Core Competencies for Psychiatric Practice: What Clinicians Need to Know

Abstract

STEPHEN C. SCHEIBER, THOMAS A. M. KRAMER, AND SUSAN E. ADAMOWSKI (EDS.): Core Competencies for Psychiatric Practice: What Clinicians Need to Know. Washington, DC: American Psychiatric Publishing Inc., 2003, 194 pp., $29.00 paperback, ISBN 1-58562-112-9. The recent upsurge of interest in the definition and specification of core competencies in psychiatry and, generally, in medicine has left many practitioners simultaneously intrigued and bewildered. It is difficult to oppose a movement which states that it favors higher standards of training and assessment for psychiatrists, that interpersonal skills and professionalism have been underemphasized or taken for granted in medical school and psychiatric training, and that learning is a lifelong activity that must be actively maintained in order for the practitioner to continue to provide high quality care. Yet the jump from these ideals to recertification examinations, detailed and highly operationalized statements about resident performance, and adoption of an entire new vocabulary (360-degree evaluations, maintenance of certification, competency itself) has left many clinicians cold, with worries that an entire new bureaucracy is about to be foisted on already-overburdened practitioners, complete with unrealistic expectations, overly detailed requirements, and detachment from the realities of clinical practice. This new volume does much to demystify the issues surrounding the specification and assessment of competent psychiatric practice. Edited by leaders in the field of educational assessment in psychiatry, with contributions from undisputed giants in psychiatric education (e.g., Michael Ebert, Larry Faulkner, Pedro Ruiz, and Daniel Winstead), this book first walks the reader through the history of the American Board of Psychiatry and Neurology (ABPN) and its various examinations, describes the growth of the competency-assessment movement in Canada (somewhat ahead of the U.S. in this area), and traces the development of precursor initiatives from the Accreditation Council for Graduate Medical Education and American Board of Medical Specialties. The reader who pays close attention to these first four chapters will find the specific competencies whose descriptions follow much more comprehensible than the one who skips these first chapters. The heart of the book is in chapters 5-11, in which specific competencies for physicians in general and for psychiatrists in particular are detailed. These are broken into six areas: patient care, medical knowledge, interpersonal and communications skills, practice-based learning and improvement, professionalism, and systems-based practice. Additionally, there is one chapter on what psychiatrists should know about neurology. As above, in some cases there is little here with which one would disagree, e.g., the physician shall demonstrate the following abilities: A. Listen to and understand patients and attend to nonverbal communication; B. Communicate effectively with patients, using verbal, nonverbal, and written skills as appropriate; [and] C. …