2024 ACLP Recommendations for Training Residents in Consultation-Liaison Psychiatry

Abstract

Background: Despite rapid shifts in consultation-liaison psychiatry (CLP) training in residency, including increasing general residency training requirements from the Accreditation Council for Graduate Medical Education, greater utilization of advanced practice providers, and effects of the coronavirus-2019 pandemic, the Academy of Consultation-Liaison Psychiatry has not updated recommendations for residency training in CLP since 2014. A national survey of residency program directors in 2021 suggested many changes to the structure of CLP rotations at individual programs over the past decade.

Objective: These recommendations are intended to guide residency program directors toward optimizing CLP training for all residents, including those who will eventually pursue CLP fellowship.

Methods: We convened a workgroup of 8 Academy of Consultation-Liaison Psychiatry members holding leadership positions in residency and fellowship education on local and national levels. The project was approved by the Academy of Consultation-Liaison Psychiatry Executive Council and conducted via a three-stage iterative process.

Results: Consensus was reached on 34 recommendations across four domains, including structural issues, faculty supervision, formal curriculum and evaluations, and elective experiences. Residents must spend sufficient time on CLP rotations to achieve relevant milestones. Given that consultants are expected to offer unique insight, the ideal placement of core CLP rotations comes at a time in residency where residents are able to provide expert opinion and lead teams. Faculty expertise in CLP and availability to provide direct supervision and oversight to trainees are essential. A separate and formal CLP didactic curriculum should exist, and elective opportunities should be offered to supplement training.

Conclusions: Establishing a strong CLP foundation for all residents is essential for ensuring competency in providing psychiatric care for medically complex patients and collaborating with our colleagues in other specialties, as well as fostering trainee interest in pursuing a career in CLP.

Keywords: consultation-liaison psychiatry; education; residency.