Psychiatry Faculty Research Articles

Trends in Individual Career Development Awards from National Institutes of Health to Physicians in Departments of Psychiatry (2013-2022).

The authors examined trends of individual career development awards from the National Institutes of Health (NIH) to psychiatry faculty, especially physicians, in comparison to other departments. Data were obtained on 33,392 career development awards from 2013 to 2022. We examined the number of awards each year averaged for 46 non-psychiatry departments, and for departments of psychiatry, the number of awards to all faculty, physicians, and physicians without a PhD. Linear regressions determined whether number of career development awards increased with time and if estimated slopes differed between faculty in non-psychiatry departments and other groups. In departments of psychiatry, 534 faculty received an NIH individual career development award during the 10-year period (534/33,392 or 1.6%), with 118 (22%) to physicians. The number of awards increased significantly over time for other departments and departments of psychiatry (estimated slopes of 3.05 and 2.38, respectively) and did not differ from one another. However, the number of awards to physicians and physicians without a PhD in departments of psychiatry (estimated slopes of 0.51 and - 0.07, respectively) have not increased. This lack of growth in awards for physicians and physicians without a PhD in departments of psychiatry differed significantly in comparison with the increase shown in awards to other departments over time (both p < 0.001). The number of NIH career development awards has increased NIH-wide, and for non-physician faculty but not for physicians in departments of psychiatry. These trends raise concerns for the future of psychiatrists in academic research.

Teaching Psychiatry Faculty to Address Unconscious Bias: Implementation of a Large-Scale Intervention.

Teaching Psychiatry Faculty to Address Unconscious Bias: Implementation of a Large-Scale Intervention.

So Why Do They Not Engage? Grounded Theory Research to Understand and Explain Why Medical Students Disengage from Undergraduate Psychiatry Education in India.

For almost 60 years, Indian psychiatry literature has called for all medical students to learn psychiatry so that millions of mentally unwell people across India might receive appropriate treatment. Yet for almost 60 years, medical students have disengaged from psychiatry education, resulting in limited learning. The literature has repeatedly cited the solution as one that involves longer exposure on posting and more exam questions, with little impact. This research sought to understand why medical students disengage from psychiatry education so that meaningful change might occur. The research utilized constructivist grounded theory, initially in one medical college in Mumbai, followed by a quantitative survey to test the findings with a wider group of interns across 10 states of India. An iterative process of data gathering and analysis was undertaken using the constant comparison method and theoretical integration. Findings identified that 98% of interns believe all MBBS (doctors) should "know" psychiatry, with "know" meaning practical skills-how to assess and treat people with mental illness. The majority of students attend psychiatry to learn those skills, but on finding faculty too overworked to teach, they disengage, saying: "there's nothing in it for me." The findings indicate that more exam questions would not increase engagement. Medical students want to learn skills to help those in mental distress. Faculty do not have time and, arguably, the training to teach them. To address the nation's mental health needs, the government needs to prioritize teaching of psychiatry skills by releasing and enabling psychiatry faculty, alongside the certification of psychiatry skills.

Evaluation of the Prevalence of Factitious Disorder and Its Demographic and Clinical Characteristics in Psychiatric Inpatients in Iran; A Cross-Sectional Study.

Diagnosing factitious disorder (FD) poses significant medical challenges; delays impact patient care and costs. Cultural factors of each country also affect illness and behavior disorders. This study examines the prevalence, demographics, and clinical features of factitious disorder patients in Iranian psychiatric hospitals. This cross-sectional study reviewed patient data from three psychiatric hospitals in Tehran from 2017 to 2022, confirming FD diagnoses by psychiatry faculty. Inclusion criteria were the diagnosis of FD according to ICD-10 in the last five years. We recorded demographic data, main stressors, symptoms and diagnoses and analyzed them with SPSS-25. Data are presented as numbers and percentages and compared between groups by chi-square test. A total of 17 cases with the diagnosis of factitious disorder were investigated in 5 years (4.315 per 10,000 patients). The highest frequency age range was between 20-30 years, and most of them were male. Our results showed that in only 7 cases, there was initial suspicion of factitious disorder or factitious disorder imposed on another (factitious disorder by proxy). Most of the patients had psychiatric comorbidities, among which the most common comorbidity was substance use disorder and cluster B personality disorder. Among the evidence of suspicion for the diagnosis of factitious disorder in 65% of cases was a history of multiple previous hospitalization and more than 40% of the cases were based on the pattern of repeated symptoms. This study showed that FD is underdiagnosed, and more attention is needed to the signs of this diagnosis in the assessments. Also, the clinical features showed that treatment should account for comorbid disorders.

