English Version - World Psychiatric Association

WORLD 

PSYCHIATRIC 

ASSOCIATION 

INSTITUTIONAL 

PROGRAM ON 

THE CORE TRAINING 

CURRICULUM 

FOR PSYCHIATRY

WORLD PSYCHIATRIC 

ASSOCIATION 

INSTITUTIONAL PROGRAM 

ON THE CORE TRAINING 

CURRICULUM FOR PSYCHIATRY 

YOKOHAMA, JAPAN, AUGUST 2002

TABLE OF CONTENTS 

Pages 

I. A MESSAGE FROM THE WORLD PSYCHIATRIC ASSOCIATION 5 

II. INTRODUCTION 7-8 

III. THE CORE TRAINING CURRICULUM FOR PSYCHIATRY 9-12 

IV. THE CORE TRAINING CURRICULUM EVALUATION COMPONENT 13-15 

V. WPA LEADERSHIP STRUCTURE 17 

VI. 

CORE TRAINING CURRICULUM FOR PSYCHIATRY 

PROGRAM STRUCTURE AND MEMBERSHIP 19-20 

VII. WPA HISTORICAL AND EDUCATIONAL PERSPECTIVES 21 

VIII. 

WPA INSTITUTIONAL PROGRAM ON CORE TRAINING 

CURRICULUM FOR PSYCHIATRY 23-24 

IX. BIBLIOGRAPHY 25-27 

X. APPENDICES 

A. STATISTICAL REPORT OF THE INTERNATIONAL SURVEY 

ON GRADUATE TRAINING IN GENERAL PSYCHIATRY 29-76 

B. POSTGRADUATE TRAINING IN GENERAL PSYCHIATRY 

SURVEY QUESTIONNAIRE 77-88

I. A MESSAGE FROM THE WORLD 

PSYCHIATRIC ASSOCIATION (WPA) 

Since its foundation in 1950, the World 

Psychiatric Association (WPA) has grown 

immensely. Today, the WPA encompasses 120 

Member Societies representing 104 countries 

throughout the world. It also has 56 scientific 

Sections. All along, the WPA has been deeply 

involved in all aspects of research and 

investigation, teaching and education, and 

patient care. Additionally, the WPA gives major 

priority to the knowledge and skills necessary 

to work in the mental health field at large. 

Needless-to-say, training and education are 

the essential links between the creation of new 

knowledge via research and investigation 

efforts and the dissemination and application 

of new knowledge via teaching and 

educational activities. This crucial paradigm 

has been all along at the root of treatment 

advances and patient care improvements. 

The WPA’s Madrid Declaration underlines that 

“It is the duty of psychiatrists to keep abreast 

scientific developments of the specialty and to 

convey updated knowledge to others. 

Psychiatrists trained in research should seek to 

advance the scientific frontiers of psychiatry” 

and “psychiatrists serve patients by providing 

the best therapy available consistent with 

accepted scientific knowledge and ethical 

principles. Psychiatrists should devise 

therapeutic interventions that are least 

restrictive to the freedom of the patient and 

seek advice in areas of their work about which 

they do not have primary expertise”. 

It is within this context that, at this time, the 

WPA decided to focus on the improvement of 

the basic training and education in psychiatry 

at the graduate level; that is, in general 

psychiatric training. This WPA efforts are 

worldwide directed and, especially, among 

developing nations. This educational thrust is a 

continuation to the previous WPA efforts on 

the “Core Curriculum in Psychiatry for Medical 

Students”, which was produced in 

collaboration with the World Federation for 

Medical Education. This core curriculum has 

been implemented in numerous medical 

schools worldwide. The idea is to help 

enhance training and education across the 

world while at the same time respecting the 

realities and differences that exist in the 

various regions of the world and in different 

cultural contexts. The current worldwide 

globalization process and the enormous 

growth in new knowledge that has taken place 

in the field of psychiatry in the last 2-3 

decades makes this current WPA effort not an 

utopian dream but a real necessity. Therefore, 

we proudly introduce the educational outcome 

of the WPA Institutional Program on “Core 

Training Curriculum for Psychiatry”. We hope 

you like it, and your assistance in appropriately 

disseminating and implementing this novel 

core curriculum worldwide will be much 

appreciated. 

Sincerely, 

Professor Juan J. López-Ibor, Jr. 

President 

Professor Ahmed Okasha 

President Elect 

World Psychiatric Association 

5

II. INTRODUCTION 

During the last 2-3 decades, the field of 

psychiatry has grown and expanded at a pace 

never seen before. The advances on 

neurosciences as exemplified, among others, 

by brain imaging techniques and the discovery 

of new psychopharmacological agents; the 

new perspectives on the field of genetics; the 

reconceptualization of the psychotherapeutic 

theories and approaches; the new venues in 

the appropriate use of culturally-appropriate 

methods of intervention; the better 

understanding of the psychosocial phenomena 

and treatments; the advent of consumeroriented 

organizations; the high priority 

currently given to ethics, patients’ rights and 

human rights at large; and other new and 

significant scientific advances, brought new 

perspectives and hope with respect to the 

diagnosis, treatment and prevention of 

psychiatric illnesses and conditions. 

Despite the enthusiasm and optimism 

prevailing in the field at the current time, some 

challenges are also present. Among them, 

finding the most appropriate way of 

integrating this wealth of new scientific 

knowledge and information in the 

undergraduate, graduate and postgraduate 

training curriculum in psychiatry. 

Concomitantly with this new growth and 

educational challenges, other issues have to be 

addressed, such as the special difficulties faced 

by some educational programs in psychiatry 

across the world. Some programs, mainly 

located in developed nations, can easily afford 

to deal with these challenges. In these 

educational programs, faculty resources, 

availability of educational equipment and 

tools, access to computers and libraries, 

affordability of required length of training, as 

well as other related educational factors, make 

more easy the necessary curriculum 

modifications, adaptations, and expansion to 

meet the evolving changes resulting from the 

creation of new knowledge. However, in other 

educational programs in psychiatry, mainly 

located in developing countries, the curriculum 

in the undergraduate, graduate, and 

postgraduate levels leave much to be desired. 

Further, the resources needed to improve this 

situation are unfortunately not available. Still, 

in some other countries the apprenticeship 

model is the only one that is primarily used to 

learn about psychiatry at the graduate and 

postgraduate level. 

It is within this context that the idea of 

providing a core training curriculum for 

psychiatry at the graduate level evolved within 

the structure of the World Psychiatric 

Association (WPA). No psychiatric organization 

other than the WPA could best provide 

educational leadership of this nature across the 

world. Besides, the WPA had already 

demonstrated its commitment, expertise and 

experience in this regard with the production 

of the “Core Curriculum in Psychiatry for 

Medical Students” in collaboration with the 

World Federation for Medical Education. The 

WPA has also shown much strength, growth, 

and priority in the field of psychiatric 

education during the last two decades. 

Therefore, this educational project was 

launched by the WPA with the aim of creating 

a “Core Training Curriculum for Psychiatry”. 

From the start of this educational project, it 

was clear that the objective was not to impose 

the graduate psychiatric curriculum from 

developed countries in other regions of the 

world. Rather, the idea from the beginning 

was to share educational expertise and 

experiences while maintaining sensitivity and 

recognition of the realities that exist in 

different regions of the world. This principle 

was kept throughout the development of this 

educational project, and thus this educational 

objective was fully accomplished in the 

outcome of this educational project. In this 

respect, our main educational goal was to 

construct the core elements of a graduate 

training curriculum in psychiatry in order to 

ensure high quality of psychiatric services via 

the creation of competent psychiatrists in all 

areas of the world. Without question, this goal 

is very idealistic but not utopian. Consumeroriented 

and advocacy groups are asking and 

even demanding better psychiatric services. 

7

World Psychiatric Association Institutional Program on the Core Training Curriculum for Psychiatry 

Also, the profession is currently paying 

attention to ethical principles and patient’s 

rights as never before in the history of our 

field. Moreover, the current globalization 

process is now reaching to all sectors of 

society, including health and mental health 

care. Therefore, to have available the elements 

required for a basic and core training 

curriculum for psychiatry with focus on 

knowledge, skills, attitudes, type of clinical 

rotations, and evaluation components is, at 

this time, timely, essential, and feasible. We 

are very much aware that psychiatric training 

is a process that encompasses undergradute, 

graduate (general psychiatry), postgraduate 

(subspecialty training, e.g., child and 

adolescent psychiatry), certification, and 

maintenance of certification. 

From a different point of view, the WPA is 

proud of the involvement in this educational 

project of the best educational experts from all 

parts of the world; encompassing different 

schools of thoughts, expertise, experiences 

and skills. However, with the common ground 

based on scientific validation, high ethical 

standards, and a proven record of outstanding 

contributions to the field. The various sections 

of this educational project will offer the 

teaching physician, the student physician, and 

the patient new ideas, models, venues, and, 

above all, a stimulus to achieve educational 

excellence in their professional efforts. This 

was our expectations with respect to this 

educational project. In this respect, the success 

of our efforts will be measured by the degree 

that our expectations will be met. 

Steering Committee: 

Professor Juan J. López-Ibor Jr. 

Chair 

Professor Ahmed Okasha 

Co-Chair 

Professor Pedro Ruiz 

Executive Director 

Professor Cornelius Katona 

Member 

Professor Felice Lieh Mak 

Member 

8

III. THE CORE TRAINING 

CURRICULUM FOR PSYCHIATRY 

The “Core Training Curriculum 

for Psychiatry” encompasses two 

educational components: The “Didactic 

Curriculum” and the “Didactic/Clinical 

Rotations”. Each of these two components 

were intensively and extensively addressed 

by two Committees composed 

of Educational Consultants appointed 

for that purpose. Each Committee met 

at a retreat held in Madrid, Spain, on 10/4/01 

and 10/5/01. The outcome of the work of 

each of these two Committees was also 

presented and reviewed by the entire group of 

Educational Consultants who participated in 

this retreat. Additionally, the final product was 

sent out for further input to the members of 

the WPA Executive Committee, to the 

members of the Steering Committee, to the 

members of the Group of Special Educational 

Consultants, to the group of Educational 

Consultants, to the group of Educational 

Advisors, and to the field at large. The 

description of the two curriculum components 

herewith described is the final product of these 

deliberations. 

DIDACTIC CURRICULUM 

The Committee that designed the Core 

elements of the Didactic Curriculum was 

composed of the following members: 

– Professor Wolfgang Gaebel (Chair) 

(Germany) 

– Professor Julio Arboleda-Flores (Canada) 

– Professor Julio Bobes (Spain) 

– Professor Jean Garrabé (France) 

– Professor Gerardo Heinze (Mexico) 

– Professor Carmen Leal (Spain) 

– Professor Maria-Inés López-Ibor (Spain) 

– Professor Juan E. Mezzich (USA) 

– Professor Driss Moussaoui (Morocco) 

– Professor Amelia Musacchio (Argentina) 

– Professors Juan J. López-Ibor Jr., Ahmed 

Okasha and Pedro Ruiz overviewed the 

work of this Committee and helped facilitate 

its process. 

Recommendations 

I. Basic sciences 

– Human growth and development 

– Behavioral and social sciences 

– Genetics 

– Neurosciences 

– Psychopharmacology 

II. Diagnostic assessment 

A. Basic knowledge (semiology and 

classification of psychiatric disorders and 

conditions): 

– Adult psychopathology 

– Child & adolescent psychopathology 

– Geriatric/old age psychopathology 

– Emergency Psychiatry 

B. Core competencies (knowledge, skills and 

attitudes) 

– Communications skills 

– Patient interview skills 

– Diagnostic tools/skills (e.g., physical 

examination, laboratory tests, brain imaging, 

etc.) 

– Advocacy skills for patient and family care 

– Cultural sensitivity (attitude) 

– Cross-specialty skills and attitudes 

(consultation and liaison psychiatry) 

III. Etiopathogenesis 

– Family genetics and risk factors 

– Growth and development 

– Behavioral, social, and cultural risk factors 

– Neurosciences and biological risk factors 

– Environmental factors (e.g., violence) 

– Support versus isolation and discrimination, 

and risk factors 

IV. Therapeutics 

– Communication and patient education 

skill 

– Development of appropriate attitudes 

(e.g., gender, cultural, and family 

sensitivity) 

– Somatic treatments 

9


– Psychopharmacotherapy 

– Other (e.g., electroconvulsive treatment, 

etc.) 

– Psychotherapies (competence in evidence 

based psychotherapies) 

– Rehabilitation and awareness of resources 

– Emergency and crisis intervention 

– Social and community psychiatry, and 

mental health enhancement approaches 

– Family dynamics and psychoeducation 

– Consultation and liaison psychiatry skills and 

techniques 

V. Prognosis 

– Short and long term course 

– Predictive outcomes 

VI. Prevention and mental health promotion 

– Reinforcement of healthy behavior 

– Fostering respect and equity for women 

– Fostering of mental health education 

– Primary, 2ndary and tertiary prevention 

interventions 

VII. General aspects 

– Informatics and knowledge management 

(e.g., internet) 

– Teaching skills 

– Teaching methodology 

– Research methodology and statistics 

– Evidence-based medicine/psychiatry 

– Epidemiological indexes (e.g., prevalence) 

– Gender sensitivity 

– Cross-cultural psychiatry 

– Religion and spirituality 

– History of psychiatry 

– Philosophy 

– Management and leadership development 

– Administrative psychiatry (e.g., 

socioeconomics) 

– The politics and provision of treatments for 

the mentally ill 

– Ethics, legal aspects (i.e., “patients” bill of 

rights), and mental health legislation based 

on local needs 

– Forensic psychiatry 

– Political advocacy for improving the care of 

the mentally ill 

10

The Core Training Curriculum for Psychiatry 

VIII. Minimum number of suggested seminar topics, lengths and year 

LEVELS 

Seminars number of hours year level 

Patient evaluation 14 to 16 1st 

Growth and development 4 to 6 1st 

Learning disability/ Mental Retardation 4 to 6 2 nd , 3 rd 

Child and Adol. Psych. 8 to 10 2 nd , 3 rd 

Crisis intervention 4 to 6 1st 

Emergency psychiatry 4 to 6 1st 

Diagnostic instruments 4 to 6 1 st , 2 nd 

Adult psychopathology over 20 1 st , 2 nd , 3 rd 

Psychopharmacology over 20 1 st , 2 nd, 3 rd 

Toxicology 2 to 4 1 st , 2 nd 

Somatic treatments 4 to 6 1 st 

Neurology/neuropsych. 14 to 16 1 st , 2 nd , 3 rd 

Brain imaging 4 to 6 2 nd , 3 rd 

Psychotherapies over 20 1 st , 2 nd , 3 rd 

Family education and therapy 4 to 6 2 nd , 3 rd 

Group therapy 4 to 6 2 nd 

Consultation and liaison 10 to 12 2 nd , 3 rd 

Drug abuse 10 to 12 1 st , 2 nd , 3 rd 

Alcoholism 8 to 10 1 st , 2 nd , 3 rd 

Geriatric/old age psychiatry 6 to 8 1 st , 2 nd , 3 rd 

Forensic psychiatry 6 to 8 3 rd 

Ethics, stigma, etc. 4 to 6 1 st , 2 nd , 3 rd 

Psych. Epidemiology 4 to 6 2 nd 

Community psychiatry 4 to 6 2 nd , 3 rd 

Psych. Rehabilitation 4 to 6 2 nd , 3 rd 

Administrative psychiatry 4 to 6 3 rd 

Cultural psychiatry 6 to 8 2 nd , 3 rd 

Sexual/gender issues 4 to 6 1 st 

History of psychiatry 4 to 6 2 nd 

Neurosciences over 20 1 st , 2 nd , 3 rd 

Research training 4 to 6 2 nd ,3 rd 

Communications skills 10 to 12 1 st 

Information/internet 2 to 4 3 rd 

Preventive psychiatry 4 to 6 2 nd , 3 rd 

Private practice 4 to 6 3 rd 

11


DIDACTIC/CLINICAL ROTATIONS 

The Committee that designed the Core 

elements of the Didactic/Clinical Rotations was 


– Professor Alfredo Calcedo Barba (Chair) 

(Spain) 

– Professor Fuad T. Antun (Lebanon) 

– Professor Edgard J. Belfort (Venezuela) 

– Professor George Christodoulou (Greece) 

– Professor Saida Douki (Tunisia) 

– Professor Rodolfo D. Fahrer (Argentina) 

– Professor Arthur M. Freeman (USA) 

– Professor Heinz Katschnig (Austria) 

– Professor Tomás Palomo (Spain) 

– Professor Jerónimo Saíz (Spain) 

– Professor Samuel Tyano (Israel) 

– Professors Juan J. López-Ibor, Jr., Ahmed 



its process. 

