Psychiatric training in medicine residencies: current needs, practices, and satisfaction.
The purpose of this study was to determine the current level of psychiatric training in internal medicine residencies, satisfaction with this training, and perceived need, if any, for more training. Surveys were mailed to all training directors of accredited primary care (N = 178) and categorical (N = 410) internal medicine residencies in the United States; 110 primary care (62%) and 238 categorical (58%) training directors returned the surveys. Seventy-five percent of categorical and 66% of primary care training directors thought their program should spend more time on psychiatric disorders. For all categories of psychiatric disorder, training intensity was greater and satisfaction with training higher in the primary care programs, but less than half of the directors were satisfied with their current level of training, e.g., 33% of categorical and 47% of primary care directors were satisfied with their residents training concerning depression. Training in somatoform disorders, psychotropic drugs, and office psychotherapy were most frequently identified as deficient. The most favored additions to the curriculum were psychiatric consultants in medical clinics and on medical wards. Although most outpatient care for psychiatric disorders is given by primary care physicians, internal medicine training directors perceive current levels of training in their residencies as inadequate. Innovative collaborations between medicine and psychiatry departments will be necessary if treatment of psychiatric disorders in primary care is to be improved.
Sullivan
M D
MD
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA.
Cole
S A
SA
Gordon
G E
GE
Hahn
S R
SR
Kathol
R G
RG
D001291:Attitude of Health Personnel; D003479:Curriculum; D006301:Health Services Needs and Demand; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D008486:Physician Executives / Q000523:psychology*; D011570:Psychiatry / Q000193:education*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States