Rrc psychiatry program requirements

Arlington, Va, American Psychiatric Publishing, Acad Psychiatry ; — PubMed Article Google Scholar. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Shashi K. Bhatia M. The authors thank Daniel R Wilson, M.

Reprints and Permissions. At the conclusion of 60 months of training in internal medicine and psychiatry, residents should have had experience and instruction in the prevention, detection and treatment of acute and chronic medical and psychiatric illness presenting in both inpatient and ambulatory settings. Trainees should be exposed to the psychiatric and medical problems in patients from adolescence to old age and receive training in socioeconomics of illness, the ethical care of patients, and in the team approach to the provision of patient care.

The training of residents while on internal medicine rotations is the responsibility of the internal medicine faculty and while on psychiatry rotations, the responsibility of the psychiatry faculty. Vacations, leave and meeting time will be shared equally by both training programs. Except for the following provisions, combined residencies must conform to the program requirements for accreditation of residencies in internal medicine and psychiatry. Residents should enter combined training at the R-1 level, but may enter as late as the beginning of the R-2 level only if the R-1 year was served in a categorical or preliminary residency in internal medicine in the same academic health center.

Under unusual circumstances and with the permission of both Boards, the Boards will consider accepting individuals who have trained in other accredited programs.

Entry after completion of an R-1 year in psychiatry which involved less than eight months of internal medicine training requires prospective approval of each Board. Residents may not enter combined training beyond the R-2 level. Transfer between combined programs must have prospective approval of both Boards, and is allowed only once during the five-year training period. In a transfer between combined programs, residents must be offered and complete a fully integrated curriculum.

A resident transferring from combined training to categorical internal medicine or psychiatry training must have prospective approval of the receiving Board. Transitional Year training shall receive no credit toward the requirements of either Board unless eight months or more have been completed under the direction of a training director of an ACGME-accredited sponsoring residency in internal medicine.

Training in each discipline must incorporate progressive responsibility for patient care, supervision and teaching of medical students and junior residents throughout the training period. Combined residencies must be coordinated by a designated director or co-directors who can devote time and effort to the educational program. An overall program director must be appointed from either specialty, or co-directors from both specialties.

If a single program director is appointed, an associate director from the other specialty must be named to ensure both integration of the training and supervision in the discipline. The two directors must embrace similar values and goals for their program. The supervising directors from both specialties must document meetings with one another at least quarterly to monitor the progress of each resident and the overall success of the program. Training requirements for credentialing for the certifying examination of each Board will be fulfilled by 60 months of training in an approved combined program.

A reduction of 12 months of training compared to that required for two separate residencies is possible due to overlap of curriculum and training requirements. The requirement of 36 months internal medicine training is met by 30 months of internal medicine training with six months of credit for training appropriate to internal medicine obtained during the 30 months of psychiatry training.

Likewise, the 36 months of psychiatry training requirement is met by 30 months of psychiatry training with six months credit for training appropriate to psychiatry obtained during the 30 months of internal medicine training. A clearly described written curriculum must be available for residents, faculty and both Residency Review Committees.

The curriculum must assure a cohesive, planned educational experience and not simply comprise a series of rotations between the two specialties. Duplication of clinical experiences between the two specialties should be avoided and periodic review of the training curriculum must be performed. This review must include the program directors from both departments, with consultation with faculty and residents from both departments. Each year of the residency should include both internal medicine rotations and psychiatry residency rotations.

Unless otherwise noted in the admission requirements, submission of proof of meeting all admission requirements is due within 30 days of applying due within five days of applying if you apply within six weeks of the program start date. However, some programs require successful completion of the required courses and submission of a final transcript within 30 days of applying. The regular admission requirement for all College programs excluding upgrading and introduction programs and those programs requiring post-secondary education is a Grade 12 or mature student high school diploma including any pre-requisite courses identified in the program admission requirements.

If you are 19 years of age or older and have been out of high school for a minimum of one year at time of application, and you do not meet the regular admission requirements, you may apply under the Mature Student admission requirements. Third, the psychotherapy requirements are excessive in their expectations, and some lack a sufficient evidence-base.

