A Call to Restructure Psychiatry General and Subspecialty Training
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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.
KeywordsResidency education Fellowship training Subspecialty training ACGME ABPN
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.
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