Training psychiatrists for 21st century health care
The residency training program has a vision to create leaders in psychiatry. We define leadership broadly and aim to train psychiatrists with future careers as physician-scientists and scholars, medical educators, clinical system leaders, and champions to the underserved. In 2010, the program began a curricular redesign process to transform the residency, introducing modern educational pedagogy that trains psychiatrists to be effective clinicians and leaders in a modern-day health care system. We have been rolling out this curriculum over the past two years and implementation of our new curriculum will be complete by July 2016.
The principles driving this change were informed by the Carnegie Foundation’s 2010 report on Educating Physicians: A Call for Reform of Medical School and Residencies, now widely cited in the medical community as the “Flexner Report version 2.0.” These principles have guided our own transformation and include:
- a longitudinal ambulatory experience as the backbone of training;
- greater individualized pathways for specialization and breadth;
- peer-assisted learning;
- collaboration with other specialties and professions;
- skills and motivation for continuous quality improvement at the individual and organizational level;
- explicit inquiry, scholarship, leadership, and teaching expectations; and
- a competency-based assessment framework for progression and advancement.
Several new rotations and experiences have followed these principles, including a longitudinal clinical experience (LCE) starting in the PGY-1 year, senior resident experiences in inpatient and outpatient psychiatry, an integrated care experience (ICE) in which residents are embedded in other medical specialties, elective opportunities earlier in training; an Areas of Distinction (AoD) program; a team-based quality improvement curriculum; a scholarship program; an expansion of our Resident Research Training Program (RRTP); and a new didactic framework organized around roles of the 21st century psychiatry leader. Our program highlights are showcased on our website.
The RTP faculty leadership team includes Erick Hung, MD (Program Director); Demian Rose, MD, PhD (Associate Program Director for Clinical Curriculum); Alissa Peterson, MD (Associate Program Director for Core Curriculum and Site Director at SFGH); Caitlin Hasser, MD (Associate Program Director for Evaluations and Site Director at VAMC); Descartes Li, MD (Site Director at Parnassus); and Susan Voglmaier, MD, PhD (Director for RRTP).
Future directions
As advances in neurosciences introduce new and emerging clinical pathways, residency training programs across the country will need to evolve their curricular approaches. Our program is actively collaborating with neurology, neurosurgery, and psychology to pilot new clinical neuroscience training rotations and didactics as we consider emerging avenues to psychiatric training. In addition, our program is committed to training psychiatrists not only committed to the individual but also to the population, and we plan to incorporate population-based tools and advances in digital mental health technology in the curriculum.
Many of these advances are similarly in development in undergraduate medical education, and here at UCSF, the Bridges Curriculum is preparing medical students to be 21st century physicians with new skills in scientific inquiry and health systems. Our residency training program is aligned with Bridges and the medical training continuum. As part of his UCSF Academy of Medical Educator’s Endowed Chair for Medical Student Education, Erick Hung, MD, will be creating funding opportunities for faculty to serve as curricular champions to the department in systems improvement, informatics, population management, and interprofessional teamwork.
