Required and Elective Experiences During the 4th Year: An Analysis of ACGME Accredited Psychiatry Residency Program Websites.

OBJECTIVE: The objective of this study was to assess and describe required and elective components of the 4th post-graduate year (PGY4) in psychiatry residency programs. METHODS: We reviewed the websites of all 193 2014-2015 ACGME accredited psychiatry residency programs for content describing the specific components of the PGY4 year. RESULTS: Nearly all residency programs (99 %) had some form of required experiences during the PGY4 year. Ninety-four percent had clinical requirements for PGY4 residents, with longitudinal outpatient clinic being the most common (77 %). All programs offered some elective time during PGY4, but the amount of time ranged from 2 months to 100 %. CONCLUSION: Virtually all residency programs include some requirements in the 4th year (most commonly didactics and outpatient clinic) in addition to a broad array of elective experiences. Although 3 years may suffice for residents to complete ACGME requirements, a variety of factors may motivate programs to include required 4th year curricula. Future studies should explore the rationales for and possible benefits of programmatic requirements throughout 4 versus only 3 years of psychiatric training.

Impact of the information age on residency training: communication, access to public information, and clinical care.

Access to technology in practice helps physicians manage information, communicate, and research topics; however, those in training receive almost no formal preparation for integrating web-based technologies into practice. One reason for this is that many faculty-aside from junior faculty or those in recent generations-did not grow up using Internet communication, may use it minimally, if at all, in their own practices, and may know little about its forms and varieties. This report presents a case to illustrate how these disparities may play out in the supervisory situation and makes suggestions about helping supervisors integrate technology-awareness into their teaching.

Recruiting researchers in psychiatry: the influence of residency vs. early motivation.

BACKGROUND: The declining numbers of clinician-researchers in psychiatry and other medical specialties has been a subject of growing concern. Residency training has been cited as an important factor in recruiting new researchers, but there are essentially no data to support this assertion. This study aimed to explore which factors have influenced motivation to conduct research among senior psychiatry residents. METHODS: The authors surveyed senior residents, inquiring about their level of interest in research, demographics, background, research experiences, and factors influencing motivation for research. The authors had confirmed participation from 16 of 33 residency programs with a class size of 10 or more. They received 127 responses, a 67% response rate, from participating programs. RESULTS: Residents with high stated interest in research differed from those with low and moderate interest in their research-intense post-residency plans. They were more likely to have graduate degrees. Those planning research careers had a consistent pattern of interest and involvement in research, starting well before residency. The majority of residents had had research exposure in college, but research involvement of those with very high versus lower interest diverged sharply thereafter. Those with high research interest were overwhelmingly male and tended to have lower debt than those with less interest. CONCLUSION: The great majority of residents appear to have decided whether or not to pursue a research career by the time they reached residency, and few of those with less than the highest research interest were enrolled in research tracks. Efforts to increase recruitment into research should center on identifying early developmental influences, eliminating barriers specific to women, and ensuring adequate funding to provide secure careers for talented potential researchers.

The American Board Of Psychiatry and Neurology: historical overview and current perspectives.

The American Board of Psychiatry and Neurology (ABPN) is a nonprofit organization founded in 1934 to serve the public interest and promote excellence in the practice of psychiatry and neurology. The ABPN is one of 24 American Board of Medical Specialties boards that have helped develop processes that identify qualified specialists through rigorous credential and training requirements and successful completion of respective certification examinations. The ABPN has had an enormous influence on the practice of psychiatry in America and the world and this influence continues to grow. Here we provide an historical overview of the ABPN, its formation, mission, roles, and changes that have taken place over the years in the certification, recertification, and maintenance of certification process.

Certification in neuromuscular medicine: a new neurologic subspecialty.

Information is provided concerning the new subspecialty certificate in neuromuscular medicine of the American Board of Psychiatry and Neurology and the eligibility requirements for such certification of practicing neurologists and child neurologists. The Accreditation Council for Graduate Medical Education has approved fellowship training in the subspecialty, and it is likely that residents who wish to pursue a career in neuromuscular medicine will select this training option.

Certification in neuromuscular medicine: a new neurologic subspecialty.

Information is provided concerning the new subspecialty certificate in neuromuscular medicine of the American Board of Psychiatry and Neurology and the eligibility requirements for such certification of practicing neurologists and child neurologists. The Accreditation Council for Graduate Medical Education has approved fellowship training in the subspecialty, and it is likely that residents who wish to pursue a career in neuromuscular medicine will select this training option.

Recruiting and rewarding faculty for medical student teaching.

