Primary Care Directors Critical of Psychiatry Training Programs

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Key Takeaways

Dissatisfaction with psychiatry training predominated among psychiatry, IM, OB/Gyn, and pediatrics directors, who frequently rated exposure minimal-to-suboptimal despite existing baseline curricular coverage.
Family practice programs diverged, with most directors reporting optimal-to-extensive psychiatry training and a majority expressing satisfaction, suggesting comparatively stronger integration of behavioral health competencies.
Internal medicine directors prioritized added instruction in psychiatric techniques and a broader range of disorders to improve diagnostic and management capability within medical settings.
Obstetrics/gynecology and pediatrics highlighted gaps in diagnostic interviewing, psychotherapy/counseling, psychopharmacology, and specific syndromes (eg, somatoform/pain, psychological factors affecting medical illness, adjustment disorders); eating disorders needed augmentation broadly.

A study of primary care training directors conducted by Hoyle Leigh,MD, Ronna Mallios, MPH, and Deborah C. Stewart, MD, found thatmost directors believed their psychiatry training programs were inadequate.

A study of primary care trainingdirectors conducted by Hoyle Leigh,MD, Ronna Mallios, MPH, andDeborah C. Stewart, MD, found thatmost directors believed their psychiatrytraining programs were inadequate.The researchers, from theUniversity of California, San Francisco,surveyed 1550 US psychiatryand primary care program directors(in family practice [FP], internalmedicine [IM], obstetrics and gynecology[OB], and pediatrics [Peds])with a questionnaire about specificareas of training as well as perceivedadequacy of training programs.

In each area, with the exceptionof FP, the directors responded thatthey were dissatisfied with the psychiatrytraining in their primary careprograms and that training was minimalto suboptimal; this was the viewof 94% of psychiatry training directors,as well as 81% of IM, OB, andPeds training directors. Interestingly,64% of FP training directors felt thattheir psychiatry training programswere optimal to extensive, and 60%were satisfied with training in theirprograms.

The researchers concluded thatwhile the basics of psychiatry trainingwere covered, all programs couldbe enhanced. Leigh told PsychiatricTimes, For IM, enhancements areneeded in training in a variety ofpsychiatric techniques and disorders;for OB, training in diagnostic interview,psychotherapy, counseling, andpsychopharmacology; and for Peds,training in diagnostic interview,somatoform/pain disorder, psychologicalfactors affecting physicalcondition, and adjustment disorders.Most programs, including FP, believetraining in eating disorders should beaugmented.