Connecting to the Future: Telepsychiatry in Postgraduate Medical Education

Objective: This study characterized and examined factors influencing psychiatry residents' and fellows' interest, exposure, and future plans to use telepsychiatry. Subjects and Methods: A 17-item electronic survey was distributed to 485 psychiatry residency and fellowship programs in the United States. Each program director or administrator was asked to voluntarily distribute the survey to his or her trainees. Chi-squared tests were performed to test differences in proportions. Stepwise multivariate logistic regression was used to model outcomes of interest. Results: In total, 283 respondents completed the survey. A majority of respondents were interested in telepsychiatry and felt that it was an important part of training. Of the 50 respondents who had clinical exposure to telepsychiatry and completed the survey, most reported that their experience increased their interest level, and two-thirds reported having either a one-time encounter or less than 6 h of multiple patient experiences via telepsychiatry. Clinical exposure to telepsychiatry was significantly related to level of training (p = 0.001) and program location (p = 0.005). Residents in their postgraduate year (PGY) 4 or fellowship were 2.6 times more likely to be exposed to clinical telepsychiatry than PGY 1-3 residents (95% confidence interval [CI] 1.41-4.95). Residents and fellows in rural programs were 4.3 times more likely to be exposed than those in urban or suburban settings (95% CI 1.07-17.28). Factors affecting trainees' plans to use telepsychiatry in their future practice include program location (p = 0.013) and interest level (p < 0.001). Residents and fellows in rural locations were 9.3 times more likely to report future plans to use telepsychiatry (95% CI 1.88-45.71). Conclusions: There is a practice gap between resident interest and resident exposure to telepsychiatry. Training programs should consider incorporating a brief telepsychiatry experience to fulfill both resident interest and the growing demand for psychiatrists.