Workplace experiences of LGBTQIA+ trainees, staff, and faculty in academic psychology, psychiatry, and neuroscience departments

ABSTRACT People identifying as lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, or other gender identities or sexual orientations (LGBTQIA+) often face workplace bias or discrimination. Unique dynamics in academic neuroscience, psychology, and psychiatry departments warrant specific investigation. Trainee, staff, and faculty participants (N = 534) completed an online survey assessing identity and workplace experiences. Many respondents were not out about their identity at work (46%) despite most being out personally (81%). A positive workplace climate is critical to outness, career satisfaction, and mental health. Experiences of exclusionary behaviour (24%) and depression (37%) were common. Qualitative responses called for explicit LGBTQIA+ inclusion in diversity and classroom curricula, structural and financial support for LGBTQIA+ people, and greater support for individuals of colour and/or identifying as trans. Respondents expressed a pervasive sentiment that academic institutions should avoid putting undue, unpaid burden of diversity work on minoritized individuals and should aim to promote meaningful structural change rather than creating the appearance of inclusivity.

Investigating Physician Training, Knowledge, and Response to Human Trafficking at an Academic Medical Center in Texas

ABSTRACT Health-care settings are critical for identifying and assisting persons who have experienced human trafficking. Studies estimate that victims have been cared for at multiple clinical sites, but the majority of victimization remains undetected due to lack of awareness, training, and time. This study examined physician human-trafficking knowledge, training, usual practice regarding response, and education modality preferences at an academic medical center. A 24-item survey was distributed to residents and faculty in family medicine, emergency medicine, psychiatry, pediatrics, oral and maxillofacial surgery, and orthopedics. Univariate and bivariate analysis were used to measure associations, demographics, and training across human trafficking (HT) knowledge, training, and usual practice. Respondents were largely identified as female (71%) and trainees (68%). Most respondents specialized in family medicine (32%), pediatrics (30%), or emergency medicine (19%). Overall, 85% of participants agreed that recognizing HT is a physician’s responsibility, however only 31% felt comfortable discussing HT with patients. Knowledge of HT was generally higher among attendings compared to residents (p-value = .04). More than half of participants (60%) reported never receiving HT or trauma-informed care training, but most reported that standard training should include HT (86% agree or strongly agree). Sixty-four percent of clinicians reported a preference of training administered through webinars or during didactic sessions. Physicians across various training levels agree that recognizing HT is a key responsibility. Standard medical training should incorporate HT and trauma-informed care and address knowledge gaps in order to equip clinicians to better detect, treat, and refer victims for the care they need. This study supports progress toward the UN Sustainable Development Goal 16 promoting just, peaceful and inclusive societies.

The World Psychiatry Exchange Program in Iran: a unique academic and personal experience.

The World Psychiatry Exchange Program in Iran is an academic experience we are delighted to share. As two participating early career psychiatrists, a local psychiatry faculty member manager, and the lead founder and international coordinator of the programme, we focus in this article on the unfolding of this new learning experience, the difficulties we encountered and the main lessons learned by the participants: commonalities and differences in training and practice in general adult psychiatry and child psychiatry in Tunisia and Iran, as well as in idioms of distress between the Arab and Persian cultures.

A Qualitative Investigation of Burnout and Well-being Among Faculty and Residents in a Canadian Psychiatry Department.

