department can expect personal growth and professional development in a supportive and collegial climate of education and training in a carefully planned sequence of experiences which are didactically rich, well supervised, and focused philosophically on each individual patient within a biopsychosocial model. Drs. Lorenzo Norris and Lisa Catapano, our Associate Residency Directors; Ms. Jill Jamshidnejad, our Residency Coordinator; and I each welcome your interest in residency training in the GWU Department of Psychiatry and Behavioral Sciences. James L. Griffith, M.D. Professor of Psychiatry and Neurology Interim Chair and Director, Psychiatry Residency Program

GWU Department of Psychiatry and Behavioral Sciences - Washington, DC

RESIDENT TEACHING
Psychiatrists face dual challenges during the coming decade. Neuroscientists continue to 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 GW psychiatry curriculum trains residents to meet both of these challenges capably.

The GW psychiatry residency is organized by its strong commitment to psychiatric humanism. GW 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. They provide both evidence-based treatments for patients’ psychiatric disorders and relief from suffering due to grief, demoralization, spiritual anguish, humiliation from stigma or social injustice, and other normal syndromes of distress. GW psychiatry residents become well-prepared for practice in the urban and international environments that characterize the Washington metropolitan area.

The GW psychiatry curriculum emphasizes eight domains of Excellence:

• Consultation-Liaison Psychiatry and Psychosomatic Medicine
• Cultural Psychiatry and Global Mental Health
• Child, Adolescent, and Family Psychiatry
• Mental Health Advocacy and Public Policy
• Community and Primary Care Psychiatry
• Broad Training in the Psychotherapies
• Medical Humanities
• Integration of Pharmacological and Psychosocial Therapies

Initial training in consultation-liaison psychiatry begins at Inova-Fairfax Hospital in the PGY-II year, when residents 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 the 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 byfaculty who supervise the development of interview skills.

Advanced training occurs in the PGY-III year with psychiatric consultations to outpatient medical clinics and bedside psychotherapies for patients hospitalized for extended periods of time. PGY-III residents are assigned as year-long liaison psychiatrists to weekly breast cancer, young adult survivors of childhood cancers, amyotropic lateral sclerosis, stroke, and women’s reproductive psychiatry clinics, where they provide outpatient psychiatric consultations and individual or family-centered psychotherapy. A large portion of brief psychotherapy, couples therapy, and family therapy training is conducted with these medically ill patients and families. Residents with career interests in consultation-liaison psychiatry are encouraged to initiate clinical research projects that are mentored by consultation-liaison psychiatry faculty. In 2011 ten different GW residents have co-authored psychosomatic medicine clinical or case reports together with GW attendings. Two residents will make symposium or research poster presentations at the 2011 Annual Meeting of the Academy of Psychosomatic Medicine.

The GW Department of Psychiatryhas a close affiliation with the Department of Neurology. PGY-II 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/GW 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.

The Department of Psychiatry at Inova Fairfax Hospital is nationally renowned for its leadership in consultation-liaison psychiatry and psychosomatic medicine. GWU psychiatry residents complete rotations during their PGY-I, PGY-II, and PGY-IV years on the 30-bed INOVA Fairfax psychiatric inpatient unit, Comprehensive Addiction Treatment Services (CATS), day treatment, and consultation-liaison services.

Cultural Psychiatry and Global Mental Health
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, ethnopharmacology, human rights and international relations, treatment of traumatic stress in post-conflict settings, torture-survivor rehabilitation, psychiatric evaluation of political asylum applicants, and international mental health services.

The GW 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. GW 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 GW Human Rights Clinic. GW 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 Global Mental Health Interest Group.

GW psychiatry residents have unique opportunities to participate in clinical research on the role of spirituality in mental health and recovery from medical and psychiatric illnesses. GW psychiatry faculty collaborate 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 GW psychiatry residency was a recipient of a 2002 Spirituality and Medicine Award and a 2006 Psychiatry Residency Curricular Award from the John Templeton Foundation.

Residents with specific career interests in global mental health can pursue an enriched Global Mental Health Track over their four years of residency training.

Child, Adolescent, and Family Psychiatry

Since its inception, the GW 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 GW department. GW 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, presenting residents 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 GW psychiatry residents go on to 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. PGY-III residents train intensively in Emotionally-Focused Couples Therapy through seminar sessions and weekly clinical supervisions.

Our GW child and adolescent psychiatry fellowship at Children's National Medical Center (CNMC) is one of the nation’s oldest andmost highly regarded child psychiatry fellowships. It provides comprehensive clinical child and adolescent psychiatry training with abundant opportunities to pursue academic and administrative psychiatry, research, and service to public and/or private populations. It provides frequent opportunities to meet with leaders in the field who are creating health policy and research that is shaping current practice. Its clinical foundation is its major teaching services— inpatient, day treatment, outpatient (including infant and toddler psychiatry), and pediatric consultation- liaison psychiatric services, each with separate units for children and adolescents. In addition, there are specific training experiences in emergency psychiatry, community psychiatry, school consultation, and forensic psychiatry. Training also occurs in subspecialty clinics for Affective Disorders, Neurobehavioral disorders, ADHD, Autism Spectrum Disorders, Sleep Disorders, Infant and Toddler Clinic, and the Feeding Team. For future academic teachers or child psychiatry researchers, a combined clinical/research track divides training time between CNMC and the National Institute for Mental Health (NIMH) over a three-year period. Clinical training in the diagnosis, treatment and clinical management of psychiatrically-ill children and adolescents is integrated with focused NIMH research training on child and adolescent psychiatric disorders.

