As the flagship teaching hospital for University of Texas Health San Antonio and a premier Level I Trauma Center in the South Texas region, this 713-bed facility is a national leader in patient care, clinical education and research. University Hospital also serves as the public district hospital for the San Antonio metropolitan area, providing charity care to the city’s most vulnerable populations. Psychiatry interns complete rotations on the hospital’s 20-bed inpatient psychiatric unit, as well off-service rotations on the general medicine, neurology, and emergency medicine services. PGY2 residents also rotate on the inpatient service, as well as the busy psychiatry consult-liaison service. PGY4 residents return to the inpatient and C/L services in a “junior faculty” capacity to provide supervision and support to PGY1-2 residents. Residents take in-house weekend call and may also moonlight at the hospital. University Hospital provides residents with a solid foundation in the treatment of high-acuity patients with serious mental illness and psychiatric disorders in medically ill patients.
Brooke Army Medical Center (BAMC)—also referred to as San Antonio Military Medical Center (SAMMC)—is the largest hospital in the U.S. Department of Defense. Located on Fort Sam Houston, it is jointly staffed by both the Army and the Air Force and provides specialty care to active duty service members, retirees, and their family members from all service branches. BAMC is also home to a Level I Trauma Center and world-class Burn Center. Psychiatry interns complete rotations on the hospital’s inpatient psychiatric unit, as well off-service rotations on the general medicine, neurology, and emergency medicine services. PGY2 residents rotate on the psychiatry consult-liaison service. PGY4 residents return to the inpatient and C/L services in a “junior faculty” capacity to provide supervision and support to PGY1-2 residents. PGY4 residents also have the opportunity to rotate on the hospital’s inpatient substance use disorder unit. Residents provide in-house night and weekend call coverage for the hospital. BAMC provides residents with a unique exposure to military medicine and the opportunity to care for U.S. service members.
Named in honor of the nation’s most decorated World War II hero, the Audie L. Murphy Memorial VA Hospital is a quaternary care facility that provides access to specialty care for a population of over 153,000 military veterans living in the San Antonio area. The hospital is conveniently located across the street from University Hospital, with an enclosed skyway in between the two facilities. Residents complete core rotations in inpatient psychiatry, emergency triage, and the consult-liaison service as well as off-service rotations in general medicine, neurology, and palliative medicine. PGY4 residents return to the inpatient and C/L services in a “junior faculty” capacity to provide supervision and support to PGY1-2 residents. Residents provide in-house night and weekend call coverage for the hospital. Psychiatry residents are well supported as inpatient care is rendered under an interdisciplinary team model consisting of social workers, a doctorate in pharmacy, and occupational/recreational therapists. Other supportive services are available for our teams to aid in the veteran’s transition back into the community, such as inpatient electroconvulsive therapy, counseling services, housing assistance, an employment program, and residential and outpatient substance recovery referrals.
Wilford Hall Ambulatory Surgical Center is a large multidisciplinary outpatient medical facility located on Lackland Air Force Base. Housing more than 25 clinical services and serving more than 55,000 patients, it is the Department of Defense’s largest outpatient ambulatory surgical center. Beginning in PGY2 year, psychiatry residents who belong to the Air Force joint program complete their psychotherapy training in the Wilford Hall mental health clinic. They also spend part of their PGY3 longitudinal outpatient rotations at the mental health clinic. Other outpatient clinical experiences available at Wilford Hall include child and adolescent psychiatry and military forensic psychiatry.
Clarity Child Guidance Center is the only not-for-profit mental health treatment center specializing in children ages 3-17 in San Antonio and South Texas. Their inpatient and outpatient programs incorporate a range of services including crisis stabilization, psychiatric evaluations, and ongoing therapy. Clarity is closely affiliated with UT Health San Antonio Department of Psychiatry and provides training opportunities for our residents to work alongside the child and adolescent fellows in the outpatient setting. PGY2 and PGY3 residents complete a longitudinal outpatient rotation that provides robust training in the treatment of both common and serious mental health disorders of childhood and adolescence.
The University Plaza Clinic is a UT Health San Antonio outpatient mental health clinic that allows residents to appreciate the satisfaction of providing psychiatric care in a community psychiatry setting. The majority of time is spent working with patients as part of the Transitional Care Clinic (TCC) program. This program provides psychiatry and psychotherapy services to patients who have recently been psychiatrically hospitalized and is supported by multi-million-dollar state and local funding. The program serves an important role in the community by providing a bridge to long-term mental health services for vulnerable, high-risk patients, thereby reducing their risk of re-hospitalization. PGY3 residents complete 1-year longitudinal outpatient experiences at the clinic working with a strong multi-disciplinary team and dedicated attending supervision. They gain robust exposure to the outpatient psychopharmacological management of serious mental illness, substance use disorders, and severe personality disorders. They also have the opportunity to gain exposure to specialized psychotherapies, including those for PTSD (CPT), Borderline Personality Disorder (DBT), and Schizophrenia (CAT).
The South Texas VA Health System operates a vast and diverse network of outpatient mental services for the large population of military veterans in the San Antonio area. PGY3 Psychiatry residents complete longitudinal outpatient rotations in a variety of adult outpatient psychiatric clinics that are located at the Audie L. Murphy hospital, the Frank Tejeda Outpatient Clinic, and the Balcones Heights Outpatient Clinic. Residents may also rotate through the VA Polytrauma Center, providing psychiatric care to veterans with traumatic brain injuries; the Intensive Community Mental health Recovery (ICMHR) Program, providing intensive psychiatric outreach to veterans with severe mental illness and severe psychosocial instability; the Prime Clinic, managing patients with severe psychotic or mood disorders; or the Homeless Patient Aligned Care Team (HPACT), accommodating the mental health needs of our veterans with unstable housing.
The University of Texas at San Antonio (UTSA) is a large public university with over 30,000 students and 150 different degree plans! The Counseling and Mental Health Services (CMHS) provides students a diverse range of therapeutic resources from individual and group counseling, biofeedback tools, mental health workshops, substance recovery programming, and case management. Approximately 9% of the total UTSA student population receive services through CMHS. Conditions treated at CMHS range from situational stressors and ADHD to severe mental illness. The counselors and staff value and support our psychiatry residents to provide a solid foundation in college mental health.
Villa Serena is a rehabilitation center for male and female veterans with substance use disorders and is affiliated with the South Texas VA Health System. During their PGY2 year, residents complete a one-month addiction psychiatry rotation at Villa Serena. They are involved in evaluation and treatment planning for veterans to determine the need for intensive outpatient programming or admission to one of three residential treatment tracks. These tracks include a 45-day “Substance Use Disorder” track that employs Motivational Interviewing in an interdisciplinary team approach, a 28-day “Resiliency and Mental Health” track that is designed to identify and treat underlying psychodynamic-triggers and develop coping skills, and a 60-day “Self-Sufficiency” track whose mission is to integrate veterans back into the community with stable housing and gainful employment. Residents also participate in the initial evaluation of the buprenorphine program, as well as the induction process and ongoing treatment for veterans maintained on buprenorphine.