Reproductive Psychiatry Training in Psychiatry Residencies: A 10-Year National Update on Persistent Barriers and...

Reproductive transitions can substantially influence the onset and course of psychiatric illness. Despite growing demand for reproductive and perinatal mental health services, reproductive psychiatry lacks standardized residency training requirements. A 2018 national survey identified substantial gaps in reproductive psychiatry education within US psychiatry residencies. We conducted a follow-up national survey to evaluate reproductive psychiatry training and identify barriers for expansion.

We conducted a cross-sectional survey of 315 US general psychiatry residency program directors between January and March 2025 using the American Medical Association FREIDA database. The 30-item survey assessed program characteristics, didactic and clinical training opportunities, specialization pathways, anticipated changes, and perceived barriers to expanding reproductive psychiatry education. Descriptive statistics summarized responses.

Thirty-five programs responded (11% response rate). Most programs offered didactic education (88%) and clinical exposure (79%) in reproductive psychiatry, though the scope and structure varied widely. Didactics most commonly addressed perinatal mood, anxiety, and psychotic disorders, while menstrual-related disorders, perimenopause, reproductive loss, LGBTQ+ reproductive health, and sexual health were less consistently covered. Outpatient reproductive psychiatry clinics were the most common clinical setting. Twenty-six percent of programs reported a dedicated track, pathway, or certificate, and nearly half of programs without one expressed interest in developing such opportunities. Barriers included limited faculty expertise (30%), curricular time (30%), and lack of specialized clinical sites (26%).

Reproductive psychiatry training opportunities have expanded since 2018 but remain heterogeneous and largely elective. Greater standardization of foundational training may help prepare psychiatrists to address mental health needs across reproductive life stages.