by Capt. Alvi Azad, MBA, DO, USAF, MC; Capt. Nicholas D. McKinnon, MD, USAF, MC; Maj. Kaustubh G. Joshi, MD, USAF, MC, FS; and Maj. Matthew D. Faubion MD, USAF, MC

Drs. Azad, McKinnon, and Faubion are from Wilford Hall Medical Center, Lackland AFB, San Antonio, Texas, and the University of Texas Health Science Center at San Antonio, Texas; Dr. Joshi is from Wilford Hall Medical Center, Lackland AFB, San Antonio, Texas.


Psychiatry (Edgemont) 2009;6(6):52–53

Financial Disclosure

Drs. Azad, McKinnon, Joshi, and Faubion report no competing interests. Nor do they have any potential conflicts of interest and financial support to disclose.

Abstract

United States Air Force psychiatry plays a vital role in Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan). Outside of the military, little is known about US Air Force psychiatry and the Wilford Hall Medical Center. Wilford Hall Medical Center is the US Air Force’s flagship hospital and premiere psychiatric hospital. This article briefly discusses the history of Wilford Hall Medical Center and its psychiatric contributions to the wars in Iraq and Afghanistan.

Key words

Wilford Hall Medical Center, Air Force psychiatry, military medicine, military psychiatry

Wilford HallAt the start of World War II, the military recruited some of the nation’s top medical specialists to serve their country. However, soon after the war ended, many of these physicians left the service when their commitment ended. In 1946, Col. Floyd Wergeland proposed the establishment of military graduate medical education programs (GME) to stimulate recruitment of future physicians. The proposal was subsequently implemented by Col. Raymond Duke in 1947, who was the Director of Education and Training at the Office of the Surgeon General.[1]

The Air Force’s largest Accreditation Council for Graduate Medical Education (ACGME)-accredited general psychiatry residency training program (approved in 1962) is located at Wilford Hall Medical Center on Lackland Air Force Base in San Antonio, Texas.2 WHMC is the flagship medical center of the US Air Force. WHMC was founded on November 16, 1957. It is the US Air Force’s largest medical facility, with a staff of 4,500 and a maximum capacity of more than 1,000 beds.[2] WHMC is one of three level-one trauma centers in San Antonio, serving the local community as well as South Central Texas. Its psychiatry residency program is merged with the University of Texas Health Sciences Center at San Antonio. This psychiatry residency training program offers unique training opportunities not seen in nonmilitary institutions. In addition to the mission of providing mental healthcare to service members, retirees, and their families, US Air Force psychiatrists are trained in occupational (military) psychiatry, such as performing fitness-for-duty evaluations, interpreting appropriate Department of Defense and Air Force directives on mental health issues, and providing mental health services to deployed personnel in austere locations.[3]

WHMC has the larger of two inpatient psychiatry units in the US Air Force.[2] Patient populations hospitalized on the inpatient unit include (but are not limited to) basic trainees (age 18–30) who often develop first-break psychotic symptoms, deployed soldiers medically evacuated from Iraq and Afghanistan for mental health symptoms, and individuals suffering from posttraumatic stress disorder. This facility also has the US Air Force’s largest outpatient mental health clinic and its only inpatient psychiatry consultation-liaison service. The faculty also currently consists of forensic-, child/adolescent-, and geriatric-fellowship–trained psychiatrists.[4] WHMC has the US Air Force’s largest psychology training program, creating a unique collaboration between the disciplines in the arenas of education, research, and patient care. WHMC is often tasked with deployment orders for its psychiatrists. At any one time, 10 to 50 percent of the US Air Force staff psychiatrists stationed at WHMC are deployed in support of military missions to Iraq and Afghanistan. Despite these shortages, GME and patient care missions at WHMC continue uninterrupted.

In a nutshell, US Air Force psychiatry, born out of the necessities of World War II, has evolved to offer a unique blend GME training, patient care, and support to the military mission in Iraq and Afghanistan today.

References
1.     Austerman WR. Mustering out the medics: AMEDD downsizing after WWII. AMEDDJ. 2003;PB 8-03-4/5/6:15–20.
2.     Office of Wing Historian. A History of the Medical Facility at Lackland AFB 1941-1951. Extracted from unpublished Lackland Air Force Base records.
3.     Ritchie EC, Benedek D, Malone R, Carr-Malone R. Psychiatry and the military: an update. Psychiatr Clin North Am. 2006;29(3):695–707.
4.     Establishment of residency training in psychiatry at USAF hospital Lackland. Unpublished letter from Brigadier General Larry A. Smith, Director of Medical Staffing and Education to Air Force Systems Command 27. Dec 1962.