Preparation for practice: child and adolescent psychiatry graduates' assessment of training experiences

To assess the perceived effectiveness of child and adolescent psychiatry residency training in preparing recent graduates for practice in diverse work settings.

Analysis of survey data of 392/797 (49.2%) of all U.S. child and adolescent psychiatrists graduating from training in 1996-1998 and on the mailing list of the American Academy of Child and Adolescent Psychiatry.

Overall, respondents reported high-quality training. They felt least prepared by training for their present practice in the areas of administration and leadership skills, medical economics and business skills, complex psychopharmacology, treatment of children with complicated developmental disabilities, and cognitive-behavioral therapy. They felt overtrained in consultation-liaison to pediatrics and inpatient work. Clinical experiences, supervisors/mentors and a well-rounded program were cited as most crucial to training. Suggestions for improvement included more "real-world" administration and leadership exposure, enhanced supervision, and improved didactics. Most felt training prepared them for their specialty board examinations.

Recruitment and training of highly skilled child and adolescent psychiatrists is a national priority. The present database assessment of efficacy in preparing graduates for diverse career practices may inform training programs and policy. An enhanced training curriculum in leadership and administrative skills and medical economics is recommended.