Research Training in Psychiatry Residency Strategies for Reform (2003) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-20
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Regarding regulatory factors, a review of the psychiatry residency accreditation requirements led the committee to conclude that these requirements should be modifier! to afford more training time for research experiences and general research literacy.
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is the most salient feature of successful programs, child and adolescent psychiatry divisions and small programs in general wiR likely require outside collaborations to develop a critical mass of resources for effective research training. Finally, while there are numerous efforts under way to enhance research training in psychiatric residency, the committee recommends the formation of a national coordinating bobly to develop, implement, and evaluate strategies toward that goal.
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to convene an expert committee that would evaluate the current goals of psychiatry residency training and consider strategies for enhancing research training during or in close proximity to residency. Specifically, the lOM committee was asked to address the following four issues in the context of adult, and child and adolescent psychiatric residency: (~)
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Regulatory factors, comprising program accreditation and individual certification requirements that are governed by the Psychiatry Residency Review Committee (RRC) under the auspices of the Accreditation Council for Graduate Medical Education (ACGME)
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, (2) provide some residents with initial research experiences that may launch them into a patient-oriented research career, and (3)
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Regulatory Factors The two regulatory bodies with the greatest influence over psychiatry residency training are the ABPN and the Psychiatry RRC. These two bodies aim to safeguard consumer health by ensuring that all residency graduates are competent to deliver quality psychiatric care.
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This recommendation is aimed at optimizing core Paining by streamlining some of the redundant or overly ambitious requirements of that training, and by permitting programs and individuals the opportunity to tailor larger portions of their training with elective experiences that might include "hands-on" research activity. The recommendation further aims to entice outstanding residents to undertake research activity by rewarding fast-paced attainment of clinical competency with greater opportunities for early research involvement.
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A review of various published curricula indicates that research literacy in psychiatry should include knowledge in at least the following areas: epidemiology, study design, biostatistics, integrated clinical neural and behavioral science, research ethics, and grant and manuscript writing skills. This knowledge could be addressed by adding content to the in-training and credentialing examinations that are a standard part of psychiatrists' transition to independent practice.
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That funding stream is under increasing pressure as federal and private payers seek ways to minimize health care costs. Research is not generally considered part of core residency training.
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Accordingly, the committee makes the following recommendation: Recommendation 4.2. Academic institutions and their psychiatry residency training programs should reward the involvement of patient-oriented research faculty in the residency training process.
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Additionally, existing curricula typically are not validated by long-term follow-up studies to Steins whether trainees were actually prepared to move into patient-oriented research careers or even to practice evidence-based medicine more efficiently. Given that it was dif
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and child and adolescent residency training programs. Supported curriculum development efforts should include plans for educating faculty to deliver each new curriculum, as well as plans for evaluating each curriculum's success in training individuals to competency and in recruiting and training successful researchers.
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Concerns about loan repayment and overall financial welI-being may discourage potential patient-oriented researchers from extended research training, which would further delay them from achieving their full earning potential. Although financial incentives for research experiences in core residency would create unacceptable compensation inequities, in
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The National Institute of Mental Health and other funding agencies should seek mechanisms to offer increased financial incentives, such as loan repayment, to trainees who commit to research training and research involvement beyond core psychiatry residency. Although financial expectations play a role in the career decisions of medical students and residents, trainees are equally if not more concemed about other issues, such as lifestyle and the intellectual content of their selected profession.
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Accordingly, the committee makes the following three recommendations: Recommendation 5.3. Departments of psychiatry, supported by the National Institute of Mental Health and other psychiatric organizations, should provide leadership in recruiting and retaining more women for psychiatry research careers.
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First, numerous factors influence a psychiatry resident's decision about a research career. Second, despite numerous national and local efforts, there is a paucity of data about which methods are truly effective at fostering research career development and success among psychiatrists.
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The National Institute of Mental Health should take the lead In organizing a national body, including major stakeholders (e.g., patient groups, department chairs) and representatives of organizations in psychiatry, that will foster the integration of research into psychiatric residency and monitor outcomes of efforts to do so.
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Table ES-1 summarizes the committee's recommendations and identifies the obstacles to research Gaining in psychiatric residency addressed by each.
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tion deter the choice of a research career. 5.2 Develop strategies to Trainees have pessimistic views of attract trainees to pa- research careers and can be unin tient-onented research.
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