With the emergence of physician-manager (PM) curricula in medical education, more effective assessment tools are needed to evaluate psychiatry trainees in this role. The aim of this study was to determine psychiatry residents', program directors', and PM educators' perceptions about PM role-assessment.
Psychiatry residents at two Canadian programs were given a survey on PM assessment and the use of portfolios to assess PM competency. Qualitative interviews of Canadian psychiatry educators and program directors were used to determine faculty perceptions on PM assessment. Authors analyzed survey data with descriptive statistics, and qualitative interviews were analyzed using a grounded theory approach.
Nearly 55% of psychiatry residents responded to the survey; 47% of residents did not want to change the way they were assessed by the PM role. Residents identified an array of assessment methods for each of the specific PM domains. Educator interview themes included supervisor and resident barriers to assessment, the need for new PM assessment approaches integrating multiple assessment methods, and a role for the use of portfolios if sufficient infrastructure was available.
The data supported a preference for a multimodal approach to assessment of the PM role. Future research should examine the implementation of the proposed PM assessment tool.
To identify the determinants of practice location and of outreach consultation of recently graduated psychiatrists.
We surveyed 153 psychiatrists who graduated from the University of Toronto Department of Psychiatry between January 1990 and June 2002 (response rate 51%), on the basis of a self-administered mail questionnaire. The survey assessed factors that influenced practice location and outreach consultation, such as demographics, links to practice communities, and outreach experiences, including rural or northern electives as a resident.
Professional variables were rated as the most important factors in choosing a practice location. Variables such as age or sex were not significantly associated with location. Nine percent reported working in communities of less than 100,000, and only 1% practised in Northern Ontario. Eighteen percent practised in the same location where they were born or raised. Forty-four percent had rural or northern experience as a resident but almost exclusively in the form of short, fly-in consultation electives. Twenty-four percent indicated that they provide outreach consultation. Psychiatry residents who participated in outreach electives were 10 times as likely as those who did not participate to continue outreach as a consultant.
Although early exposure to rural or northern medicine leads to significantly greater continued involvement in outreach activities after graduation, our findings suggest the need for more long-term, on-site residency training opportunities in rural and remote areas.
The authors sought to determine the learning needs, experiences, and attitudes of psychiatric residents in relation to war and mental health; to discover if residents in their training program have had clinical experiences with patients affected by war and if they believed that they were adequately trained to deal with these encounters; and to explore if residents believe psychiatrists should play a role in the lives of those affected by war and, if so, what types of roles they believe psychiatrists should take.
The authors developed a survey to assess resident attitudes toward psychiatrists' roles in relation to war and related clinical experiences and learning needs. The survey was administered to psychiatric residents at the largest psychiatric residency program in Canada.
The majority of the 52 respondents believed that psychiatrists have a role in mitigating the effects of war. Although 75% of residents (n=38) had encountered a patient who was traumatized by war, none reported feeling completely prepared. Approximately 90% of residents (n=44) reported that they would like to learn more about this area.
In a Canadian residency program that does not provide clinical rotations in a military hospital, most psychiatric residents surveyed were interested in the effects of war on mental health and would like more clinical training in this area.