Psychiatry Residency Directors' Attitudes Toward and Uses of the Medical Student Performance Evaluation and Other Potential Tools for Residency Selection.

OBJECTIVE: A survey was conducted to determine US psychiatry residency directors' attitudes regarding current measures of medical student performance and their preferences for the future. METHODS: A team of psychiatry medical student educators and residency program directors developed a 23-question survey. In July 2021, links to the survey were sent out to all program directors registered with the American Association of Directors of Psychiatric Residency Training. RESULTS: Seventy program directors out of 223 initiated the survey, resulting in a response rate of 31.4%. Forty percent of respondents reported that the most important use of the Medical Student Performance Evaluation (MSPE) is in screening out applicants for interviews, and only 26.1% reported that the MSPE in its current form could be trusted to provide a valid and reliable assessment of a student's medical school performance. Most respondents agreed that in the absence of United States Medical Licensing Examination (USMLE) step 1 numerical scores, the existing MSPE format/content requirements should be modified, use a set of ranking categories that are uniform across all medical schools, and be supplemented with additional measures of the student's character and ability specific to psychiatry. CONCLUSIONS: US psychiatry program directors are eager for change when it comes to the MSPE and how it reports rankings, grades, and professionalism. The transition of the USMLE step 1 score reporting to pass/fail presents an opportunity to pursue this change and for stakeholders from all medical specialties to work together toward a shared goal of an improved residency selection process.

Psychiatry Resident Quality of Life.

OBJECTIVE: The objective of this study was to evaluate psychiatry resident physician quality of life. METHODS: A voluntary, anonymous, 10-min survey was e-mailed to residents from all 14 Accreditation Council for Graduate Medical Education (ACGME)-accredited programs in Pennsylvania, New Jersey, and Delaware. Included in the survey was the Multi-Cultural Quality of Life Inventory (MQLI). RESULTS: Response rate was 112 (34.1%). Internal consistency of the MQLI was high (Cronbach's alpha 0.92), and follow-up exploratory factor analysis extracted only one underlying factor (60.1% variance among all 10 items). Average total MQLI score was 80.6. No significant difference in MQLI total was found for therapy status, sex, or race. Post-graduate year (PGY) 4 residents scored higher on total MQLI score (86.7) (F = 2.80, p = 0.04) and ranked occupational functioning and community and services support subscales significantly higher (occupation F = 2.73, p = 0.048, community F = 3.11, p = 0.030). Total MQLI score for residents over the age of 40 (n = 3) was significantly lower (F = 3.45, p = 0.019). CONCLUSION: Despite the stresses of residency training, residents from a variety of programs in one geographic area report an encouraging quality of life on the MQLI. Psychiatry resident quality of life is similar to that reported in other populations of mental health professionals.

Use and characterization of personal psychotherapy by psychiatry residents.

OBJECTIVE: The authors evaluated psychiatry resident participation in and description of personal psychotherapy, reasons for being in psychotherapy, and barriers to personal psychotherapy. METHODS: All 14 program directors for programs accredited by the Accreditation Council for Graduate Medical Education in Pennsylvania, New Jersey, and Delaware provided e-mail addresses for current categorical residents. The authors e-mailed a voluntary, anonymous, 10-min survey to residents through www.SurveyMonkey.com . The survey inquired about time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, reasons for being in or not being in therapy, and overall resident wellness. RESULTS: Of the 328 residents e-mailed, 133 (40.5 %) replied to the survey, of which 34 (26.5 %) were in personal psychotherapy. Most residents described their psychotherapy as psychodynamic, once weekly, and located in a private practice not affiliated with the resident's academic center. Approximately half (49 %) were in treatment with a social worker (MSW, LCSW) or psychologist (PhD or PsyD). "Self-awareness and understanding" was the most commonly reported primary and contributing reason for being in psychotherapy. Close to half of the respondents (44.5 %) listed personal stress, substance dependence, mood, anxiety, or other psychiatric symptoms as the primary reason for seeking personal psychotherapy. The most common reasons for not entering psychotherapy were time and finances. Residents who were in personal psychotherapy valued personal psychotherapy as more important to training than residents who were not in personal psychotherapy. Half of all respondents reported that their program recommends psychotherapy. CONCLUSION: Far fewer residents responding to the survey reported being in psychotherapy than residents from some previous surveys. A continuing discussion of whether and how to accommodate personal psychotherapy in the training and education of psychiatry residents by psychiatry educators is warranted.

Psychotherapy Training: Residents' Perceptions and Experiences.

OBJECTIVE: This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. METHOD: A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. RESULTS: Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. CONCLUSION: Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more psychotherapy education than they are receiving. Further research and discussion about how much psychotherapy training is feasible in an evolving field is required.