Mental Health Advocacy and Public Policy
Located a few blocks from the White House and State Department, the physical proximity of GW 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. GW psychiatry residents can pursue a joint Psychiatry Residency/MPH Degree in Mental Health Policy. The GW 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.

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
GW 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. 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.

Pathways to Housing DC is a unique community agency that specifically targets homelessness among people in the District of Columbia who are disabled by mental illnesses. Pathways for Housing has received numerous awards and commendations for the effectiveness of its innovative program, including the Gold Award from the American Psychiatric Association. Most Pathways patients have been both homeless and dually-diagnosed with mental illnesses and substance use disorders. The “housing first” Pathways model provides housing first, then supportive treatment services for mental and physical health, substance abuse, education and employment. Housing is provided in apartments scattered throughout the community. Psychiatric care is supported by ten ACT teams that make home visits and respond to crises. A walk-in psychiatric clinic is provided at the Q Street NE center. PGY-III and PGY-IV residents learn assertive community treatment and the “housing first” model at Pathways for Housing DC.

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.

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’s’, 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.

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 GW residency, GW 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, seven models of individual brief psychotherapies (cognitive-behavior, interpersonal, solution-focused, narrative, existential, 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 GW 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 GW 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. PGY-IV residents who show special aptitudes for psychodynamic psychotherapy can be selected as Prager Fellows, which provides funded support for advanced studies or research in psychoanalytic psychotherapy.

Medical Humanities
The GW Medical Humanities Program, directed by Linda Raphael, Ph.D., Associate Clinical Professor of Psychiatry, is a vibrant component of the GW 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 GW 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.GW.edu/~ccas/grad/medicine_society.html). In addition, residents can pursue graduate school studies in the GW 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 GW 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 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 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 GW Inpatient Psychiatry Unit is an 18-bed acute treatment unit in the 380-bed GW 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 GW Emergency Medicine Department and 6-South Inpatient Psychiatry Unit.

PGY-II Year

The PGY-II residency class is expanded to 7 or 8 residents each year through admission of additional residents who have 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. 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. Residents also train intensively in Emotionally-Focused Couple Therapy, a major evidence-based psychotherapy for couples in conflict. 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 breast cancer, young adult survivors of childhood cancers, 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 GW 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 GW 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 GW 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 GW 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 GW 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 GW 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 GW 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, and a new patient assessment supervisor.

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.

RESEARCH AND SCHOLARSHIP
It is important for all psychiatrists to have skills necessary to evaluate critically the evidence guiding clinical practice. Particularly for those pursuing academic careers, our program emphasizes learning how to conduct research, to evaluate study findings critically, to write and publish, and to make compelling conference presentations. Residents participate in seminars on research methodology and scholarly writing skills. They also present a Grand Rounds based on a critical review of the literature on a t topic of their choosing. Under the leadership of Lisa Catapano, MD, PhD, and Michael T. Compton, MD, MPH, every resident prepares a written manuscript based on a research project, case report/series, or literature review, which is submitted for publication in a peer-reviewed journal. Residents interested in research have a broad array of opportunities, from the clinical research carried out by our own departmental faculty to that of our colleagues at the National Institute of Mental Health and other local organizations.

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 are drawn both from our full-time academic and voluntary clinical faculties, 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
(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 GW Hospital)

Bedside Interviewing
James Griffith, M.D.
(Four sessions in July – September)

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

Cultural Psychiatry and Sociocultural Assessment
James Griffith, M.D. and Robin Berlin, M.D.
Weekly during September - October

International Psychiatry and Global Psychiatry Policy
Amir Afkhami, M.D., Ph.D.
Weekly during November – 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
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
Jerrold Post, M.D. and Barrie Seidman, L.C.S.W. 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

Emotionally-Focused Couple Therapy
James Griffith, M.D.
Weekly during September - December

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 Neuroscience 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

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 GW 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

Human Sexuality
Jeffrey Akman, M.D. and Invited Faculty
Weekly during July – August

Social Neuroscience of Stigma
James Griffith, M.D.
Weekly during October

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

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 GW psychiatry residency. The GW School of Medicine provides strong medical student education in the behavioral sciences, and as many as 10% of the GW 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.

The content on these web pages is intended for educational and informational purposes only and is not designed to replace medical advice or professional medical services. The information should not be used as a substitute for the medical care and advice of your physician. Medical decisions should be made in consultation with your qualified health care provider. There may be variations in treatment that your health provider may recommend based on individual facts and circumstances.