Academic Psychiatry

, Volume 42, Issue 2, pp 197–201 | Cite as

Reproductive Psychiatry Residency Training: A Survey of Psychiatric Residency Program Directors

  • Lauren M. Osborne
  • Joanna V. MacLean
  • Erin Murphy Barzilay
  • Samantha Meltzer-Brody
  • Laura Miller
  • Sarah Nagle Yang
In Brief Report

Abstract

Objective

The reproductive life cycle has unique influences on the phenotypic expression of mental illness in women. Didactic and clinical training focused on these sex-specific influences should be a vital component of the education of future psychiatrists. The authors sought to determine the current state of and attitudes toward reproductive psychiatry in resident education.

Methods

The authors administered a web-based survey to psychiatry residency training directors. They assessed the availability of both mandated and optional didactic and clinical training experiences in reproductive psychiatry.

Results

Fifty residency program directors answered the survey, for a response rate of 28%. More than half of residency program directors (59%) reported requiring some training in reproductive psychiatry. Both the breadth and depth of topics covered varied greatly among programs. Lack of time (48%) and lack of qualified faculty (26%) were the most frequently cited barriers to more training. Only 40% of residency directors surveyed agreed that all residents should be competent in reproductive psychiatry.

Conclusions

These findings suggest that specific training in reproductive psychiatry is inconsistent in US residency programs, and that training that does exist varies considerably in clinical time and content. Given that women comprise more than 50% of all psychiatric patients and most women will menstruate, give birth, and undergo menopause, future psychiatrists would benefit from more systematic instruction in this area. The authors propose the development of a national, standardized reproductive psychiatry curriculum to address this gap and aid in producing psychiatrists competent to treat women at all stages of life.

Keywords

Reproductive psychiatry Residency education Women’s mental health Curriculum 

Notes

Acknowledgements

The authors would like to acknowledge the other members of the National Task Force on Women’s Reproductive Mental Health for their help in the conceptualization of this project: Vivien Burt, Kara Driscoll, Elizabeth Fitelson, and Alison Hermann. They would also like to acknowledge Kim Leventhal, MD, who assisted with the administration of the unpublished survey referred to in the discussion.

The survey reported in this study was granted exemption by the Institutional Review Board of Johns Hopkins University School of Medicine.

Compliance with Ethical Standards

Disclosures

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Funding Sources

None

References

  1. 1.
    National Institutes of Health. Revitalization Act of 1993 (PL 103-43), entitled Women and Minorities as Subjects in Clinical Research. http://orwh.od.nih.gov/clinical/women-and-minorities.
  2. 2.
    Kirschstein RL, Merritt DH. Report of the public health service task force on women’s health issues, volume I. Public Health Rep. 1985;100:73–106.Google Scholar
  3. 3.
    Richards M, Rubinow DR, Daly RC, Schmidt PJ. Premenstrual symptoms and perimenopausal depression. Am J Psychiatry. 2006;163(1):133–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Cohen LS, Soares CN, Joffe H. Diagnosis and management of mood disorders during the menopausal transition. Am J Med. 2005;19(118 Suppl 12B):93–7.CrossRefGoogle Scholar
  5. 5.
    Epperson CN, Steiner M, Hartlage SA, Eriksson E, Schmidt PJ, Jones I, et al. Premenstrual dysphoric disorder: evidence for a new category for DSM-5. Am J Psychiatry. 2012;169(5):465–75.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    O’Hara MW, Wisner KL. Perinatal mental illness: definition, description, and aetiology. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):3–12.CrossRefPubMedGoogle Scholar
  7. 7.
    Parry BL. Perimenopausal depression. Am J Psychiatry. 2008;165(1):23–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Howard LM, Molyneaux E, Dennis C-L, Rochat T, Stein A, Milgrom J. Non- psychotic mental disorders in the perinatal period. Lancet. 2014;384:1775–88.CrossRefPubMedGoogle Scholar
  9. 9.
    Huddle TS, Heudebert GR. Viewpoint: taking apart the art: the risk of anatomizing clinical competence. Acad Med. 2007;82:536–41.CrossRefPubMedGoogle Scholar
  10. 10.
    Osborne LM, Hermann A, Burt V, Driscoll K, Fitelson E, et al. Reproductive psychiatry: the gap between clinical need and education. Am J Psychiatry. 2015;172(10):946–8.Google Scholar
  11. 11.
    Davisson L, Nuss M, Cottrell S. Women’s health curriculum for internal medicine residents: development, implementation, and evaluation. J Grad Med Educ. 2010;2(3):398–403. doi: 10.4300/JGME-D-09-00069.1.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Spagnoletti CL, Rubio DM, McNeil MA. Internal medicine residents preparedness to care for reproductive-age and pregnant women. Teach Learn Med. 2007;19(3):257–63.CrossRefPubMedGoogle Scholar
  13. 13.
    Kwolek DS, Witzke D, Sloan DA. Assessing the need for faculty development in women’s health among internal medicine and family practice teaching faculty. The Women’s Health Education Working Group (WHEWG). J Womens Health Gend Based Med. 1999;8(9):1195–201.CrossRefPubMedGoogle Scholar
  14. 14.
    Emmons S, Sells CW, Eiff MP. A review of medical and allied health learners satisfaction with their training in women’s health. Am J Obstet Gynecol. 2002;186(6):1259–67.CrossRefPubMedGoogle Scholar
  15. 15.
    Alan Guttmacher Institute, Fact Sheet: Unintended Pregnancy in the United States. https://www.guttmacher.org/sites/default/files/factsheet/fb-unintended-pregnancy-us_0.pdf. Accessed 10/19/16.
  16. 16.
    Pew Research Center. Childlessness up among all women; down among women with advanced degrees. Pew Research Center’s Social & Demographic Trends Project. http://www.pewsocialtrends.org/2010/06/25/childlessness-up-among-all-women-down-among-women-with-advanced-degrees/. Accessed 10/19/16.
  17. 17.
    Direkvand-Moghadam A, Sayehmiri K, Delpisheh A, Kaikhavandi S. Epidemiology of premenstrual syndrome: a systematic review and meta-analysis. J Clin Diagn Res. 2014;8(2):106–9.PubMedCentralGoogle Scholar

Copyright information

© Academic Psychiatry 2017

Authors and Affiliations

  • Lauren M. Osborne
    • 1
  • Joanna V. MacLean
    • 2
  • Erin Murphy Barzilay
    • 3
  • Samantha Meltzer-Brody
    • 4
  • Laura Miller
    • 5
  • Sarah Nagle Yang
    • 6
  1. 1.Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.The Warren Alpert Medical School of Brown UniversityProvidenceUSA
  3. 3.University of California—Los AngelesLos AngelesUSA
  4. 4.University of North Carolina—Chapel HillChapel HillUSA
  5. 5.Loyola University Stritch School of MedicineHinesUSA
  6. 6.Case Western Reserve UniversityClevelandUSA

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