Mission

The Psychiatric Physician Associate Residency Program is committed to producing highly skilled and competent Physician Associates who can provide exceptional mental health care to our military members. Our mission is accomplished through two primary purposes. The first is to produce graduates with expertise in evidenced based mental health care for assessing, diagnosing, and managing a variety of mental health, emotional, behavioral, and substance use disorders, including crisis management. The second is to ensure competency in military organization and occupational psychiatry to improve day to day functioning in the workplace and ensure military members meet retention and deployment standards. The Psychiatric Physician Associate Residency provides military Physician Associates an opportunity to develop advanced competencies in both psychopharmacological and non-psychopharmacological treatment.

Vision

Our vision is to create the premier post-graduate Physician Associate residency through the pursuit of academic and clinical excellence. We will achieve our vision by developing mental health trained practitioners who are prepared to conduct evidence-based mental health treatment and provide quality care for patients with a wide variety of psychiatric, emotional, and behavioral disorders in both outpatient and inpatient settings, including the battlefield. Our graduate mental health trained Physician Associates may also function as clinical subject matter experts and will become future leaders and mentors by setting the example of clinical excellence for Physician Associates worldwide.

Aims

Our program aims to improve the overall well-being of our service members, while also advancing the field of psychiatry within the Physician Associate profession.

The program is designed to provide residents with a strong educational foundation in Psychiatry. Trainees will engage in intensive reading assignments from essential resources such as the DSM-5-TR and the American Psychiatric Association Textbook of Psychiatry – which are carefully correlated with clinical rotations to enhance the overall learning experience. To review and assess knowledge, residents participate in regular meetings with the program director or the associate program director. Additionally, they join academic lectures alongside psychiatry peers, covering topics over a 12-month curriculum. This interactive learning environment utilizes targeted questions and discussions to challenge residents, fostering the development of effective clinical management skills for patients with mental health disorders.

The rotations that we currently offer are listed below.

BAMC-In processing and Behavior Health Familiarization (One Month)

• Administrative in-processing for the hospital, complete required trainings for MHS GENESIS.
• Begin familiarization with behavior health interviewing, charting, and treatments.
• Residents can also attend the Army’s Combat Operational Stress Control Course.

BAMC-Residential Treatment Program (Three Weeks)

PA residents participate as members of an interdisciplinary treatment team and gain exposure to comprehensive assessment, treatment planning, psychopharmacologic management, and recovery-oriented care for patients with substance use disorders and co-occurring psychiatric conditions in a 12-bed residential setting. Clinical experiences include psychoeducation, group therapy, recreational therapy, occupational therapy, and coordination of care to support stabilization, relapse prevention, and transition to appropriate follow-on services.

BAMC-Consult & Liaison Mental Health Services (Three Weeks)

This rotation provides residents with experience delivering psychiatric consultation and liaison services within the medical center. Working alongside the consult team, residents evaluate patients referred by primary medical and surgical services, complete comprehensive psychiatric and safety assessments, and develop recommendations for treatment and disposition. The rotation emphasizes collaboration with interdisciplinary care teams, management of psychiatric symptoms in medically complex patients, and clear communication of mental health recommendations across inpatient and acute-care settings.

BAMC-Inpatient Services (Three Weeks)

This three-week rotation provides residents with experience delivering acute psychiatric care to military members in an inpatient setting. As part of an interdisciplinary psychiatric treatment team, residents conduct intake evaluations, participate in daily rounds, monitor patients’ clinical progress, and contribute to treatment and discharge planning. Under the supervision of experienced psychiatrists, residents further develop skills in individual therapy, psychopharmacologic treatment, risk assessment, crisis stabilization, and coordination of follow-on behavioral health care.

WHASC-Child and Adolescent Psychiatry and Sleep Medicine Clinic (Two Weeks)

This rotation combines clinical experience in child and adolescent psychiatry and sleep medicine. Residents spend several days each week in the Child and Adolescent Psychiatry Clinic, developing skills in age-appropriate assessment, diagnostic interviewing, risk assessment, family-centered care, and treatment planning for common mental health concerns. The remainder of the rotation is completed in the Sleep Medicine Clinic, where residents gain experience in the assessment, diagnosis, and management of sleep disturbances and disorders, including insomnia and obstructive sleep apnea. Under supervision, residents are exposed to sleep-study interpretation and pharmacologic and nonpharmacologic interventions, including cognitive behavioral therapy for insomnia, while developing an understanding of the relationship among sleep, mental health, development, and overall functioning.

WHASC-Alcohol and Drug Abuse Prevention and Treatment (Two Weeks)

Residents participate in interdisciplinary care consisting of patient evaluations, treatment planning, medication management, individual and group interventions, and coordination of care for patients with co-occurring psychiatric and substance use conditions. The rotation emphasizes evidence-based approaches to substance use treatment, relapse prevention, recovery support, with the unique occupational and readiness considerations involved in caring for military beneficiaries.