Recommendations 

I. General concepts 

– All didactic/clinical rotations should start 

after obtaining the Medical Doctor degree. 

– General psychiatry didactic/clinical rotations 

cover all ages in the life cycle. 

– Didactic/clinical rotations finished after 

medical school completion and before the 

graduate training starts can be counted as 

part of the general psychiatric residency 

training program. However, they must 

supervised, and need to take place in 

accredited programs. 

– Three years was considered the minimum 

training period for the completion of the 

graduate residency training in general 

psychiatry. As general psychiatry training 

develops, there is also a need to enable 

physicians to obtain further 

postgraduate/subspecialized training and 

experience (i.e., forensic psychiatry, 

addiction psychiatry, child and adolescent 

psychiatry, geriatric psychiatry, etc.). 

– All postgraduate training in psychiatric 

subspecialties should take place after 

completion of the graduate trainig in general 

psychiatry (e.g., child and adolescent 

psychiatry, forensic psychiatry, etc.). 

– Some countries may be able to afford longer 

periods of graduate training in general 

psychiatry (e.g., 48 months). 

– All didactic/clinical rotations are considered 

as full time equivalent. 

II. Basic didactic/clinical rotations 

– Six months minimum in neurology and 

primary care/internal medicine. 

– Eighteen months minimum of general 

psychiatry, which include inpatient, day 

hospital, rehabilitation and outpatient 

services. These rotations can include: adult, 

geriatric and child and adolescent patients. 

– Six months minimum of complimentary 

didactic/clinical rotations will be available. 

They include three months in consultation 

and liaison psychiatry and three months in 

community-based psychiatry. 

III. Exposure-based didactic/clinical rotations 

– Emergency psychiatry. 

– Alcohol, drug abuse, and dually-diagnosed 

disorders and conditions. 

– Rehabilitation psychiatry 

– Forensic psychiatry. 

– Mental retardation/learning disability 

– These specialized didactic/clinical rotations 

might be offered as a minimum of two 

months, full time rotations if the appropriate 

facilities are available. 

12

IV. THE CORE TRAINING CURRICULUM 

EVALUATION COMPONENT 

The core training curriculum evaluation 

component was designed by a Committee of 

Educational Consultants appointed for this 

purpose. This Committee addressed 

intensively and extensively this topic during a 

two-day retreat held in Madrid, Spain, on 

10/4/01 and 10/5/01. The outcome of the 

work of this Committee was presented and 

reviewed by the entire group of Educational 

Consultants who participated in this retreat. 

Additionally, the final product of this 

Committee was sent out for further input to 

the members of the WPA Executive 

Committee, to the members of the Steering 

Committee, to the members of the group of 

Special Educational Consultants, to the 

members of the group of Educational 

Consultants, to the members of the group of 

Educational Advisors, and to the field at large. 

The description of the core training curriculum 

evaluation component described here is the 

final result of these deliberations. The 

Committee that designed the core training 

curriculum evaluation component was 


– Professor Felice Lieh Mak (Chair, China) 

– Professor Shakir Ansari (England) 

– Professor Harold I. Eist (USA) 

– Professor Christian Haasen (Germany) 

– Professor Ruben Hernández (Venezuela) 

– Professor F. Gerard Moeller (USA) 

– Professor Roger Montenegro (Argentina) 

– Professor Tarek Okasha (Egypt) 

– Professor Herman M. Van Pragg 

(Netherlands) 

– Professor Norman Sartorius (Switzerland) 

– Professors Juan J. López-Ibor, Jr., Ahmed 



its process. 

The provision of good quality supervision is an 

essential element in psychiatric training. 

Supervision has both clinical and educational 

functions and provides opportunities for 

clinical case review, career guidance, critical 

appraisal of the scientific literature, and topic 

teaching and planning. Regular and protected 

time needs to be set aside for supervision 

which should have clear and pre-planned 

learning objectives linked to trainees’ needs. 

Supervision skills include the ability to set and 

monitor standards, to give constructive 

feedback, to respect trainees’ autonomy as 

adult learners, to provide mentoring, and to 

act as advocates for the trainees they 

supervise. 

Recommendations. 

I. General aspects 

– The evaluation of the training entry process 

should focus on motivation and empathy. 

– The evaluation of the training exit process 

should focus on knowledge, patient care, 

communication skills, professionalism, and 

empathetic development. 

– Formative and summative assessment 

should be an integral part of the evaluation 

process. 

– The process of evaluation should be 

integrally related to curricular learning 

objectives. 

– Whenever possible, appropriate assessment 

devises should be used for evaluation 

purposes; for instance, objective structured 

clinical examination (OSCE), written or 

computer-based multiple-choice questions 

examination (MCQ), chart stimulated recall 

oral examination (CSR), case logs, etc. 

– Self-assessment methods are quite beneficial 

as part of the evaluation process. 

– The evaluation process should take into 

consideration cultural and regional factors. 

– Local psychiatric societies can be part of the 

evaluation process. 

II. Evaluation components 

– Residents evaluation by faculty, to be used 

for educational improvement. 

– Faculty evaluation by residents, to be used 

to improve teaching and faculty 

development. 

13


– Program evaluation by residents and faculty, 

to be used to improve the educational 

programs. 

– Program evaluation by outside accreditation 

agencies. 

– Evaluations are to be done individually and 

anonymously, in a group format, and to be 

used for program improvement. 

– Evaluation of teaching materials and tools 

should also take place. 

– The role of the individual supervisor in the 

evaluation process is essential in conveying 

the accumulated evaluation data, based on 

educational goals and objectives. 

– Oral and written evaluations should take 

place twice a year to determine the level of 

the educational progress and the quality of 

the curriculum. 

– Patients’ log books should be an integral 

part of the evaluation process. 

– There should be a qualifying exit 

examination with a written component to 

assess “knowledge”, and an oral 

component to assess communication and 

interviewing “skills”. 

III. Focus of the evaluation 

A. Local curriculum 

– Should be compatible with WPA outline. 

– Should encompass clinical psychiatry. 

– Undertaking clinical assessment. 

– Coordinating delivering and monitoring 

treatment. 

– Contributing to multiprofessional case 

management. 

– Be autonomous, ethical professional 

practice. 

– Include management and leadership. 

– Include research, informatics and knowledge 

management. 

– Should have demonstrable (and externally 

validated) local relevance. 

– Should be culturally sensitive. 

– Should be deliverable in terms of available 

local training facilities. 

– Should have explicit, assessable learning 

objectives. 

– Should be reviewed and revised as necessary 

B. Training programme 

– Should be rooted in evidence-based 

practice. 

– Should respect autonomy of adult learners. 

– Should include feedback from trainees and 

be modified accordingly. 

– Should include site visits which in turn 

should. 

– Have explicit evaluation criteria. 

– Be independent of local scheme (e.g., 

delivered by national training body). 

– Include trainee representation. 

– Ensure appropriate balance between service 

and training needs. 

– Ensure trainees are properly represented in 

the planning of training 

– Ensure availability of: 

– Formal teaching appropriate to local 

curriculum. 

– Clinical experience appropriate to local 

curriculum. 

– Supervision. 

– Mentoring. 

– Career advice. 

– Ensure trainee are able to express concerns 

related to: 

– Quality of training. 

– Exploitation. 

– Bullying. 

– Harassment. 

– Unequal opportunities. 

– Provide mechanisms to enforce necessary 

improvements and discontinue bad training 

C. Individual trainee 

– Should have provision for both formative 

(regular and documented constructive 

feedback) and summative assessments 

(exam, etc.). 

– Should use log book record of range of 

experiences and of supervision. 

– Should emphasize competencies (which 

include appropriate skills and attitudes). 

– Should have explicit and relevant standards 

(where possible be criterion rather than peer 

referenced). 

– Should be fair and be shown to be 

perceived as such by trainees. 

– Should be externally validated. 

– Should use range of assessment (including 

examination) methods appropriate to skills/ 

competencies being assessed with in turn 

should have demonstrable links to 

curriculum and should have demonstrable 

validity and reliability. 

14

The Core Training Curriculum Evaluation Component 

IV. Complimentary elements 

– Offer courses periodically on didactic 

methodology directed to teachers/faculty. 

– Consider the role of computers in the 

training process. 

– Faculty should have a well established 

minimum level of educational qualifications. 

– Appropriate physical facilities are essential 

components of the educational and teaching 

process. 

WPA can play an ongoing and relevant 

role in the evaluation of the 

educational process of residency 

training programs (e.g., conducting 

written examinations, sponsoring 

didactic courses for faculty, participating 

in the evaluation and program 

validation process, etc.). 

15

V. WPA LEADERSHIP STRUCTURE 

– President: Prof. Juan J. Lopez Ibor Jr., 

(Spain) 

– President Elect (Vice President): Prof. Ahmed 

Okasha(Egypt) 

– Secretary General: Prof. Juan E. Mezzich 

(USA) 

– Secretary for Finance: Prof Marianne C. 

Kastrup (Denmark) 

– Secretary for Meetings: Prof. Driss 

Moussaoui (Morocco) 

– Secretary for Education: Prof. Roger 

Montenegro (Argentina) 

– Secretary for Publications: Prof. Mario Maj 

(Italy) 

– Secretary for Sections: Prof. George N. 

Christodoulou (Greece) 

17

VI. CORE TRAINING CURRICULUM FOR PSYCHIATRY 

PROGRAM STRUCTURE AND MEMBERSHIP 

STEERING COMMITTEE 

– Professor Juan J. López-Ibor, Jr. (Chair, Spain) 

– Professor Ahmed Okasha (Co-Chair, Egypt) 

– Professor Pedro Ruiz (Executive Director, USA) 

– Professor Cornelius Katona (UK) 

– Professor Felice Lieh Mak (China) 

SPECIAL EDUCATIONAL CONSULTANTS 

– Professor Peter Berner (France) 

– Professor Jorge A. Costa e Silva (Brazil) 

– Professor Michael G. Gelder (UK) 

– Professor Pierre Pichot (France) 

– Professor Benedetto Saraceno (Switzerland) 

– Professor Norman Sartorius (Switzerland) 

– Professor Costas Stefanis (Greece) 

EDUCATIONAL CONSULTANTS 

– Professor Carlo A. Altamura (Italy) 

– Professor David Ames (Australia) 

– Professor Shakir Shyam Ansari (UK) 

– Professor Fuad T. Antun (Lebanon) 

– Professor Julio Arboleda-Flores (Canada) 

– Professor Edgard J. Belfort (Venezuela) 

– Professor Julio Bobes (Spain) 

– Professor Alfredo Calcedo Barba (Spain) 

– Professor Robert Cancro (USA) 

– Professor José L. Carrasco (Spain) 

– Professor Edmund Chiu (Australia) 

– Professor George Christodoulou (Greece) 

– Professor John Cox (UK) 

– Professor Eduardo Cuenca (Spain) 

– Professor Saida Douki (Tunisia) 

– Professor Michael H. Ebert (USA) 

– Professor Harold I. Eist (USA) 

– Professor Rodolfo D. Fahrer (Argentina) 

– Professor Edward F. Foulks (USA) 

– Professor Arthur M. Freeman (USA) 

– Professor Janos Furedi (Hungary) 

– Professor Pierre M. Furlan (Italy) 

– Professor Wolfgang Gaebel (Germany) 

– Professor Jean Garrabé (France) 

– Professor José Giner (Spain) 

– Professor David Goldberg (UK) 

– Professor M. Gomez Beneyto (Spain) 

– Professor Robert W. Guynn (USA) 

– Professor Christian Haasen (Germany) 

– Professor Gerardo Heinze (México) 

– Professor Ruben Hernández (Venezuela) 

– Professor Cyril Höschl (Czech Republic) 

– Professor Fritz Hohagen (Germany) 

– Professor Povl Munk Jorgensen (Denmark) 

– Professor Mariane Kastrup (Denmark) 

– Professor Heinz Katschnig (Austria) 

– Professor Carmen Leal (Spain) 

– Professor Maria Inés López-Ibor (Spain) 

– Professor Mario Maj (Italy) 

– Professor Juan E. Mezzich (USA) 

– Professor F. Gerard Moeller (USA) 

– Professor Anu A. Matorin (USA) 

– Professor Roger Montenegro (Argentina) 

– Professor Srinivasa R. Murthy (India) 

– Professor Amelia Musacchio (Argentina) 

– Professor Driss Moussaoui (Morocco) 

– Professor Yoshibumi Nakane (Japan) 

– Professor Tarek Okasha (Egypt) 

– Professor Tomás Palomo (Spain) 

– Professor Darrel A. Regier (USA) 

– Professor Zoltan Rihmer (Hungary) 

– Professor Jerónimo Saíz (Spain) 

– Professor Shridhar D. Sharma (India) 

– Professor Constantine R. Soldatos (Greece) 

– Professor Eliot Sorel (USA) 

– Professor Donna E. Stewart (Canada) 

– Professor John A. Talbott (USA) 

– Professor Allan Tasman (USA) 

– Professor Francisco Torres (Spain) 

– Professor Samuel Tyano (Israel) 

– Professor Herman M. Van Pragg 

(Netherlands) 

– Professor Daniel K. Winstead (USA) 

EDUCATIONAL ADVISORS 

– Professor Werner Pankratz (WPA Zone 1, 

Canada) 