As discussed earlier in this chapter, psychodynamics is particularly problematic because there have been few if any clinical trials supporting the efficacy of this therapy Eisenberg, , although some findings may be emerging Simpson et al. Additionally, it appears unrealistic that, during a 4- or 5-year residency crowded with numerous other responsibilities and learning requirements, residents can achieve competency in all of these different forms of psychotherapy; this is true especially for psychodynamics, given its complexity and typical duration.

As an alternative, the committee suggests that the psychotherapy requirement be modified to mandate more generic attainment of competency in psychotherapy while offering the option for competency achievement in specific forms such as psychodynamics.

The aim should be to train psychiatrists in evidence-based psychotherapy methods and provide them with sophisticated knowledge common to all major forms of psychotherapy. As a possible guide to such training goals, Beitman and Yue detail a curriculum consolidating common factors that cut across various psychotherapeutic approaches. This curriculum parses psychotherapy into the generic and chronological stages of 1 engagement, 2 pattern search, 3 change, and 4 termination.

This parsing of general constructs is used to teach trainees psychotherapeutic concepts and skills that can be adapted to a variety of clinical situations. It also gives trainees theoretical connectivity to many of the major schools of psychotherapy, including psychodynamics.

Along with such didactic training, the RRC requirements could mandate that residents become competent in a small number e. The precise choice of methods could be left to the individual training program and also to the personal, albeit monitored, goals of the trainees themselves. Winstead, Tulane University, April 7, To the extent that certain programs wish to offer more extended psychotherapy training of any type, 1-year fellowships, similar to those currently in existence for substance abuse, pain management, and forensics, could be created to train a subset of psychiatrists ACGME, a; b; As stated previously in this chapter, emphasis of evidence-based methods in the training of psychiatrists has the potential added benefit of attracting research-oriented medical students who may have been discouraged by psychiatry's apparent over-reliance on traditional practice methods.

A fourth opportunity to expand research training time lies in the fact that the RRC clinical requirements unnecessarily constrain the schedule of child and adolescent psychiatry trainees because they must fulfill many of the same service requirements as adult psychiatrists. Thus they are prevented from following the obvious path of focusing more on pediatric medicine from the outset of their residency.

Part of the issue is that some residents do not choose to enter the child and adolescent subspecialty until they have already completed much of their adult training, which is the foundation of the specialty, whereas some make the choice early enough that they might exchange some adult service time for more time in child and adolescent service. Accordingly, for psychiatric trainees who commit to child and adolescent training early PGY1 , the following types of adjustments to the training requirements might logically be permissible and act as an incentive to pursue a specialty that currently is in great need of more applicants Kim et al.

This project has already developed a list of six general competencies for all physicians: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice. The overall aim is to emphasize product e. The committee strongly supports this approach, and believes it has the potential to provide programs with the flexibility to reward qualified and motivated residents with earlier and more extensive research training.

A recent survey of 70 research-oriented departments of psychiatry among allopathic U. The aggregate amount of time these programs spent on research topics generally was less than 6 percent of the total curriculum Balon and Singh, To investigate this apparent dearth of research training time, the committee reviewed the research requirements of the Psychiatry RRC in both adult and child and adolescent psychiatry and compared them with the requirements for several other medical specialties see Table above for a summary of clinical and research requirements of various programs.

It appears, then, that both pathology and neurology have slightly stronger written expectations for research training during residency as compared with psychiatry, although the differences among the three sets of requirements are small.

As part of the academic environment, an active research component must be included within each accredited subspecialty program. The program must ensure a meaningful, supervised research experience with appropriate protected time—either in blocks or concurrent with clinical rotations—for each resident, while maintaining the essential clinical experience.

Evidence of recent productiv ity by both the program faculty and by the residents as a whole, will be required, including publication in peer-reviewed journals. Residents must learn the design and interpretation of research studies, responsible use of informed consent, and research methodology and interpretation of data. The program must provide instruction in the critical assessment of new therapies and of the medical literature. Residents should be advised and supervised by qualified faculty members in the conduct of research.

