The essential elements of this curriculum are the 1) consistent review and emphasis on the four researched-based SBP roles of the psychiatrist; 2) recovery principles of person-centered care and shared decision-making; 3) requirement that residents interact with patients in community and home settings; 4) integration of didactic courses and clinical rotations; and 5) focus on the supervisor/supervisee relationship.
Although some recovery-oriented practices were used infrequently (for example, facilitating peer advocacy), a number of important practices were endorsed at relatively high levels. The association of recovery-oriented practices with awareness of recovery concepts suggests that education and advocacy may promote such practices.
To examine the variety of roles filled by psychiatrists functioning as medical directors in community settings, a survey of all members of the American Association of Community Psychiatrists was undertaken. A total of 168 respondents classified themselves as agency medical directors or program medical directors. Medical directors also classified their breadth of supervisory responsibility as including medical staff only, medical and other clinical staff, or all staff (including administrative staff). A classification scheme of six types of medical director positions based on level of operation and breadth of supervisory responsibility was created. This classification helps clarify the medical director's role, providing guidance to psychiatrists and agencies negotiating job descriptions for this position.
Objective-The growth of Public Psychiatry Fellowships [PPF's] has reached a new developmental stage, providing a wide array of academic partnerships and educational opportunities in psychiatric leadership and administration. The authors examine the evolution of these programs and illustrate three distinct models.Methods-Data from yearly surveys and discussions with PPF Directors were used to identify key similarities and areas of divergence as the programs have evolved.Results-The first period of program expansion took place 8-10 years ago when new programs were modeled on the Columbia PPF, and key elements of that program and the American Association of Community Psychiatrists (AACP) guidelines were incorporated broadly. Examples of multiple source (Columbia), single source (Yale and UCSF), and grant-funded programs (Alabama and UCSD) are presented.Conclusions-A review of the current status of PPF's reveals a diversity of structures and strategies for success, which can be attributed to the range of their funding sources. The advantages and potential disadvantages of those models are outlined with respect to the educational experience and opportunities for growth and sustainability.Keywords public psychiatry; fellowships; academic partnerships Public Psychiatry Fellowships (PPF's) provide advanced training to psychiatrists who are interested in engaging in clinical care, teaching, and program/policy development and evaluation within the public sector. They are based in diverse settings, including urban, NIH Public Access
Despite respondents' beliefs that clinical collaboration activities contributed most to job satisfaction, performance of administrative tasks was found to best correlate with overall job satisfaction. Furthermore, overall job satisfaction was related to the performance of administrative tasks and not to the job title of medical director alone. Most of the medical directors in the survey had program-level, rather than agency-level, responsibilities. The findings indicate that the role of program medical director can serve as a crucial next step for staff psychiatrists, offering the opportunity to perform administrative tasks, which, according to the results, improves job satisfaction in public-sector positions.
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