title: A Call to Restructure Psychiatry General and Subspecialty Training.
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.
authors.affiliation: Yale University School of Medicine, VA Connecticut Healthcare System, West Haven, CT, USA. Paul.Kirwin@yale.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Kirwin
authors.affiliation: Yale University School of Medicine, VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Conroy
authors.affiliation: The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Constantine
authors.initials: C
authors.lastname: Lyketsos
authors.affiliation: Long Island Jewish Medical Center/North Shore University Hospital, Glen Oaks, NY, USA.
authors.forename: Blaine
authors.initials: B
authors.lastname: Greenwald
authors.affiliation: McLean Hospital, Harvard Medical School, Belmont, MA, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Forester
authors.affiliation: American Association for Geriatric Psychiatry, Bethesda, MD, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: deVries
authors.affiliation: Tripler Army Medical Center, Honolulu, HI, USA.
authors.forename: Iqbal Ike
authors.initials: II
authors.lastname: Ahmed
authors.affiliation: Yale University School of Medicine, VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Ilse
authors.initials: I
authors.lastname: Wiechers
authors.affiliation: University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Zdanys
authors.affiliation: University of Connecticut School of Medicine, Farmington, CT, USA.
authors.forename: David
authors.initials: D
authors.lastname: Steffens
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D002568:Certification; D005257:Fellowships and Scholarships; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D011570:Psychiatry / Q000193:education*; D013038:Specialization; D000078329:Workforce
keywords: ABPN; ACGME; Fellowship training; Residency education; Subspecialty training