OBJECTIVE: Finding time to teach psychiatry has become increasingly difficult. Concurrently, changes in medical student education are elevating demands for teaching. Academic psychiatry is challenged by these pressures to find innovative ways to recruit, retain, and reward faculty for teaching efforts. To address this challenge, the authors recommend a multifactorial approach to meeting the medical student educational mission of psychiatry departments. METHODS: This approach includes a variety of efforts including having Chairs serve as role models, enforcing the service requirements of volunteer faculty, expanding teaching venues, providing faculty development, elevating the status of teaching through academies, attending to promotion of faculty educators, establishing and nominating faculty for teaching awards, and using medical center resources to provide rewards for teachers. CONCLUSION: Academic leaders must acknowledge the inherent value of teaching to the academic enterprise and delegate sufficient resources to recruit, retain, and reward educators for the essential work that they perform.

Certification in child neurology: new directions for the twenty-first century.

The American Board of Psychiatry and Neurology was formed in 1934, and the first certifying examination was administered in 1935. It was not until 1969 that the American Board of Psychiatry and Neurology began conducting certifying examinations in child neurology. Since then, 10 child neurologists have served as American Board of Psychiatry and Neurology directors and nearly 1500 child neurologists have been certified, more than 200 of whom have also attained certification in the subspecialties of clinical neurophysiology, neurodevelopmental disabilities, and pain medicine. This article describes the evolution of the certification process as the Board has endeavored to use the best testing methodologies to fulfill its commitment to the public and to its constituents in psychiatry and neurology. Training pathways in child neurology are also reviewed as they have evolved in response to evident staff shortages and to promote entry into academic careers.

Board certification in child neurology and neurology: cohort study.

This study followed the progress of a cohort of child neurology and neurology graduates who sought certification by the American Board of Psychiatry and Neurology (ABPN). The 211 candidates were recent graduates when they initiated the certification process in October 1994, and 92% of them have achieved certification. First-attempt performances on the Part I and Part II examinations were related; 62% of those certified passed both on their first attempts. Of those who were certified, 24% also achieved certification in at least one additional ABPN specialty (psychiatry) or subspecialty (clinical neurophysiology, neurodevelopmental disabilities, and pain medicine). Overall, it was estimated that 82% of the 1994 child neurology and neurology graduates sought ABPN certification, and of these, 82% were successful.

Vascular neurology: a new neurologic subspecialty.

This article presents information about the American Board of Psychiatry and Neurology's new subspecialty certificate in vascular neurology, including the requirements for board certification. Practicing neurologists and child neurologists who have a major focus in vascular neurology can apply for the new certificate. In addition, the Accreditation Council for Graduate Medical Education has approved fellowship training in the subspecialty, and it is likely that residents who wish to pursue a career in vascular neurology will select this training option.

Subspecialty certification by the American Board of Psychiatry and Neurology.

OBJECTIVE: The authors describe the approval processes for subspecialties and the mechanisms for certification and recertification and review the status of training programs and numbers of diplomates with subspecialty certification. METHODS: Published information and relevant data bases were reviewed. To date, 5,327 child and adolescent psychiatry, 2,595 geriatric psychiatry, 1,854 addiction psychiatry, and 1,384 forensic psychiatry certificates have been awarded. In clinical neurophysiology and pain medicine, specialties that are primarily for neurologists and child neurologists, 21 and 28 psychiatrists, respectively, have been certified. There are 113 residency programs in child and adolescent psychiatry, 62 in geriatric psychiatry, 43 in addiction psychiatry, and 40 in forensic psychiatry. There are no psychiatry-based training programs in clinical neurophysiology and pain medicine. While this may not be of concern for clinical neurophysiology, it may lessen psychiatry's contribution to pain medicine. RESULTS: The ABPN took a conservative approach to establishing subspecialty certification in psychiatry. CONCLUSION: It is expected that subspecialists will enhance patient care through their clinical activities as well as through teaching and research.

Child neurology training via the research pathway: outcome study.

This article describes a residency training track that was developed by the American Board of Psychiatry and Neurology to promote the career development of child neurologists who wanted to become researchers. In this pathway, 1 year of research in the basic neurosciences replaces 1 year of pediatrics or internal medicine. Since 1992, 38 residents from more than 20 training programs have been accepted into this pathway. Of the 28 who have completed residency training, 22 are in academic positions as faculty or fellows, and 6 are working in nonacademic hospital settings. Of these 22, 6 describe their research as basic, and 12 describe their research as being both basic and clinical; 15 have been successful in obtaining external funding. Thus far, these trainees have published more than 125 articles in peer-reviewed journals. Although small in scope, this training track has met its objective of producing clinician-scientists.

The implications of core competencies for psychiatric education and practice in the US.

