Local Trainers Research Articles

Diaspora Haitians Help Their Home Country Improve MH Care

Help to improve Haiti’s mental health services may need to come from outside the nation but must be coordinated with those on the scene, say people involved in the effort.

G220(P) Neonatal Resuscitation – A survey on training of junior doctors

AimsAll junior doctors undertaking paediatric rotation are expected to attend deliveries and provide at least the basic level of neonatal resuscitation. This is quite daunting especially to junior doctors at...

Improving trainee psychiatrist's handover: standard setting and audit

Purpose – The 2006 Post Graduate Medical Education Trust Board (PMETB) trainees' survey indicated inadequacies in handover procedures amongst medical and psychiatry trainees nationwide; and in 2007 a local psychiatry trainees' survey found inadequate handover procedures. The purpose of this paper is to show how to improve handover practice through standard setting and sequential audit. Design/methodology/approach – A Trust wide Standard Operating Procedure (SOP) for handover was developed. Trainees were audited on perception of handover experiences (2008, 2009 and 2010). Findings – The audit revealed that the SOP was not consistently followed. Handing over “active problems” (AP) was perceived to occur frequently in 2008 (93.75 per cent), improved in 2009 (100 per cent for AP, 98 per cent for “problems which may arise”, (PA)); however deteriorated in 2010 (93 per cent for AP, 69 per cent for PA). Trainee satisfaction rates with handover improved each year (57 per cent in 2008, 75 per cent in 2009, 87 per cent in 2010, X2=3.7, df=2, p=0.16). Practical implications – SOP development, subsequent audits and sharing of results improved handover practice. This has implications for training and patient safety. This project demonstrates a method of improving handover practices in a large mental health trust. Originality/value – The work conducted is of interest to those working in psychiatry, not only from an education and training perspective, but also for clinical practice, in the UK as well as internationally.

Substance abuse prevention in Cape Town's peri-urban settlements: local health trainers' perspectives

South Africa currently experiences high levels of alcohol and other drug (AOD) abuse. As a result there is a need for the initiation of regional AOD abuse prevention programmes with a specific focus on youth prevention strategies. The Medical Knowledge Institute (MKI) is a non-profit organisation which develops and facilitates health information workshops to members of disadvantaged peri-urban communities in South Africa. This research investigated the views of eight local MKI health trainers on factors contributing to AOD abuse in their communities. Although the expected focus of the discussion was on prevention strategies and effective interventions, the trainers placed more emphasis on the individual and community factors influencing AOD abuse. The themes which emerged through the research included: status, government, (di)stress, gender, recreation, consequences and community. This research holds significance as it has the potential to assist further development of community-based AOD prevention workshops and to guide public health policy and service development for AOD abuse.

Trauma-Aid, Humanitarian Assistance Program Germany

Trauma-Aid Germany was founded in 2002 by dedicated eye movement desensitization and reprocessing (EMDR) therapists to help people traumatized by calamities, disaster, or violence to overcome the psychological consequences and regain emotional stability and mental health. Trauma-Aid, also known as the Humanitarian Assistance Program Germany, works in crisis areas abroad, offering nonprofit trainings in EMDR therapy and establishing projects to support and treat trauma victims and survivors. Projects in China, Slovakia, Indonesia, Thailand, Cambodia, Burma, Rwanda, and Haiti, in cooperation with other nongovernmental organizations and the German government, have supported trained participants in the treatment of clients in the respective countries and the initiation of local research projects. The basic principle is to work with networks of local practitioners or mental health worker, experts, and universities to establish structures that will maintain themselves in future. Nearly all countries to which Trauma-Aid Germany has taken training have meanwhile set up their own EMDR organizations, with many local EMDR trainers already trained or in training.

Standardising paediatric resuscitation training in New South Wales, Australia: RESUS4KIDS

A key competency for all health-care workers (HCWs) who care for children is the ability to respond to a child in respiratory or cardiorespiratory arrest. However, evidence suggests that medical and nursing staff may not have the knowledge and clinical skills to respond to these emergencies. The aim of this project was to create a standardised, evidence-based, paediatric life support course that would be available free to all HCWs in New South Wales (NSW), including NSW Ambulance. A paediatric life support course was designed along current education principles. It used e-learning as pre-learning and a face-to-face short practical course, combining team work and communication with practical paediatric resuscitation skills training. The programme was designed to empower local trainers to deliver a standardised course to local participants. A total of 14,000 participants have completed the mandatory e-learning component, and over 8600 participants have completed the short practical course, across all NSW Local Health Districts, including NSW Ambulance. RESUS4KIDS has also been adopted by the universities of Sydney and Newcastle undergraduate medical and nursing programmes. Outside of NSW and ACT, over 400 participants have completed the course in facilities in Queensland, South Australia, Victoria and the Northern Territory. We have developed a course that is available, at no cost to individuals or facilities, to all HCWs in NSW, including students, paramedics and general practitioners. We would encourage all other jurisdictions to consider adopting the programme.

