How Success Nearly Wrecked a Residency Experience

The number of residents in a second-year program increased almost threefold between 1965 and 1971. Total patient visits increased by almost 100 percent. However, the average number of monthly patient visits per resident decreased, indicating a loss of efficiency. After discussing how the clinic dealt with this problem, the author concludes that increases of this magnitude require the addition of more supervising psychiatrists, changes in administrative style, and adequate clerical assistance and space.