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Medication backup in psychiatry residency programs.

M Riba1, R S Goldberg, A Tasman

  • 1Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, 06030-0001, USA.

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|January 21, 2014
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Summary
This summary is machine-generated.

Most U.S. psychiatry residency programs involve trainees in medication backup, where psychiatrists provide medications to patients in psychotherapy with non-physicians. This practice, common in later residency years, raises both utility and ethical considerations.

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Area of Science:

  • Psychiatry
  • Medical Education
  • Clinical Practice

Background:

  • Medication backup, defined as psychiatrists providing medications to patients in psychotherapy with non-physicians, is a practice within U.S. adult psychiatry residency training.
  • The prevalence and nature of this practice in residency programs were not well-documented prior to this study.

Purpose of the Study:

  • To survey directors of U.S. adult psychiatry residency training programs regarding the practice of medication backup by trainees.
  • To understand the extent, settings, training methods, and perceived utility and ethical concerns associated with medication backup in residency programs.

Main Methods:

  • A 1988 survey was distributed to all directors of U.S. adult psychiatry residency training programs (N=202).
  • 110 program directors responded, providing data on the implementation and supervision of medication backup by residents.

Main Results:

  • 85% of responding programs (94 out of 110) involved residents in medication backup, primarily during the PGY-3 and PGY-4 years.
  • Common settings included university hospital inpatient services and community mental health center outpatient clinics. Supervision was the most frequent training method (84 programs).
  • A majority of program directors (64) viewed medication backup as useful, while 48 expressed ethical concerns.

Conclusions:

  • Medication backup by psychiatry residents is a widespread practice in U.S. training programs.
  • The findings highlight the need for further investigation into the educational and ethical implications of medication backup in psychiatric residency training.