Board 384 - Research Abstract Low-Dose High-Frequency Simulation Training Reduces Early Neonatal Mortality (Submission #993)

Introduction/Background Globally, almost 4 million newborn infants die each year. The simulation-based Helping Babies Breathe (HBB) course, developed by the American Academy of Pediatrics to train providers in basic neonatal resuscitation, is under implementation in more than 55 low-resource countries, aiming to reduce early neonatal mortality worldwide. Tanzania was the first country to pilot test National implementation of HBB.1 In April 2010 Tanzanian master instructors conducted a one day HBB course at Haydom Lutheran Hospital in Northern Tanzania. Seven months later, in November 2010 staff from labor ward was tested simulating routine care of neonates and basic neonatal resuscitation. The pass-rate increased from 41% to 74% (p=0.016) and from 18% to 74% (p≤0.0001) respectively, however, no improvement of clinical management was observed in the delivery room during these seven months.2 Therefore, systematic low-dose high-frequency (LDHF) HBB simulation training in the labor ward was initiated by local HBB trainers supported by local leaders. The objective of this study was to determine whether implementation of LDHF HBB training would enhance performance of basic neonatal resuscitation in clinical practice, reduce the incidence of early neonatal mortality within 24 hours, and the number of fresh stillbirths. Methods An ongoing observational study in the delivery room started in July 2009. Trained research assistants (n=14), working shifts (3/24 hours), have observed every delivery and recorded data (e.g. perinatal characteristics, time to stimulation and bag mask ventilation and perinatal outcomes) on a data collection form. Implementation of LDHF HBB training started in February 2011. A newborn simulator was placed in the labor ward easily accessible for frequent practicing. Local HBB trainers have assisted and conducted frequent re-trainings supported by local leaders. Results Observational baseline data (01.02.10-31.01.11) includes 4876 deliveries/newborns. Observational after implementation data (01.02.11-31.01.12) includes 4743 deliveries/newborns. Birth attendants trained in HBB was 67.5% versus 90.8% (p≤ 0.0005) in the two periods. Number of neonates being stimulated was 704 (14.4%) versus 758 (16.0%) (p=0.032). Number of neonates in need of bag mask ventilation was 352 (7.2%) versus 259 (5.7%) (p=0.003). Early neonatal mortality was 11.1/1000 (n=54) versus 7.2/1000 (n=34) (p=0.047). Fresh stillbirth rate was 16.0/1000 (n=78) versus 14.4/1000 (n=68) (p=0.517). Conclusion LDHF in-situ HBB training facilitated by local HBB trainers improved clinical management and outcome of neonates at Haydom Lutheran Hospital. This was not the case after a one day HBB training. The significant reduction in neonatal mortality likely reflects the increase in babies being stimulated with induction of spontaneous breathing among newborns in primary apnea, reversing the asphyxial process and reducing the need for bag mask ventilation. Thus, transfer of new knowledge and skills into clinical practice with improved patient outcome was achievable through systematic LDHF in-situ simulation training supported by local trainers and leaders.

Teaching the Management of Surgical Emergencies Through a Short Course to Surgical Residents in East/Central Africa Delivers Excellent Educational Outcomes