This study used semi-structured interviews with faculty and residents in psychiatry to inform a qualitative, process-based understanding of well-being and related concepts, as well as to identify and critically explore strategies for maintaining well-being in psychiatry. Using interpretive description as a qualitative research methodology, semi-structured phone interviews were conducted with 12 faculty (nine clinical and three non-clinical) and five residents in a Canadian psychiatry department between September and December 2019, prior to the onset of the COVID-19 pandemic. Interviews were transcribed, coded, and subsequently analyzed for themes by the research team. Fourteen women and three men completed the study, consisting of nine faculty members, five psychiatry residents, and three non-clinical PhD scientists. Four themes were developed from the interview data: (1) The nature of working in academic psychiatry, (2) professional identity as a double-edged sword, (3) feelings of isolation and powerlessness in the system, and (4) strategies to support well-being. In the absence of many qualitative perspectives on well-being in academic psychiatry, the findings of this study can be used as a first step to inform future interventions and meaningful institutional change around well-being in psychiatry. The findings may help to enable conversations about well-being that embrace humanity and vulnerability as essential components of professional identity in psychiatry and provide opportunities for open discussion and support.

Piloting online training in the Pacific-Ophelia project for child and adolescent mental health.

In June 2020, St Vincent's Mental Health, Fiji National University, and the Royal Australian and New Zealand College of Psychiatrists, Faculty of Child and Adolescent Psychiatry collaborated to deliver online, specialized child and adolescent mental health (CAMH) training to Pacific-based healthcare workers. This accompanying research aimed to understand the telehealth model and structures that would sustain an engaged community of practice and support the development of professional networks across the Pacific. Quantitative and qualitative feedback was analyzed to understand participation and self-rated measures of skills, knowledge, and confidence in providing health care for children and young people, as well as experiences of training, including access, engagement, and applicability of the initiative to the Pacific Islands health care organizations. Ophelia Training was able to meet the stated learning objectives. The data from all stakeholders identifies the value of a telehealth initiative incorporating training, technical assistance, knowledge networks, and professional coaching as a capacity building approach. This program offers an integration of research and practice. This regional approach to understanding telehealth capacity for Pacific Island mental health services is valuable for informing decision-making with respect to clinical care, management, workforce training and policy. It also provided an opportunity to improve health inequalities, by improving access to CAMH training via telehealth.

Moving Forward

In a recent child psychiatry faculty development discussion, I reflected with my colleagues on the new generation of emerging doctors. One colleague noted that these individuals were going to change medicine as we know it. The change, we all discussed, was in relation to the entire structure and practice of medicine, especially around social justice and health equity. Gone will be the days of steeped hierarchies and “pimping” rounds, of being bystanders to injustice, of disconnecting from systemic change. Remember that shocking and revealing book, The House of God, published in 1978? (Full disclosure, I couldn’t stomach more than a chapter when I tried to read it in medical school.) Dehumanizing practice, tradition, and structure must become a thing of the past.

Teaching psychiatry in a low-income country during the COVID-19 pandemic: A hybrid collaborative psychiatry course.

Amoud University in Borama is located in the self-declared state of Somaliland, in the Horn of Africa. Past conflicts and resulting economic hardship have led to a lack of local academic psychiatry faculty and resources. Amoud has been for some years partnering with voluntary faculty in the United Kingdom to teach psychiatry to its medical students through in-person "teaching missions." This was recently led by a Borama-native psychiatry resident in Ethiopia. COVID-19 added further hardships due to restrictions to travel and in-person gatherings. These challenges also created the opportunity for the development of an innovative, international, hybrid (online onsite), self-sustaining partnership model which has been successful in improving psychiatry teaching for undergraduate students in 2020-2021 and will continue in 2021-2022. An international, 'online-connected' department of psychiatry comprising a primary care physician in Somaliland, three postgraduate trainees in Ethiopia and the United States, and three senior psychiatrists in the United Kingdom developed a local faculty-led, hybrid-delivered, dynamic curriculum (bedside teaching, in person and online lecturing) that adapted to the needs, resources, faith and culture of Somaliland. While 2020-2021 has been the pilot year for the program, the overall experience has been enriching for students and faculty, leading to valuable cross-cultural conversations with impact on teaching and research. While learning about Somalilanders' and trauma, the program leads, also the authors of this article, have identified ways to harness the resilience and faith of students to bring about improvements in global mental health.

