Trends in Ethnicity, Race, and Sex Among Psychiatry and Non-psychiatry Residency Applicants, 2008-2019

OBJECTIVE

The objective of this study was to examine trends in racial/ethnic and gender representation among US psychiatry residency applicants compared with non-psychiatry applicants.

METHODS

Using publicly available applicant data, racial/ethnic and gender distributions of psychiatry residency applicants from 2008 to 2019 were examined and compared with non-psychiatry residency applicants. Both longitudinal trends within both cohorts and cross-sectional, between-group differences were examined.

RESULTS

From 2008 to 2019, the percentage of female, American Indian/Alaskan Native (AIAN), Black, Hispanic, and Native Hawaiian/Other Pacific Islander (NHPI) psychiatry and non-psychiatry residency applicants increased (p<.001). Within each year, Black and Asian applicants comprised a larger percentage of psychiatry applicants compared with non-psychiatry applicants (p<.001). Between 2008 and 2019, Black psychiatry and non-psychiatry applicants increased from 9.1% to 11.6% and 6.6% to 7.6%, respectively; Asian psychiatry and non-psychiatry applicants decreased from 39.5% to 30.5% and 27.5% to 26.6%, respectively; White psychiatry and non-psychiatry applicants increased from 26.7% to 38.2% and 42.7% to 49.2%, respectively.

CONCLUSIONS

Racial/ethnic and gender characteristics of US psychiatry residency applicants represent the future of the US psychiatric workforce. The US psychiatry residency applicant pool has become increasingly diverse from 2008 to 2019. Initiatives should work to enhance representation of psychiatry applicants from historically marginalized backgrounds, and simultaneously to recruit and retain a diverse psychiatric workforce following residency training.

Recruiting Underrepresented Minority Students into Psychiatry Residency: a Virtual Diversity Initiative

OBJECTIVE

The COVID-19 pandemic has significantly hindered medical student career planning and clinical rotations. Recruitment and networking may be more influential in match outcomes than previous cycles. Medical residency training programs have significant challenges in recruiting diverse applicants. The American Psychiatric Association's Black Caucus developed a virtual recruitment event for residency programs with robust diversity initiatives and underrepresented medical students. This article evaluates our methods, short-term results, and influence on participating medical students.

METHODS

The authors sent web-based invitations to all programs subscribed to the American Association of Directors of Psychiatric Residency Training listserv. Programs that demonstrated intention and commitment to diversity, equity, and inclusion were selected. The authors used various social media platforms and the Black Caucus listserv to advertise to medical students. Student participants received an online feedback survey consisting of multiple-choice and open-ended questions.

RESULTS

Thirty-six programs and one hundred seven medical students participated in the 2-day diversity fair. Seventy-six students completed the following survey, which is a response rate of 71%. A majority of students reported that this event strongly influenced their interest in a program (71.05) and are actively considering a residency program they had not previously considered (69.74). A majority of medical students (89.47) strongly agreed that program representatives treated them with professionalism and respect.

CONCLUSION

This event improved communication between highly valued underrepresented minority students applicants and residency programs. A notable majority of participants found the program overwhelmingly beneficial.

Coaching and mentoring: an overview for trainers in psychiatry

Although mentoring has been widely accepted as a support mechanism for newly appointed consultants, there are many other applications of coaching and mentoring that are less widely appreciated, such as in the development of leadership skills or in having coaching conversations with trainees to facilitate learning. This article summarises some of the basic principles and practices of coaching and mentoring, with a focus on useful knowledge for psychiatric trainers. It describes some of the qualities and skills needed in a coach or mentor; the use of questioning techniques and models; and how the coach or mentor needs an awareness of the importance of the contract in the coaching and mentoring relationship, of the role of coaching or mentoring supervision, and of the ability to evaluate coaching or mentoring. It also discusses some of the organisational context, challenges and opportunities of embedding coaching and mentoring more deeply into the work culture. It is argued that coaching and mentoring as supportive interventions have not been prioritised in the National Health Service in the same way that they have been in the private business sector, where performance and financial success are measurably increased by these techniques.

Diversity by Race, Ethnicity, and Sex within the US Psychiatry Physician Workforce

OBJECTIVE

This study assessed the distribution of race, ethnicity, and sex within the US psychiatry physician workforce and trends from 1987 to 2016.

METHODS

The authors used physician workforce data to assess differences in race, ethnicity, and sex among psychiatric practicing physicians, faculty, fellows, residents, residency applicants, and medical graduate cohorts. Binomial tests were used for comparison between individual cohorts and to US population statistics. A simple linear regression model was used to assess trends among psychiatric residents and faculty over years 1987-2016.

RESULTS

Within psychiatry, historically underrepresented minorities in medicine (URMs) had less representation as residents (16.2%), faculty (8.7%), and practicing physicians (10.4%) compared with the US population (32.6%), Ps < 0.0001. Females were underrepresented as psychiatric practicing physicians (38.5%, P < .0001). There was greater URM representation among residents (16.2%) compared with that of Psychiatry faculty and practicing physicians (Ps < .0001). Racial/ethnic representation did not differ significantly compared with subspecialty fellows; however, the addiction subspecialty contained the least URM and female diversity. Historical trends indicated the proportion of female faculty (0.9%/yr) increased nearly 1.5 times faster than that of female trainees (0.6%/year). Conversely, the proportion of URM residents (0.26%/year) increased over 4 times faster than that of URM faculty (0.06%/year), with black faculty actually decreasing in proportion.

CONCLUSIONS

Female and URM representation within the psychiatry physician workforce is significantly lower than US population demographics; however, trends indicate diminishing underrepresentation. While psychiatry residency remains more diverse than other specialties, specific trends identify poor minority representation among psychiatry faculty and fellows as areas needing attention.

Achieving Mental Health Equity: Community Psychiatry

There are historical predicates for the inequities noted in present-day community mental health. Stigma has led to discrimination for those living with mental illness. It is more difficult for research to occur, and to access care (prevention, early identification, evidence-based treatment services) because funding is limited and workforce development curtailed. Strategies to decrease stigma are suggested, means to enhance funding are offered, and models for workforce development are noted. Different treatment delivery systems are suggested to recruit and retain sufficient numbers of culturally competent and trauma-informed providers, so as to maximize access to necessary services.

Remote Telepsychiatry Workforce: a Solution to Psychiatry's Workforce Issues

PURPOSE OF REVIEW

The purpose of this paper is to demonstrate how a remote workforce may increase access to care while reducing physician burnout. We review workforce issues and organizational and individual obstacles for implementing a telepsychiatry workforce including administrative, logistical, and clinical considerations and offer resources for how to overcome barriers that may arise in implementing a remote workforce.

RECENT FINDINGS

There is an increasingly unmet demand for mental health services and a shortage in psychiatrists. Burnout may be a key factor contributing to psychiatrists working less, pursuing less acute cases, and leading to worsened outcomes for patients and the psychiatrists themselves. Telepsychiatry provides comparable patient and provider satisfaction and equal outcomes when compared with face-to-face encounters. We provided 3 case examples to demonstrate psychiatrists demonstrating successful delivery of care in a range of clinic settings and workplace configurations while optimizing their quality of life and reducing their risk of burnout.