In Africa surgical trainees (residents) are often 'at the coalface' in managing surgical emergencies. A practical course on management of surgical emergencies was developed, as requested and guided by the learning needs of surgical trainees in East/Central Africa, to teach structured thinking processes in surgical emergencies; to thoroughly assess participants' knowledge, technical and non-technical skills; and to correlate assessment scores with participants' feedback on course quality. Curriculum design was aimed at learners' needs, as guided by local trainers and previous teaching. A 5-day course was developed on emergencies in critical care and trauma, general surgery, orthopaedics, obstetrics and urology; delivered through lectures, tutorials and practical sessions, with individual mentoring. Participants' knowledge was assessed through end-of-course tests and, with their practical and non-technical skills, evaluated formatively. Opportunity for immediate detailed feedback was provided, and for follow-up 6 months later. All participants completed the course successfully, passed knowledge tests, and received satisfactory scores in continuous assessment. There was good correlation between formative and summative assessment scores. Candidates rated course content, delivery and usefulness very highly; 'open text' noted no such previous training. After six months 90 % of course participants indicated that the course had significantly improved their ability to manage surgical emergencies. An intensive course on management of surgical emergencies can be effectively delivered by a small core faculty for each specialty. Feedback from participants and local faculty indicated that this course filled a specific learning niche. Effective assessment can be based on continuous evaluation during course participation.

Souhaits de pratique des internes de psychiatrie : résultats d’une enquête nationale

For many years, the numerus clausus limiting the number of medical students has increased in France. The government wants to reform the residency process to homogenize medical studies. However, the suggested residency program changes would imply changes in the length of residency, in the mobility of residents after residency, their access to unconventional sectors, and more generally, the responsibility of the resident and his/her status in the hospital. In this context, we have investigated the future plans of all psychiatry residents in France. To study the desires of psychiatry residents in France, regarding their training, their short and long-term career plans, and to analyze the evolution of those desires over the last 40 years. A survey was carried out among residents in psychiatry from November 2011 to January 2012. An anonymous questionnaire including four parts (resident's description, residency training and trainees choice, orientation immediately after residency, professional orientation in 5-10 years) was sent by the French Federative Association of Psychiatrists Trainees (AFFEP) to all French psychiatrist trainees, through their local trainee associations (n=26) and through an on line questionnaire. The questionnaire was answered by 853 of the 1615 psychiatry residents (53%), of which 71% were women. At the end of the residency, 76% of residents reported that they would like to pursue a post-residency position (chief resident, senior physician assistant university hospitals); 22% reported wanting to work in another city. Between 5 to 10 years after completion of the residency, 71% reported wanting to work in a hospital, and 40% preferred to have their own private practice. Almost a third of the trainees wished to work in the child and adolescent psychiatry field, for some of them in an exclusive way, for others, combined with a practice in adult psychiatry.

Evaluation of the Effectiveness of HIV Voluntary Counseling and Testing Trainings for Clinicians in the Odessa Region of Ukraine

In Ukraine, only 28% of HIV-infected individuals are aware of their HIV status. Expansion of voluntary HIV counseling and testing (VCT) in primary and specialty health care settings holds promise for increasing the number of people who know their HIV status and can access care. To build capacity among health care providers to deliver VCT, we conducted two-day trainings on basic HIV knowledge and on VCT procedures in the Odessa region of Ukraine. The training programwas developed by local trainers in collaboration with faculty from the US Southeast AIDS Training and Education Center and was delivered in the clinical settings where trainees worked (n=392). We assessed training effectiveness in terms of change in knowledge among clinician trainees, comparing HIV specialists and nonspecialists and those working in urban and rural clinical settings. All else being equal, compared with their urban HIV-specialist peers, trainees who were rural nonspecialists demonstrated significantly greater increases in general HIV knowledge scores. This effort demonstrates that brief, on-site training programs support the expansion of VCT by increasing the knowledge and skills of rural nonspecialist clinicians to levels equal with urban HIV specialists.

Early Experience in Establishing and Evaluating an ACGME-Approved International General Surgery Rotation

In 2011, the Accreditation Council for Graduate Medical Education Surgery Residency Review Committee first provided guidelines for elective international general surgery rotations. The Vanderbilt general surgery residency program received Surgery Residency Review Committee approval for a fourth-year elective in Kenya beginning in the 2011-2012 academic year. Because this rotation would break ground culturally and geographically, and as an educational partnership, a briefing and debriefing process was developed for this ground-breaking year. Our objectives were to prepare residents to maximize the experience without competing for cases with local trainees or overburdening the host institution and to perform continuous quality assessment and improvement as each resident returned back. Briefing included health protection strategies, a procedures manual containing step-by-step preparation activities, and cultural-sensitivity training. Institutional Review Board exemption approval was obtained to administer a questionnaire created for returning residents concerning educational value, relations with local trainees, physical environment, and personal perceptions that would provide the scaffold for the debriefing conference. The questionnaire coupled with the debriefing discussion for the first 9 participants revealed overall satisfaction with the rotation and the briefing process, good health, and no duty hours or days-off issues. Other findings include the following: (1) emotional effect of observing African families weigh cost in medical decision making; (2) satisfactory access to educational resources; (3) significant exposure to specialties such as urology and radiology; and (4) toleration of 4 weeks as a single and expressed need for leisure activity materials such as books, DVDs, or games. The responses triggered adjustments in the briefing sessions and travel preparation. The host institution invited the residents to return for the 2012-2013 year as well as 2013-2014. Detailed preparation and the follow-up evaluation for assessment and improvement of this nascent international surgery experience are associated with resident satisfaction and the host institution has agreed to continue the rotation.