45.5 Physician Burnout and the COVID-19 Pandemic: The Silent Epidemic

Physician burnout is a widespread issue that affects both the quality of life of physicians as well as their mental health. A 2021 Medscape study showed that the average physician burnout, across specialties, is 42%, which is the same as in 2020. However, burnout in psychiatrists nationwide increased from 35% in 2020 to 41% in 2021. While there are many hypotheses about the reason for this increase, the most obvious one seems to be the COVID-19 pandemic. Commonly cited reasons for burnout among all physicians include too many bureaucratic tasks (58%), spending too many hours at work (37%), and lack of respect from administrators or colleagues (37%). We administered the Physician Well-Being Index (PWBI) to physicians and trainees at a large academic medical center in the Southeast to assess burnout levels. The PWBI is a validated index that consists of 7 yes/no questions and 2 questions that have a 7-point Likert scale. Data were compared for the period of March 1, 2019 to March 1, 2020 and from March 1, 2020 to January 31, 2021. Among all faculty physicians, there was an increase of the mean score from 1.48 (193 respondents) to 1.49 (225 respondents), a 0.29% increase. Only 6 psychiatry faculty responded to the survey, and among them, the mean score increased from 2.17 to 3.17. This is a 19.34% increase, but the results are preliminary given the small sample size. For trainees in both the organization as a whole and in the psychiatry program, there was a decrease in the mean score. For all trainees, the mean score decreased from 2.70 (145 respondents) to 2.64 (80 respondents). This is a decrease of 2.27%. For psychiatry trainees, the score decreased from 3.79 (19 respondents) to 3.11 (9 respondents). Overall, there was an increase in burnout reported in both all faculty physicians as well as psychiatry faculty, but a decrease in burnout among trainees. The question arises about the well-being of nonrespondents, and if they were in fact too burned out to bother filling out the survey. One possible theory about the decreased burnout among trainees is that the average age of trainees is younger, and they may have felt more ease with the technology used to provide telehealth services during the pandemic. Additionally, trainees teleworked from home, and this has several benefits that could reduce burnout, such as eliminating commute times and having more family time.

31.6 Burnout and Depression Among Residents and Faculty in a Single Academic Medical Institution: A Pilot Study

Burnout is defined as a long-term, unresolvable job stress leading to feelings of exhaustion, overwhelm, cynicism, detachment from job, and a lack of sense of personal accomplishment. Medscape Physician Burnout surveys have shown that over 40% of physicians report burnout. There is a scarcity of studies that investigated the association between physician burnout and depression. Our study aimed to investigate this association and to compare this association's changes by groups of interest. The Maslach Burnout Inventory (MBI) and Quick Inventory of Depressive Symptomatology–Self Report (QIDS-SR) were used to assess burnout (N = 168) and depression (N = 167) among faculty and trainees (residents and fellows) in Psychiatry and Pediatrics at a large academic medical institution in the Southeast. The 3 subscale scores of MBI (emotional exhaustion [EE], depersonalization [DP], and personal accomplishment [PA]) and QIDS-SR scores were analyzed between trainees vs faculty, race, gender, and specialty. χ2 and Fischer’s exact tests were used to determine statistical significance of categorical association. Approximately 28% of faculty and trainees had high EE, and trainees reported nearly twice as much moderate EE than faculty (18.75% vs 39.29%). Trainees had high DP compared to faculty (41.07% vs 12.5%), and more psychiatrists reported high DP than pediatricians (35.81% vs 12.87). Notably, African American physicians reported a higher rate of depression than White physicians and physicians of other races (14.29% vs 11.11% and 11.9%, respectively) with no difference in depression rates between faculty and residents, by specialty, or by gender. Eleven percent of trainees and 14% of faculty reported clinically significant depression. There was significant correlation between burnout and depression (p < 0.0001). Physicians in training were twice as likely to experience burnout. High burnout is a predictor of clinically significant depression. Although this is a pilot study with only 2 specialties, the rate of depression is found to be higher (11%-14%) than the general population (7.1%). Creating a better understanding of the interrelationships among these measures can increase awareness among the physician community, which may help identify burnout early, seek help, and prevent serious downstream effects such as anxiety, depression, and suicide.