JMC-Adolescent Clinic (Two Weeks)

Residents practice in an adolescent primary care setting, with an emphasis on identifying and addressing mental health concerns that may arise during routine medical care. Residents work collaboratively with the primary care team to assess adolescents with potential mental health conditions, including mood, anxiety, and eating disorders, and to support appropriate evaluation, intervention, and referral when needed. The rotation emphasizes developmentally appropriate communication, confidential adolescent care, family engagement, and coordination of mental health services within an integrated care environment.

MHST-Emergency Psychiatry (Eight Weeks)

This two-month advanced rotation, completed toward the end of the program, provides residents with experience in emergency psychiatric care through a partnership with a civilian hospital. Residents evaluate and help manage patients presenting with acute and severe psychiatric conditions, including schizophrenia spectrum disorders, bipolar disorder, and substance-induced psychosis. 

Residents are expected to function with increasing independence under indirect supervision while developing skills in crisis assessment, risk evaluation, diagnostic formulation, acute stabilization, medication management, and disposition planning. The rotation also provides exposure to antipsychotic and mood-stabilizing medications that may be less commonly encountered in military treatment settings. A current Texas medical license is required to participate in this rotation.

Mental Health Outpatient Clinic (Longitudinal Rotation)

This longitudinal rotation provides residents with ongoing outpatient psychiatric experience throughout the program. Beginning in the second month of fellowship, residents spend one week each month in a military outpatient mental health clinic, where they manage a continuity patient panel and provide follow-up care over time.

Residents develop increasing proficiency in the evaluation and management of psychiatric conditions in the outpatient setting, with emphasis on medication management, individual therapy, monitoring treatment response, and adjustment of care plans. The rotation also strengthens skills in therapeutic alliance, continuity of care, documentation, and coordination with the interdisciplinary mental health team.

Physician Associates in this program will have the opportunity to work with Army and Air Force Psychiatrists and learn about the missions unique to each branch. San Antonio is a joint service marketplace allowing residents to care for patients from all services. Residents also gain experience communicating with different command structures and learning each service's readiness requirements.

All residents will engage in staff officer and administrative projects and participate in monthly meetings with other military officers. Residents will also gain a unique experience to understand clinic dynamics, military policies, and procedures, and how to effectively deliver patient care with various resources and constraints.

Residents are encouraged to participate in research and scholarly activities. Joint Base San Antonio provides a unique and robust platform for psychiatry and Physician Associate research. The Department of Mental Health’s education division oversees approximately 40 research projects to include collaborations with agencies such as the National Center for Post Traumatic Stress Disorder and the U.S. Army Medical Material Development Activity Center. Residents will have opportunities to work and collaborate with other officers within the education department.

All residents are required to complete Quality Improvement and Patient Safety training. The program also incorporates resident and faculty feedback as part of the Quality Improvement and Patient Safety curriculum.

Our residency program is dedicated to empowering future leaders in military psychology. Residents will have access to many online courses, didactic workshops, and mentorship opportunities to aid their professional development. Upon completion of training, graduates will be prepared to sit for the National Commission on Certification of Physician Associates Certificate of Added Qualifications in Psychiatry.

• Brooke Army Medical Center
• Captain Jennifer Moreno Clinic
• Wilford Hall Ambulatory Surgical Center
• Methodist Hospital Specialty and Transplant

Military Physician Associates interested in this program will need to apply through their Branch Specific education managers. Army PAs will apply through the Long-Term Health Education and Training.

Interested applicants should reach out directly to the SAUSHEC Psychiatric Physician Associate Residency for all questions about this program. Email is the preferred method of communication.

Program graduates will be required to take the National Commision on Certification of Physician Associates Certification of Added Qualification in Psychiatry to become fully certified. This exam is offered bi-annually, and applicants are eligible to take the CAQ exam upon graduation. To be eligible to take the specialty certification exam, graduates must complete all pre-requisites required by the NCCPA by September 6th of their graduation year. The NCCPA website has information on requirements and timeline.

Resident/Fellow as Teacher Opportunities.

All residents will have the opportunity to train and mentor other learners within their rotations and didactic training.

Our faculty are well trained and well educated in many things to include subspecialities in psychiatry, neurology, addiction medicine, and pain management.

All residents are encouraged to seek out mentorship both within and outside the department, to foster a diverse support network. Each resident will be under the direct supervision of the program director or assistant program director and will be evaluated for each rotation and be encouraged to discuss all feedback.

The program prioritizes the well-being of all residents by creating a psychologically safe space, promoting self-care, and preventing burn out. Initiatives include regular check-ins, mentorship opportunities, team building events, morale days, and workshops on resilience and self-care.