Physician competence is a universal concern, one that Canada and the US have addressed in differing, but also in similar, ways. Focusing on the roles physicians play, the Royal College of Physicians and Surgeons of Canada (RCPSC) has implemented a uniform procedure for developing and assessing competencies. The US does not have a parallel body but has instead different organizations responsible for different phases of medical education from residency through practice. These groups are working with 6 categories of core competencies to be used for assessment purposes. The categories are patient care, medical knowledge, interpersonal and communication skills, practice-based learning and improvement, professionalism, and systems-based practice. This article presents the US core competencies for psychiatric practice as they are currently being implemented through the American Board of Psychiatry and Neurology, Inc.

Certification in neurodevelopmental disabilities: the development of a new subspecialty and results of the initial examinations.

The American Board of Psychiatry and Neurology, in collaboration with the American Board of Pediatrics, administered the first Subspecialty Certification Examination in Neurodevelopmental Disabilities to 190 candidates on April 3, 2001, and the second to 80 candidates on April 9, 2002. This report describes the history of the certifying examination including the process of its development and the results of the first and second examination administrations. The purpose of the Certification Examination in Neurodevelopmental Disabilities is to assess knowledge of qualified candidates in the subspecialty. A committee comprised of child neurologists and pediatricians developed this examination. Of the 190 pediatricians (n = 169) and child neurologists (n = 21) who completed the examination in 2001, 157 (83%) passed the examination. The second group of examinees included 68 pediatricians and 12 child neurologists, and the pass rate was 70%. The 213 candidates certified to date have received ten-year time-limited certificates that may be renewed by recertification process beginning in 2010. After the "grandfathering period," candidates for the examination must complete ACGME-approved training programs in the subspecialty.

Subspecialty certification in geriatric psychiatry.

OBJECTIVE: The authors describe the development of certification and recertification processes for geriatric psychiatry, the American Board of Psychiatry and Neurology's second subspecialty in psychiatry. METHODS: Authors referenced databases of the certifying organizations and consulted published surveys of examinees. RESULTS: Since the first certification examination was administered in 1991, 2,595 certificates have been awarded. Because the certificates are time-limited, diplomates must sit for recertification every 10 years. Thus far, about 63% of the diplomates who have needed to do so have been recertified. CONCLUSION: It is estimated that 5,000 geriatric psychiatrists will be needed to meet future healthcare needs. Thus, the demand for this expertise will be increasing, and it is anticipated that board-certified geriatric psychiatrists will continue to play leading roles in educating practitioners from multiple disciplines.

Achieving board certification in psychiatry: a cohort study.

OBJECTIVE: The purpose of this study was to track the progress of a cohort of graduates of psychiatry residency training programs in achieving certification by the American Board of Psychiatry and Neurology (ABPN). These data provide a detailed picture of how recent graduates perform on the ABPN's examinations. METHOD: The subjects for this study were the 739 new candidates who sat for the part I examination in fall 1994. The cohort's performance on the part I and part II examinations was analyzed, as was the relationship between performance on the two examinations. RESULTS: Approximately 8 years after their first attempt at the part I examination, 85% of the cohort were certified, and 15% were not. The majority passed both the part I and part II examinations on the first attempt. Those who passed part I on the first attempt were more likely than those who failed to pass part II on the first attempt. Of the 627 who were certified at follow-up, 199 (32%) were also certified in one subspecialty, and 29 (5%) were certified in two, for a total of 257 subspecialty certificates. CONCLUSIONS: The results of this study suggest that most recent graduates of residency training programs who attempt the ABPN process are likely to become board certified, and the majority will do so by passing both components on the first attempt.

An experiment in graduate medical education: combined residency training in pediatrics, psychiatry, and child and adolescent psychiatry.

As an experiment in graduate medical education, a 5-year curriculum in pediatrics, psychiatry, and child and adolescent psychiatry was developed and evaluated over a 10-year period. The evaluation results suggested that the program's goal to create a cadre of specialists was achieved in terms of recruitment, performance during training, fostering of clinical reasoning ability, board certification rates, and postgraduate activities. As a result, the American Boards of Pediatrics and of Psychiatry and Neurology decided to make the combined training track permanent, and the numbers of training sites and residents have since been expanded.

The Examination for Added Qualifications in Geriatric Psychiatry.

Geriatric psychiatry was the first subspecialty area for which The American Board of Psychiatry and Neurology, Inc. (ABPN) offered an examination for added qualifications. The American Board of Medical Specialties approved the proposed specialty in 1989, and the first examination was administered in 1991 to 661 candidates, and the second, 1 year later, to 578 candidates. This paper describes the test development and standard-setting procedures, test results, and candidates' feedback about the examination.