– Professor Harold I. Eist (WPA Zone 2, USA) 

– Professor Carlos Berganza (WPA Zone 3, 

Guatemala) 

19


– Professor Antonio Pacheco (WPA Zone 4, 

Venezuela) 

– Professor Miguel R. Jorge (WPA Zone 5, Brazil) 

– Professor Brian Martindale (WPA Zone 6, UK) 

– Professor Kari Pylkakänen (WPA Zone 7, 

Finland) 

– Professor Salvador Cervera (WPA Zone 8, 

Spain) 

– Professor Petr Smolik (WPA Zone 9, Czech 

Republic) 

– Professor Valery K. Krasnov (WPA Zone 10, 

Russia) 

– Professor Said Abdel Azim (WPA Zone 11, 

Egypt) 

– Professor Fuad T. Antun (WPA Zone 12, 

Lebanon) 

– Professor Michael O. Olatawura (WPA Zone 

13, Nigeria) 

– Professor Clifford W. Allwood (WPA Zone 

14, South Africa) 

– Professor Ijaz Haider (WPA Zone 15, 

Pakistan) 

– Professor Parameshvara Deva (WPA Zone 

16, Malaysia) 

– Professor Jiro Suzuki (WPA Zone 17, 

Japan) 

– Professor Noel M. Wilton(WPA Zone 18, 

Australia) 

20

VII. WPA HISTORICAL 

AND EDUCATIONAL PERSPECTIVES 

The World Psychiatric Association was founded 

in 1950, with Professor Jean Delay as its 1st 

President (1950-1957). The events evolving in 

the health/mental health field as an outgrowth 

of the 2nd World War led to a search for 

solutions at an international if not a global 

level. During this period, the World Health 

Organization (WHO) launched the publication 

of the Sixth Revision of the International 

Classification of Diseases, which included, for 

the 1st time, a section dedicated to psychiatric 

disorders. Additionally, the need for scientific 

exchanges on a worldwide basis became a 

reality. The field was rapidly changing and 

expanding during this period. The advances in 

diagnostic classification, psychotherapeutic 

treatment modalities, psychopharmacological 

approaches, full recognition of the brain-mind 

inter-relationship, and the new treatment 

implications based on sociocultural factors, 

brought into the field and profession a new 

conceptualization of the understanding of 

psychiatric disorders, as well as their treatment 

and prevention. 

The need for a close international collaboration 

was quite clear during this period, and the 

vision and leadership of the profession was just 

ripe at that time. Thus, a series of WPA World 

Congresses were organized (1950, 1957, 

1961, and subsequently). By the early 1960s, 

different schools of thought and professional 

ideologies became well integrated under the 

worldwide umbrella of the WPA. In the early 

1970s, the profession became conscious and 

concerned with respect to issues related to 

patient rights and human rights at large. The 

WPA responded quite appropriately to these 

needs, and thus, in 1977, formulated the 

Hawaii declaration on Ethical Guidelines in 

Psychiatric Practice; this Declaration was later 

amended in 1983 (Vienna). Subsequently, a 

new and updated declaration on Ethical 

Standards for Psychiatric Practice was 

approved in 1996 (Madrid), and expanded in 

1999 (Hamburg). In the late 1980s and early 

1990s, the field began to focus attention in 

the ever-expanding area of education. Taking 

a leadership role in this respect, the WPA 

produced a series of educational programs, 

and through the Education Coordination 

Center a WPA educational liaison network was 

developed, a WPA educational website was 

created, and continuing medical education 

credits are now offered in WPA Congresses. 

Along these lines, the WPA has also recently 

launched a series of initiatives that are quite 

relevant to the educational field. For instance, the 

WPA sponsored the journal “World Psychiatry”, 

developed a publication series focusing on 

“evidence and experience in psychiatry”, and 

another series on “images of psychiatry”. 

Additionally, a series of books, journals and other 

related scientific and educational publications has 

recently evolved out of the WPA Scientific 

Sections, Standing and Operational Committees, 

and Proceedings of World Congresses and 

Regional Meetings. In addition, the WPA 

published the “Core Curriculum in Psychiatry for 

Medical Students”. This educational publication, 

under the able leadership of Professor Michael G. 

Gelder and Professor Felice Lieh Mak provided 

the international field with the basic knowledge, 

skills and attitudes required by medical students 

learning about psychiatry. Furthermore, it offered 

a good opportunity for general physicians to 

learn the basic knowledge as to how to diagnose 

and treat psychiatric disorders and conditions. 

It is within this historical and educational 

context that the WPA Institutional Program on 

the “Core Training Curriculum for Psychiatry” 

was conceptualized, designed, and developed. 

This core training curriculum for psychiatry 

takes full advantage, where possible, of 

modern educational theory concepts of core 

competencies, realistic and assessable learning 

objectives, and problem-based learning. 

Additionally, the concept of “lifelong learning” 

and the seamless link between training and 

continuing professional development is also an 

integral objective of this core training 

curriculum for psychiatry. 

21

VIII. WPA INSTITUTIONAL PROGRAM ON CORE 

TRAINING CURRICULUM FOR PSYCHIATRY 

The idea of the “Core Training Curriculum for 

Psychiatry” was 1st introduced to the WPA 

Standing Committee on Education in 1997 by 

Professor Pedro Ruiz. The recently published 

WPA “Core Curriculum in Psychiatry for 

Medical Students” certainly served as a stimulus 

in this regard. The WPA Operational Committee 

on Education quickly embraced this idea, 

deliberated it and formulated it. This Committee 

at that time was composed by Professor Roger 

Montenegro (Chair) (Argentina), Professor 

David Goldberg (England), Professor Srinivasa 

Murthy (India), Professor Pedro Ruiz (USA), 

Professor Constantin R. Soldatos (Greece), and 

Professor Samuel Tyano (Israel). This Committee 

commissioned Professor Pedro Ruiz to design a 

questionnaire which could be used to survey 

the international field with respect to 

educational data pertaining to existing 

postgraduate psychiatric (general) residency 

training programs. This questionnaire was 

designed, reviewed and approved by the WPA 

Operational Committee on Education in 1998. 

In August of 1999, Professor Pedro Ruiz 

conducted a workshop on “Development of the 

International Curriculum for the Postgraduate 

Training in General Psychiatry” during the WPA 

XI World Congress in Psychiatry held in 

Hamburg, Germany. The idea was to test the 

field’s readiness for such an educational effort. 

Needless-to-say, this workshop was well 

attended and the discussion that took place 

confirmed the relevance and need of such a 

project for the field of psychiatry at large. 

In December 1999, Professor Roger 

Montenegro, on behalf of the WPA Standing 

Committee on Education, presented to the 

WPA Executive Committee the proposal of 

putting in action an Educational Project aiming 

to the creation of a “Core Training Curriculum 

for Psychiatry”. This proposal was unanimously 

approved by the WPA Executive Committee at 

that time. Subsequently, a WPA Steering 

Committee was appointed to coordinate this 

Institutional Educational Program, with 

Professor Pedro Ruiz as Executive Director. In 

June of 2000, the WPA Steering Committee 

met in Paris, France, during the WPA Regional 

Meeting and the “Congress International du 

Jubilee”. In this meeting, it was decided that 

the best approach to achieve the success of this 

educational project was to consider its three 

basic components, i.e., the “Didactic 

Curriculum”, the “Didactic/Clinical Rotations”, 

and the “Curriculum Evaluation Component”. 

During the Spring and Summer of 2001, the 

field’s outreach survey phase was instituted using 

the questionnaire designed for this purpose. The 

questionnaire was sent to all WPA Member 

Societies, the members of the WPA educational 

liaisons network, the educational component of 

the WPA website, and selected educational 

programs worldwide. Needless-to-say, the 

assistance of the WPA Secretary General, 

Professor Juan R. Mezzich, and his able staff, as 

well as the WPA Secretary for Education, 

Professor Roger Montenegro, and his able staff 

was crucial for the success of this phase of the 

educational project. As a result of these efforts, 

36 worldwide educational programs participated 

by completing the survey’s questionnaire and 

providing very relevant information in this regard. 

Programs that collaborated in this phase of the 

educational project included: 

– Institute of Postgraduate Training in 

psychiatry (APSA), Buenos Aires (Argentina) 

– Italian Hospital, Buenos Aires (Argentina) 

– University of Buenos Aires, Buenos Aires 

(Argentina) 

– National Institute of Health (NIH), Yerevan 

(Armenia) 

– Graylands Hospital, Mt. Claremont 

(Australia) 

– University of Vienna, Vienna (Austria) 

– Azerbaijan Medical University, Baku 

(Azerbaijan) 

– Azerbaijan State Institute for Postgraduate 

Training, Baku (Azerbaijan) 

– University of Chile, Santiago (Chile) 

– Pontificial Bolivarian University, Medellin 

(Colombia) 

23


– University of Caldas, Manizales (Colombia) 

– Havana Psychiatric Hospital, Havana (Cuba) 

– Institute for Postgraduate Medical 

Education, Praha (Czech Republic) 

– The Royal College of Psychiatrists, London 

(UK) 

– “Diplome d’Etudes Specialisees,” Paris 

(France) 

– Eginition Hospital/Athens University, Athens 

(Greece) 

– University of Debrecen Medical and Health 

Science Center, Debrecen (Hungary) 

– University of Pecs, Pecs (Hungary) 

– Airlangga University, Surabaya (Indonesia) 

– Geha Psychiatric Center, Tel Aviv (Israel) 

– Tokyo University, Tokyo (Japan) 

– University of Malaysia, Kuala Lumpur 

(Malaysia) 

– National University “Autonoma” of Mexico, 

Mexico D.F. (México) 

– University College Hospital, Abuja City 

(Nigeria) 

– University Medical Faculties in Poland, 

Warsaw Poland) 

– Almaty Institute of Postgraduate Training for 

Physicians, Almaty (Republic of Kazakhstan) 

– Residency Program, Bucharest (Rumania) 

– Al Obrejia Hospital, Bucharest (Rumania) 

– University of Cape Town, Obervatory 

(South Africa) 

– University of Witwatersrand, Johannesburg 

(South Africa) 

– University of Navarra, Pamplona (Spain) 

– University Hospital, Valladolid (Spain) 

– University of the Republic of Uruguay, 

Montevideo (Uruguay) 

– Menninger Clinic, Topeka (USA) 

– Mount Sinai School of Medicine, New York 

City (USA) 

– University of Texas at Houston, Houston 

(USA) 

In the Summer of 2001, under the supervision 

of the WPA Secretary General, Professor Juan 

E. Mezzich, the staff of the WPA Secretariat 

prepared a statistical report based on the 

educational data secured from the survey’s 

questionnaires received. This statistical report 

was used as background information for the 

next phase of the educational project. I should 

emphasize that the data used for the statistical 

report came from educational programs located 

in all regions of the world, from the Americas, 

Europe, Africa, Asia and the South Pacific. 

The next phase of this educational project took 

place in a retreat setting which followed the WPA 

International Congress that took place in Madrid, 

Spain on 9/30/01 to 10/4/01. During the retreat, 

three Committees were organized to formulate 

the “Didactic Curriculum”, the “Didactic/Clinical 

Rotations” and the “Curriculum Evaluation 

Component”. The statistical report previously 

alluded to was used as background information 

for the work of these three Committees. 

Subsequent to this retreat, Professor Pedro Ruiz 

integrated the recommendations made by the 

group of Educational Consultants into the 1st 

draft report of this educational project. During 

the early part of the Winter of 2001, this draft 

was circulated for review and feedback among 

the members of the WPA Executive Committee, 

the members of the Steering Committee, the 

group of Special Educational Consultants, the 

group of Educational Consultants, and the 

group of Educational Advisors. The WPA Zone 

representatives were appointed as Educational 

Advisors for this phase of the educational 

project. During the beginning of 2002, the 

report was distributed among the Presidents of 

the WPA Member Societies, the Chairs of the 

WPA Sections, and the field at large for further 

review and feedback. 

In the Spring of 2002, the Steering Committee 

met to offer a final touch to the last draft report 

of this educational project. Shortly afterwards, the 

WPA Executive Committee approved the final 

draft of this WPA Institutional Program. Shortly 

afterwards, a copy of the Executive Summary of 

the report was published and distributed in the XII 

World Congress of Psychiatry in Yokohama, 

Japan in August 2002. Subsequently, the final 

report was published and made available to the 

field at large. The outcome of this educational 

project emanated from many hours of hard work, 

as well as the involvement of dozens of 

educational experts from around the world. The 

task on hand was quite challenging and complex. 

However, the outcome of this educational project 

was most rewarding and promising. Hopefully, 

many general psychiatric training programs across 

the world will benefit from the utilization of this 

“Core Training Curriculum for Psychiatry” for 

years to come. 

24

IX. BIBLIOGRAPHY 

We are fully aware that local Directors of 

Training are best suited to select 

and provide guidance about appropriate 

suggested reading material. However, 

we wanted to stimulate the reading 

process by providing a few bibliographic 

references directly related to relevant 

educational topics. 

AADPRT Task Force on the Quality of 

Residency Programs: The Assessment of 

Programs and Options for Distributing 

Psychiatric Residents in the Service of 

Health Care Reform. Academic Psychiatry 

1999; 23(2): 61-70. 

Alarcon RD, Foulks EF, Vkkur M (eds.): 

Personality Disorders and Culture: Clinical 

and Conceptual Implications. New York, 

John Wiley & Sons, Inc., 1998. 

Alarcon RD, Ruiz P: Cultural Psychiatry Across 

the World: Scope and Perspectives. In J.M. 

Oldham, M.B. Riba (eds.): Review of 

Psychiatry, Volume 4. Washington, D.C., 

American Psychiatric Press, Inc., 1995, pp. 

599-626. 

Bienenfeld D, Klykylo W, Knapp V: 

Development of Competency-Based 

Measures for Psychiatry Residency. 

Academic Psychiatry 2000; 24(2): 68-76. 

Bobes Garcia J, Gonzalez Seijo JC, Saiz 

Martinez PA: “Prevencion de las Conductas 

Suicidas Y Parasuicidas”. Barcelona, España, 

Masson, 1997. 

Bobes J, Bousono M, Gonzales MP, Saiz PA: 

“Trastornos de Ansiedad y Transtorhos 

Depresivos en Atencion Primaria”. 

Barcelona, España, 2001. 

Christodoulou GN: Developments in 

Postgraduate Psychiatric Training. 

Psychiatriki 1995; 6(2):110. 

Foulks EF: Culture and Personality Disorders. 

In J.E. Mezzich, A. Kleinman, H. Fabrega, 

Jr., D.L. Parron (eds.): Culture and 

Psychiatric Diagnosis: A DSM-IV 

Perspective. Washington, D.C., American 

Psychiatric Press, Inc., 1996, pp. 243-252. 

Foulks EF: Cultural Issues. In M. Hernsen, W. 

Sledge (eds.): Encyclopedia of 

Psychotherapy, Volume I. New York, 

Academic Press, 2002, pp. 1-10. 

