Psychiatry Graduate Medical Education in Military and Veterans Affairs Training Facilities

Abstract

Psychiatric training in military treatment facilities of the Department of Defense (DoD) and in the hospitals of the Department of Veterans Affairs (VA) has a vital impact on graduate medical education for both military and civilian physicians. While the footprint of DoD training is small compared to the fact that approximately two-thirds of physicians will have received at least some training in the VA system, understanding the contribution each system makes to the care of service members, military families, and veterans is vital to improving their treatment outcomes. Military veterans are omnipresent in our clinical work, and bridging the civil-military gap can occur through the vantage of military culture. Psychiatrists join the military through a number of different pathways before, during, and after medical school, and similarly, civilian psychiatrists rotate in VA hospitals as medical students and as residents. The clinical learning environment in both systems is affected by the patient population they serve, not simply one of more men than women but of the different nature of the illnesses and injuries they have experienced. Ultimately, the culture of learning is shaped by an ethos of “serving those who serve”-leaders in medical education who remain vigilant for the mental health consequences of war.