Variations in Application Instructions for Forensic Psychiatry Fellowships

Morris, Nathaniel P.; Hirschtritt, Matthew E.; Edwards, Matthew L.

doi:10.1007/s40596-019-01128-5

Cited by 6 publications

(10 citation statements)

References 14 publications

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“…Our findings suggest that existing ADP fellowships do not adequately interface with potential applicants. This is consistent with studies of websites for other psychiatry and neurology subspecialties 8 , 13 . Our racial and gender diverse focus groups demonstrated that applicants want more information regarding diversity/health equity, intersecting identities of fellows, faculty, and patients, and curricular content.…”

Section: Discussionsupporting

confidence: 87%

“…A recent study examining the priorities of psychiatry residents interested in consult-liaison psychiatry fellowships or other psychiatry subspecialties—including addiction, child and adolescent, forensic, and geriatric—found that lifestyle, finances, and academic opportunities were the most important factors in deciding where to apply 4 . Another study of forensic psychiatry fellowship applicants found that improving the consistency and transparency of information might decrease stress related to the online application process and streamline recruitment 8 . Given the shortage of ADP specialists, it is critical to elucidate how recruitment might be improved, including understanding how trainees engage with existing ADP fellowship websites.…”

Section: Introductionmentioning

confidence: 99%

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Perceptions on Navigating ACGME-Accredited Addiction Psychiatry Fellowship Program Websites: A Thematic Analysis across a Race- and Gender-Diverse Pool of Potential Applicants

et al. 2022

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Background: There is an alarming shortage of addiction psychiatrists in the United States. To promote interest in addiction psychiatry (ADP), it is essential to maximize resources available through ADP fellowship websites. The aim of this study was to investigate the perceived adequacy and accessibility of content on ADP fellowship websites and discover what further information is considered important among trainees interested in becoming addiction specialists. Methods: Three virtual focus groups were conducted between January and February 2021 among medical students and residents in diverse geographic regions. Participants were asked about the availability of information on ADP fellowship program websites and other material they would like to see available. Focus groups were recorded, with data transcribed and coded using NVivo 11 and Dedoose. A coding scheme was deductively developed based on the core research questions. Results: The majority of participants (N = 27) identified areas of dissatisfaction with the content currently available on ADP websites. The sample was highly representative of racial and ethnic minoritized trainees (n = 12) and genderqueer/non-binary participants (n = 3). Three major themes were identified and durable across all focus groups: lack of emphasis on diversity/health equity, lack of portrayal of everyday life and activities of fellows, and inadequate representation of curricula. Overwhelmingly, participants identified a dedication to health equity (for example, working with minoritized populations) as a key deciding factor in whether to apply to a particular ADP fellowship. Conclusions: ADP fellowship websites are perceived to have considerable variability in the amount and quality of information. Many do not appear to provide the full spectrum of content desired by diverse potential applicants, such as information regarding current fellows and community-centered initiatives. This is concerning, as it suggests ADP fellowships may be interfacing poorly with burgeoning leaders, especially those from race and gender minoritized backgrounds, neglecting potential opportunities to develop future addiction specialists.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Perceptions on Navigating ACGME-Accredited Addiction Psychiatry Fellowship Program Websites: A Thematic Analysis across a Race- and Gender-Diverse Pool of Potential Applicants

et al. 2022

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“…We used STATA MP, version 15.1 (StataCorp LLC) for all analyses related to NSDUH and accounted for the complex survey design. We multiplied the NSDUH prevalence rates by population estimates from the Bureau of Justice 15 , 16 and the US census 17 to calculate the number of incarcerated and nonincarcerated individuals affected by each condition along with a lower and upper bound based on the NSDUH 95% CIs. We used these numbers to estimate the proportion of disease burden and corresponding 95% CIs among incarcerated individuals.…”

Section: Methodsmentioning

confidence: 99%

“…8 In addition to studies examining general health care services, other work has documented shortcomings in medication quality and access in correctional settings. 5,6,12,[15][16][17] In a review of more than 400 lawsuits filed over alleged mistreatment of incarcerated people, reporters found that approximately one-third of suicide attempts among people in jail occurred after staff allegedly failed to provide medications for mental illness. 18 Conversely, there have been studies demonstrating overprescribing of antipsychotics among incarcerated individuals.…”

Section: Introductionmentioning

confidence: 99%

Estimated Use of Prescription Medications Among Individuals Incarcerated in Jails and State Prisons in the US

et al. 2023

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ImportanceAlthough incarcerated individuals experience higher rates of chronic conditions, little is known regarding the use of prescription medications in jails and prisons in the US.ObjectiveTo characterize treatment with prescription medications in jails and state prisons relative to noncorrectional settings in the US.Design, Setting, and ParticipantsThis cross-sectional analysis using 2018 to 2020 data from the National Survey on Drug Use and Health (NSDUH) estimated the prevalence of disease among recently incarcerated and nonincarcerated adults in the US. The study used 2018 to 2020 IQVIA’s National Sales Perspective (NSP) to quantify the distribution of medications to incarcerated and nonincarcerated populations. The NSP provides national dollar and unit sales of prescription medications across multiple distribution channels, including prisons and jails. The study population included incarcerated and nonincarcerated individuals from NSDUH. Seven common chronic conditions were assessed. Data were analyzed in May 2022.ExposuresMedications being sent to correctional facilities vs all other settings in the US.Main Outcomes and MeasuresThe main outcomes were distribution of medications to treat diabetes, asthma, hypertension, hepatitis B and C, human immunodeficiency virus (HIV), depression, and severe mental illness to incarcerated and nonincarcerated populations.ResultsThe proportion of pharmaceuticals distributed to jails and state prisons to treat type 2 diabetes (0.15%), asthma (0.15%), hypertension (0.18%), hepatitis B or C (1.68%), HIV (0.73%), depression (0.36%), and severe mental illness (0.48%) was much lower compared with the relative burden of disease among this population. The incarcerated population in state prisons and jails accounted for 0.44% (95% CI, 0.34%-0.56%) of estimated individuals with diabetes, 0.85% (95% CI, 0.67%-1.06%) of individuals with asthma, 0.42% (95% CI, 0.35%-0.51%) of hypertension, 3.13% (95% CI, 2.53%-3.84%) of hepatitis B or C, 2.20% (95% CI, 1.51%-3.19%) of HIV, 1.46% (95% CI, 1.33%-1.59%) of depression, and 1.97% (95% CI, 1.81%-2.14%) of severe mental illness. After adjusting for disease prevalence, the relative disparity was 2.9-fold for diabetes, 5.5-fold for asthma, 2.4-fold for hypertension, 1.9-fold for hepatitis B or C, 3.0-fold for HIV, 4.1-fold for depression, and 4.1-fold for severe mental illness.Conclusions and RelevanceIn this cross-sectional, descriptive study of the distribution of prescription medications for chronic conditions in jails and state prisons, the findings suggest that there may be underuse of pharmacological treatment in correctional facilities relative to the nonincarcerated population. These findings, which require further investigation, may reflect inadequate care in jails and prisons and represent a critical public health issue.

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“…While it is possible that the increase in general psychiatry applications will later translate to an increase in fellowship applications, fellowship programs must consider multiple methods of garnering interest in subspecialty training as well as potential barriers to fellowship interest. Morris et al [3] and Michaelsen et al [4] outlined some challenges facing forensic psychiatry fellowships specifically. In reading these articles and others, the distinction between symptom and cause is not clearly apparent.…”

Section: Commentarymentioning

confidence: 99%