The effects of sequence of clinical experience during psychiatry residency

This article provides a preliminary report on the educational impact of scheduling inpatient rotations either before or after an out patient year. The inpatient psychiatry evaluations of a group of PGY-3 residents who had their inpatient training rotation after a psychodynamically focused outpatient PGY-2 were compared with those of a group of PGY-2 residents who had their initial psychiatry training at the same inpatient service with the same supervisors during the same academic year. The PGY-3 residents had more difficulty in acquiring inpatient diagnostic skills, in understanding the range of inpatient psychopathology, in understanding the range of therapeutic interactions, and in development of professional psychiatric identity than PGY-2 residents on the same rotation. The implications of these preliminary findings for educational planning and future research are discussed.