Thank you for your interest in Saint Elizabeths Hospital Psychiatry Residency Training Program. Ours is a four year training program in psychiatry accredited by the Accreditation Council for Graduate Medical Education (ACGME). This program is primarily based at Saint Elizabeths Hospital, which is the public psychiatric hospital for the District of Columbia operated by the D.C. Department of Mental Health. The D.C. Department of Mental Health also operates Mental Health Services Division and the Comprehensive Psychiatric Emergency Program both of which form integral parts of the Residency Program.

Several other institutions including Providence Hospital, Prince George’s Hospital Center, Washington School of Psychiatry and Children’s Hospital National Medical Center provide key sites for clinical rotations within this residency training program. Together, these sites offer a wide range of settings where residents work with individuals from a variety of cultural and socioeconomic backgrounds, representing a full gamut of psychiatric disorders.

Saint Elizabeths Hospital is a free-standing public psychiatric hospital that provides treatment to individuals with severe mental illness. The Hospital has played a central role in the history and development of forensic psychiatry in the United States. Saint Elizabeths Hospital serves as the primary clinical site for the Forensic Psychiatry fellowship program sponsored by Georgetown University. In addition, Saint Elizabeths also has training programs/internships in psychology, chaplaincy and dentistry. Five medical schools offer psychiatry clerkships at Saint Elizabeths. We also have an externship program for graduates of medical school looking to gain clinical experience in the US.

Our program envisions psychiatry as a field whose origins are firmly rooted in medicine. It is a discipline which integrates neurobiology, psychology and sociology, each of which deepens our understanding of human behavior and enhances delivery of the best psychiatric care. The rapidly expanding neurochemical and neuropsychological understanding of human behavior is combined with an understanding of human development, psychodynamics and the individual's social and cultural milieu to cultivate humane care and provide the most effective treatments.

Clinical experience remains the best foundation of psychiatric training. Throughout their training, residents are responsible for the treatment of a wide range of patients. Careful attention is paid to insure that each resident has extensive longitudinal experience with patients who suffer from chronic, severe mental illnesses as well as patients with significant neurotic and characterological difficulties, which interfere with their personal relationships or occupational functioning. Residents are provided an opportunity to work extensively with adults, children, groups, families, and provide consultation to organizations within the community, all in a supervised setting.

Our training program prepares residents to treat mentally ill population, both as inpatients and outpatients. Many of the most severely mentally ill are involved with the legal system. Circumstances may involve civil commitment, guardianship, competency to stand trial or legal insanity. The program provides a balanced education with the emphasis on learning psychopharmacology and psychotherapy from top psycho pharmacologists and psychoanalysts in the country. Residents are placed in university student health clinics and in public/private clinics for outpatient psychotherapy experience. Training in neurology is another area of particular strength. The long-standing association between Saint Elizabeths Hospital and the National Institutes of Mental Health (NIMH) provides for many research opportunities. Jose Apud M.D., Ph.D., who is a graduate of this program, is the Chief of Clinical Psychiatry at the Clinical Brain Disorders Branch of NIMH, and Teodor Postolache, M.D., is the Director of the Mood and Anxiety Disorders Clinic at University of Maryland. Elective research experiences for our residents are easily arranged at NIMH and at the University of Maryland at Baltimore.

In all, Saint Elizabeths Hospital Psychiatry Residency Program provides comprehensive training in all major areas of psychiatric practice with the goal of graduating skilled general psychiatrists. We anticipate that many of our graduates will pursue further training in psychiatric specialties, such as Community Psychiatry, Child and Adolescent Psychiatry, Psychiatric Research, Forensic Psychiatry and Psychoanalysis. All of us at Saint Elizabeths Hospital invite you to explore our training opportunities in psychiatry.

HISTORY

The Saint Elizabeths Campus is situated in Washington, DC, on heights overlooking the Potomac and Anacostia Rivers. Since it opened its doors in 1855, as the first federal mental hospital, Saint Elizabeths has been a geographical and historical landmark at the center of change in American psychiatry and has been training physicians and psychiatrists throughout its history. It is inspiring to walk the tree shaded campus Dorothea Dix secured for the recovery of the mentally ill a century ago. It was on this campus where the prominent Neurologist Dr. Walter Freeman pioneered and hoped to perform on a wide scale within the hospital, his highly controversial transorbital approach to lobotomy, which was blocked by the acting hospital Superintendent. ). Dr. Richard J. Wyatt, a half century later, helped pioneer animal studies in brain transplantation that led to trials now occurring throughout the world on adrenal transplantation for the treatment of Parkinson's disease. Working at Saint Elizabeths Hospital you will grasp part of a rich legacy that has repeatedly made psychiatric history and public controversies. Saint Elizabeths psychiatrists participated in the first battle of forensic experts, the trial of President Garfield's assassin, Charles Guiteau. The Hospital's involvement with forensic psychiatry continued with William Alanson White's testimony in the Leopold and Loeb trial and Winfred Overholser's testimony in the case of the literary giant, Ezra Pound. Today there are many cases of the famous and infamous that challenge our diagnostic, therapeutic and medico-legal understanding.

