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December 6, 2021

Modernizing Psychiatry Training for Neurologists—From Off-Service to In-Service

Author Affiliations
  • 1Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York
  • 2Department of Psychiatry, Weill Cornell Medicine, New York, New York
  • 3Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, New York
  • 4Department of Neurology, Maimonides Medical Center, Brooklyn, New York
JAMA Neurol. 2022;79(2):113-114. doi:10.1001/jamaneurol.2021.4456

Off-service training (clinical experiences in which a trainee is embedded in a service other than their primary specialty) in psychiatry for neurology residents has been a long-standing requirement of the Accreditation Council for Graduate Medical Education (ACGME).1 The ACGME mandates neurology residents complete 1 month of full-time clinical experience in psychiatry without further specification. Neurology is the only field besides psychiatry with mandated psychiatry training. This requirement is a reflection of the shared history of neurology and psychiatry, the pathophysiologic overlap of brain disease, and the frequency of psychiatric comorbidity among individuals with neurologic disease.2,3 However, the current model of psychiatry training does not meet the needs of neurology trainees with the majority of neurology residency graduates underprepared for providing psychiatric care in routine neurologic practice.4

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