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Core Competencies for Psychiatric Practice

What Clinicians Need to Know (A Report of the American Board of Psychiatry and Neurology)

Edited by Stephen C. Scheiber, M.D., Thomas A. Kramer, M.D., and ABPN

  • ISBN 978-1-58562-112-5
  • Item #62112

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The practice of medicine has changed radically during the past few decades. Patients—better informed than ever—now demand more of their physicians, viewing them as partners rather than revering them as sole decision-makers.

In this environment, nonnegotiable core competencies—ever-evolving and measured by certification, recertification, and, more recently, maintenance of certification—are more important than ever.

Written from the perspective of those responsible for educating and certifying the next generations of psychiatrists, this groundbreaking compendium by distinguished contributors offers—for the first time—a concise look at the final product of the June 2001 Invitational Core Competencies Conference sponsored by the American Board of Psychiatry and Neurology (ABPN) as regards psychiatry (with a future comparable publication focusing on neurology). Divided into four parts,

  • Part I sets the stage for the current concept of physician competence by presenting a brief history of medical competence, explaining the logic behind the development of the current competence outline.
  • Part II provides two different views of how to look at core competencies: how competence is defined by the Royal College of Physicians and Surgeons of Canada and, based on some of their work, what is currently being done in the United States.
  • Part III discusses the organizing principles—identified in 1999 by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS)—that frame all of our conversations about competence, as currently delineated for psychiatrists across the six core competency categories: Patient Care, Medical Knowledge, Interpersonal and Communications Skills, Practice-Based Learning and Improvement, Professionalism, and Systems-Based Practice. Also presented are discussions of when in a physician's career these competencies should be assessed and what methodologies would be appropriate for that assessment.
  • Part IV discusses how the psychiatry core competencies are changing board certification and recertification. Also presented are informed predictions about the changes that medical school faculty and residency training directors will have to make and how practitioners will have to change behaviors to maintain their board certification.

Concluding with an appendix outlining the six core competencies for psychiatry, this invaluable resource will both help psychiatric residents and their faculty and training directors understand the core competencies important to the ABPN and provide practitioners with a view of what will be contained in their upcoming maintenance of certification programs now being designed.


  • Contributors
  • Foreword
  • Preface
  • Abbreviations
  • Part I: An Introduction to Core Competencies
  • Chapter 1. What Core Competencies Mean to Psychiatrists and Trainees
  • Chapter 2. The Evolving Concept of Clinical Competence in Psychiatric Practice
  • Part II: Origins of Core Competencies: Canadian Groundbreaking and American Development
  • Chapter 3. Advance Standards: The Canadian Concept of Specialty Competencies as Delineated by Physician Roles
  • Chapter 4. The ACGME and ABMS Initiatives: Toward the Development of Core Competencies
  • Part III: Core Competencies and the Practice of Psychiatry Today: The ABPN Initiative
  • Chapter 5. General and Psychiatry-Specific Patient Care Core Competencies
  • Chapter 6. General and Psychiatry-Specific Medical Knowledge Core Competencies
  • Chapter 7. Interpersonal and Communications Skills Core Competencies
  • Chapter 8. Practice-Based Learning and Improvement Core Competencies
  • Chapter 9. Professionalism Core Competencies
  • Chapter 10. Systems-Based Practice Core Competencies
  • Chapter 11. Cross Competencies: What Psychiatrists Should Know About Neurology
  • Part IV: The Impact of Core Competencies
  • Chapter 12. Implications of the Core Competencies on ABPN Certification and Maintenance of Certification for Psychiatric Practitioners
  • Chapter 13. Implications of the Core Competencies on the Full Spectrum of Psychiatric Medical Education for Clinical Psychiatric Practice: From Medical School Through Continuing Medical Education
  • Chapter 14. A Forward View: Core Competencies in Future Psychiatric Practice
  • Appendix A: Psychiatry Quadrad Core Competencies Outline
  • Index

About the Authors

Stephen C. Scheiber, M.D., is Clinical Professor of Psychiatry at Northwestern University Medical School in Evanston, Illinois; Clinical Professor of Psychiatry at the Medical College of Wisconsin in Milwaukee; and Executive Vice President of the American Board of Psychiatry and Neurology, Inc. in Deerfield, Illinois.