Innovative psychiatry medical education initiative: empowering and supervising trainees for future teaching in psychiatry training program establishment in Somaliland

AimsSomaliland is a de facto state in the horn of Africa. It unilaterally declared independence from rest of Somalia in 1991. Medical education in Somaliland started in the year 2000.Aim of the study is to explore the feasibility of teaching program for the country by its future potential psychiatry educators. The initiative started in 2019 to seek trainees with interest in academic psychiatry and support them with medical education skills. This is intended to prepare them for leading future teaching roles in both undergraduate and residency/fellowship in psychiatryAmoud University wanted to empower junior doctors at the university to have teaching skills needed to set up residency program. The Somaliland government asked Ethiopian ministry of health to offer psychiatry residency program for general practitioners in Somaliland to have future residency and fellowship in psychiatry. Several psychiatry trainees worked with the visiting professor from the United Kingdom who joined Somaliland medical school as visiting professor in psychiatryMethodThe visiting professor supported the trainee in setting up a psychiatry undergraduate training curriculum in line with Somaliland medical school curriculum. Before the teaching methods were didactic and role play based. The faculty introduced different teaching methods including flipchart, small/large group teaching which was student centered education. Students received a online survey to reflect on psychiatry teaching they received. post course survey was conducted at the end of the teaching to evaluate the teaching initiative.ResultSurvey revealed interesting pattern that students preferred class room based teaching in comparison to online teaching. 90 percent of the attendees showed interest in flipchart teaching compared to didactic model. They expressed increasing understanding of the subject matter when they read and discuss among themselves instead of lectures. 70% of students prefer more clinical teaching compared to online sessions.52% liked the new teaching module compared to the lecturing sytle.ConclusionSupervision of early career psychiatrists to undertake future academic psychiatry roles is an important step in building psychiatry faculty in medical schools. As the case of Somaliland this retains trainees in teaching roles in the future to teach undergraduates mental health courses. The other benefit is empowering them to set up psychiatry training program to close the service delivery gap with skilled psychiatrists in the future. Somaliland plans to set up its psychiatry residency/fellowship programs soon after this initiative.

Predictors for Matriculation into Geriatric Psychiatry Fellowship: Data from a 2019-2020 National Survey of U.S. Program Directors.

ObjectiveWith the number of geriatric psychiatry fellows declining from a peak of 106 during 2002–2003 to 48 during 2020–2021, this study aims to investigate characteristics of the geriatric psychiatry training requirement across U.S. psychiatry residency programs and to identify specific factors which may influence residents to pursue geriatric psychiatry subspecialty training.MethodsThe authors queried the American Medical Association’s Fellowship and Residency Electronic Interactive Database Access system to compile a list of program directors from the Accreditation Council for Graduate Medical Education sponsored general adult psychiatry residency programs. Program directors were emailed an anonymous multiple-choice survey to ascertain specific characteristics of their program’s geriatric psychiatry training experiences. This study’s primary outcome was the percentage of residents entering geriatric psychiatry fellowship after completion of general psychiatry training. Linear regression analysis determined which variables may be associated with this primary outcome.ResultsOf 248 surveyed, 60 programs (24%) responded to the survey. Only one of the independent variables revealed a statistically significant association with the percent of residents that became geriatric psychiatry fellows: the number of geriatric psychiatrists at the residents’ home institution (p=0.002).ConclusionsConsistent with previous data, the presence of geriatric psychiatry faculty members is strongly associated with the decision to pursue subspecialty training in geriatric psychiatry.

202 - PSYCHOSOCIAL INTERVENTIONS FOR PEOPLE WITH DEMENTIA AS STRATEGIES TO MANAGE BEHAVIOURAL AND PSYCHOLOGICAL SYMPTOMS [supported by European Association of Geriatric Psychiatry – EAGP

Symposium ChairsLia Fernandes (Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal) lfernandes@med.up.ptSujoy Mukherjee (Faculty of Old Age Psychiatry, The Royal College of Psychiatrists, United Kingdom) Sujoy.Mukherjee@westlondon.nhs.ukIntroduction Lia FernandesSymposium OverviewPresentation 1 Sujoy MukherjeeThe treatment of Behavioural and Psychological Symptoms of Dementia: where do we stand?Presentation 2 Ana Rita FerreiraAssessing unmet needs in nursing homes: a promising way to prevent neuropsychiatric symptomsPresentation 3 Slavisa LamounierThe Arts as a medium for improving social inclusion in dementiaPresentation 4 Lídia SousaMusic-based interventions in the acute setting for patients with dementia

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

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

Dynamic Trainee Support for Residents Involved in COVID-19 Treatment and Response.

