Academic community program with ACGME commendation status. Outpatient training in a fully integrated educational environment at STHC, a freestanding co-located clinic with IM and FM residents. Medical student teaching. Psychotherapy training starts PGY2 at Gonzaga and WSU counseling centers. Full QIPS curriculum. Addictions clinic with suboxone training. Telepsychiatry, ECT, junior attending and numerous other elective opportunities during PGY4. Child fellowship started July 2021