Training Residents in High-Value, Cost-Effective Care: a National Survey of Psychiatry Program Directors

Acad Psychiatry. 2020 Jun;44(3):324-329. doi: 10.1007/s40596-020-01218-9. Epub 2020 Mar 24.


Objective: The goal of this study was to explore how prepared psychiatry programs are to teach residents to practice resource management and high-value, cost-effective care.

Methods: An anonymous online survey was sent to 187 psychiatry training directors between July and September 2015.

Results: Forty-four percent of training directors responded to the survey. While most training directors who responded (88%) agreed that that graduate medical education has a responsibility to respond to the rising cost of health care, fewer than half agreed that that their faculty members consistently model cost-effective care (48%), that residents have access to information regarding the cost of tests and procedures (32%), and that residents are prepared to integrate the cost of care with available evidence when making medical decisions (44%). Only 11% reported providing training in resource management. Barriers cited to teaching cost-effective care included a lack of information regarding health care costs (45%), a lack of time (24%), a lack of faculty with relevant skills (19%), and competing training demands and priorities (18%). Training directors also noted a lack of available curricular resources and assessment tools (21%). Another 12% cited concerns about cost containment overriding treatment guidelines. Ninety percent of training directors agreed that they would be interested in resources to help teach high-value, cost-effective care.

Conclusions: Most psychiatry programs do not provide formal training in resource management but are interested in resources to teach high-value, cost-effective care. Curricula for residents and faculty may help meet this need.

Keywords: Curriculum; High-value care; Program directors; Residency milestones; Residency training; Resource manager.

MeSH terms

  • Cost-Benefit Analysis*
  • Curriculum / standards
  • Education, Medical, Graduate
  • Humans
  • Internship and Residency*
  • Physician Executives / statistics & numerical data*
  • Psychiatry / education*
  • Surveys and Questionnaires