Health care reform and postgraduate psychiatric education - Challenges andsolutions

Psychiatric educators must prepare to teach in an era in which funding for education is move difficult to obtain, all forms of treatment are shorter, patients are discharged from the hospital while they are still acutely ill, the burden of paperwork and other administrative tasks is greater psychiat rists provide less psychotherapy, and residents are no longer able to play a primary role in the treatment of patients covered by third-party payment schemes. A surcharge an a national insurance plan could make up for funding deficits, but this is not likely to occur in the near future. A more reali stic model involves billing for services of faculty who integrate direct pa rticipation in patient cave with teaching and better definitions of the rol e that residents can play in modern patient care. Overage from clinical act ivities driven by faculty may provide sufficient funding for resident servi ces that provide an opportunity for longitudinal patient experiences. Strat egies for political action and for better collaborations with primary cave faculty are discussed.