Psychiatry Residency Program in Baltimore

Our community-based hospitals provide the opportunity for residents to learn about the specific needs of patients in Baltimore City and County. Residents spend all four years in various community-based clinical services. We aim to expose residents to diverse clinical settings in the community and diverse faculty who have experience with the complex needs and makeup of the community at the two primary training sites, MedStar Franklin Square Medical Center and MedStar Harbor Hospital. As a community hospital system, we are a close-knit group of highly dedicated professionals who are focused on truly understanding the unique needs of the patients in the communities that we serve.

We aim to train our residents in culturally appropriate care. We have extensive didactics in cultural psychiatry in all four years of the residency. Classes include understanding ourselves/personal cultural influences, the cultural formulation interview, social determinants of mental health, Baltimore culture and populations, immigrant issues, refugee mental health, microaggressions, understanding sex/gender/sexual orientation, family involvement/roles in treatment, impact of information technologies, cultural factors shaping placebo effects and healing, religion and health, global psychiatry, impact of gun violence, culture and managing countertransference, the association of Anthropology with Cultural Psychiatry, and climate change.

Rotations provide the opportunity to treat patients from diverse cultural groups including LGBTQ+, Spanish-speaking, immigrant, African American, and different religious groups at both main sites and affiliated sites.

There will also be a yearly Culture and Community Day that is sponsored by the department and led by the residents that will be a day of scholarly talks and celebration of diversity with community involvement. We also focus on culture and social determinants of health in our community hospitals as a matter of course during every clinical encounter.

We aim to train residents to be leaders in their field and active advocates for patients and overall community mental health and to develop a sense of social responsibility to work toward optimal care for their patient, the community, and our profession. We teach about the business aspects of healthcare as well including coding and efficient documentation and the laws that govern the administrative aspects of psychiatry and medicine in general. Residents will have lectures from the MedStar Advocacy Office and can take part in a relevant elective in the 4th year. Residents will also be encouraged to take part in the Maryland Psychiatric Society’s Legislative Advocacy Day in Annapolis. They can observe or participate in individual advocacy. Residents who elect to do this will receive training on how to communicate with state government leaders about important bills that influence the practice of psychiatry to convey their individual views.

As an urban and suburban community hospital system, we aim to train residents to work independently and within interdisciplinary teams. We will train residents in the optimal use of telehealth and effective collaboration with other health professionals to address all of the patients’ needs. The MedStar Health System has instituted Collaborative Care in over 49 primary care programs, including a unique mobile treatment multidisciplinary collaborative care program to treat people with somatic and psychiatric illnesses. Residents have rotations in at least 2 of these services and have the opportunity to experience more during their electives.

The stigma of mental illness continues and pervades many aspects of most societies including the medical profession. Residents will learn to be advocates by identifying structural stigma in healthcare in the way insurance operates, being proactive in communicating with other providers around the care of our patients who often have multiple co-occurring medical and social issues, understanding the importance of using non-judgmental, neutral language in medical notes and when discussing patients with collaborating colleagues, communicating openly, honestly, and respectfully with our patients, especially with the initiation of the Interoperability Act (CURES Act) which readily shares chart information with patients. Residents will learn this through didactics, observing faculty, participating in community programs, and practicing patient communication with supervision.

Residents will learn how to be effective educators. The goal of life-long learning and passing on the information you learn to other colleagues and patients is a value held deeply and is emphasized in our program. Effective teaching and communication is taught in didactics classes and residents are observed and hone their skills teaching students, and educating colleagues, patients, and their families during clinical rotations. Residents are also encouraged and mentored to present at national professional meetings. The importance of scholarship and contributing to the body of knowledge in psychiatry in some way is a hallmark of who we are as physicians.

The Wellness Committee seeks to promote resident wellness by organizing and putting on various events to enhance resident well-being and strengthen relationships in our residency community. It is run by residents and supported by MedStar Wellness staff.

The Retreat Committee organizes the annual resident retreat, a one-day event when all of our MedStar Healthy Baltimore psychiatry interns and residents are excused from their clinical duties to participate in team-building activities that not only emphasize core values of the department, such as intellectual curiosity and the importance of reflection but also encourage camaraderie and promote friendships beyond the clinical setting.

We are enthusiastic about our program and its future. Each year the recruitment committee puts time, thought, and enthusiasm into the applicant interview and selection process to ensure our future residents are a good match for our program. Residents from all classes are encouraged to join the committee and support this important process.

The resident representative elected by the resident group attends the Program Evaluation and Improvement Committee The Education Committee’s goal is to evaluate and recommend improvement in the Residency program.

Equity, Inclusion, and Diversity (EI&D) are at the heart of the MedStar SPIRIT values and there is a robust EI&D Council across the system. There are several areas of focus including Awareness, Communications, Education and Development, Community Involvement, and Health Equity.

We also encourage residents to join a group of faculty within our department who are committed to social justice and inclusivity with the following goals:

• Integration of social justice education into all didactics and specific longitudinal didactics in cultural psychiatry for all 4 years.

• Expectations of consideration of social justice and cultural humility in all core clinical rotations

• Incorporation of reflection on diversity and inclusion at the retreat and all resident meetings.

• Cultivation of a diverse library with sections devoted to Black authors, promotion of LGBTQ+ health, anti-racism, and immigrant issues.

• Development of new efforts focused on recruitment of minority trainees.

• Participation in MedStar Equity, Inclusion & Diversity Initiatives

• Development of Culture and Community Day

• Tour of Baltimore with discussion of history and culture

• Encouragement to participate in the Maryland Psychiatric Society Community and Diversity Coalition

This is one of the highlights of our program. Residents organize this full day dedicated to Diversity and community impact with faculty mentoring and support.

Having a diverse and dedicated core faculty team with expertise in various specialties is crucial for providing comprehensive training opportunities for residents. With more than nine highly dedicated core faculty members, residents can benefit from a broad spectrum of knowledge and experiences, allowing them to explore diverse interests within their field of study.

The residency program offers several events that explore the uniqueness of the Baltimore community to train residents in a holistic community approach to care.

As a community hospital system, we continuously work towards a better understanding of the historical and socio-cultural influences of health in Baltimore communities. One way we seek to teach and experience this is with an annual tour of Baltimore neighborhoods with people knowledgeable in the lived experiences of the people who live and work here. This is a special opportunity to gain humility in our ongoing attempts to understand and address some social determinants of health.

This is one of the highlights of our program. Residents organize this day dedicated to supporting diversity, intercultural dialogue, and promoting community change with faculty mentoring and support. The goal is to work to reduce health disparities in our community and understand the importance of this work in our role as physicians.

CCD is sponsored by the residency training office but is mostly a resident-driven program. Interested residents pick the year's topic on a cultural diversity and equity topic of their choosing, and plan the day that includes invited lecturers, community leaders, faculty speakers, panels, interactive exercises, resident presentations, and a grand rounds speaker. Food is provided and the day is a celebration of diversity that culminates with a planned community initiative related to the day’s topic.