Collaborating With Service Users to Select Psychiatry Residents Committed to Health Equity and Social Justice

Area of Science:

• Medical Education
• Psychiatry
• Health Equity

Background:

• Academic psychiatry has a history of marginalizing individuals with mental health conditions.
• Medical education is beginning to incorporate concepts like structural competency and cultural safety.
• Equitable health service delivery requires careful consideration of medical workforce diversity and values.

Purpose of the Study:

• To describe the implementation of a revised resident selection process in general adult psychiatry.
• To involve individuals with lived experience of mental health and/or substance use issues (service users) in resident selection.
• To foster commitment to health equity and social justice among incoming psychiatry residents.

Main Methods:

• A collaboration between service users and faculty at the University of Toronto (2016-2021).
• Iterative refinement of the selection process by a working group, co-led by service users since 2019.
• Revision of personal letter and interview day writing prompts and assessment rubrics to focus on social justice and advocacy.
• Direct participation of service users in reviewing candidate applications alongside faculty and residents.

Main Results:

• The revised selection process successfully integrated service user perspectives.
• Writing prompts and rubrics were redesigned to emphasize health equity and social justice.
• Service users actively participated in evaluating candidates, demonstrating meaningful engagement.

Conclusions:

• Meaningful service user engagement can effectively reshape medical education selection processes.
• Prioritizing service user needs requires long-term institutional commitment and power sharing.
• Strengthening service user involvement is crucial for advancing health equity in psychiatry.