Mission

The NMCP Psychiatry Residency Program provides a high-quality educational experience ensuring that its graduates will possess the knowledge, sound clinical judgment, and requisite skills pertaining to the diagnosis, treatment, and prevention of all psychiatric disorders as well as other common medical and neurological disorders that relate to the practice of psychiatry, especially as it pertains to the military. The rigorous 4-year didactic and clinical experience provides residents with a thorough and well-balanced presentation of psychological, socio-cultural, and neurobiological observations, as well as in-depth exposure to diagnostic and therapeutic procedures in the field of psychiatry. It also provides the education and training necessary to understand key psychiatric literature, to evaluate the reliability and validity of scientific studies, and to incorporate new knowledge into the practice of medicine.

Vision

Our graduates will be ready to care for warfighters and their beneficiaries throughout the globe, from field hospitals and ships to state hospitals. They will be outstanding, well-rounded clinicians and leaders, ready to reshape military psychiatry to meet the needs of an increasingly dynamic environment.

Aims

We will strive for excellence in patient care, medical knowledge, interpersonal and communication skills, practice-based learning, and systems-based care as it pertains to psychiatry. We will hold ourselves to the highest levels of professionalism and officership while practicing compassionate care of patients and ourselves. We will remain dedicated to examining our biases and recognizing the disparities that exist in our system.

Conferences  

Residents are excused from clinical duties to attend conferences, psychotherapy trainings, and didactics.

Weekly Grand Rounds

The Directorate of Mental Health hosts a weekly grand rounds series on Thursdays at 12 p.m. featuring a variety of speakers from across the country. Most sessions occur virtually so that our colleagues stationed overseas and residents rotating off-site are able to attend.

FOCUS

A weekly article review course for our PGY3s that teaches core concepts of how to review medical literature. Each week a different, newly-published article is presented by a resident and reviewed in a group setting with the rest of the class.

Resident Journal Club

Held monthly to review landmark psychiatric articles and to practice critical appraisal of the literature. Attended by residents and faculty and led by a small group of both junior and senior residents.

Therapy Group (T-Group)

A weekly resident and intern process group led by a faculty member not involved in resident assessment.

Didactics:

PGY1 Didactics

Held weekly on Tuesdays, ~1 hour. Focus is on broad introduction to psychiatry, journal club, and introduction to military psychiatry.

PGY2 Didactics

Held weekly on Wednesday, ~4 hours. Covers the following:

• Child Development, Psychopathology, and Psychopharmacology (28 hours)
• Neuropsychological Testing (4 hours)
• Introduction to Therapy (3 hours)
• Psychopharmacology (28 hours)
• Introduction to Group Therapy (8 hours)
• Emergency Psychiatry (8 hours)
• Consult Liaison Psychiatry (12 hours)
• Addiction Psychiatry (12 hours)
• Reflective Practice (8 hours)
• Interview Skills (12 hours)
• Intro to Psychoanalytic Therapy (8 hours)
• Neuroscience (12 hours)
  

PGY3 Didactics

Held weekly on Wednesday, ~3 hours. Covers the following:

• Psychopharmacology (40 hours)
• Introduction to Research (8 hours)
• Psychotherapy (24 hours)
• Forensics (8 hours)
• Interview Skills (12 hours)
• Intro to Psychoanalytic Therapy (24 hours)
• Perinatal Psychiatry (8 hours)
• Geriatric Psychiatry (8 hours)

PGY4 Didactics

Held every Thursday, ~3 hours. Covers the following:

• Psychopharmacology (30 hours)
• Neurology (30 hours)
• Operational Psychiatry (16 hours)
• Interview Skills (12 hours)
• Ethics (8 hours)
• Board Prep, Telepsychiatry, Transition to Practice (8 hours)

Table Guide:

All rotations are conducted at Naval Medical Center Portsmouth (NMCP) unless otherwise indicated.

1. RRMC: Riverside Regional Medical Center
2. VAMC: Veterans Administration Medical Center
3. Hampton: Hampton Community Service Board
4. CHKD: Children's Hospital of the King's Daughter
5. Sentara: Sentara Norfolk General Hospital

Available electives include but are not limited to:

• Multiple Operational Electives (Surface Forces, Naval Special Warfare, Submarines, Marine Corps)
• Child and Adolescent Psych (Outpatient and Consult-Liaison)
• Addictions Psych
• Community Psych
• Forensics Psych
• Electroconvulsive Therapy
• Transcranial Magnetic Stimulation
• Correctional Psych
• Group Psychotherapy
• Neuroradiology
• Pain Management
• Research

Residents are encouraged to identify other experiences in our geographic area that are of interest to further expand the available electives.