Dynamic Trainee Support for Residents Involved in COVID-19 Treatment and Response.

APA Achievement Award Winners Meet Contemporary Challenges With Innovation

Back to table of contents Previous article Next article APA & MeetingsFull AccessAPA Achievement Award Winners Meet Contemporary Challenges With InnovationMark MoranMark MoranSearch for more papers by this authorPublished Online:13 Apr 2020https://doi.org/10.1176/appi.pn.2020.4b22AbstractThis year’s winners use collaboration and community engagement to extend psychiatric expertise to distressed populations and rural hospitals facing a shortage of mental health manpower.APA’s 2020 Achievement Award winners include innovative community and academic-based services focusing on veterans’ health and mental health, support for victims of sex trafficking, and psychiatric support of primary care practices given the shortage of mental health professionals.Since 1949, the Psychiatric Services Achievement Awards have recognized creative models of service delivery and innovative programs for people with mental illness or disabilities. Each year, APA bestows a Gold, a Silver, and a Bronze Award. Following are this year’s winners:Lt. Col. (Ret.) Army Medical Service Corps Michael Richardson, vice president for mental health and brain health programs of the Wounded Warrior Project’s Warrior Care NetworkMollie Gordon, M.D., medical director of the Baylor College of Medicine Anti-Human Trafficking ProgramZsuzsa Szombathyne Meszaros, M.D., Ph.D., director of the residency training program in the Department of Psychiatry and Behavioral Science at SUNY Upstate Medical CenterGold Award: Warrior Care Network. The Warrior Care Network, based in Jacksonville, Fla., is a collaboration of the Wounded Warrior Project and four academic medical centers throughout the United States: Emory Healthcare, Massachusetts General Hospital, Rush University Medical Center, and UCLA Health. The program operates in cooperation with the Department of Veterans Affairs to enhance access to clinical and family-centered treatment for veterans experiencing posttraumatic stress disorder, traumatic brain injury, and related conditions. Care is offered through standard outpatient treatment and an innovative intensive outpatient program.Silver Award: Baylor College of Medicine Anti-Human Trafficking Program. In this collaboration with the Houston Mayor’s Office and the Office of the Governor of Texas, Baylor Department of Psychiatry faculty members supervise two psychology postdoctoral fellows and a clinical social worker/case manager to address the problems related to human trafficking through a medical and public health lens. Through the program, health care professionals and community providers are trained in the identification and treatment of victims of human trafficking. By maintaining a working relationship with community-based case managers, the program enables victims to be referred for mental health treatment. An interdisciplinary approach enables the appropriate response to patients’ individual needs and provides a better chance for recovery and healing from this trauma.Bronze Award: SUNY Upstate Medical University. SUNY Upstate Medical University is located in a rural area where there is a serious shortage of psychiatrists. To help mitigate this problem, the school’s residency program has partnered with rural hospitals to support additional residency positions that will provide community care. The hospitals contract with the school with the understanding that the residents assigned to them, besides receiving standard residency training, will spend two months of the first two years of residency and one day a week during the second two years at a rural hospital site. The residents are committed to spending the five years after residency at the rural site. The first graduate has now started full-time work, and 12 residents are providing care to rural communities where people in need would otherwise have great difficulty accessing psychiatric care. ■ ISSUES NewArchived

US Psychiatry Faculty: Academic Rank, Gender and Racial Profile.

The gender and racial underrepresentation persist in academic psychiatry faculty appointments. Our study investigated the gender and racial distribution and its temporal trends in academic psychiatry faculty positions across the USA over a 12-year period. Using the annual reports of the Association of American Medical Colleges (AAMC), a retrospective cross-sectional study was conducted. Simple descriptive statistics analyzed the time trends and the distribution of gender and race across academic ranks, tenure, and degree types. Over the 12-year study period, the White race was the most represented at each rank. In the lower academic ranks, there was an increased representation of Asians, while the minority race/ethnicities experienced minimal increment. Similarly, males were overrepresented at higher academic ranks, with females increasing in proportion at lower academic ranks. Females and minorities remain underrepresented in academic psychiatry faculty positions, especially among senior academic and leadership positions. Differences in tenure tracks and degree types may contribute to the overrepresentation of White and male academic physicians.