In 1981 the fellowship in public psychiatry was established at New Yor
k State Psychiatric Institute and Columbia University College of Physi
cians and Surgeons to provide subspecialty training for psychiatrists
who plan careers in die public sector Ten one-year postresidency fello
wships are awarded annually. The fellowship consists of supervised wor
k and didactic experiences focused on the clinical modalities most eff
ective in public mental health services and the managerial skills that
the psychiatrist must possess to make those services work well, Fello
ws work three days a week at collaborating public-sector agencies thro
ughout the New York metropolitan area, The curriculum includes an acad
emic seminar, which gives fellows an introductory overview of major to
pics in public psychiatry; In organizational practicum, which is an ex
ercise in management principles and practices; an evaluation practicum
, which addresses the theory and practice of program evaluation; and a
n applied seminal; organized as a cycle of clinical, administrative, f
iscal, and evaluation presentations in which each fellow applies the c
oncepts learned in the other seminars to his or her field placement wo
rk. Of the 75 fellows who have graduated from the program, only six ha
ve chosen to leave the public arena. Nearly all work full time in the
public sector, where more than half hold management positions, More th
an three-fourths hold academic appointments at medical schools in the
area in which they are working as public psychiatrists.