PGY-1

Interns do not take psychiatry call when assigned to the Internal Medicine wards or Emergency Medicine service. On all other rotations, they take a twelve-hour daytime psychiatry call on Saturdays and Sundays throughout the year when assigned to Psychiatry, Neurology, Family, Operational, and Addiction. With a complement of six interns, each intern takes approximately nine call shifts per calendar year.

PGY-2

Second year residents are assigned to one month of Night Float. Night Float covers the emergency and inpatient psychiatry services from 7:30 p.m. through morning turnover (typically departing the hospital at 8 a.m.). Night Float covers the hospital each evening with the exception of Fridays (when this is covered by the resident on call). Second year residents share call responsibilities for weekends and holidays, taking approximately 15 call shifts per calendar year.

PGY-3

Third year residents are assigned to cover two weeks of Night Float. They also share call responsibilities for weekends and holidays, taking approximately 15 call shifts per calendar year.

PGY-4

Fourth year residents are assigned to cover two weeks of Night Float. They also share call responsibilities for weekends and holidays, taking approximately five call shifts per calendar year.

Beyond developing outstanding psychiatrists, our program focuses on building exemplary officers. Our residency’s operational training begins in the PGY1 year when each of our interns completes a month-long rotation with either Surface Warfare, our submarine forces, or with Naval Special Warfare. Our PGY4s complete an additional operational rotation with a focus on preparing to step into the role of the embedded psychiatrist for one of these communities. Residents have the option of completing these rotations with the U.S. Marine Corps as well if that is their area of interest.

In addition to the operational rotations, we teach a 16-session course on the fundamentals of operational psychiatry, including the basics of the military’s organization, history of military psychiatry, and a discussion of embedded mental health roles in the Navy and USMC. This course also involves field trips to the various embedded environments.

All of our residents are required to maintain Basic Life Support qualification and Advanced Cardiac Life Support throughout training. Navy Interns are required to attend C4 or Bushmaster (those from USUHS). All Psychiatry residents must receive training to participate in Special Psychiatric Rapid Intervention Teams (SPRINT).

All interns complete an introduction to psychiatric history taking course organized through our Simulation Center where they are asked to complete brief evaluations of simulated patients with various psychiatric disorders. They are observed and given feedback by our senior faculty members. This is intended as a learning experience only and is not a graded encounter.

We teach a longitudinal leadership course that extends over the entire residency program. This course focuses on the fundamentals of leadership, recognizing and building your leadership style, and military history, and was designed by one of our former residents who served as a Marine Infantry Officer prior to attending medical school.

All of our residents are required to engage in scholarly activity during their residency. The minimum expected is one podium presentation in both their 2nd and 4th years and one poster presentation at some point during residency (can be at a local or national conference). Podium presentation requirements can be met by presenting at Grand Rounds or at a conference. These requirements can be waived by the Program Director if the resident has engaged in a higher level of research (i.e., wrote a book chapter, published a case report, undertook an IRB-approved study, etc.). These situations will be reviewed on a case-by-case basis.

For interested residents, a research track is available with protected time away from clinical duties to engage in scholarly work. Please discuss with the Program Director if you are interested in pursuing this track.

Residents are required to work as a class beginning in the PGY3 year or earlier on a quality improvement project. This quality improvement activity or project requires the residents to demonstrate an ability to analyze, improve and change practice or patient care. The class, as a whole, will identify and present their QI project idea by December of their PGY3 year to the EPC or Program Director. The proposed project will be done under the supervision of a faculty member of their choosing. The class will give a formal presentation on their project and its outcome before completion of PGY4 year to EPC, NMCP QI Symposium, or Grand Rounds. In that presentation, they are expected to describe the planning, implementation, and results of the project.

