All directors of U.S. adult psychiatry residency training programs (N = 202) were surveyed in 1988 about the practice of medication backup by trainees in their programs. Medication backup was defined as "the provision of medications by psychiatrists to patients receiving psychotherapy from nonphysicians." Of 110 respondents, 94 of the programs (85%) had residents providing medication backup, the majority in the PGY-3 and -4 years. The university hospital inpatient service and the community mental health center outpatient clinic were the most common sites. Supervision was the most prevalent training method (84 programs), followed by lectures and seminars (45). Sixty-four program directors viewed medication backup as a useful and important function for the psychiatrist; 48 raised ethical concerns. Results point to the need for further investigation into the practice of medication backup in residency training.Abstract Teaser