Foulks EF, Bland JJ, Shervington D: 

Psychotherapy Across Cultures. In J.M. 

Oldham, M.B. Riba (eds.): Review of 

Psychiatry, Volume 14. Washington, D.C., 


511-528. 

Foulks EF, Westermeyer J, Ta K: 

Developing Curricula for Transcultural 

Mental Health for Trainees and Trainers. 

In S.O. Okpaku (ed.): Clinical Methods in 

Transcultural Psychiatry. Washington, D.C., 


339-362. 

Garza Trevino ES, Ruiz P, Venegas Samuels K: 

A Psychiatric Curriculum Directed to the 

Care of the Hispanic Patient. Academic 

Psychiatry 1977; 21(1): 1-10. 

Gonzalez CA, Griffith EEH, Ruiz P: Cross- 

Cultural Issues in Psychiatric Treatment. In 

G.O. Gabbard (ed.): Treatment of 

Psychiatric Disorders, 3rd Edition, Volume I. 

Washington, D.C., American Psychiatric 

Press, Inc., 2001, pp. 47-67. 

Griffith EEH, Ruiz P: Cultural Factors in the 

Training of Psychiatric Residents in an 

Hispanic Urban Community. Psychiatric 

Quarterly 1977; 49(1): 29-37. 

Heim C, Newport DJ, Bonsall R, Miller AH, 

Nemeroff CB: Altered Pituitary-Adrenal Axis 

Responses to Provacative Challenge Test in 

Adult Survivors of Childhood Abuse. 

American Journal of Psychiatry 2001; 158: 

575-581. 

Kahn SR, Cowan KA, Ruiz P: The Role of 

Group Psychotherapy in Psychiatric 

Residency Training. The Jefferson Journal of 

Psychiatry 1996; 13(1): 27-34. 

Kapoor V, Matorin AA, Ruiz P: Termination of 

Psychotherapy: A Training Perspective. 

Journal of Psychiatric Practice 2000; 6(6): 

334-340. 

25


Katschnig H, Sartorius N, Freeman H: Quality 

of Life in Mental Disorders: New York, John 

Wiley, 1997. 

Kendler KS, Thornton LM, Prescott CA: 

Gender Difference in the Rates of Exposure 

to Stressful Life Events and Sensitivity to 

Their Depressogenic Effects. American 

Journal of Psychiatry 2001; 158: 587-593. 

Kuruvilla K: A Common Minimum Programme 

Needed in Post-Graduate Training in 

Psychiatry. Indian Journal of Psychiatry 

1996: 38(3): 118-119. 

López-Ibor JJ, Lenz F: Training and Education 

in Psychiatry. Facultas Verlag. Viena, 1984 

Lowinson JH, Ruiz P, Millma RB, Langrod JS 

(eds.): Substance Abuse: A Comprehensive 

Textbook. Baltimore, Maryland, Williams 

and Wilkins Co., 1997. 

Matorin AA, Collins DM, Abdulla A, Ruiz P: 

Women’s Advancement in Medicine and 

Academia: Barriers and Future Perspectives. 

Texas Medicine 1997; 93(11): 60-64. 

Matorin AA, Lile B, Ruiz P: Educating Primary 

Care Physicians in the Diagnosis and 

Treatment of Depressive Disorders. Studi di 

Psichiatria 2002; 

Matorin AA, Ruiz P: Training Family Practice 

Residents in Psychiatry: An Ambulatory 

Care Model. International Journal of 

Psychiatry in Medicine 1999; 29(3): 327- 

336. 

Matorin AA, Venegas Samuels K, Ruiz P, Butler 

PM, Abdulla A: U.S. Medical Students 

Choice of Careers and its Future Impact on 

Health Care Manpower. Journal of Health 

and Human Services Administration 2000; 

22(4): 495-509. 

McHugh P. Slavney PR: The Education of 

Psychiatrists. In M.G. Gelder, J.J. Lopez Ibor, 

Jr., N.C. Andreasen (eds.): New Oxford 

Textbook of Psychiatry. Oxford England, 

Oxford University Press, 2000. 

Mohl PC, Sadler JZ, Miller DA: What 

Components Should be Evaluated in a 

Psychiatric Residency. Academic Psychiatry 

1994; 18: 22-24. 

Moloney J, MacDonald J. Psychiatric Training 

in New Zealand. Australian and New 

Zealand Journal of Psychiatry 2000; 34(1): 

146.153. 

Okasha A: The Future of Medical Education 

and Teaching: A Psychiatric Perspective. 

American Journal of Psychiatry 1997; 154 

(S6): 77-85. 

Okasha A: Setting for Learning: The 

Community Beyond. Medical Education 

1995; 29 (Supplement 1): 112-115. 

Panzarino Jr. PJ: Psychiatric Training and 

Practice Under Managed Care. 

Administration and Policy in Mental Health 

2000; 28(1): 51-59. 

Robinowitz CB, Yager J: Future of Psychiatry 

Education. In L.J. Dickstein, M.B. Riba, J.M. 

Oldham (eds.): Review of Psychiatry, 

Volume 15. Washington, D.C., American 

Psychiatric Press, Inc., 1996, pp. 581-604. 

Robinson GE: A Clinician Guide to 

Menopause. Washington, D.C., American 

Psychiatric Press, Inc., 1997. 

Rousseau C, Perreault M, Leichner P: 

Residents’ Perception of Transcultural 

Psychiatric Practice. Community Mental 

Health Journal 1995; 31(1): 73-89. 

Ruiz P (ed.): Ethnicity and 

Psychopharmacology. Washington, D.C., 

American Psychiatric Press, Inc., Review of 

Psychiatric Series, Volume 19, No. 4, 2000. 

Ruiz P: Living and Dying with HIV/AIDS: A 

Psychosocial Perspective. American Journal 

of Psychiatry 2000; 157(1): 110-113. 

Ruiz P: “La Docencia de Postgrado en 

Psiquiatria en los Estados Unidos: Una 

Perspectiva Contemporanea”. In L. 

Menendez de Nucette (ed.): “Los 

Postgrados en Psiquiatria en Venezuela”. 

Maracaibo, Venezuela, Ediciones Astro Data 

S.A., 1998, pp. 104-112. 

Ruiz P: New Perspectives in Cultural 

Psychiatry. Journal of Practical Psychiatry 

and Behavioral Health 1998; 4(3): 150-156. 

Ruiz P: Assessing and Treating Culturally 

Diverse Individuals: A Hispanic Perspective. 

Psychiatric Quarterly 1995; 16: 329-341. 

Ruiz P: Cuban Americans: Migration, 

Acculturation and Mental Health. In R.G. 

26

Bibliography 

Malgady, O. Rodriguez (eds.): Theoretical 

and Conceptual Issues in Hispanic Mental 

Health. Malabar, Florida, Krieger Publishing 

Co., 1994, pp. 70-89. 

Ruiz P: The Role of Culture in Psychiatric Care. 

American Journal of Psychiatry 1988; 

155(12): 1763-1765. 

Schnapp WB, Stone S, Van Norman J, Ruiz P: 

Teaching Ethics in Psychiatry: A Problem- 

Based Learning Approach. Academic 

Psychiatry 1996; 20(3): 144-149. 

Special Issue: Psychiatric Education in the Arab 

World. The Arab Journal of Psychiatry 

1998; Supplement: 1-55. 

Special Issue: Training in Psychiatry: A 

European Perspective. European Archives of 

Psychiatry and Clinical Neuroscience 1997; 

247 (Supplement 1) (6): S1-S47. 

Stein TS: A Curriculum for Learning in 

Psychiatric Residences About 

Homosexuality, Gay Men, and Lesbians. 

Academic Psychiatry 1994; 18: 59-70. 

Stewart DE: Antidepressant Drugs During 

Pregnancy and Lactation. International 

Journal of Clinical Psychopharmacology, 15: 

S19-24, 2000. 

Stotland NL, Stewart DE (eds.): Psychological 

Aspects of Women’s Health Care. 

Washington, D.C., American Psychiatric 

Press, Inc., 2001. 

The Royal College of Psychiatrists: Curriculum 

for Basic Specialist Training and the MRC 

Psych Examination. Gosport, Hants, United 

Kingdom, Ashford Colour Press Ltd., 2001. 

Van Beinum M: Psychiatrists Need Different 

Training for 21 st Century. British Medical 

Journal 2001; 323(7310): 449. 

Walton H: Education and Training in 

Psychiatry. London, England, King Edward’s 

Fund, 1986. 

Webb LC, Juul D, Reynolds CF, Ruiz B, Ruiz P, 

Scheiber SC, Scully J: How Well Does the 

Psychiatry Residency In-Training 

Examination Predict Performance on the 

American Board of Psychiatry and 

Neurology Part I Examination? American 

Journal of Psychiatry 1996; 153(6): 831- 

832. 

27

APPENDIX A 

STATISTICAL REPORT 

OF THE INTERNATIONAL SURVEY 

ON GRADUATE TRAINING 

IN GENERAL PSYCHIATRY

TABLE OF CONTENTS 

Pages 

I. INTRODUCTION 33 

II. STATISTICAL TABLES 35-63 

Table 1. Identification 

Table 2. Duration of the Program and Number of Trainees 

Table 3. Requirements A: Admission, Graduation and Certification Process 

Requirements B: Training Program Accreditation and Other Important 

Information/Comments 

Table 4. Structure of Training: Primary Care 

Table 5. Structure of Training: Neurology 

Table 6. Structure of Training: Emergency Psychiatry 

Table 7. Structure of Training: Inpatient Psychiatry 

Table 8. Structure of Training: Outpatient Psychiatry 

Table 9. Structure of Training: Consultation & Liaison Psychiatry 

Table 10. Structure of Training: Child & Adolescent Psychiatry 

Table 11. Structure of Training: Geriatric Psychiatry 

Table 12. Structure of Training: Addiction Psychiatry 

Table 13. Structure of Training: Forensic Psychiatry 

Table 14. Structure of Training: Community Psychiatry 

Table 15. Other Didactic/Clinical Rotations 

Table 16. Supervision 

Table 17. Methods Used for Delivering the Content of Training 

Table 18. Methods of Access to Knowledge 

Table 19. Content of Training: Key Seminars, Other Seminars 

Table 20. Evaluation Methodologies of the Quality of Educational Activities 

Table 21. Subspecialty Training 

III. ADDITIONAL COMMENTS 65-76 

Appendix 1: On Primary Care 

Appendix 2: On Neurology 

Appendix 3: On Emergency Psychiatry 

Appendix 4: On Inpatient Psychiatry 

Appendix 5: On Outpatient Psychiatry 

Appendix 6: On Consultation & Liaison Psychiatry 

Appendix 7: On Child & Adolescent Psychiatry 

Appendix 8: On Geriatric Psychiatry 

Appendix 9: On Addiction Psychiatry 

Appendix 10: On Forensic Psychiatry 

Appendix 11: On Community Psychiatry 

Appendix 12: On Supervision 

Appendix 13: On Methods Used for Delivering the Content of Training 

Appendix 14: On Methods of Access to Knowledge 

Appendix 15: On Content of Training 

Appendix 16: On Evaluation Methodologies of the Quality of Educational Activities 

Appendix 17: On Special Training Issues

I. INTRODUCTION 

The International Survey on Graduate 

Training in General Psychiatry was the first 

formal activity of the WPA Institutional 

Program aimed at developing a Core 

Training Curriculum for Psychiatry. This 

Institutional Program, which as such 

reflects the top priority assigned by the 

WPA’s General Assembly to the 

development of this curriculum, is Chaired 

by Prof. Juan J. López-Ibor, Jr. (WPA 

President) and Co-chaired by Prof. Ahmed 

Okasha (WPA Vice President and President 

Elect). Developments in the neurosciences, 

psychopharmacology, epidemiology, 

psychotherapies and cultural studies are 

now leading to the need to re-examine the 

identity and role of psychiatrists and to 

develop a basic international framework 

for graduate training in general psychiatry. 

The questionnaire for this Survey was 

designed by Prof. Pedro Ruiz, Executive 

Director of this Institutional Program. To 

facilitate its completion, an electronic 

version was prepared by Prof. Roger 

Montenegro, WPA Secretary for Education 

and webmaster of the WPA Online. 

Despite its substantial length, the Survey 

aroused considerable interest across the 

world and was responded to by the 

directors of 36 educational programs from 

the Americas, Europe, Africa, Asia, and the 

South Pacific. The completed 

questionnaires were received and 

processed by the WPA Secretariat, which 

assumed the responsibility of conducting 

data analysis and the preparation of this 

report. 

As shown in the table of contents, the 

main components of this Statistical Report 

are a set of tables presenting the 

quantitative results obtained from the 

structured sections of the questionnaire 

and an accompanying set of appendices 

containing the additional comments 

offered by some programs on various 

sections of the questionnaire. The 

responses received from programs 27 

through 36, as listed on table 1, had their 

responses taken into consideration in the 

development of the WPA Core Training 

Curriculum for Psychiatry, but they were 

not included in the statistical tables. 

It is hoped that this Statistical Report will 

provide a helpful informational basis for 

the development of a useful WPA Core 

Training Curriculum for Psychiatry. 

