• Nyapati R Rao.
• Department of Psychiatry, State University of New York SUNY-Downstate Medical Center, 450 Clarkson Avenue, Box 1203, Brooklyn, NY 11203, USA. nrraomd@pol.net
• Acad Psychiatry. 2003 Jan 1; 27 (4): 269-76.

ObjectiveThis study examines trends in the supply, distribution, and demographics of psychiatry residents during the 1990s. It evaluates the extent to which the predicted downsizing of psychiatry residency training programs actually occurred and how it affected training programs of different sizes and locations.MethodData for this study were obtained from the American Medical Association's (AMA) Annual Survey of Graduate Medical Education (GME) Programs, the AMA GME directory, and the APA Graduate Medical Census. The study compares the roles played by international medical graduates (IMGs) in contrast to U.S. medical graduates (USMGs) in these trends.ResultsThere was a significant decline in the number of residents during the years studied. The median training program size also decreased. International medical graduates found broad acceptance in training programs of all locations and sizes, including medical school based programs. Implications of the findings are discussed regarding the impact of current graduate medical education (GME) and immigration policies on future workforce patterns.ConclusionThe field will have to decide whether it can afford anymore residency downsizing in light of emerging evidence of a shortage of psychiatrists.

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