Psychiatry encompasses a broad range of illnesses and a particularly broad range of treatments. We practice in a variety of care levels and provide treatment in the form of psychopharmacology, neuromodulation, psychotherapy, and other psychosocial treatments, including individual, family, and group. Our work has a broader social context, not infrequently involving the legal and educational systems and the social safety net. There will always be a diversity of treatments and approaches in our field, and maintaining the psychiatrist’s familiarity with the full range of treatments is a challenge for training programs. The tension between the need to provide generalists to take care of many and subspecialists to advance knowledge and provide expertise on specific problems will continue and increase. We will need to support both general and subspecialty training as psychiatric medicine continues to diversify.
Training programs will need to balance training psychiatrists who will practice in traditional roles, such as general psychiatry outpatient provider, with fellowship training for subspecialty experts, as well as potential new roles like clinical neuroscientist and behavioral health specialist integrated with primary care practice.