Due to the amount of publications in basic science and clinical care, it is hard for psychiatric residents to keep up-to-date with literature (1). Journal clubs are becoming a popular strategy to overcome this problem (2). In the United Kingdom and Ireland, 97% of all tutors involved in psychiatry training stated that their academic programs included a journal club (3).

A journal club can be defined as a group of people who meet periodically to discuss papers. A variety of reviews have analyzed the educational objectives and the most appropriate methodology for the efficient operation of a journal club. The objectives are to stimulate residents to keep up with recent literature, to practice evidence-based medicine, to demonstrate continuing medical education abilities, to learn critical appraisal skills, and to promote social contact. The methodology includes compulsory attendance, application of the basic principles of adult learning, an experienced moderator, and a regular venue. Sharing food is also recommended (4).

According to a MEDLINE search we carried out in December 2007 using the terms “psychiatry” [MeSH] AND “journal club,” only a few published papers are devoted to journal clubs in psychiatry training (3–5), and none of them explore the preferences of the residents involved. This lack of information can affect optimal postgraduate program planning.

In this article we describe the main article characteristics preferred by our residents as well as the structure of our journal club, the papers presented over the past 3 years, and the general satisfaction of the residents. Our aim is to give ideas to residency directors for implementing a journal club in a postgraduate psychiatry program.

Our psychiatry postgraduate program lasts 3 years, with three residents in each year. After the exclusion of one resident who had left the program and another resident who is also an author (RF), only seven residents were eligible to participate in the study.

The residents in our postgraduate program participate in a journal club moderated by the director of the program. The meetings take place weekly in cycles of 9 weeks. First- and second-year residents can propose two articles from Archives of General Psychiatry, American Journal of Psychiatry, or British Journal of Psychiatry, and third-year residents can propose two articles from any journal. At the first meeting, eight papers are selected by vote. In a 1-hour weekly meeting with compulsory attendance, one resident must present the selected article to the audience. The meetings begin with a quiz on the article, and then a resident is randomly selected to comment on the article’s strengths and weaknesses and impact on patient care. After this introduction, the resident in charge of the presentation gives a slide show with the key issues of the paper, a critical appraisal of the methodology, and its main findings. Breakfast is provided to the participants.

The general satisfaction was evaluated on a scale of 1 to 7 (1=least satisfactory, 7=most satisfactory). Open suggestions were encouraged.

To find out residents’ preferences when selecting a paper, we distributed a multiple-choice questionnaire that included four questions regarding preferred subject (mood disorders, psychotic disorders, anxiety disorders, etc.), scope (neurosciences, biological therapies, psychology, psychotherapies, or psychiatric epidemiology), type of paper (reviews and meta-analyses, randomized-controlled trials, observational studies, or clinical guidelines), and reason for selection (methodological quality, clinical applicability, personal interest, or novelty). Residents had to choose only one option according to their preference.

All articles discussed in journal clubs between 2002 and 2005 were reviewed and classified according to main subject, scope, and type.

One hundred thirty-one articles were reviewed, and seven residents were surveyed. The general satisfaction average score was 6.3 (SD=0.35). The most frequent suggestion was to give more flexibility in the selection of journals and articles. Results obtained from the residents’ surveys and articles review are detailed in Table 1 and Table 2, respectively.

To our knowledge, this is the first paper that explores psychiatric residents’ preferences for a journal club in a postgraduate psychiatry program.

Mood disorders was the most frequent subject chosen in both residents’ surveys and articles reviewed. This may be related to the high prevalence of mood disorders; in Chile the lifetime prevalence of major depressive episodes in the general population is 9.2% (6). The second most popular subject was psychotic disorders, probably because schizophrenia is one of the most challenging disorders in psychiatry from a historical and psychopathological point of view. The low preference for articles related to personality disorders and psychotherapy is remarkable and might reflect residents′ preference for issues related to neuroscience and pharmacotherapy, but might also relate to difficulties for the discussion of more humanistic subjects in the current journal club format. Participants of Taylor and Warner’s (3) survey complained about the lack of flexibility in evidence-based journal clubs, which excluded from discussion psychodynamic issues. This fact has to be addressed, considering that psychotherapy is an important part of general psychiatry training.

Residents also preferred meta-analyses and randomized controlled trials, which may reflect a growing interest in evidence-based psychiatry, although this trend is debatable (7). It is remarkable that although residents did not prefer observational studies, they selected them most frequently (almost 50%). We do not have any documented hypothesis to explain this yet.

The great interest in articles with biological approaches matches the strong development of biology in psychiatry. In a recent survey of 77 directors of psychiatry training programs (1), 86% of directors reported that they had increased their neuroscience curriculum and expected to increase it further. The high interest in clinically useful articles highlights the clinical emphasis of our program.

This study has important limitations. The number of residents surveyed was small, and the study was conducted in only one postgraduate program, so any generalization of the results must be taken with caution. If we want to come to general conclusions, it is necessary to include larger programs from different countries. Furthermore, we only surveyed preferences about journal type. We did not address resident preferences related to the structure of the journal club or how junior residents felt about the limitation of journals available to them. We only had one global measure of resident satisfaction, so we could not know what factors explain the high satisfaction obtained in this survey. These limitations could be addressed in a follow-up study.

At the time of submission, the authors declared no competing interests.