G152(P) Multidisciplinary Newborn Resuscitation Training in Ethiopia and the RCPCH VSO Fellowship Scheme

AimsIn Ethiopia the neonatal mortality rate is 37/1000 live births and perinatal asphyxia is an important contributor. Like many African countries Ethiopia has made significant progress towards millennium development goal...

G146(P) The Impact of Teamwork and Practical Skills Training in Obstetric Emergencies and Neonatal Resuscitation at a Tertiary Hospital in Ethiopia

AimsTo evaluate the effect on the stillbirth rate at a tertiary institution in a low-resource setting through the development of a multi-disciplinary training programme using local trainers.MethodsTwenty-one senior staff (anaesthetists,...

G18(P) Developing Strong Local Faculties to Improve Teaching For the MRCPCH and Enhance Paediatric Training

BackgroundPass rates for the Paediatric Clinical Membership exam (MRCPCH) vary across the UK1. This is equally true for London, where the availability of high quality exam-focused teaching differs significantly among...

Training the Trainers of Tomorrow Today - driving excellence in medical education.

Training the Trainers of Tomorrow Today (T4) is a new way to deliver “Training for Trainers”. Responding to local dissatisfaction with existing arrangements, T4 builds on 3 essential requirements for a future shape of training:1. Clinical Leadership and a Collaborative Approach2. Cross-Specialty Design and Participation3. Local Delivery and Governance NetworksDesign principles also included: 3 levels of training to reflect differing needs of clinical supervisors, educational supervisors and medical education leader, mapping to GMC requirements and the London Deanery's Professional Development Framework; alignment of service, educational theory and research; recognition of challenges in delivering and ensuring attendance in busy acute and mental health settings, and the development of a faculty network.The delivery plan took into account census of professional development uptake and GMC Trainee Surveys. Strong engagement and uptake from the 11 Trusts in NW London has been achieved, with powerful penetration into all specialties. Attendance has exceeded expectations. Against an initial 12 month target of 350 attendances, 693 were achieved in the first 8 months.Evaluation of content demonstrates modules are pitched appropriately to attendees needs, with positive feedback from trainers new to the role. Delivery style has attracted high ratings of satisfaction: 87% attendees rating delivery as “good\\excellent”. External evaluation of impact demonstrated improved training experiences through changes in supervision, the learning environment and understanding of learning styles.We have addressed sustainability of the programme by advertising and recruiting Local Faculty Development Trainers. Volunteer consultants and higher trainees are trained to deliver the programme on a cascade model, supported by the Specialty Tutors, individual coaching and educational bursaries. The Trainers are local champions for excellence in training, provide a communication between the programme and local providers, are a repository of expertise in their service, and trouble shoot local barriers to engagement.

La formation aux psychothérapies des internes de psychiatrie en France : résultats d’une enquête nationale