33

Statistical Report of The International Survey on Graduate Training in General Psychiatry 

II. STATISTICAL TABLES 

Table 1. Identification 

PROGRAM 

NUMBER 

INSTITUTION 

1 University of Navarra, Pamplona, Spain 

2 University Hospital, Valladolid, Spain 

3 University of Vienna, Vienna, Austria 

4 Residency Program, Bucharest, Romania 

5 University of Pecs, Pecs, Hungary 

6 Eginition Hospital/Athens University, Athens, Greece 

7 Institute for Postgraduate Medical Education, Praha, Czech Republic 

8 National Institute of Health (NIH), Yerevan, Armenia 

9 University of Cape Town, Obervatory, South Africa 

10 University of Chile, Santiago, Chile 

11 Institute of Postgraduate Training in Psychiatry (APSA), Buenos Aires, Argentina 

12 Mount Sinai School of Medicine, New York City, USA 

13 University of Texas Medical School at Houston, Houston, USA 

14 University of Caldes, Manizales, Colombia 

15 Pontificial Bolivarian University, Medellin, Colombia 

16 University of Buenos Aires, Buenos Aires, Argentina 

17 Azerbaijan State Institute for Post Graduate Training, Baku, Azerbaijan 

18 Tokyo University, Tokyo, Japan 

19 University of Witwatersrand, Johannesburg, South Africa 

20 Graylands Hospital, Mt. Claremont, Australia 

21 Menninger Clinic, Topeka, USA 

22 University of Malaysia, Kuala Lumpur, Malaysia 

23 Al Obrejia Hospital, Bucharest, Romania 

24 Azerbaijan Medical University, Baku, Azerbaijan 

25 Italian Hospital, Buenos Aires, Argentina 

26 University of the Republic of Uruguay, Montevideo, Uruguay 

27 The Royal College of Psychiatrists, London, England 

28 University Medical Faculties in Poland, Warsaw, Poland 

29 University College Hospital, Abuja City, Nigeria 

30 National University “Autonoma” of Mexico, Mexico D.F., Mexico 

31 Geha Psychiatric Center, Tel Aviv, Israel 

32 Havana Psychiatric Hospital, Havana, Cuba 

33 University of Debrecen Medical and Health Science Center, Debrecen, Hungary 

34 Almaty Institute of Postgraduate Training for Physicians, Almaty, Republic of 

Kazakhstan 

35 “Diplome d’Etudes Specialisees”, Paris, France 

36 Airlangga University, Surabaya, Indonesia 

35


Table 2. Duration of the Program and Number of Trainees 

ITEMS n (N = 26) % 

1. Duration one year 2 7.7 

two years 1 3.9 

three years 7 26.9 

four years 9 34.6 

five years 5 19.2 

six years 2 7.7 

2. Number of trainees 

Total 1 to 15 6 23.1 

16 to 30 12 46.1 

31 to 45 2 7.7 

more than 45 5 19.2 

blank 1 3.9 

First year 1 to 4 10 38.4 

5 to 8 7 26.9 

9 to 12 1 3.9 


blank 4 15.4 

Second year 1 to 4 9 34.6 

5 to 8 6 23.1 

9 to 12 2 7.7 


blank 6 23.1 

Third year 1 to 4 8 30.8 

5 to 8 8 30.8 

9 to 12 1 3.8 


blank 5 19.2 

Fourth year 1 to 4 6 23.1 

5 to 8 5 19.2 

9 to 12 2 7.7 


blank 11 42.3 

Fifht year 1 to 4 6 23.1 

5 to 8 5 19.2 

9 to 12 2 7.7 


blank 11 42.3 

Sixth year 1 to 4 0 0.0 

5 to 8 1 38.8 

9 to 12 0 0.0 


blank 25 96.2 

36


Table 3a. Requirements A: Admission, Graduation and Certification Process 

Program & Place Admission Requirements Graduation Procedures Certification Process 

1. Pamplona, Spain 

M.D. degree, residency 

application, 

and candidate 

selection via 

interview. 

Enacted by the 

Specialty 

Commission of the 

Education Ministry. 

Activity logs and 

supervisory reports 

filed with the Central 

Education Commission. 

Recertification: N/A 

2. Valladolid, 

Spain 

National test for 

entering residents 

(MIR). 

License to practice 

medicine. 

Local and national 

evaluation after four 

years of training 

monitored by the 

National Health and 

Education Ministries. 


3. Vienna, 

Austria 

M.D. degree. 

N/A 

Specialty exam. 


4. Bucharest, 

Romania 

M.D. degree and 

MCQ exam. 



medicine issued by 

Minister of Health. 

Recertification: every 

three years 

5. Pecs, 

Hungary 


availability of a 

residency slot. 

After six years of training, 

State exam offered by 

universities. 

N/A 

6. Athens, 

Greece 


license to practice 


the Minister of 

Health. 

Successful supervisory 

reports and evaluation by 

the Director of 

Training. 

N/A 

7. Praha, 

Czech Republic 

Not specific. 

Graduation exam and 

supervised patient 

interview and review 

of medical records. 

Oral examination 

focusing on three clinical 

cases, one emergency 

case and one 

administrative case. Also 

an essay on a topic 

chosen by the resident. 

Certification 

examination focusing 

on the practice of 

psychiatry. Recertification: 

Based 

on an accredited CME 

program provided and 

monitored by a Chamber 

of Physicians. 

37


Table 3a. Requirements A: Admission, Graduation and Certification Process (cont.) 


8. Yerevan, 

Armenia 

Documented 

progress of graduate 

medical education and 

competence in general 

medicine and 

mental sciences. 

Performance certification 

by supervisors and 

Director of Training, 

computerized exam 

in accordance to medical 

license program (with 

70% of valid answers), 

graduation exam and 

initial medical license to 

practice medicine, issued 

for 1-3 years. 

Same as for graduation; 

both processes run 

simultaneously. 

Recertification: 

Certification in Psychiatry, 

Narcology 

and Psychotherapy 

enacted by the Minister 

of Health, letter of 

reference, advanced 

postgraduate 

training of no less than 

200 hours and 

computerized test in 

accordance to a medical 

license program. 

9. Observatory, 

South Africa 

Two years 

postqualification. 

FCPych (SA) part 1 and 

part 2 exams of the 

College of Psychiatrists 

of South Africa. 

Certification based 

on registration as 

specialists with the Health 

Professions Council of 

South Africa. 

Recertification based on 

Continuous 

Professional Development 

Program over a period of 

five years, which includes 

250 points of which 50 

points are on ethics. 

10. Santiago, 

Chile 

Application for 

postgraduate school. 

M.D. degree. 

Final exam conducted by 

the Postgraduate School 

of the University of Chile. 

Special certification 

enacted by the University 

of Chile.Recertification: 

N/A 

38




11. Buenos Aires, 

Argentina (APSA) 

M.D. degree and license 

to practice 

medicine.Evaluation 

conducted by a Board of 

Admissions. 

Completion of theoretical 

and clinical requirements 

during the three years of 

training. 

Certification is based 

on either a mandatory 

legal process through the 

Health Ministry or a 

voluntary process through 

the “Consejo 

de Certficacion de 

Profesionales Medicos” 

sponsored by the 

Academy of Medicine. 


five years. 

12. New York, USA 

M.D. degree 

required.USML Part I and 

II exams (with scores of 

75 or above). 

Succesful completion 

of a 4 year ACGME 

accredited program. 

Certification based on a 

written and oral exam 

conducted by the 

American Board 

of Psychiatry and 

Neurology. 

Recertification 

every ten years. 

13. Houston USA 

M.D. degree required. 

USML I and II exams with 

scores of 75 or above 

required. 

Succesful completion of a 

4 year ACGME accredited 

program. 




American Board of 

Psychiatry and Neurology. 

Recertification: every ten 

years. 

14. Manizales, 

Colombia 

Competency exam on 

general medicine, with a 

minimum score of 70%. 

Admission interview. 

Three years of approved 

training, and two years of 

elective research training. 

N/A 

15. Medellin, 

Colombia 

M.D. degree. General 

Medicine exam , and an 

admission interview. 

Three years of approved 

training, and two years 

of elective research 

training. 

N/A 

39





Argentina 

(Buenos Aires 

University) 


to practice 


conducted by a Board of 

Admissions. 


and clinical requirements 

during the three years of 

training. Dissertation and 

oral exam at the end of 

training. 

Certification is based on 

either a mandatory legal 

process through the 


voluntary process 

through the “Consejo de 

Certficacion de 




Recertification: every five 

years. 

17. Baku, Azerbajia 

(State Institute) 

M.D. degree, internship 

and letters of reference. 

Completion of all 

graduate training 

requirements. 

Certification based on 

completion of training in 

psychiatry. 

Recertification: every 3-5 

years based on a 

refreshing course. 

18. Tokyo, Japan 

Successfully passing the 

National Board Exam. 

Admission interview. 

Six years of medical 

courses after high school 

graduation. 

Certification exam based 

on 8 case reports after 

five years of 

postgraduate training. 


three years based on a 

one day educational 

course. 

19. Johannesburg, 

South Africa 

M.D. degree, internship, 

one year community 

service and six months 

as a Medical Officer in 

psychiatry. 

National examination of 

the College of 

Psychiatrists during the 

third year of training, 

Qualification as a Fellow 

of the College of 

Psychiatrists and a 

research report for the 

Univeristy. M.MedPsych 

Program during the 

fourth year of training. 


completion of five years 

of training, F.C.Psych or 

M.Med Specialty certified 

by the Health Professions 

Council of South Africa. 

Recertification: based on 

retention of Certification 

by obtaining fifty 

Continued Professional 

Development points 

every year. 

40




20. Mount Claremont, 

Australia 

MBBS degree, two years 

of medical experience, 

and full registration with 

the Medical Board of 

West Australia. 

Fulfillment of all 

requirements of the Royal 

Australian and New 

Zealand College of 

Psychiatry. 

Advanced training on 

child, adult mental health 

and old age psychiatry 

needed. Recertification: 

based on Maintenance of 

Professional Standards. 

21. Topeka, USA 

M.D. degree required. 

USML Part I and II exams 

(with scores of 75 or 

above). 

Succesful completion 

of a 4 year ACGME 

accredited program. 




American Board of 

Psychiatry and 

Neurology. 

Recertification: every ten 

years. 

22. Kuala Lumpur, 

Malaysia 

MBBS degree, rotating 

internship, one year as 

Medical Officer, 

successfully passing the 

general government 

examination, 

appropriately passing 

psychological tests, 

admission interview and 

three letters of reference. 

Successfully passing the 

part I and part II required 

exams during the four 

years of training. 


six months of supervision 

before consideration for 

specialty status in MOH. 

Recertification: in 

progress. 

M.D. degree and MCQ 

exam. 

23. Bucharest, Romania 

(Al Obrejia Hospital) 

M.D. degree and letters 

of reference. 




Minister of Health. 


three years. 

24. Baku, Azerbajian 

(Medical University) 

Completion of all 

graduate training 

requirements. 


completion of training 

in psychiatry. 

Recertification: every 3-5 

years based on a 

refreshing course. 

41





Argentina (Italian 

Hospital) 


to practice 


conducted by a 

Board of Admissions. 


and 

clinical requirements 

during the three 


Dissertation and oral 

exam at the end of 

training. 

Certification is based on 

either a mandatory legal 

process through the 


voluntary process through 

the “Consejo 

de Certficacion de 




Recertification: every five 

years. 

26. Montevideo, Uruguay 


successful competition 

for positions in medical 

residencies. 

Completion of all training 

requirements and two 

clinical tests. 

Certification granted by 

the Ministry of Health. 


27. London, England 

M.D. degree.Approval by 

the Royal College of 

Psychiatrists. 

Completion of all training 

requirements during 6-7 

years of training followed 

by 

a National Commission 

Examination. 

Certification exam 

conducted by the Royal 

College of Psychiatrists. 

Recertification: based on 

Continued Personal 

Development. 

28. Warsaw, Poland 

Three options: 

1) Acceptance for 

residency at a provincial 

level. 

2) Securing employment 

in a psychiatric institution. 

3) Volunteering in a 

psychiatric program. 

Completion of 6-7 years 

of training, followed by a 

National Commission 

Exam. 

N/A 

42


Table 3b. Requirements B: Training Program Accreditation and other Important Information/Comments 

Program Number Training Program Accreditation Other Important Information/Comments 

1 

Accreditation granted by the National 

Commission on Psychiatry 

None 

2 


Commission on Psychiatry 

Organized tutorials on theory, practice and 

research. Departmental annual reports 

3 

Full spectrum of psychiatric inpatients and 

outpatients. 

Adequate number of teachers 

None 

4 

No data available 

None 

5 

Programs accredited by the Hungarian 

College of Psychiatrists 

None 

6 

Training centers approved by the Ministry 

of Health 

The Hellenic Psychiatric Association has 

recommended a national 

training curriculum and training evaluation 

procedures 

7 

This program is approved and operated by 

the Ministry of Health 

None 

8 

Training programs accredited by 

the National Institute of Health 

None 

9 

Training programs accredited by the Medical 

and Dental Committee of the Health Professions 

Council of South Africa 

None 

10 

Accreditation granted by the Association of 

Medical Faculties 

None 

11 

Accreditation granted by the National Board 

of University Evaluation and Accreditation 

Recently a certification program was initiated 

by the National Academy of Medicine 

12 

Training programs are accredited by the 

Accreditation Council of Graduate Medical 

Education 

An inservice training exam must 

take place annually 

13 



Education 



43


Table 3b. Requirements B: Training Program Accreditation and other Important Information/Comments (cont.) 


14 


None 

15 


None 

16 


Board of University Evaluation and 

Accreditation 

Recently a certification program was 

initiated by the National Academy of 

Medicine 

17 

Training programs approved by the 

Scientific Board of Azerbajian and the 

Scientific Medical Council of 

the Ministry of Health 

None 

18 


None 

19 


the Medical and Dental Committee of the 

Health Professions Council of South Africa 

None 

20 

Training programs approved by the Royal 

Australian and New Zealand College of 

Psychiatry 

None 

21 



Education 



22 

Training programs approved by the 

National Postgraduate Committee 

in Psychiatry composed of members from 

the government, universities and the 

organized profession 

None 

23 


None 

24 


None 

25 


None 

26 


the Graduate School of the Faculty of 

Medicine 

Certification procedures supervised 

by the Health Ministry 

44


Table 3b. Requirements B: Training Program Accreditation and other Important Information/Comments (cont.) 


