TITLE>Evaluation of Public Psychiatry Fellowship
Over the past few years, the Faculty has sent yearly questionnaires to all alumni of the Fellowship program. There were 88 graduates through May 1996. Seventy-eight of the 88 (89%) responded over the past three years (72 in the past two years). We were able to learn the primary work activity of all but four of the remaining ten, so that an unusually complete picture of the present profile of professional activities of the graduates is available. The primary purpose of this evaluation was to gather information that might guide decision-making about curriculum and training procedures. In addition, we hoped to learn something about the fate of young psychiatrists who choose to enter this difficult field, having some extra academic preparation by virtue of their experience in the program.
Of the 82 graduates for whom we have information, their present primary work setting is as shown, by auspice:
As is evident from this data, 75 of these 82 alumni (91%) work in public settings. Thus, only seven of our graduates (9%) have chosen to leave the public arena as the principal focus of their professional effort in the fifteen years of the program's existence. This is in dramatic contrast to the most recent survey of APA members (1987-88) which revealed that 48% identified private practice as their primary work setting.
Alumni maintain a strong commitment to their field placement agencies. Twenty-six of 59 (44%) alumni still in NY (representing 32% of all alumni) are in the agency in which they did their field placement.
Another way to demonstrate the commitment of our alumni to the public sector is the fact that the vast majority of our respondents work full-time in their primary work setting (mean = 37 hrs/wk). Furthermore, they are far more likely to be involved in management responsibility than the average psychiatrist. Of alumni for which we have partial information: 43/80 (54%) report management positions.
The graduates of the Fellowship have continued to bridge the gap between academic and public psychiatry by gaining and maintaining appointments at medical schools in the area in which they are also working as public psychiatrists. Of 79 for whom we have information, 61 (77%) have academic appointments. They report that their experience in the training program has helped them to qualify for those appointments, which in turn increase their effectiveness in their day-to-day work efforts. They find that they are able to bring to their work new information and stimulating interchange around clinical and management issues. Several of the graduates are now voluntary faculty of the Fellowship; they give lectures to the present class of fellows and serve as field placement supervisors. This process has allowed previous fellows to share their recent experiences with their younger colleagues and keep the faculty abreast of changes in the public system that need to be addressed in the teaching program.
Effectiveness of Recruitment
It is important to note that the fellows are highly qualified junior psychiatrists. The Fellowship has trained eleven Mead-Johnson Fellows and one Burroughs-Welcome Fellow. More than half of the fellows over the past five years have been chief residents at major teaching programs: PI (Columbia), Mt. Sinai, St. Vincent's, NYU, State University at Downstate, and Creedmoor (Columbia) in New York City, as well as Cambridge Hospital (Harvard), Duke, University of Mississippi, UMDNJ (Rutgers) and St. Elizabeth's. Most applicants come on the basis of the program's reputation among psychiatric residents and/or word-of-mouth recommendations from present or past fellows.
We are particularly proud of our ability to recruit women and minorities. Of all 88 fellows there have been 37 women (42% compared to 23% in the APA survey), and 33 minorities (37% compared to 30% in the APA survey; including 9 African-Americans, 14 Hispanics and 10 Asian-Americans). These proportions are also substantially higher than the recent proportions (34% women, 15% minorities) reported for junior rank appointments in psychiatry among Health Sciences Departments and Schools nationwide (1992-93 National Availability Pools).
In recent years the Fellowship has attained national prominence. One sign of this is an increasing number of applicants from beyond the NY Metropolitan Area: in recent years applications have been received from psychiatric residents in Massachusetts, Texas, New Mexico, Mississippi, Virginia, California, Washington D.C., Philadelphia, North Carolina. Rhode Island, New Jersy and Oregon. The Fellowship was selected as a finalist for the American College of Psychiatrist's 1994 Award for Creativity in Psychiatric Education. Finally, in recognition of the outstanding quality of the training program, the Substance Abuse and Mental Health Services Administration (SAMHSA) of the Federal Government awarded the Fellowship a three year grant (1992-95) to provide supplementary funding for 1-2 fellows each year.