According to a recent change in the French legislation (2010) regarding the regulation of the use of the title of "psychotherapist", psychiatrists are now allowed to use this title at the end of their training, without any additional training. However, various publications from 2000 have shown that there is no specific training in psychotherapy at a professional level during the training of psychiatrists. To study the current situation of the Academic training of French psychiatrists in psychotherapy during their residency, their interest for these therapies, their level of satisfaction regarding their training, and the importance of additional private training programs. A survey was carried out among residents in psychiatry from October 2010 until January 2011. An anonymous questionnaire covering five domains (academic teaching, psychoanalysis, extra-academic training, interest in a more developed model of training, supervision) was sent by the French Federative Association of Psychiatrists Trainees (AFFEP) to all French psychiatrist trainees, through their local trainee associations (n=26). The questionnaire was answered by 869 of the 1334 psychiatry residents (65%). The vast majority of the trainees reported being interested in psychotherapy, but 75% thought that their training in psychotherapy (psychoanalysis, cognitive-behavioral therapy [CBT] and systemic therapy) is insufficient. In 20 of the 26 universities, more than half of the trainees reported that their training was insufficient in the three fields; in four universities, more than half of the trainees were satisfied with at least one field. Yet, satisfaction rates were very different among universities: for example, 27% were satisfied with their psychoanalytic training in Paris and 87% in Strasbourg; 7% were satisfied with their CBT training in Strasbourg, but 65% in Nice. The vast majority (97%) believes that supervision about therapeutic relationship is necessary during residency rotations in the hospital. More than three quarters (78%) would like to have supervision at least twice a month. Yet, only 51% of respondents have such supervision. Once again, large disparities were observed between different Academies: for example 74% had supervision in Montpellier, but only 29% in Marseille. The vast majority (95%) of trainees would like a two-phase model of training (general theoretical teaching plus in-depth training in one or more methods), which is different to the current training model. Our results show a clear discrepancy between the importance of training in psychotherapy for psychiatrists, the interest of psychiatry students for these therapies, and the very high rate of dissatisfaction for the training received, as well as the rate of students supervised during their training period at the hospital. These results differ from what is observed in other countries, where satisfaction rates are much higher among students, and various psychotherapy training methods are proposed in a much more homogeneous manner. More research is required to understand the reasons for these difficulties with the psychotherapy training of psychiatrists in France, and to propose new models of training to improve this situation.

The global health chief resident: modifying an established role, strengthening a collaboration

What problems were addressed? The growing desire among medical trainees for structured exposure to global health issues has increased the demand for short-term field experiences in health care centres abroad. Establishing collaborations to provide these opportunities involves maintaining a balance between sponsoring and host institution interests. Trainees encounter a number of challenges in the course of these experiences, including personal and medical cultural differences, and ethical concerns relating to professionalism and patient care. The job of chief resident encompasses a host of administrative, educational and clinical activities that are well suited to addressing the needs that emerge as a result of these experiences. What was tried? In the 2010–2011 academic year, the Yale Primary Care Residency Programme created two new leadership positions: global health chief residents. These chiefs split their time between Yale and the established Makerere University–Yale University (MUYU) medical education collaboration based at Mulago National Referral Hospital, in Kampala, Uganda, the country’s national referral and teaching hospital. These two individuals are committed to careers in global health and had previously spent a total of 15 months working at Mulago Hospital in various capacities; thus they were familiar with the institution, faculty staff and leadership. Although they fulfilled typical clinical and educational responsibilities when in the USA, their goals during the time they spent in Uganda included providing educational supervision to visiting and local trainees, participating in direct patient care as members of the local faculty, and providing administrative support to the Kampalaand New Haven-based staff of the collaboration. Clinically, the chief residents served as attending physicians and held both bedside and classroom teaching sessions for Ugandan trainees. Administratively, they facilitated cross-cultural communications regarding finances, procedures and educational content, assisted the local staff and visiting trainees in understanding one another’s needs, standardised the on-site orientation process, and involved staff and faculty members from both universities in completing a summary report of the first 5 years of the collaboration. Importantly, their cumulative experiences with both institutions enabled them to provide emotional support and gave them the insight they needed to assist visiting trainees in processing their clinical and personal experiences. What lessons were learned? A tense political situation, arising from the presidential election that occurred during their stay, intermittent public demonstrations and a terrorist attack in Kampala a few months prior to their arrival, reduced the number of trainees who visited Uganda as part of the MUYU collaboration during the chief residents’ tenure. The chiefs took appropriate safety precautions and followed US State Department recommendations. Instead of negatively impacting the experience, this provided a greater opportunity for involvement in Ugandan medical education and in the administrative structure of the collaboration than had been anticipated. Recently proposed guidelines for global health training experiences emphasise the responsibilities of sponsoring institutions regarding the mentorship of visiting trainees, with a view towards meeting local needs and the priorities of host institutions. We successfully modified a well-established educational role, that of the chief resident, to improve the experience of our trainees while on rotation abroad and also demonstrated a commitment between international collaborators. We believe this role is reproducible and would strongly encourage all international collaborations that involve undergraduate or postgraduate medical education to consider placing a chief resident on site.

Examining the Scale and Outcomes of Global Health Fellowship Programs in the United States

Examining the Scale and Outcomes of Global Health Fellowship Programs in the United States

OC-028 Developing sustainable GI endoscopy training in Malawi

IntroductionSustainable endoscopy services could improve management of upper gastrointestinal malignancy and haemorrhage, both common in Malawi. Since 2008 we have committed to improving endoscopy training through an International Health Link...