27 

Accreditation based on side visits and close 

monitoring of programs, and conducted by 

a Committees of the Royal College of 

Psychiatrists 

None 

28 

Training programs are approved by Medical 

Centers and the Ministry of Health, based 

on a National Commission recommendation 

None 

45


Table 4. Structure of Training: Primary Care 

ITEMS n (N = 26) % 

1. Length (months) 

2. Years Level 

3. Settings 

1 to 2 2 7.7 

3 to 4 6 23.1 

5 to 6 3 11.5 


blank 2 34.6 

first 11 42.3 

second 3 11.5 

third 1 3.9 

fourth 1 3.9 

emergency 9 34.6 

inpatient 11 42.3 

outpatient 9 34.6 

consultation 6 23.1 

Note: See additional comments in Appendix 1 

Table 5. Structure of Training: Neurology 



3. Settings 

ITEMS n (N = 26) % 


1 to 2 12 46.2 

3 to 4 7 26.9 

5 to 6 3 11.5 


blank 2 7.7 

first 10 38.5 

second 7 26.9 

third 3 11.5 

fourth 2 7.7 

other 1 3.9 





other 2 7.7 

46


Table 6. Structure of Training: Emergency Psychiatry 

ITEMS n (N = 26) % 



3. Settings 

1 to 2 7 26.9 

3 to 4 4 15.4 

5 to 6 4 15.4 


blank 9 34.6 

first 11 42.3 

second 13 50.0 

third 8 30.8 

fourth 5 19.2 






Table 7. Structure of Training: Inpatient Psychiatry 



ITEMS n (N = 26) % 


1 to 6 3 11.5 

7 to 12 10 38.5 

13 to 18 5 19.2 


blank 1 3.9 

first 13 50.0 


third 12 46.1 

fourth 5 19.2 

47


Table 8. Structure of Training: Outpatient Psychiatry 

ITEMS n (N = 26) % 



3. Settings 

1 to 6 10 38.5 

7 to 12 9 34.6 

13 to 18 1 3.9 


blank 3 11.5 

first 7 26.9 


third 12 46.1 

fourth 10 38.5 

fifth 1 3.9 

children 10 38.5 

adolescent 16 61.5 

adults 20 76.9 

elderly 18 69.2 


Table 9. Structure of Training: Consultation & Liaison Psychiatry 



3. Settings 

4. Patient population 

ITEMS n (N = 26) % 


1 to 2 4 15.4 

3 to 4 8 30.8 

5 yo 6 2 7.7 


blank 9 34.5 

first 5 19.2 


third 11 42.3 

fourth 4 15.4 

fifth 1 3.9 



adult 13 50.0 

child 6 23.1 

48


Table 10. Structure of Training: Child & Adolescent Psychiatry 



3. Settings 

4. Patient population 

ITEMS n (N = 26) % 


1 to 2 5 19.2 

3 to 4 10 38.5 

5 yo 6 7 26.9 


blank 3 11.5 

first 2 7.7 

second 9 34.6 

third 10 38.5 

fourth 6 23.1 

fifth 1 3.9 




adult 0 0.9 

child 7 26.9 

Table 11. Structure of Training: Geriatric Psychiatry 



3. Settings 

ITEMS n (N = 26) % 


1 to 2 5 19.2 

3 to 4 3 11.5 

5 to 6 4 15.4 


blank 14 53.9 

first 1 3.9 

second 5 19.2 

third 8 30.8 

fourth 2 7.7 

fifth 0 0.00 



49


Table 12. Structure of Training: Addiction Psychiatry 



3. Settings 

ITEMS n (N = 26) % 


1 to 2 7 26.9 

3 to 4 7 26.9 

5 to 6 2 7.7 


blank 10 38.5 

first 2 7.7 

second 4 15.4 

third 6 23.1 

fourth 7 26.9 

fifth 0 0.0 



Table 13. Structure of Training: Forensic Psychiatry 



3. Settings 

ITEMS n (N = 26) % 


1 to 2 4 15.3 

3 to 4 6 23.1 

5 yo 6 2 7.7 


blank 14 53.9 

first 0 0.0 

second 3 11.5 

third 10 38.4 

fourth 5 19.2 

fifth 1 3.9 



court 5 19.2 

other 1 3.9 

50


Table 14. Structure of Training: Community Psychiatry 



3. Settings 

ITEMS n (N = 26) % 


1 to 2 3 11.5 

3 to 4 7 26.9 

5 to 6 3 11.5 


blank 10 38.6 

first 2 7.7 

second 7 26.9 

third 11 42.3 

fourth 7 26.9 

fifth 1 3.9 

other 1 3.9 


day hospital 9 34.6 

residential programs 4 15.4 

51


Table 15. Other Didactic/Clinical Rotations 

Program 

Number 

Type Length Year Level Setting Comments 

2 Psychosocial No data 3 & 4 Day hospital None 

Rehabilitation 

4 Child Neurology 4 months 3 Inpatient None 

Neurosurgery 2 months 2 Inpatient 

Endocrinology 2 months 2 Inpatient 

5 Rehabilitation 3 months 4 Inpatient None 

and outpatient 

6 Special Weekly 3, 4, 5 Outpatient Sleep dx, genetic 

Outpatient Clinics 

counseling, sexual 

dx, eating dx, etc. 

8 Disaster and Accident 2 weeks 2 Military program None 

Med. 

9 Behavioral Therapy 6 months 3 Outpatient None 

Clinic 

10 Personality dx 4 months 2 & 3 Inpatient Obligatory rotation 

and outpatient 

13 Crisis Intervention 2 months 4 Hospital or None 

community 

14 Sports program No data 1, 2, 3 No data None 

20 Geriatrics 12 months 5 Inpatient, None 

community or 

forensic program 

23 Internal Med. 6 months 1 & 2 No data None 

Endocrinology 3 months 1 & 2 No data 

25 Eating dx 2 months 2 Outpatient None 

26 Rehabilitation 1 month 3 Hospital None 

52


Table 16. Supervision 

ITEMS n (N = 26) % 

1. Hours per week 

2. Type 

1 to 2 5 19.2 

3 to 4 4 15.4 

5 to 6 4 15.4 


blank 8 30.8 

individual 19 73.1 

group 14 53.9 

other 4 15.4 


Table 17. Methods Used for delivering the Content of Training 

ITEMS n (N = 26) % 


Lectures 18 69.2 

Seminars 22 84.6 

Grand Rounds 17 65.4 

Courses 16 61.5 

Case Conferences 22 84.6 

Other 2 7.7 

Table 18. Methods of Access to Knowledge 

ITEMS n (N = 26) % 


Textbooks 23 88.5 

Library 23 88.5 

Internet 21 80.8 

Other 4 15.4 

53


54 

Table 19. Content of Training: Key Seminars 

ITEMS n (N = 26) % 

1. Patient Evaluation 

a) Hours 1 to 10 3 11.5 

11 to 20 8 30.8 

> 20 5 19.2 

blank 10 38.5 

b) Years level 1 12 46.2 

2 4 15.4 

3 2 7.7 

4 1 3.9 

5 1 3.9 

2. Growth & Development 

a) Hours 1 to 10 9 34.6 

11 to 20 3 11.5 

> 20 2 7.7 

blank 12 46.2 


2 4 15.4 

3 3 11.5 

4 0 0.0 

5 0 0.0 

3. Adult Psychopathology 

a) Hours 1 to 10 5 19.2 

11 to 20 1 3.9 

> 20 11 42.3 

blank 9 34.6 


2 9 34.6 

3 6 23.1 

4 1 3.9 

5 0 0.0 

4. Emergency Psychiatry 

a) Hours 1 to 10 7 27 

11 to 20 3 11.5 

> 20 3 11.5 

blank 13 50.0 


2 7 26.9 

3 3 11.5 

4 1 3.9 

5 0 0.0 

5. Crisis Intervention 

a) Hours 1 to 10 2 26.9 

11 to 20 2 7.7 

> 20 2 7.7 

blank 15 57.7 


2 5 19.2 

3 3 11.5 

4 1 3.9 

5 0 0.0 

Note: See additional comments in Appendix 15


Table 19. Content of Training: Key Seminars (cont.) 

ITEMS n (N = 26) % 

6. Diagnostic Instruments 

a) Hours 1 to 10 12 46.2 

11 to 20 2 7.7 

> 20 3 11.5 

blank 9 34.6 


2 7 26.9 

3 5 19.2 

4 1 3.9 

5 0 0.0 

7. Psychopharmacology 

a) Hours 1 to 10 3 11.5 

11 to 20 5 19.2 

> 20 10 38.5 

blank 8 30.8 


2 8 30.8 

3 7 26.9 

4 3 11.5 

5 1 3.9 

8. Somactic Treatments 

a) Hours 1 to 10 10 38.5 

11 to 20 5 19.2 

> 20 1 3.8 

blank 10 38.5 


2 5 19.2 

3 3 11.5 

4 2 7.7 

5 1 3.9 

9. Neurology / Neuropsychiatry 

a) Hours 1 to 10 4 15.4 

11 to 20 3 11.5 

> 20 8 30.8 

blank 11 42.3 


2 8 30.8 

3 6 23.1 

4 0 0.0 

5 0 0.0 

10. Psychotherapies 

a) Hours 1 to 10 3 11.5 

11 to 20 3 11.5 

> 20 11 42.4 

blank 9 34.6 


2 10 38.5 

3 8 30.8 

4 2 7.7 

5 1 3.9 


55


56 


ITEMS n (N = 26) % 

11. Family Therapy 

a) Hours 1 to 10 9 34.6 

11 to 20 3 11.5 

> 20 5 19.3 

blank 9 34.6 


2 7 26.9 

3 6 23.1 

4 2 7.7 

5 1 3.9 

12. Group Therapy 

a) Hours 1 to 10 9 34.6 

11 to 20 3 11.5 

> 20 3 11.5 

blank 11 42.4 


2 9 34.6 

3 5 19.2 

4 2 7.7 

5 1 3.9 

13. Consultation & Liaison 

a) Hours 1 to 10 4 15.4 

11 to 20 5 19.2 

> 20 5 19.2 

blank 12 46.2 


2 8 30.8 

3 5 19.2 

4 2 7.7 

5 1 3.9 

14. Child & adolescent Psych. 

a) Hours 1 to 10 3 11.5 

11 to 20 3 11.5 

> 20 9 34.6 

blank 11 42.4 


2 7 26.9 

3 7 26.9 

4 3 11.5 

5 0 0.0 

15. Substance Abuse 

a) Hours 1 to 10 8 30.8 

11 to 20 2 7.7 

> 20 6 23.1 

blank 10 38.4 


2 2 7.7 

3 6 23.1 

4 2 7.7 

5 1 3.9 




ITEMS n (N = 26) % 

16. Alcoholism 

a) Hours 1 to 10 4 15.4 

11 to 20 4 15.4 

> 20 4 15.4 

blank 14 53.8 


2 2 7.7 

3 6 23.1 

4 1 3.9 

5 0 0.0 

17. Geriatric Psychiatry 

a) Hours 1 to 10 7 26.9 

11 to 20 2 7.7 

> 20 4 15.4 

blank 13 50.0 


2 7 26.9 

3 7 26.9 

4 1 3.9 

5 0 0.0 

18. Forensic Psychiatry 

a) Hours 1 to 10 4 15.4 

11 to 20 3 11.5 

> 20 6 23.1 

blank 13 50.0 


2 4 15.4 

3 6 23.1 

4 2 7.7 

5 0 0.0 

19. Ethics 

a) Hours 1 to 10 6 23.1 

11 to 20 3 11.5 

> 20 2 7.7 

blank 15 57.7 


2 3 11.5 

3 4 15.4 

4 0 0.0 

5 0 0.0 

20. Psychiatric Epidemiology 

a) Hours 1 to 10 6 23.1 

11 to 20 1 3.9 

> 20 2 7.7 

blank 17 65.3 


2 6 23.1 

3 3 11.5 

4 1 3.9 

5 0 0.0 


57


58 


ITEMS n (N = 26) % 

21. Patient Evaluation 

a) Hours 1 to 10 6 23.1 

11 to 20 2 7.7 

> 20 5 19.2 

blank 13 50.0 


2 2 7.7 

3 10 38.5 

4 3 11.5 

5 0 0.0 

22. Psychiatric Rehabilitation 

a) Hours 1 to 10 9 34.6 

11 to 20 2 7.7 

> 20 1 3.9 

blank 14 53.8 


2 1 3.9 

3 7 26.9 

4 3 11.5 

5 0 0.0 

23. Administrative Psychiatry 

a) Hours 1 to 10 6 23.1 

11 to 20 1 3.9 

> 20 1 3.9 

blank 18 69.1 


2 0 0.0 

3 4 15.4 

4 2 7.7 

5 0 0.0 

24. Cross-Cultural Psychiatry 

a) Hours 1 to 10 6 23.1 

11 to 20 3 11.5 

> 20 1 3.9 

blank 16 61.5 


2 5 19.2 

3 1 3.9 

4 0 0.0 

5 1 3.9 

25. Sexual / Gender Issues 

a) Hours 1 to 10 9 34.6 

11 to 20 1 3.9 

> 20 3 11.5 

blank 13 50.0 


2 3 11.5 

3 4 5.4 

4 1 3.9 

5 1 3.9 




ITEMS n (N = 26) % 

26. History of Psychiatry 

a) Hours 1 to 10 5 19.2 

11 to 20 1 3.9 

> 20 3 11.5 

blank 17 65.4 


2 4 15.4 

3 0 0.0 

4 0 0.0 

5 0 0.0 

27. Medical Sciencies / Neurosc 

a) Hours 1 to 10 4 15.4 

11 to 20 5 19.2 

> 20 5 19.2 

blank 12 46.2 


2 3 11.5 

3 4 15.4 

4 2 7.7 

5 1 3.9 

28. Research Training 

a) Hours 1 to 10 8 30.7 

11 to 20 2 7.7 

> 20 4 15.4 

blank 12 46.2 


2 4 15.4 

3 4 15.4 

4 3 11.5 

5 1 3.9 

29. Communication Skills 

a) Hours 1 to 10 5 19.2 

11 to 20 1 3.9 

> 20 3 11.5 

blank 17 65.4 


2 2 7.7 

3 2 7.7 

4 2 7.7 

5 1 3.9 


59


60 

Table 19. Content of Training: Other Seminars 

Program Year 

Seminars Hours 

Number 

Level 

5 Information-internet 4 4 

6 Preventive psychiatry 9 

Specific disorders 4 

10 Epilepsy 2 and 3 

Cognitive-behavioral 2 and 3 

Systemics 2 and 3 

Psychoanalisis 2 and 3 

11 Preventive psychiatry 8 

Some specific disorders 4 

Psychoeducation 18 

12 Countertransference 8 1 and 2 

Chronic mental illness 5 1 and 2 

Religious Issues 4 1 and 2 

Eating Disorders 2 1 and 2 

Neurochemistry 3 1 and 2 

Prite review 12 1, 2, 3 and 4 

Interviewing techniques 17 1, 2 and 3 

Psychological testing 6 1 and 2 

Neuropsychology 2 1 and 2 

Sexual disorder 2 3 and 4 

Couple therapy 4 3 and 4 

Advanced cultural issues 5 3 and 4 

Career options 2 3 and 4 

Psychology of trauma 5 3 and 4 

Managed mental health care 2 3 and 4 

Board review course 38 3 and 4 

13 Private practice 4 4 

Behavioral / social sciences 8 4 

14 Psychodynamics 180 1 and 2 

Social anthropology 44 1 

Philosophy of science 44 1 

Seminology and psychiatric interview 65 1 

Brief psychoterapy 44 2 

Cognitive therapy 40 2 

16 Cultural articulation 160 1, 2 and 3 

Psychoanalysis 160 1, 2 and 3 

20 Indigenous psychiatry 15 2 

Sexual abuse issues 6 3 

Social psychiatry 24 3 

22 Anthropology-social 4 1 

Social psychology 4 1 

Clinical psychology 20 1 

Neuroanatomy 30 1 

Neuropsychology 3 1 

Neurophysiology 30 1 

Neuropharmacology 15 1 

Clinical interviewing 15 1 

25 Eating disorders 20 2 

Informatics 10 3


Table 20. Evaluation Methodolgies ont the Quality 

ITEMS n (N = 26) % 

Resudebts feedback yes 22 84.6 

no 2 7.7 

blank 2 7.7 

Log book yes 16 61.5 

no 8 30.8 

blank 2 7.7 

Mock exams yes 14 53.8 

no 8 30.8 

blank 4 15.4 

Written inservice examinations yes 15 57.7 

no 9 34.6 

blank 2 7.7 

Methods of evaluation yes 8 30.8 

of skills & attitudes no 2 7.7 

blank 16 61.5 

CME activities yes 17 65.4 

no 2 7.7 

blank 7 26.9 

Other methods of evaluation yes 2 7.7 

no 1 3.8 

blank 23 88.5 


61


62 

Table 21. Subspecialty Training 

ITEMS n (N = 26) % 

1. Child Psychiatry 

a) Y/N yes 14 53.9 

no 5 19.2 

blank 7 26.9 

b) Years of training 1 5 35.7 

2 5 42.9 

3 0 0.00 

4 0 0.0 

5 1 7.1 

c) Number of positions 1 to 4 5 35.7 

5 to 8 1 7.1 

> 8 2 14.3 

d) Current number of trainess 1 to 4 5 35.7 

5 to 8 2 14.3 

> 8 2 14.3 

2. Forensic Psychiatry 

a) Y/N yes 5 19.2 

no1 12 46.2 

blank 9 34.6 


2 0 0.0 

3 0 0.0 


5 to 8 0 0.0 

> 8 2 40.0 


5 to 8 0 0.0 

> 8 2 40.0 

3. Addiction Psychiatry 

a) Y/N yes 7 26.9 

no 10 38.5 

blank 9 34.6 


2 0 0.0 

3 0 0.0 


5 to 8 1 14.3 

> 8 2 28.6 


5 to 8 0 0.0 

> 8 2 28.6 

4. Geriatric Psychiatry 

a) Y/N yes 5 19.2 

no 9 34.6 

blank 12 46.2 


2 1 20.0 

3 0 0.0 


5 to 8 0 0.0 

> 8 1 20.0 


5 to 8 0 0.0 

> 8 1 20.0 

(*) Note: The percentages for items b, c and d for each Subspecialty are computed 

usign as baseline the number of programs acknowledging that Subspecialty.


