Academic Psychiatry

The authors report on the declining number of clinician-researchers in psychiatry and other medical specialties, and have gathered data on reasons why. Surveying senior residents, they queried on level of interest in research, as it relates to demographics, previous research experience, and social/situational factors. Residents with greater research interest had shown a longer and more consistent pattern of seeking out research niches. They also were more likely to be male and tended to have lower debt obligations. It appears that some barriers to entering a research-oriented career, such as financial considerations or social expectations, could be better addressed.

The authors have created a brief guide for psychiatry residents on how to optimize the transition to independent practice. They have reviewed available literature and have drawn from their own experiences as recent graduates and senior faculty members with experience in recruitment and training of psychiatrists. The transition to practice should involve an understanding of personal and professional options; assembling a “team” of supportive figures, such as family, peers, and mentors; and finding ways of coping with isolation and patient management.

“Standardized patients” have long been used in clinical training; they can provide a detailed “history” and can respond meaningfully to the trainees' questions. However, this approach is limited by time constraints, availability and competence of actors, and costs. An alternative is the use of the automated “virtual patient.” In addition to the advantages of scheduling flexibility and cost containment, these “avatars” can provide a more controlled setting, where trainees can be evaluated on appropriateness of questions in light of responses and their understanding of specific difficulties.