Opportunities Abound for Residents to Participate in Annual Meeting

Back to table of contents Previous article Next article Residents' ForumFull AccessOpportunities Abound for Residents to Participate in Annual MeetingSarah Johnson, M.D.Sarah JohnsonSearch for more papers by this author, M.D.Published Online:15 Jul 2011https://doi.org/10.1176/pn.46.14.psychnews_46_14_17_1Aloha: Hello and goodbye!"Aloha" was a term we all heard a lot at the recent APA annual meeting in Honolulu. I was taught that it means both hello and goodbye. So "hello" to all of you who couldn't make it, and "goodbye" to all of the great meeting memories—at least until next year! At this year's annual meeting, it was clear that many members-in-training and other psychiatry residents took advantage of numerous educational and social activities that meeting organizers planned for them. Some of the highlights included the first annual Resident Poster Competition and workshops offered exclusively to residents and early career psychiatrists. For those of you who could not join us, I will recap some of the highlights of the meeting. On Saturday, the annual meeting's opening day, the International Medical Graduate (IMG) Institute was held and offered IMG trainees an opportunity to develop leadership skills and share ideas. At noon on the same day, local residents from the University of Hawaii psychiatry residency program gave visitors an insiders' view of local hot spots and happenings at the "How to Survive the Annual Meeting" orientation session. Sunday began with a breakfast session titled "How to Navigate the APA," and distinguished guests included then APA President-elect John Oldham, M.D., and past Assembly Speaker Gary Weinstein, M.D. The Chief Residents' Leadership Conference was also held on Sunday, and incoming chief residents from across the country gathered to learn how to be more effective leaders. Mindfulness, conflict resolution, and effective communication were featured topics. "Meet the Experts: Sunny Side Up Breakfast" was an exciting way to start Monday. Experts from all subspecialties in psychiatry generously volunteered to talk with residents and early career psychiatrists (ECPs) over breakfast. On Tuesday, Nada Stotland, M.D., a past APA president, joined residents and ECPs for the workshop "How to Submit and Present a Workshop." Young psychiatrists were encouraged to develop and present workshops for next year's meeting in Philadelphia and become involved in the annual meeting. Later in the day, three teams of residents battled for bragging rights during the annual MindGames competition—a "Jeopardy"-like event testing residents' knowledge of a wide range of psychiatry-related topics. Additionally, workshops were held each day designed for (and often led by) residents. Topics included ABPN board review preparation, development of DSM5, cultural-diversity issues, HIV psychiatry, global mental health, psychotherapy issues, and patient suicide. The editorial staff of the Residents' Journal also held their annual workshop and planning session to encourage trainees to contribute to the American Journal of Psychiatry. In addition to offering sessions on the latest scientific and clinical information, the annual meeting allowed residents to learn more about how APA functions and the many things it does for psychiatrists and for the patients we treat. So what do you do if you are reading this and regretting not making it to Hawaii for the meeting? Start planning for next year! The 2012 APA meeting will be held in Philadelphia May 5 to 9. Each year, the Scientific Program Committee includes a Resident Track consisting of scientific sessions specially designed for members-in-training. If you have chiefly aspirations, talk to your program director about the opportunity to attend the Chief Residents Leadership Conference. Are you active in research? Consider submitting a poster presentation. Have you always wanted to participate in a workshop? Find a mentor in your area and submit a workshop proposal. (The deadline for workshop proposals is September 12.) If professional travel is not possible within your resident budget, consider applying for an APA or affiliated organization travel award. Available awards are updated frequently on the APA Web site at <www.psych.org/MainMenu/EducationCareerDevelopment/ResidentsMembersinTraining/AwardsandFellowships.aspx>. Applications and additional information can be found under the heading "Education and Career Development" in the "Resident" link. Some training programs or APA district branches may also help with travel costs for residents involved with poster or workshop presentations. It never hurts to ask! I would like to send a special thank you to all of the residents who made the annual meeting a success—especially the hospitable local trainees. It is such a joy to be part of an organization that truly values its young members. I hope to see all of you in Philadelphia next May! Sarah Johnson, M.D., is the member-intraining trustee on the APA Board of Trustees and a PGY-5 addiction psychiatry fellow at the University of Louisville. ISSUES NewArchived