Table 21. Subspecialty Training (cont.) 

ITEMS n (N = 26) % 

5. Administrative Psychiatry 

a) Y/N yes 1 3.8 

no 12 46.2 

blank 13 50.0 

b) Years of training 1 1 100 

2 0 0.0 

3 0 0.0 

c) Number of positions 1 to 4 1 100 

5 to 8 0 0.0 

> 8 0 0.0 


5 to 8 0 0.0 

> 8 0 0.0 

6. Consultation and Liaison Psychiatry 

a) Y/N yes 3 11.5 

no1 11 42.3 

blank 12 46.2 


2 0 0.0 

3 0 0.0 


5 to 8 0 0.0 

> 8 1 33.3 


5 to 8 0 0.0 

> 8 1 33.3 

7. Psychopharmacology 

a) Y/N yes 3 11.5 

no 11 42.3 

blank 12 46.2 


2 1 33.3 

3 0 0.0 


5 to 8 0 0 

> 8 1 33.3 


5 to 8 0 0.0 

> 8 1 33.3 

8. Other Type of Subspecialty Training: 

Psychoterapy 

a) Y/N yes 1 3.8 

no 0 0 

blank 25 96.2 

b) Years of training 1 0 0 

2 0 0 

3 1 100 


5 to 8 0 0 

> 8 1 100 

d) Current number of trainess 1 to 4 0 0 

5 to 8 0 0.0 

> 8 1 100 

(*) Note: The percentages for items b, c and d for each Subspecialty are computed 

usign as baseline the number of programs acknowledging that Subspecialty. 

63

III. ADDITIONAL COMMENTS 

APPENDIX 1 

Additional comments on primary care 

(Complementary to table 4) 

Program 1: 

This rotation takes place in the Department on 

Internal Medicine. This rotation can take place 

in the Outpatient Clinics or the Inpatient Units 

depending of the possibilities and needs of the 

Department of Internal Medicine. An attempt 

is made to rotate equally in both settings. 

Program 6: 

According to national regulations, these six 

months of Internal Medicine are not under the 

supervision of the psychiatric program. 

Program 8: 

There are special courses in psychiatry and 

family psychology for primary care physicians 

which are separate from the specialization 

courses in psychiatry. 

Program 9: 

Post basic MBchB training plus two years of 

experience. 

Program 10: 

These subjects are offered in the pregraduate 

studies. 

Program 13: 

Must be done during the first year of training. 

Program 15: 

We don’t have primary care didactic/clinical 

rotations. 

Program 17: 

There is a one month course for physicians, 

pediatrists and neurologists; the duration of this 

course is one week for primary care physicians. 

APPENDIX 2 

Additional comments on neurology 


Program 1: 

Similar to the rotation of internal medicine; this 

rotation can take place in the outpatient clinics 

or the inpatient units, depending of the 

possibilities and needs of the Department of 

Internal Medicine. An attempt is made to 

equally use both settings. 

Program 2: 

The neurology rotation takes place during the 

internal medicine rotation. 

Program 6: 

According to national regulations, the twelve 

months of neurology rotation are not under 

the supervision of the psychiatric program. 

Program 10: 

This is a three month obligatory rotation. It 

must take place at the programs of the 

University of Chile. 

Program 14: 

This rotation has a full time duration of two 

months. 

Program 19: 

Neurology is a major component of the final 

psychiatric training examination. 

Program 23: 

This rotation usually takes place during the 

first two years of training. 

Program 25: 

Neurology is an optional rotation which 

includes supervised clinical practice. 

65


APPENDIX 3 

List of comments on emergency psychiatry 


Program 1: 

The seminar/course in emergency psychiatry is 

part of the compulsory training required by the 

Educational Commission of the University of 

Chile. 

This rotation is divided in two phases: the first 

phase takes place during the first year and is 

based on on-call supervision (the frequency of 

the calls are 1-3 per week); the second phase 

takes place in the emergency center under 

supervision. 

Program 4: 

The rotation consists of one day per month 

experience during the adult psychiatric training 

and during the child and adolescent psychiatric 

training. 

Program 10: 

This experience is an optional three month 

rotation. 

Program 13: 

It is based on exposure to emergency 

psychiatry during the fourth year of training. 

Program 14: 

The number of calls in this rotation are eight 

per month of twelve hours each. 

Program 19: 

Most units/rotations have an emergency 

component. 

Program 20: 

Most Registrars do some emergency psychiatry 

for each didactic/clinical rotation. 

APPENDIX 4 

Additional comments on inpatient psychiatry 


Program 2: 

The objective is for an eight month rotation in 

an inpatient unit, but it may vary. 

Program 6: 

This rotation takes place in short and medium 

stay inpatient units. 

Program 10: 

There must be a six month rotation in male 

and female inpatient units. 

Program 12: 

Each resident carries 8-9 patients under 

supervision. 

Program 13: 

The minimum inpatient rotation in the USA is 

nine months and the maximum is eighteen 

months. 

Program 14: 

This rotation takes place in a combined 

inpatient and outpatient three month 

rotation during the first and second year of 

training. 

Program 19: 

This rotation takes place during the entire four 

years of training; there must be experiences in 

acute and chronic units. 

Program 20: 

Senior Registrars can elect to extend their 

adult inpatient rotations. 

Program 25: 

This experience consists of eight calls per 

month during the first year, six calls per month 

during the second year, and four calls per 

month during the third year. 

66

Additional Comments 

APPENDIX 5 

Additional comments on outpatient psychiatry 


Program 1: 

This rotation has a length of six months. 

Program 2: 

This rotation has a minimum length of eight 

month, but the length is variable according to 

other rotations. 

Program 10: 

This rotation focuses on adult ambulatory 

patients. 

Program 12: 

Emphasis is made on biopsychosocial treatment 

approoaches and continuity of care. Experience 

with chronic patients is also expected. 

Program 13: 

The length of this rotation is twelve months, 

20% or one day per week must be continuous 

in order to provide a good continuity of care 

experience. Up to 10% can be with children 

and adolescents. Some elderly experience is 

welcomed. 

APPENDIX 6 

Additional comments on consultation 

and liaison psychiatry 


Program 1: 

There is not an exclusive period for this 

rotation. This activity takes place when the 

resident is in the inpatient units or doing 

psychiatric consultations. 

Programs10: 

This rotation takes place at the University of 

Chile Hospital which provides exposure to all 

specialties and subspecialties. 

Program 12: 

All clinical services are included in this rotation 

(e.g., oncology, cardiology, intensive care, 

etc.). 

Program 13: 

This rotation takes place during the third year 

of training. 

Program 14: 

The outpatient experience with children and 

adolescents takes place during the three 

month rotation in child psychiatry. 

Program 19: 

The length of this rotation is six months, and 

the experience is mostly with adult patients. 

Program 20: 

Most of this experience takes place in 

community clinics. 

67


APPENDIX 7 

Additional comments on child 

and adolescent psychiatry 


Program 1: 

This experience takes place mainly under 

supervision by a child psychiatrist. It also 

consists of receiving consultations form other 

departments (e.g., pediatrics). 

Program 2: 

Proposed as a subspecialty or specific 

educational field in child and adolescent 

psychiatry. 

Program 10: 

Child and adolescent psychiatry is integrated 

within the adult psychiatric training 

program. 

Program 12: 

Each resident carries 4-5 children and 3 

adolescent cases. 

Program 13: 

The minimum requirement is two months of 

either inpatient or outpatient experience. 

Additionally, one month of C&L psychiatry is 

encouraged. 

Program 14: 

This experience consists of a full time 

involvement in child and adolescent psychiatry. 

Program 23: 

This rotation usually takes place during the 

first two years of training. 

APPENDIX 8 

Additional comments on geriatric psychiatry 


Program 1: 

This supervised clinical experience 

in geriatric psychiatry takes place 

during the inpatient psychiatric 

rotation. Approximately 10% 

of the patients admitted to the psychiatric 

service are elderly. 

Program 2: 

Geriatric psychiatry is being proposed as a 

subspecialty training. 

Program 6: 

This experience takes place during 

the adult psychiatric rotation. 

There is also the opportunity 

to follow elderly patients in the psychogeriatric 

clinic. A once per week rotation 

in the geropsychiatric clinic could take place 

during the last three years of psychiatric 

training. 

Program 10: 

This experience is part of the psychiatric 

outpatient rotation. 

Program 12: 

Each resident carries 7-8 geriatric cases. 

Program 13: 

This experience takes place during 

he inpatient psychiatric rotation, 

and during the second year of training. 

However, outpatient experiences 

with geriatric patients can also take place 

during the third and fourth years of psychiatric 

training. 

Program 14: 

This experience usually takes place in a 

General Hospital, but it can also take place in 

a Geriatric Hospital. 

Program 15: 

We do not have a specific rotation in geriatric 

psychiatry in our program. 

68


Program 17: 

This geriatric experience takes place in our 

program as part of the general psychiatric 

training. 

Program 19: 

While we do not have a specific geriatric 

rotation, clinical exposure in geriatric 

psychiatry takes place in most of our general 

psychiatric rotations. 

APPENDIX 9 

Additional comments on addiction psychiatry 


Program 1: 

This rotation takes place during the three 

month rotation in the public health network. 

Program 2: 

Acohol and substance abuse psychiatry is 

being considered as a subspecialty training in 

our program. 

Program 6: 

Trainees have the option to rotate once per 

week during the last three years of training in 

the substance and alcohol abuse clinic. 

Program 10: 

This experience consists of a four month 

mandatory rotation. 

Program 12: 

Each resident is responsible for 7-8 addiction 

cases. 

Program 13: 

This rotation takes place in the inpatient unit 

during the second year of training. However, 

outpatient rotations are also possible during 

the third or fourth year of training. 

Program 14: 

This experience takes place in a specialized 

program on substance abuse. 

Program 19: 

While there is no specific addiction rotation, 

management of addiction cases usually takes 

place in all clinical rotations. 

Program 26: 

This experience takes place as part of the 

general psychiatric rotations. 

69


APPENDIX 10 

Additional comments on forensic psychiatry 


Program 2: 

This experience is included in the “Guide of 

Education of Specialized Physicians.” 

Program 4: 

This experience consists of one day a week in 

the first, third, fourth and fifth years of 

psychiatric training. 

Program 13: 

In the USA, exposure is required rather than 

an assigned period of rotation. This experience 

can also take place during the second, third or 

fourth year of training. 

Program 14. 


program (the Institute of Forensic Medicine 

and Prisons). 

Program 17: 


program under the aegis of the Ministry of 

Health. 

Program 19: 


forensic program. 

Program 26: 

This experience is based on theoretical courses 

of thirty hours duration that takes place every 

two or three years. 

APPENDIX 11 

Additional comments 

on community psychiatry 


Program 2: 

This experience takes place during the 

ambulatory community psychiatry, primary 

care, and psychiatric rehabilitation rotations. 

Program 6: 

This experience takes place in day hospitals, 

outpatient clinics, or community mental health 

centers. The residents have the option to select 

any of these sites. 

Program 10: 

This experience is obligatory during the 

psychiatric outpatient rotations. 

Program 12: 

This experience consists of the management of 

thirty patients with chronic mental illness in 

day hospitals and outpatient settings. 

Program 13: 

This experience consists of exposure during 

the psychiatric training. 

Program 14: 

This experience takes place in a facility with a 

high prevalence of mental illness (e.g., General 

Hospitals). 

Program 17: 

This experience is based on courses and 

seminars. 

Program 19: 

This experience has a high priority in our 

psychiatric training program. 

Program 22: 

This experience consists of a one month 

rotation in a community mental health 

program and a three month rotation in a day 

center which also includes an outpatient group 

psychotherapy program. 

70


APPENDIX 12 

Additional comments on supervision 


Program 1: 

Our information system facilitates the 

monitoring of the residents’ supervisory 

experience. 

Program 6: 

Our objective is to offer supervision once per 

week throughout the training program. 

Program 10: 

Supervision in our program consists of 

approximately 517 hours. 

Program 11: 

Individual supervision is available as required. 

Program 13: 

A minimum of two hours of individual 

supervision per week is mandatory; 

Additionally, the residents receive supervision 

from the clinical programs where they rotate. 

Program 14: 

There is a minimum of two hours per week of 

analytically-oriented psychotherapy 

supervision. Additionally, there is ongoing 

supervision throughout the period of training. 

APPENDIX 13 

Additional comments on methods used 

for delivering the content of training 


Program 7: 

All usual modalities are used, although not 

structured. 

Program 10: 

All modalities are used during the three years 

of training. 

Program 11: 

Modern pedagogic technical support is used: 

videos, slides, transparencies, role playing, etc. 

Program 13: 

All modalities are used during the four years of 

training. 

Program 23: 

Weekly courses are conducted in a traditional 

two-hour period, covering the entire 

psychiatric curriculum. There are also weekly 

case presentations and extensive courses of 2- 

5 days duration. 

Program 22: 

Supervision is offered in every modality of 

care. 

Program 27: 

The Royal College of Psychiatrists stipulates 

that, in addition to clinical and general 

supervision with clinical tutors and educational 

supervisors, the trainee is allocated one hour 

of protected time each week with his/her 

Educational Supervisor. For their sole benefit, 

the trainees set the agenda for this hour of 

supervision. 

Program 28: 

The tutorial system is obligatory; thus, the 

residents may have contact with their tutors 

and can rely on their support in all-arising 

problems and activities. 

71


APPENDIX 14 

Additional comments on methods 

of access to knowledge 


Program 2: 

Departmental library, hospital library and 

medical school library. 

Program 7: 

Departmental library and medical school 

library. 

Program 8: 

At present, there are not enough financial 

resources to provide trainees with access to 

the internet on a regular basis. However, 

faculty have access to the internet. 

Program 10: 

The department of psychiatry has a library. 

Program 13: 

Libraries must be available and accessible in all 

USA psychiatric training programs. 

Program 16: 

A strong emphasis on teaching, based on 

patients’ needs and issues, is given. 

