Training psychiatry residents as consultants in primary care settings

Patients seen in primary care medical settings often have psychiatric disorders that often So undetected by their primary care physicians. It is important that psychiatry residents be trained in the specific skills necessary to work ns consultants ill primary care settings; The authors describe 2 years of primary care consultation-liaison rotation experience for 4th-year psychiatry residents (16 rotations, one-half day per week for 12 months or 1 day per week for 6 months). Residents' evaluations of their experience were generally positive. The presence of a supervising attending psychiatrist who worked the same clinic resulted ill higher satisfaction and effectiveness ratings. Other issues identified by residents included need for specific preparation for working ill such settings, frequent misunderstanding of the psychiatry resident's role by primary care providers, and the difficulty of establishing relationships and communicating with multiple clinic providers. Authors discuss modifications of this rotation and recommendations for the establishment of similar rotations elsewhere.