Psychiatric Residency Training and the Changing Economic Scene

Efforts to contain the cost of medical care are having a profound impact on psychiatric residency training programs, which must cope with diminishing levels of funding from both federal and private sources. The programs are also being buffeted by other forces that help shape psychiatry's manpower needs, such as the corporatization of American medicine, new models of health care delivery, the regulation of medical care, the trend toward subspecialization, a perceived oversupply of physicians, and the growing number of mental health professionals who are not physicians. The author discusses how these developments are impinging on residency training programs and what the programs can do to meet the challenges they pose. He believes psychiatry will be best served by resisting tendencies to compromise on the quality of training for its future practitioners.