Geriatric Psychiatry and Fellowship Programs in the United States

Abstract

Psychiatric disorders are extremely common in the elderly and are a major cause of morbidity and mortality. For example, 8% to 15% of the geriatric population has clinically significant symptoms of depression (NIH Consensus Conference, 1992). Elderly Americans commit suicide at a rate twice the national average (National Strategy for Suicide Prevention, 2007). Ten to 15% of elderly community residents have Alzheimer's disease (AD) or other dementias (Evans et al., 1989). AD is the seventh-leading cause of death in the United States (Centers for Disease Control 2006).

Assessing research competency development in Canadian psychiatry residency programs: A systematic review and future directions

“…10 Working groups in psychiatry have defined 20 EPAs across four stages of residency training, with some for specific psychiatric subspecialties. 11–34 Although the RCPSC has described the research requirements and emphasized research as an essential component of psychiatric training, 35,36 the only EPA related to research in the current CBD framework is early in training within the Foundations of Discipline (FoD) stage (EPA #5), which specifies that two direct observations from at least two different observers are required of the resident to “perform a critical appraisal and presenting psychiatric literature.” Key features of this EPA include: (1) “A focus on critical appraisal of literature to make appropriate clinical decisions and to encourage lifelong learning and acquisition of new knowledge and skills in the specialty”; (2) “Includes posing a clinically relevant question, performing a literature search, critically appraising the literature, and presenting in a group setting”; and (3) “Includes presentations such as grand rounds, journal club, case conference, morbidity and mortality rounds or quality improvement rounds.”…”

“…8 To operationalize CBD, the RCPSC has adopted "entrustable professional activities" (EPAs), 9 which are units of professional practice entrusted to trainees demonstrating the necessary competence to execute the activity independently. 10 Working groups in psychiatry have defined 20 EPAs across four stages of residency training, with some for specific psychiatric subspecialties. Although the RCPSC has described the research requirements and emphasized research as an essential component of psychiatric training, 35,36 the only EPA related to research in the current CBD framework is early in training within the Foundations of Discipline (FoD) stage (EPA #5), which specifies that two direct observations from at least two different observers are required of the resident to "perform a critical appraisal and presenting psychiatric literature."…”