Redefining the General Psychiatrist: Values, Reforms, and Issues for Psychiatric Residency Education

The structure and content of gen-era! psychiatric residency educa-tion must be redesigned to ensure the continued relevance ofthe pro-fession of psychiatry as managed care and cost containment become more influential in the health care delivery system. The general psy-chiatrist in this new health care environment must be prepared to participate in a multidisciplinary team of health care professionals, have expertise in treating complex cases that often combine physical and psychological disorders, criti-cally examine the role of psycho-therapy, acknowledge patients as active participants in treatment, and integrate clinical and finan-cial decision making. Reformed psychiatric residency curricula should include an expanded range of training settings, preparation for a variety ofdinical roles, prac-tice in developing strategiesfor im-proved service utilization, and op-portunities to develop expertise in neuropsychopharmacology, to work with patients with serious mental illness, and to practice integration of psychotherapy with other core skills. In addition, redesigned cur-ricula should enhance residents’ Dr. Beige! is professor of psychia-try at the University of Arizon