Mission

The Psychiatric Physician Assistant Residency Program is committed to producing highly skilled and competent Physician Assistants 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 to include 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 Assistant Residency provides military Physician Assistants an opportunity to develop advanced competencies in both psychopharmacological and non-psychopharmacological treatment.

Vision

Our vision is to create the premier post-graduate Physician Assistant 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 an outpatient and inpatient setting to include the battlefield. Our graduate mental health trained physician assistants may also function as clinical subject matter experts and will become future leaders and mentors by setting the example of clinical excellence for physician assistants 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 assistant profession.

The program is designed to provide residents with a strong educational foundation in Psychiatry. Residents will engage in intensive reading assignments from essential resources such as the DSM-5-TR and the American Psychiatric Association Textbook of Psychiatry, as well as other relevant education materials. These reading assignments will be correlated with the clinical rotations to enhance the overall learning experience. Residents participate in regular meetings with program director or associate program director to review and assess knowledge. Additionally, residents will attend and participate in academic lectures with psychiatry residents, covering topics over a 12-month period. This interactive learning environment will challenge residents with questions and discussions, leading to 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-Addiction Medicine Intensive Outpatient Program (One Month)

Residents participate as part of a multidisciplinary team specialized in treating addictions and behavior health disorders in the outpatient setting. Utilizing a variety of evidence-based interventions including group and individual counseling, psychoeducation, journal writing, self-help programs, and psychopharmacological treatments.

BAMC-Residential Treatment Program (One Month)

12-bed residential facility supporting patients with substance use disorders and co-occurring psychiatric disorders. Residents will learn and participate in psychoeducation, group therapy, recreational therapy, occupational therapy and psychopharmacological treatments.

BAMC-Consult & Liaison Behavioral Health Services (One month)

Residents learn to provide mental health consultation services to primary medical teams, complete safety assessments, and recommend appropriate disposition of psychiatric patients.

BAMC-Inpatient Services (One Month)

• Provide acute psychiatric care to military members as part of a psychiatric team.
• Learn to conduct intake interviews, monitor daily progress, and make discharge recommendations.
• Practice individual therapy and medication management under supervision of knowledgeable Psychiatrists.

Wilford Hall Ambulatory Surgical Center-Sleep Medicine Clinic (One Month)

• Learn about the diagnosis and management of sleep disturbances and disorders.
• Familiarization with sleep studies and treatment of obstructive sleep apnea, learn about different medications used to treat sleep disorders.
• Participate in cognitive behavior therapy for insomnia.

Methodist Hospital Specialty and Transplant (Two Months)

Residents have the opportunity to partner with a civilian hospital and learn to manage severe psychiatric illness such as schizophrenia, bi-polar disorder, and substance induced psychosis. Become proficient in the use of antipsychotics and mood stabilizers not commonly used in the military population. A Texas State Medical License is required for the rotation.

Mental Health Outpatient Clinic (Three Months)

Management of psychiatric patients in the outpatient setting with a focus on medication management and individual therapy. Residents will have a once per week continuity clinic starting in the second month of the fellowship at a military outpatient clinic. There is also the opportunity for a one-month rotation at an embedded behavior health unit at Fort Cavazos for familiarization with operational behavioral health.

Physician Assistants 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 services 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 activity. Joint Base San Antonio provides a unique and robust platform for psychiatry and physician assistant research. The Department of Behavioral 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 Assistants Certificate of Added Qualifications in Psychiatry.

• Wilford Hall Ambulatory Surgical Center
• Methodist Hospital Specialty and Transplant

Military Physician Assistants 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 Assistant 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 Assistants 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.

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.