Our program’s rotations, didactics, supervision, and mentorship experiences ensure our graduates are prepared to practice psychiatry in the military and in civilian settings. To ensure we are meeting the individual needs of each of our trainees, and helping them to maximize their potential, professional development is a primary focus of the twice-yearly meetings each resident has with the program director. During these sessions, we ensure residents have mentors to help them meet their specific goals, and we discuss training opportunities in the Navy, Navy Medicine, USUHS, or beyond that will help them become the psychiatrist they aim to be.

• Sentara Norfolk General Hospital
• Veterans Affairs Medical Center Hampton
• Norfolk Community Service Board
• Riverside Regional Medical Center
• Children's Hospital of the King's Daughters (CHKD)
• Hampton Community Service Board

Psychiatry provides opportunities for clinical rotations in Inpatient Psychiatry, Child & Adolescent Psychiatry, and Consult Liaison/Emergency Psychiatry for both MS3 (case-by-case basis) and MS4s.  Please visit our medical student rotation description page here for additional rotation information.

We welcome interview requests from medical students, interns, residents, general medical officers (flight/dive/FMF/Surface), or current staff physicians in any specialty (in the case they wish to seek approval to obtain a second residency training). We also welcome applicants from any uniformed service. Prospective applicants are encouraged to reach out early in the interview season by contacting us at the program email. We require a CV, personal statement, and unofficial transcript ahead of the interview.

Interviews can be conducted in person or virtually. Please contact the Program Leadership via email (located in contact us section) if you wish to schedule an interview.

Program graduates are eligible to take the written board examination offered by the American Board of Psychiatry and Neurology. This exam is offered annually in September; graduates are board eligible immediately upon graduation and are encouraged to take the examination the September following their graduation date.

Our program strives to empower each of our residents to act as educators. Our acute services include medical student rotators from USU and HPSP, as well as off service interns. The residents are expected to mentor and train these students while on these rotations. In the PGY4 year, the senior residents provide the majority of instruction in introduction to psychiatry to our first-year residents. We have ample additional training opportunities for our enlisted personnel, nurses, psychologists, and social workers.

We also encourage each of our senior residents to take formal classes in teaching through the USUHS Faculty Development Course.

Our training program has faculty with subspecialty training in Child/Adolescent, Neuromodulation, and Consult-Liaison psychiatry.

Mentorship is the cornerstone of our program. We believe that good mentorship can change an individual’s trajectory and we ensure that each of our residents is exposed to a variety of mentors with diverse perspective and experiences to ensure that each resident is able to achieve their clinical, academic, and military goals.

The PGY1 residents are assigned a more senior resident global supervisor with whom they should have the opportunity to meet with on a regular basis for mentorship. PGY1s are also assigned a psychiatry faculty global supervisor to meet with at least monthly. The PGY2 residents are assigned a faculty global supervisor with whom they should meet with at least weekly. PGY3 and PGY4 residents are assigned a faculty global supervisor and a psychotherapy supervisor who, in addition to overseeing their clinical and academic progression, will provide mentorship on a weekly basis.

Finally, each resident meets individually with the Program Director to received mid-point and end-of-the-year feedback. During these sessions it is the program’s intention to better understand each resident’s goals and their progress toward these goals. Based on these sessions we try to connect each resident with a sponsor in the larger Navy psychiatry community who can provide additional mentorship in alignment with their goals.

Resident well-being is of utmost importance to our program. We strive to create a culture of openness, support, purpose, and connection. We emphasize the following:

Time Away

We recognize that time to rest and socialize with loved ones is critical for maintaining a work-life balance. PGY1s are authorized three weeks of leave, and PGY2s-4s are authorized four weeks of leave per academic year. In the past year we implemented “fifth Wednesdays” in which the afternoon of any fifth Wednesday in a month is protected time away from the residency. We also work with each resident to maximize parental leave.

Pathways for Reporting

We want to ensure that all residents are able to share feedback with the program freely. As such, we have a number of reporting pathways to include direct feedback to the program leadership and chief residents, an anonymous comments box, and biannual anonymous resident surveys.

Treatment

We encourage all residents to consider engaging in their own individual therapy both for their education and for their overall well-being. We have pathways to help residents establish mental health care both within the military system and with network mental health providers outside of our system. We additionally offer the Peer Support Network as a way to receive additional, anonymous care should they not want to go through the program.

Purpose

We recognize that purpose looks different for each individual, so we strive to ensure that each resident is exposed to a breadth of experiences and patients. We have developed our program such that there is flexibility for each resident to tailor residency to their interests.