Skip to main content

Advertisement

SpringerLink
Log in

A Call to Restructure Psychiatry General and Subspecialty Training

  • In Depth Article: Commentary
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Dire shortages of psychiatrists with special expertise in geriatrics, substance abuse, forensics, and psychosomatics create barriers to care for populations with complex mental disorders and pose a significant public health concern. To address these disparities in access to care, we propose streamlining graduate medical education to increase efficiency and enhance cost-effectiveness while simultaneously increasing the number of psychiatric subspecialists in these key areas. We propose that trainees interested in subspecialties complete their general training in 3 years, while meeting ACGME required milestones, and then utilize their 4th year to complete subspecialty fellowship training. Eligible trainees would then qualify for psychiatry subspecialty certification and general psychiatry ABPN certification at the end of 4 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Eden J, Katie Maslow K, Le M, and Blazer D, Editors, and the Committee on the Mental Health Workforce for Geriatric Populations Board on Health Care Services. The Mental Health and Substance Use Workforce for Older Adults: In Who’s Hands? Institute of Medicine of the National Academies, The National Academies Press, Washington. D.C., July 2012.

  2. American Psychiatric Association. “APA Supports Institute of Medicine Report Calling for Increased Mental Health Workforce Capacity to Care for Growing Geriatric Population” July 16, 2012, No. 12–34, press@psych.org .

  3. ACGME. 2014. Number of accredited programs for the current academic year (2013–2014) http://www.acgme.org/adspublic/ (accessed January 3rd, 2014).

  4. Geriatric Workforce Policy Studies Center (GWPSC). 2010b. Table 3.5 Geriatric psychiatry fellowship programs 1995/96-2010/11: American Geriatrics Society. http://www.adgapstudy.uc.edu/figs_graduate.cfm (accessed February 5, 2013).

  5. ABPN (American Board of Psychiatry and Neurology). 2012. Initial certification statistics. http://www.abpn.com/cert_statistics.html (accessed January 3rd, 2014).

  6. ABPN. 2012. Maintenance of certification statistics. http://www.abpn.com/moc_statistics.html (accessed January 3rd, 2014).

  7. Abrams M, Patchan K, Boat T, editors. Research training in psychiatry residency:strategies for reform, Institute of Medicine of the National Academies. Washington: The National Academies Press; October 2003.

  8. Emmanuel EJ, Fuchs VR. Shortening Medical Training by 30%. Journal of the American Medical Association, Vol. 307, No. 11, March 21, 2012

  9. Zweifler J. Why We Should Reduce Family Practice Training to Two Years. Academic Medicine, Vol. 78, No. 9/September 2003.

  10. AMA. http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/medical-student-debt/background.page (accessed January 3rd, 2014)

  11. Dorsey ER, Nincic D, Schwartz JS. An Evaluation of Four Proposals to Reduce the Financial Burden of Medical Education. Academic Medicine, Vol. 81, No. 3/March 2006.

  12. Benbassat J, Baumal R. Expected benefits of streamlining undergraduate medical education by early commitment to specific medical specialties. Adv Health Sci Educ. 2012;17:145–55.

    Article  Google Scholar 

Download references

Disclosures

All authors are involved with the academic missions of their home institutions. Several are either active Geriatric Psychiatry Fellowship Directors (Kirwin, Greenwald) or Associate Fellowship Directors (Conroy, Zdanys). Several are past Geriatric Psychiatry Fellowship and/or Section Directors (Lyketsos, Steffens, Ahmed), and several are past General Psychiatry Program Directors (Kirwin, Ahmed) and former Deputy Chair (Ahmed). Several are Department Chairs (Steffens) or Chair/Vice-Chairs (Lyketsos, Greenwald). One is an RWJ Fellow (Wiechers). One is a medical school Psychiatry Clerkship Director (Forester). One is a recent CEO of the AAGP (deVries). One is a recent Senior Associate Dean (Reynolds) and two are Endowed Professors (Reynolds, Lyketsos). One author (Ahmed) currently serves on the Psychiatry Review Committee for the ACGME. He worked on this proposal before his appointment to the Psychiatry Review Committee.

Author information

Authors and Affiliations

  1. Yale University School of Medicine, VA Connecticut Healthcare System, West Haven, CT, USA

    Paul Kirwin, Michelle Conroy & Ilse Wiechers

  2. The Johns Hopkins Hospital, Baltimore, MD, USA

    Constantine Lyketsos

  3. Long Island Jewish Medical Center/North Shore University Hospital, Glen Oaks, NY, USA

    Blaine Greenwald

  4. McLean Hospital, Harvard Medical School, Belmont, MA, USA

    Brent Forester

  5. American Association for Geriatric Psychiatry, Bethesda, MD, USA

    Christine deVries

  6. Tripler Army Medical Center, Honolulu, HI, USA

    Iqbal Ike Ahmed

  7. University of Connecticut Health Center, Farmington, CT, USA

    Kristina Zdanys

  8. University of Connecticut School of Medicine, Farmington, CT, USA

    David Steffens

  9. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Charles F. Reynolds III

Authors
  1. Paul Kirwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michelle Conroy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Constantine Lyketsos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Blaine Greenwald
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Brent Forester
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christine deVries
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Iqbal Ike Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ilse Wiechers
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kristina Zdanys
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. David Steffens
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Charles F. Reynolds III
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul Kirwin.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kirwin, P., Conroy, M., Lyketsos, C. et al. A Call to Restructure Psychiatry General and Subspecialty Training. Acad Psychiatry 40, 145–148 (2016). https://doi.org/10.1007/s40596-014-0144-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40596-014-0144-5

Keywords

Search

Navigation