In 1987, the administrative control of Saint Elizabeths Hospital was transferred from the federal government to the District of Columbia's Commission on Mental Health Services (CMHS), which developed a comprehensive mental health services delivery system. As a result of recent organizational changes, the District of Columbia Department of Mental Health (DMH) has replaced CMHS. Learning psychiatry within DMH builds upon its continuity with the past, which illuminates present practices and nurtures the vision of the future. When Dorothea Dix, the great mental health reformer of the nineteenth century, founded Saint Elizabeths Hospital in 1852, she gave it a mission: ”The most humane care and enlightened curative treatment". This mission and her dedication to excellence are just as relevant today as the Department of Mental Health strives to provide the best care in the least restrictive environment and to find new modes of treatment for those most difficult to treat. Today there are 350 inpatients and large number of outpatients throughout our public mental health system.

During your training, you will learn the main modalities of psychotherapy (individual, family and group) and the main psychotherapeutic orientations (psychoanalytic, cognitive-behavioral, supportive and interpersonal). The campus you walk has been a seedbed for many of these. Staff members of Saint Elizabeths were a major force in introducing psychoanalysis to the public hospital in the last century. The creative arts therapies (art, music, dance, bibliotherapy and psychodrama) and pastoral counseling have all had pioneering departments on the Saint Elizabeths Campus. These continue to provide valuable treatment and training services here.

The Psychiatric Residency Training Program was formally initiated in 1938. The DMH places a strong emphasis on training and education at all levels, and the Psychiatry Residency Training Program remains a central component of the DMH. The Program's inclusion within a comprehensive mental health system allows many training sites such as schools, nursing homes, geriatric centers and shelters for the homeless to be readily available for residency training.

THE NEW HOSPITAL BUILDING

The new hospital building has replaced nearly all of the old buildings on campus. The new Hospital serves about 300 patients and covering approximately 450,000 square feet in a state-of-the-art design.

Highlights include:

Residential Areas: Individuals receiving treatment at Saint Elizabeths live in small “pods”—units of 26 almost all single bedrooms—that are designed to keep them comfortable, active, and safe. Each bedroom has an exterior window for plenty of outdoor lighting. Each pod has space for dining, activities, therapy and medical care and provides access to an outdoor garden terrace.

Space for Recovery-Based Treatment: While patients reside in pods, they spend their days in one of two treatment malls, which provide therapy, life skills training and other activities. As a result, their daily lives reflect the rhythm of the outside world: eating breakfast and dinner at home and working, learning, and eating lunch outside the home during the day.

Low Environmental Impact: A number of features reduce the “footprint” of the building. Among them is a 32,000 square foot Green roof. The natural membrane that comprises the roof naturally insulates the building and provide a natural habitat in an urban setting.

Public Access: The new Hospital features a 250-seat auditorium, providing a venue for musical and theatrical performances by individuals staying at the Hospital as well as training, meetings, and events for the general public as well as staff. An outdoor stage will be used for performances in the spring and summer.

Art and History: A museum near the main entrance to the Hospital narrates and animates the Hospital’s ground-breaking history. Art commissioned by the DC Commission on the Arts and Humanities adorns the main entrance and corridors.

The Psychiatry Residency Training Program benefits from a number of specific improvements in the n ew facility. The Hospital has wireless connectivity throughout and clinical staff are able to utilize laptops. This has significantly improved efficiency and enabled staff to spend more time providing clinical care. There is an admission suite for both civil and forensic patients resulting in an appropriate environment for completion of initial psychiatric assessments.

The Education and Training section of the Hospital includes multiple classrooms, seminar rooms, as well as an observation room with a one way mirror. The state of the art library features meeting space, a rare books room, an archives room and an outside veranda. Finally, the on-call suite for residents and psychiatry staff includes two bedrooms, a lounge, and a kitchenette.

Altogether, the new Saint Elizabeths Hospital enables the District of Columbia to provide state-of-the-art inpatient care to individuals with serious mental illness. It represents a true renewal of the mission that Dorothea Dix envisioned so many years ago.