Innovative Funding Resources for Residency Training Programs.

Abstract

To the Editor: The challenge of having an insufficient number of mental health care providers in the United States persists. Although psychiatric residency training spots have expanded, we have not been able to supply a sufficient number of psychiatrists to many parts of the country. One way forward is for more communities in need of psychiatrists to develop GME programs. At least 5 states do not have any psychiatric residency training programs.1 A quick review of the largest 100 cities in the United States reveals 27% do not have a psychiatric residency program and 7% do not have any Accreditation Council for Graduate Medical Education (ACGME) accredited programs at all.1,2 The Institute of Medicine’s Committee on the Governance and Financing Graduate Medical Education report3 in 2014 suggested a focus on reorganization through innovative approaches to health care delivery instead of relying on increased governmental funding. We represent 2 relatively new programs that are the product of such inventive approaches to funding GME. The LSU-Our Lady of the Lake psychiatry residency was developed as part of a larger agreement between the state of Louisiana, LSU Health Sciences Center and Our Lady of the Lake Regional Medical Center with funding primarily from the state. The Carolinas Medical Center psychiatry program was established with a substantial gift from a local philanthropist and will be maintained through GME funding sources. Though there are always obstacles to overcome in any new project, both programs have offered numerous benefits for our trainees and our communities. Our programs have the benefit of an excitement and energy often lacking at more established programs and have resulted in a welcoming and positive culture. Without long-standing traditions to be honored, innovative approaches to meeting ACGME requirements can be considered, and our residents feel empowered to engage in improving these programs. From a clinical perspective, we are providing expanded mental health services to our communities and hopefully, recruiting psychiatrists who will consider practicing in these same communities. We propose that the Association of American Medical Colleges, in conjunction with the ACGME, consider an outreach project geared toward communities without medical and/or psychiatric residency education. Experts in the development of GME could collaborate with experts on local needs and resources to explore program development. The ultimate goal of this collaboration would be to decrease the residency bottleneck and increase access to health care in our country for psychiatrists, as well as other medical specialties. Krystle Graham, DOPsychiatry residency program director, Sandra and Leon Residency Program, Atrium Health Department of Psychiatry, Charlotte, North Carolina; [email protected]Kathleen A. Crapanzano, MD, MACMAssociate professor of clinical psychiatry, Department of Psychiatry, Louisiana State University Health Sciences Center, and program director, LSU-Our Lady of the Lake Psychiatry Residency program, Baton Rouge, Louisiana; [email protected]; ORCID: https://orcid.org/0000-0002-6182-4973.