Latest Updates:  September 3, 2008

St. Elizabeths Hospital Residency Training Program is accredited as a four-year training program in psychiatry by the Accreditation Council for Graduate Medical Education (ACGME).  This program is primarily based at St 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 D.C. Community Services Agency, which provides outpatient mental health rehabilitation services, and the Comprehensive Psychiatric Emergency Program. Both form integral parts of this residency program.

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

St. Elizabeths Hospital has a long-standing mission to provide the best care to people with severe mental disorders, and to train clinicians in multiple disciplines to further this mission. In addition to psychiatry, we also have an active program for medical students and graduates of medical school doing externships.

Our program conceives of psychiatry as a field which is firmly rooted in medicine and also a discipline which requires the integration of contributions from neurobiology, psychology and sociology, each of which deepens our understanding of human behavior and informs our delivery of the best psychiatric care. The rapidly expanding neurochemical and neuropsychological understanding of human behavior needs to be combined with an understanding of human development, psychodynamics and the individual's social and cultural milieu in order to achieve humane care and provide the most effective treatments. The DMH/St. Elizabeths Psychiatric 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 psychiatry, psychiatric research, forensic psychiatry and psychoanalysis and public psychiatry.

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 with an opportunity for extensive supervised work with adults, children, groups, and families in addition to providing consultations to organizations within the community. Each resident has elective time to pursue more specialized interests.

St. Elizabeths Hospital has also played a central role in the history and development of forensic psychiatry in the United States. Our training program trains residents to treat the most severely mentally ill people, both as inpatients and outpatients.  Many of the most severely mentally ill are involved with the legal system, whether for civil commitment, guardianship, competency to stand trial, or legal insanity.  Forensic Psychiatry is a particular focus of training for those who are interested in this field.

The long-standing association between St. Elizabeths Hospital and the National Institutes of Mental Health (NIMH) provides for many research opportunities. Jose Apud MD PhD, who is a graduate of this program, is the Chief of Clinical Psychiatry at the Clinical Brain Disorders Branch of NIMH, and Teodor Postolache, MD, who was previously member of our faculty, 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. 

History and Philosophy

The St. 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, St. 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. At the same campus on which Dr. Walter Freeman pioneered his highly controversial transorbital approach to lobotomy (he was blocked by the Superintendent from performing the operation here on a wide scale), 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.

Walking through the John Howard Forensic Pavilion -named for the British reformer of the Enlightenment, you will grasp part of a rich legacy that has repeatedly made psychiatric history and public controversies. St. Elizabeths psychiatrists participated in the first battle of forensic experts, the trial of President Gaffield'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 Overholsers testimony in the case of Ezra Pound. Today there is a host of cases of the famous and infamous that challenges our diagnostic, therapeutic, and medico legal understanding.

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

In 1987, the administrative control of St. 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 practice and nurtures the vision of the future. When Dorothea Dix, the great mental health reformer of the nineteenth century, founded St. 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 apt 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 450 inpatients and over 5000 outpatients throughout our public mental health systems.

The Psychiatric Training Program was formally initiated in 1938. The DMH places a strong emphasis on training and education at all levels, and the Psychiatry 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.