Program 19: 

Attendance at conferences and workshops. 

Our trainees have the advantage of a very rich 

clinical exposure. Our program has an almost 

1:1 ratio between trainees and 

supervisors/consultants. 

Program 23: 

There is a modern documentation and 

information center in the teaching hospital in 

Bucharest, with a library, psychiatric journals, 

and computers with internet access. 

APPENDIX 15 

Additional comments on content of training 


Program 7: 

The program varies each term and covers a 

substantial portion of the list of topics in 

seminars and courses provided by the Institute 

for Postgraduate Education (IPVZ). The 

courses are not obligatory, except for a course 

in administrative and emergency medicine. 

. 

Program 11: 

Training is in process, with interdisciplinary 

teams, in partnership with patients and their 

families. 

Program 12: 

There is overlap of certain lectures. 

Program 13: 

The program offers clinical conferences, 

journal clubs, case presentations, problem 

based learning (PBL) groups, and video 

conferences. Grand Rounds take place during 

all 4 years of training. 

Program 16: 

The program uses scientific videotapes and 

video conferences as a training tool. 

Program 19: 

The courses offered make emphasis on guided 

clinical experiences. Residents rotate through 

clinical units every six months. During the 

rotations the residents are exposed to a wide 

range of psychiatric experiences. 

Program 20: 

The program offers journal clubs on a variety 

of topics, and also visiting expert faculty. 

72


APPENDIX 16 

Additional comments 

on evaluation methodologies 

about the quality 

of educational activities 


Residents Feedback 

Program 2: 

Feedback provided during periodic meetings 

with mentors. 

Program 5: 

Feedback provided via individual discussion 

with a Committee of the Hungarian Psychiatric 

Society. 

Program 8: 

Feedback provided via monthly meetings. 

Program 12: 

Feedback provided through semiannual 

meetings of the faculty. 

Program 13: 

Feedback provided at least twice a year by the 

Director of training. 

Program 14: 

Feedback based on individual 

evaluations reviewed every six months by the 

faculty. 

Program 17: 

The trainees take three testing exams 

(primary, intermediate and final) 

during the training period. 

The results of these tests are discussed with 

the residents and kept on file. 

Program 25: 

Feedback provided to the residents by their 

instructors. 

Program 26: 

Feedback is based on participation in seminars, 

ateneos, and clinical lectures. 

Program 27: 

Feedback is based on log books of recorded 

activities. 

Log Books 

Program 2: 

Log books activities are evaluated by the local 

Commission on teaching. 

Program 7: 

Log books are used to monitor residents’ skills 

and knowledge. 

Program 8: 

Log books are kept in the form of a diary. 

Program 9: 

Log books are used to only monitor 

psychotherapy cases and supervision. 

Program 13: 

Log books are required for 

accreditation purposes by the American 

Council of Graduate Medical Education. 

Log books must be used during all four years 

of training. 

Program 17: 

Log books are used to prepare 

the presentation to faculty of three paper 

reports. 

Program 19: 

Log books are used to document case studies, 

which are required for psychotherapy 

monitoring, and for the Part I and Part II of 

the qualifying exams. 

Program 22: 

Log books are currently being considered. 

Mock Exams 

Program 1: 

Based only on one annual inservice training 

exam (PRITE Exam). 

Program 8: 

Mock exams conducted by the end of the first 

year. 

Program 11: 

Mock exams are conducted based on the 

PRITE exam model. 

73


Program 12: 

Mock exams are based on patient interviews, 

case presentations, case formulations, and 

treatment reviews. 

Program 13: 

Mock exams are required by the American 

Council of Graduate Medical Education for 

accreditation purposes. They must be 

conducted during the second, third and fourth 


Program 17: 

Mock boards are based on special examination 

cards focusing on psychopathology, modalities 

of treatment, rehabilitation and prevention. 

Program 19: 

Mock boards are based on clinical and oral 

examinations. 

Program 22: 

Mock boards are conducted during the first 

year and the final year exams. 

Written Inservice Examinations 

Program 2: 

A written exam will be used as a final test of 

competency in general psychiatry and 

psychiatric subspecialties. 

Program 5: 

Based on a test focusing on psychotherapy at 

the end of the residency training. 

Program 8: 

Based on the integration of scientific research 

and publications. 

Program 13: 

The PRITE exam must be conducted in all four 

years of training as a required by the American 

Council of Graduate Medical Education. 

Program 22: 

Conducted during the first and the fourth year 

of training. 

Program 26: 

Based on seminars offered during the first year 

of training. 

Methods of Evaluation of Skills and Attitudes 

Program 1: 

Conducted via residents supervision. 

Program 2: 

Conducted by the tutors of each rotation. 

Program 9: 

Conducted via case presentations and 

examinations under supervision. 

Program 10: 

Conducted every six months via evaluations. 

Program 13: 

Conducted via mock boards and inservice 

training examinations (PRITE exam). 

Program 14: 

Conducted via supervision of patient 

interviews, case presentations, and 

psychotherapy supervision. 

Program 15: 

Conducted on an ongoing basis by the tutors. 

Reports are provided to an evaluation 

committee. 

Program 16: 

Based on oral individual evaluations. 

Program 17: 

All residents’ qualifications are evaluated by 

the Attesting Commission of the Ministry of 

Health. 

Program 19: 

Continuously monitored by teaching 

consultants. 

Program 20: 

Based on semiannual reports prepared by the 

clinical supervisors. 

Program 22: 

Based on annual reports prepared 

by the faculty and university appointed 

supervisors. 

Program 25: 

Based on individualized psychiatric and 

psychotherapy supervision. 

74


Program 26: 

Based on patient’s clinical interviews and 

ateneos. Also conducted during the final 

clinical tests. 

Program 27: 

Tested via MRCPsych writers and clinical 

examinations. 

Continuing Medical Education Activities 

Program 1: 

CME activities of all academic departments are 

announced weekly. 

Program 6: 

CME activities are announced by the Hellenic 

Psychiatric Association. 

Program 8: 

A minimum of 200 CME hours are required 

every five years. 

Program 11: 

CME activities are based on participation in 

local, national and international scientific 

meetings. 

Program 12: 

Based on books and lectures. 

Program 13: 

Residents are encouraged to attend 

conferences offering CME credits. 

Program 17: 

The Health Care Law of the Azerbaijan 

Republic requires physicians to attend 

postgraduate courses every 3-5 years 

and to succefully pass designated 

examinations. 

Program 22: 

CME activities are required by the National 

Medical Council. 

Program 25: 

CME research training activities are offered. 

Program 28: 

CME activities are organized at local and 

national levels by the Polish Psychiatric 

Association and the academic departments of 

psychiatry. 

Other Methods of Evaluations 

Program 10: 

A final examination is conducted 

by the Post-Graduate School of the University 

of Chile. 

Program 11: 

Individual, group and institutional evaluations 

are conducted by trainees, teachers, 

supervisors, patients and their families based 

on interdisciplinary team approaches, and with 

a high priority on ethical standards. 

Program 13: 

Two hours per week of individual examinations 

are required during all four years of training. 

Program 20: 

An examination is conducted by the Royal 

Australian and New Zealand College of 

Psychiatrists during the fourth year of training. 

Also, a dissertation is conducted during the 

final year of training. 

Program 22: 

Residents evaluations are conducted during 

the first and the final year of training. 

75


APPENDIX 17 

Additional comments on special training 

issues 

Program 2: 

The psychiatric program of the University 

Hospital of Valladolid (Spain) follows legislative 

policies for the Spain territory according to the 

Program of Education of Resident Physicians 

which determine the admission process, years 

of specialty, etc. The specific features of the 

education of resident physicians in the 

Department of Psychiatry of the University 

Hospital of Valladolid follows the policies of 

the “Guide of Education of the Specialized 

Physicians” developed by the National 

Commission of the Specialty of Psychiatry. 

Program 12: 

Residents are trained on core domains as 

follows: 1) patient care, 2) medical knowledge, 

3) practice-based learning, 4) interpersonal 

and communication skills, 5) professionalism, 

and 6) system-based care. 

Program 19: 

Although there is no subspecialty training 

other than child psychiatry, the clinical 

rotations in our department offer strong 

emphasis on forensic psychiatry, consultation 

& liaison psychiatry, psychopharmacology and 

community psychiatry. 

Program 28: 

In our medical school, psychiatric training 

has been introduced in the residency training 

programs of family medicine, neurology, 

internal medicine and otorhinolaryngology. 

Plans are under way to restructure 

our residency training program 

in psychiatry in order to develop 

a network system of community mental health 

services. 

76

APPENDIX B 

GRADUATE TRAINING 

IN GENERAL PSYCHIATRY 

SURVEY QUESTIONNAIRE

Graduate Training in General Psychiatry Survey Questionnaire 

BASIC INFORMATION 

Name of training program: — 

Institution: — 

Program address: — 

City: — State/Province: — 

Country: — Postal code: — 

Telephone: — Fax: — 

E-mail: — 

Director of training: — 

Contact person: — 

Duration of program: — years 

Total number of trainees: — 

Number of trainees per year: first: ———————————— , second: ——————————————, 

third: —————————————— , fourth: —————— , fifth: ———————————————, 

sixth: —————————————— , other: — 

Admission requirements: — 

Graduation procedures: — 

Specialty certification process, if any: — 

— 

Specialty recertification process, if any: — 

— 

Training program accreditation requirements, if any: — 

— 

Other important information/comments: — 

— 

79


STRUCTURE OF TRAINING 

Didactic/clinical rotations 

Primary care (internal medicine, family practice, pediatrics, etc.): 

Length: — months 

Year level: ——————— first,—————————— second, ———————— third, 

——————— fourth, 

Other: — 

Settings: ——————————— emergency, ————————————— inpatient, ———————— outpatient, 

———————— consultation, other: — 

Other important comments: — 

— 

Neurology: 

Length: —months 

Year level: — first, — second, — third, — fourth, 

Other: — 

Settings: ———————— emergency, —————————— inpatient, —————— outpatient, 

—————— consultation, other: — 


— 

Emergency psychiatry: 



Other: — 

Settings: — general hospital, — outpatient, 

Other: — 


— 

80


Inpatient psychiatry: 



Other: — 

Patient population: — children, — adolescents, — adults, 


— 

Outpatient psychiatry: 

Length: —months 


Other: — 

Patient population: — children, — adolescents, — adults, 

——————————— elderly, other: — 


— 

Consultation and liaison psychiatry: 



——————————— fifth, other: — 

Settings: — inpatient, — outpatient, other: — 

Patient population: — adult, — child, 

Other: — 


— 

81


Child and adolescent psychiatry: 



Other: — 

Settings: — inpatient, — outpatient, — consultation, 

Other: — 


— 

Geriatric psychiatry: 



——————————— fifth, other: — 

Settings: — inpatient, — outpatient, other: — 


— 

Addiction psychiatry: 



——————————— fifth, other: — 

Settings: — inpatient, — outpatient — 

Other: — 


— 

82


Forensic psychiatry: 



——————————— fifth, other: — 

Settings: — inpatient, — outpatient, — court, 

Other: — 


— 

Community psychiatry: 



Other: — 

Settings: — outpatient, — day hospital: — residential 

programs, other: — 


— 

Other clinical didactic/clinical rotations, if any (e.g., electives): 

a. Type: — 

Length: — 

Year level: — 

Settings: — 

Other comments: — 

— 

b. Type: — 

Length: — 


Settings: — 


— 

83


c. Type: — 

Length: — 


Settings: — 


— 

d. Type: — 

Length: — 


Settings: — 


— 

Supervision 

Hours per week: — 

Type: — individual, — group, —, other: — 

— 


— 

Methods used for delivering the content of training 

Please check all that apply: 

Lectures —, seminars —, grand rounds —, courses — 

case conferences —, other: — 


— 

84


Methods of access to knowledge 

Please check all that apply: 

Textbooks, ——————, library ———————, internet ———————, other: ——————————, 


— 

Other issues pertaining to the “structure of training” not previously addressed: — 

— 

— 

CONTENT OF TRAINING 

In this section, the objective is to list all of the seminars that are offered as part of the didactic 

curriculum in your postgraduate training program in psychiatry, the number of sessions for each 

seminar, and the year level(s) in which the seminars are offered. A list of the seminars that are 

traditionally offered in most postgraduate training programs in psychiatry is included in order to 

facilitate your notation of the seminars. Therefore, please also add the seminars offered in your 

training program which are not listed here. 

Seminars # of sessions/hours Year level 

Patient evaluation — — 

Growth and development — — 

Adult psychopathology — — 

Emergency psychiatry — — 

Crisis intervention — — 

Diagnostic instruments — — 

Psychopharmacology — — 

Somatic treatments(e.g., ECT) — — 

Neurology/neuropsychiatry — — 

Psychotherapies — — 

Family education and therapy — — 

Group therapy — — 

Consultation & liaison psych. — — 

Child & adolescent psychiatry — — 

Drug abuse — — 

Alcoholism — — 

Geriatric psychiatry — — 

85


Forensic psychiatry — — 

Ethics, stigma, etc — — 

Psychiatric epidemiology — — 

Community psychiatry — — 

Psychiatric rehabilitation — — 

Administrative psychiatry — — 

Cross-cultural psychiatry — — 

Sexual/gender issues — — 

History of psychiatry — — 

Medical sciences/neurosciences — — 

Research training — — 

Communication skills — — 

Information internet — — 

Preventive psychiatry — — 

Private practice — — 

Other seminars, if any: 

Seminars # of sessions/hours Year level 

— — — 

— — — 

— — — 

Other issues pertaining to the “content of training” not previously addressed: — 

EVALUATION METHODOLOGIES 

Please describe the methods used in your postgraduate training program in psychiatry to evaluate 

the quality of the educational activities. 

Residents feedback: — yes — no 

Comments: — 

Log-book: — yes — no 

— 

Comments: — 

86 

—


Mock exams: — yes — no 

Comments: — 

— 

Written inservice examinations: — yes — no 

Comments: — 

— 

Methods of evaluation of skills and attitudes if any: 

Comments: — 

— 

Continuing medical education activities: — yes — no 

Comments: — 

— 

Other methods of evaluation, if: — 

— 

Comments: — 

— 

SUBSPECIALTY TRAINING 

Please provide information regarding any formal subspecialty training offered in your program. 

1. Child psychiatry: — yes — no, if yes: 

Years of training: — 

Number of available positions: — 

Current number of trainees: — 

2. Forensic psychiatry: — yes — no, if yes: 




3. Addiction psychiatry: — yes — no, if yes: 




87


4. Geriatric psychiatry: — yes — no, if yes: 




5. Administrative psychiatry: — yes — no, if yes: 




6. Consultation and liaison psychiatry: — yes — no, if yes: 




7. Psychopharmacology: — yes — no, if yes: 




8. Other type of subspecialty training: — 












Special training issues 

Please provide any other relevant information with regard to your postgraduate training program in 

psychiatry which was not previously addressed and that you consider important: 

— 

— 

— 

88

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