Resident Honors Department Chair Who Led Through Katrina

This article is part of a series in the Residents’ Forum in which residents write about a mentor or psychiatrist who made a deep impression on them or influenced their career path. More information is available by contacting Catherine Brown at [email protected].

Daniel Winstead, M.D., has been the chair and Heath Professor in Tulane Medical School’s Department of Psychiatry and Behavioral Sciences for almost 26 years. At the time of his appointment as chair in July 1986, he was serving as associate chief of staff of education at the VA.

Dr. Winstead first decided to pursue a career in academic psychiatry about halfway through his medical school career, thanks mostly to the influence of his mentors at the time, particularly Dr. Barry Blackwell, an expert in psychopharmacology and treatment issues regarding compliance/adherence and the subtle effects of medications that may resemble the effects of placebo; and Dr. Jack Lindy, the training director at the University of Cinicinnati, a heavily psychoanalytically oriented program at the time. At Tulane, Dr. Winstead also credits the assistance of Donald Gallant, M.D., who introduced him to the Behavioral Sciences Research Group.

Dr. Winstead also served in the U.S. Army. He was assigned to Nuremburg, Germany, and during that time he was able to organize peer learning groups to study for the board exams and review psychotherapy cases.

As chair at Tulane, Dr. Winstead said that his greatest reward has been getting to watch people he has mentored move into successful academic careers and board positions. He also has appreciated being able to continue to publish and conduct his research projects.

Dr. Winstead has enjoyed being active on a national level and continues to do so. He was a director of the American Board of Psychiatry and Neurology (ABPN) prior to being on the Residency Review Committee for Psychiatry of the Accreditation Council for Graduate Medical Education, and he served as president of a number of state and regional organizations, as well as national organizations like the Academy of Psychosomatic Medicine and the American College of Psychiatrists. Dr. Winstead said these were “fun times” for him, and that he is humbled by the opportunities he has had.

Dr. Winstead’s career has not been without hardship. During his tenure as chair at Tulane, Hurricane Katrina struck New Orleans, flooding much in its path including Dr. Winstead’s home. In the wake of this tragedy, Tulane became synonymous with overcoming adversity. Due to Dr. Winstead’s leadership, the Tulane Department of Psychiatry and Behavioral Sciences remolded itself and redirected its efforts to serving the community in new and innovative ways. Furthermore, Dr. Winstead pointed out that the department owes a great deal of thanks to Baylor and the University of Texas, which were very generous and supportive during this time by giving the department space to continue teaching Tulane medical students there.

When asked what advice he has for other programs experiencing times of crisis, Dr. Winstead emphasized maintaining lines of communication in the department and focusing on the mission at hand. He noted that he and Candy Legeai, senior department administrator, have previously published in Academic Psychiatry about how they succeeded in these difficult tasks.

“Medical student teaching is job one,” he said in an interview. “Sometimes people don’t necessarily like to hear that because they see themselves as only doing research, training residents, or treating patients. These are all importance facets of academics, but medical student teaching does come first, and that’s why we deployed a group of our very best teachers to Houston to continue with the medical students.”

Dr. Winstead’s leadership has continued to guide the program through difficult times. The mental health care system in Louisiana and indeed across the United States is currently facing a chaotic period of change with broad spending cuts, and Dr. Winstead’s philosophy to overcome these challenges is to “hunker down and hang on to what is important while continuing to do the best you can to weather the times.”

As far as advice for both students and faculty pursuing a career in academics, Dr. Winstead said that a solid footing in the science of psychiatry is important, followed by selecting an area of interest in which expertise can be developed and papers published. “Academics is a marathon, not a sprint; there are going to be good times, and there are going to be rough times”.

He went on to say that psychiatrists who are faced with a slow time in terms of their academic productivity should use that time to broaden their horizons. Dr. Winstead used such times to take several courses from the School of Public Health at Tulane that have helped him in academia.

As a great deal of Tulane’s research programs were essentially “wiped out” during Katrina, other programs, in particular the academic writing class offered by Dr. L. Lee Tynes, have helped residents interested in careers in academia by showing them how to start small with book reviews, case reports, and literature reviews. Dr. Winstead emphasized how programs of this sort help individuals get off on the right foot in terms of developing publications and becoming familiar with scientific literature. Dr. Winstead also believes that for those who want to go into academics, research training is important. At Tulane, Roy Weiner, M.D., offers a two-year program that culminates in either a certificate or degree depending on the amount of coursework; another excellent avenue is the VA Mental Illness Research, Education, and Clinical Centers Fellowship that I am about to start with Thomas Newton, M.D., and Mark Kunik, M.D., in Houston. These types of fellowships and degrees were not available when Dr. Winstead was starting his academic career, and he therefore strongly encourages students to take advantage of these opportunities.

After his time as chair comes to an end, Dr. Winstead plans to take a part-time sabbatical in New Orleans while continuing to work with the ABPN assisting with comparing PRITE and Child PRITE scores and the scores on the new computerized board exam. As past president of the American College of Psychiatrists, he noted he is in an excellent position to help facilitate that work. Dr. Winstead also hopes to work, with the assistance of Laura Roberts, M.D., to survey former Laughlin Fellows and PRITE Fellows of the American College of Psychiatrists concerning the outcome of their leadership development activities. ■