The Accreditation Council of Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) recently mandated that training programs must demonstrate resident competence and proficiency in several forms of evidence-based psychotherapies (1, 2). In the United States, residents must attain competence in supportive, psychodynamic, and cognitive therapies, with exposure to couple, family, and group therapies (1). In Canada, residents must have proficiency (be prime therapist with ongoing supervision) in supportive, psychodynamic, cognitive, family, or group therapy; have working knowledge (be a co-therapist or observe) in behavioral, dialectical-behavioral, interpersonal, and family or group therapies; and possess introductory knowledge in brief psychodynamic, mindfulness, relaxation, and motivational interviewing (2). Psychotherapy requirements in both countries pose significant challenges for training programs, given the lack of resources to train residents in a variety of evidence-based psychotherapies and the on-going confusion over the definition of competence (3). Although the literature offers some guidance in this area (4, 5), programs continue to struggle to meet these demands.