Core Competencies for Psychiatric Practice

Book excerpt: The practice of medicine has changed radically during the past few decades. Patients -- better informed than ever -- now demand more of their physicians, viewing them as partners rather than revering them as sole decision-makers. In this environment, nonnegotiable core competencies -- ever-evolving and measured by certification, recertification, and, more recently, maintenance of certification -- are more important than ever. Written from the perspective of those responsible for educating and certifying the next generations of psychiatrists, this groundbreaking compendium by distinguished contributors offers -- for the first time -- a concise look at the final product of the June 2001 Invitational Core Competencies Conference sponsored by the American Board of Psychiatry and Neurology (ABPN) as regards psychiatry (with a future comparable publication focusing on neurology). Divided into four parts, Part I sets the stage for the current concept of physician "competence" by presenting a brief history of medical competence, explaining the logic behind the development of the current competence outline. Part II provides two different views of how to look at core competencies: how competence is defined by the Royal College of Physicians and Surgeons of Canada and, based on some of their work, what is currently being done in the United States. Part III discusses the organizing principles -- identified in 1999 by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) -- that frame all of our conversations about competence, as currently delineated for psychiatrists across the six core competency categories: Patient Care, Medical Knowledge, Interpersonal and Communications Skills, Practice-Based Learning and Improvement, Professionalism, and Systems-Based Practice. Also presented are discussions of when in a physician's career these competencies should be assessed and what methodologies would be appropriate for that assessment. Part IV discusses how the psychiatry core competencies are changing board certification and recertification. Also presented are informed predictions about the changes that medical school faculty and residency training directors will have to make and how practitioners will have to change behaviors to maintain their board certification. Concluding with an appendix outlining the six core competencies for psychiatry, this invaluable resource will both help psychiatric residents and their faculty and training directors understand the core competencies important to the ABPN and provide practitioners with a view of what will be contained in their upcoming maintenance of certification programs now being designed.