Thomas A. M. Kramer, M.D., is Director of Student Counseling and Resource Service at The University of Chicago in Chicago, Illinois.

Susan E. Adamowski, Ed.D., is Director of New Assessment Initiatives at the American Board of Psychiatry and Neurology, Inc. in Deerfield, Illinois.

Stephen C. Scheiber M.D., and colleagues have provided the psychiatric community with a comprehensive review of the core competencies initiative. This volume reviews the process by which the competencies were developed, the nature of each of the competencies, and possible methods of assessment. This will be a useful guide for program directors, residents, academic faculty and also practitioners of psychiatry as they prepare for continued maintenance of certification. To the larger medical community, this volume also provides an exemplar of how a specialty can respond productively to the competency initiative toward the aim of enhancing patient care and physician formation.—David C. Leach, M.D., Executive Director, Accreditation Council for Graduate Medical Education, Chicago, Illinois

As psychiatry program directors and residents struggle with defining, implementing, assessing and remediating core competencies in psychiatry, this book's publication could not be more timely. The book is an outstanding compilation of the history of the evolution of the competency movement (Section I), the delineation of core competencies from both the Canadian and the ACGME perspectives(Section II), detailed discussion of the ACGME competencies with chapters addressing each of the 6 competencies as defined by the psychiatry and neurology quardrads (Section III), culminating in Section IV, which addresses how these competencies may impact psychiatric trainees and practicing psychiatrists in the future, particularly related to the certification and maintenance of certification processes as well as medical education in general. The book's organization is such that it can easily be used both as a book to read front to back as well as a reference book for specific questions that may come up in the day to day work on competencies. This book will undoubtedly be a highly valuable asset for the psychiatric educator and the trainee as psychiatric training, indeed, all of medical training in the United States moves toward competency based curricula and assessment. Recognizing that the competency movement is a work in progress, the authors have provided a template from which educators can move toward the ultimate goal. . . [of providing] real and realistic means for physicians to display their skills, all of which are to be used for the benefit of the patients they serve.—Sandra B. Sexson, M.D., Associate Professor, Psychiatry and Pediatrics, Emory University School of Medicine, President-elect, American Association of Directors of Psychiatric Residency Training

This text is an outstanding, comprehensive review of the historical perspective, evolution and development, proposed details of implementation, and the possible impact of the Core Competencies on the field of psychiatry. In addition, it challenges every educator to ponder the questions 'What do we want the next generation of psychiatrists to learn?' and 'How will we evaluate if we are achieving our goals?'—Bruce R. Levy, M.D., President, American Association of Directors of Psychiatric Residency Training; Director, Education and Training, Department of Psychiatry, Long Island Jewish Medical Center; Associate Professor of Clinical Psychiatry, Albert Einstein College of Medicine, Bronx, New York

A collaboration between medical experts from the United States and Canada has resulted in this valuable blueprint for identifying and assessing skills central to the practice of psychiatry. . . . As a textbook/reference source, Core Competencies for Psychiatric Practice is a must-have tool in any psychiatrist's office. Practicing psychiatrists, individuals just beginning the educational process toward certification, medical school faculty and program directors will find it most useful as it provides a timeline and testing methods for assessing specific core competencies as well as suggestions for re-evaluation.—Behavioral Healthcare Tomorrow, 1/1/2005

The ABPN conference has provided psychiatry with a potential road map and guidebook to the future. Armed with this road map and guide, the field of psychiatry has a tool to respond to inevitable detours and advances in our knowledge base, as well as changes in our systems of care, to assure ourselves and the public of our ability to meet the needs now and in the future.—Sidney H. Weissman, M.D., Journal of Clinical Psychiatry, 1/1/2005

Psychiatry residency training directors' work will be made somewhat easier by knowing and understanding the information contained in this book.—Michael J. Schrift, DO, Doody Book Reviews, 1/1/2005

Core Competencies for Psychiatric Practice is both a hopeful and a helpful report. Its authors have brought much wisdom and insight to these discussions, and most readers will be convinced that defining and assessing core competencies not only will be a central feature of training programs and practice but also will contribute to the improved care of patients and their families.—John S. McIntyre, M.D., Psychiatric Services, 1/1/2005

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