Leigh Hoyle, Stewart Deborah, Mallios Ronna
Department of Psychiatry, Fresno Medical Education Program, University of California, San Francisco, CA 93703, USA.
Gen Hosp Psychiatry. 2006 May-Jun;28(3):189-94. doi: 10.1016/j.genhosppsych.2005.10.003.
Some 40% of patients treated by primary care physicians have significant mental health problems. Only about half eventually receive mental health care, usually by the primary care physicians, often inadequately. Recently, there has been an increased attempt to incorporate psychiatry in primary care training programs. The authors sought to assess the current status of psychiatry training in Internal Medicine (IM), Family Practice (FP), Pediatrics (Peds) and Obstetrics and Gynecology (Ob/Gyn) residency programs.
All 1365 directors of accredited residency training programs in IM, FP, Ob/Gyn and Peds received a 16-item anonymous questionnaire in 2001-2002, collecting descriptive data concerning their psychiatry training.
A great majority of IM (71%), Ob/Gyn (92%) and Peds (85%) training directors felt that the training was minimal or suboptimal, as compared to 41% of FP training directors (P<.001). Sixty-four percent of FP program directors were satisfied with their training (P<.001). In contrast, 54% of other PC program directors were dissatisfied with their psychiatry training. All programs utilized ambulatory care setting extensively. Family Practice programs had more types of mental health teachers, teaching formats and teaching settings (P<.001). A majority of IM (57%) and Peds (70%) residencies desired more psychiatry training in their programs compared to only a third of FP and 40% of Ob/Gyn programs (P<.001). Teaching in clinical settings was preferred by all except Ob/Gyn programs (P<.001). Psychiatry departments contributed more to IM and Peds programs than others.
A majority of primary care training programs are dissatisfied with the current status of their psychiatric training except for FP programs. Family Practice programs have the most variety in training formats, venues and teachers. There are some specialty-specific differences in perceived needs and desires in psychiatric training.
在初级保健医生治疗的患者中，约40%有明显的心理健康问题。最终只有约一半的患者接受了心理健康护理，通常是由初级保健医生提供的，但往往不够充分。最近，越来越多地尝试将精神病学纳入初级保健培训项目。作者试图评估内科（IM）、家庭医学（FP）、儿科学（Peds）以及妇产科（Ob/Gyn）住院医师培训项目中精神病学培训的现状。
2001 - 2002年，向所有1365名经认可的IM、FP、Ob/Gyn和Peds住院医师培训项目主任发放了一份包含16个项目的匿名问卷，收集有关他们精神病学培训的描述性数据。
与41%的FP培训主任相比，绝大多数IM（71%）、Ob/Gyn（92%）和Peds（85%）培训主任认为培训最少或不理想（P<0.001）。64%的FP项目主任对他们的培训感到满意（P<0.001）。相比之下，其他初级保健项目主任中有54%对他们的精神病学培训不满意。所有项目都广泛利用门诊护理环境。家庭医学项目有更多类型的心理健康教师、教学形式和教学环境（P<0.001）。与只有三分之一的FP项目和40%的Ob/Gyn项目相比，大多数IM（57%）和Peds（70%）住院医师希望在他们的项目中接受更多的精神病学培训（P<0.001）。除了Ob/Gyn项目外，所有项目都更喜欢在临床环境中教学（P<0.001）。精神病学系对IM和Peds项目的贡献比其他项目更多。
除了FP项目外，大多数初级保健培训项目对其精神病学培训的现状不满意。家庭医学项目在培训形式、场所和教师方面种类最多。在精神病学培训的感知需求和期望方面存在一些特定专业的差异。
