The psychiatrist of the future


As a psychiatry resident in the early 1980s, Carol A. Bernstein, MD, remembers a teaching setting where young physicians worked long hours, male residents outnumbered female residents, and messages were delivered in the form of handwritten notes.

Dr. Carol A. Bernstein, New York University

Dr. Carol A. Bernstein

Today, the learning environment for psychiatry residents is vastly different. Duty-hour restrictions are routine, the gender gap has narrowed, and electronic communication in its many forms, is the norm. Medical advancements give residents a greater ability to treat patients and improve illnesses, said Dr. Bernstein, a clinical psychiatry professor and vice chair for education in psychiatry at New York University. However, residents also face a range of modern challenges, such as higher learning expectations, a more litigious culture, and a practice landscape increasingly reliant on ratings and patient satisfaction scores.

“This is a generation – whether you want to call it the Millennials or the iGen – [who have] been pushed to do more and more,” said Dr. Bernstein, a past president of the American Psychiatric Association. “Medical care has become very complicated, and it is very hard for trainees to get mastery of it.”

At the same time, the digital world that today’s residents are accustomed to has become a double-edged sword in medical education, said Donna M. Sudak, MD, outgoing president of the American Association of Directors of Psychiatric Residency Training. Technology has generated new ways of learning, such as online modules, but also created opportunities for distraction, she said.

Dr. Donna M. Sudak, Drexel University, Philadelphia

Dr. Donna M. Sudak

“All of us, our learners as well as ourselves, need to figure out the best balance of using technology in order to facilitate learning,” Dr. Sudak said. “The pro is having the world at your fingertips and the ability to work with other people across the country. The con is the temptation to be attached to your screen, rather than truly listening to the person you’re in the room with – as a psychiatrist, that’s even more critical.”

The new faces of psychiatry

Interest in psychiatry has grown steadily over the years. In 2018, 2,739 medical school graduates ranked for a PGY-1 psychiatry residency, up from 1,806 ranked applicants in 2008, according to data from the National Residency Matching Program. Of the 2018 ranked applicants, 1,540 matched to a residency program. Data from the Association of American Medical Colleges (AAMC) show that 47% of psychiatry residency applicants in 2018 were women.

Millennial graduates are choosing psychiatry for a variety of reasons. For Nina Vasan, MD, MBA, the career path meant an opportunity to make a broader impact.

Dr. Nina Vasan, Stanford (Calif.) University

Dr. Nina Vasan

“Mental health is a defining social issue of our time, and in medical school I felt like if I committed my time and energy to improving mental health, I would maximize the impact I make on the world,” said Dr. Vasan, who finished residency at Stanford (Calif.) University in 2018. “I feel even stronger about that today. … I felt drawn to both the fundamental way in which we get to connect with our patients on an individual level and impact their lives, as well as the broader societal-level change that must happen in the coming years that I want to be a part of.”


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