As they stand now, the psychiatry requirements are confusing and sometimes ambiguous. In contrast with the Psychiatry RRC, which accredits residency training programs , the ABPN certifies individual psychiatrists by means of written and oral examinations and an audit of specific training experiences leading up to those examinations ABPN, b.

The ABPN examination focuses primarily on direct patient care issues in which certified clinicians should be proficient see Box There are virtually no questions devoted to research methodology and data analysis, with the possible exception of a few questions on statistics in the epidemiology section and on experimental psychology approaches in the behavioral and social sciences section.

As of April , the ABPN had no official policies regarding research training during residency and had not implemented or suggested training pathways that would support research in residency personal communication, S.

Although most other specialty boards also lack research tracks, the dermatology, anesthesiology, pediatrics, and internal medicine boards, at least, have developed such pathways Hostetter, ; IOM, The pediatrics and internal medicine pathways are described in Chapter 2. The dermatology training track is similar to the regular track that includes basic or clinical research training for all residents, but the research track allows the explicit integration in lieu of other training activities of investigative or didactic experience after PGY2 has been completed American Board of Dermatology, The anesthesiology pathway has two options: option A involves 6 months of clinical or basic research in the context of a month residency; option B involves 18 months of research in the context of a month residency The American Board of Anesthesiology, The ABPN has considerable influence on residency-based research training in at least three ways.

Second, it must approve all applicants for the certification examination, and this approval process involves retrospective determination of whether a given applicant completed all the prescribed RRC requirements e.

Third, the ABPN is responsible for the content of the certification examination, thereby encouraging residents to learn certain facts and concepts in lieu of others ABPN, Thus it is arguably the principal national organizing body that can impact residency training, and residency-based research training efforts that are not in some fashion sanctioned or promoted by the ABPN are likely to have more limited success than those that are.

Although experience in graduate medical education is a very important selection factor, research experience is not necessarily considered relevant personal communication, B.

Barzansky, AMA, October 22, In its annual report to the AMA membership, the CME commented about a great variety of issues affecting graduate medical education, including resident work hours, Medicare funding for graduate medical education, and medical school debt. Research training was not explicitly mentioned in this report, although the importance of continuous evaluation of best practices in medical education was a clearly stated goal CME, Given the importance of training clinical scientists to develop and validate contemporary best practices, one can only assume that the AMA would support efforts to enhance research training in the psychiatric residency.

At that meeting, they discuss their research goals with peers and senior psychiatric researchers, who offer ad vice and guidance regarding a research career APA, A retrospective study of participants in the colloquia from to found that of the respondents reported some continued degree of research involvement since participating APA c. Of that group, 67 had received local department research funding, and 80 had received external funding, including 35 federal grants, as principal investigators APA c.

Although these data cannot be used to assess the impact of the colloquia, they do suggest that the program is succeeding in bringing together a good number of newly developing psychiatrist-researchers. However, it does have several small-scale research training initiatives. These initiatives, funded by the federal government and pharmaceutical companies, provide fellowship see Chapter 2 for more detail or seminar experiences AACAP, a; c; d.

The AACAP has also convened a task force to develop a residency-based curriculum aimed at training child psychiatrist-researchers and one that that also integrates research content throughout the residency i. Leckman, Yale University, April 4, These organizations represent the perspectives of residency training directors, department chairs, student clerkship directors, and psychopharmacologists, respectively.

None of them has a direct impact i. Over the course of this report, it became clear to the committee that all of these organizations have at least some appreciation for the importance of research and research training opportunities in the context of psychiatric residency, although many tend to be focused on more immediate, day-to-day clinical training and practice issues. The committee understands and respects the fact that these two bodies aim to safeguard consumer health by ensuring that residency graduates are trained to deliver quality psychiatric care.

We also understand that a national regulatory effort is complex and that defined requirements both timed and untimed are useful in the documentation of residency training.