The nation’s shortage of child and adolescent psychiatrists has pushed medical educators to rethink how long training should take — and early evidence suggests the physicians coming out of shortened, competency-based programs are arriving better prepared than ever, according to John Walkup, MD, president of the American Academy of Child and Adolescent Psychiatry.
Dr. Walkup, who also chairs the Pritzker Department of Psychiatry and Behavioral Health at Lurie Children’s Hospital and is a professor at Northwestern University’s Feinberg School of Medicine, said the field is moving away from rigid, time-based residency requirements toward a model that measures readiness by skill rather than the calendar.
That shift is tied to a specific workforce proposal AACAP put forward a few years ago: compress the traditional five-year path to board certification in adult and child psychiatry into four years.
“So we could do four residents for five years, or we could do five residents for four years. That’s a 20% increase in our workforce over a period of time, and so there are ideas like that, and we’re beginning to hear rumblings within pediatrics, where they’re shortening some of the subspecialty programming from three years to two years,” he said.
He added that internal medicine is beginning similar conversations about shortening training to address its own workforce gaps.
Rather than compromising quality, Dr. Walkup said the trainees entering the psychiatry field now are arriving with a “super high” baseline understanding — a shift he credits partly to psychiatry’s rising appeal among young physicians.
“There’s something about this generation that is really interested in this human part of medicine, psychiatry, and particularly in children and adolescents,” he said. “We’ve benefited over the past four or five years from a very high quality group of people coming from medical school into psychiatry and child psychiatry.”
The stakes for closing the workforce gap remain high. Dr. Walkup noted that longitudinal data suggests roughly 20% of kids will have a mental health concern before they graduate high school. In many places, he said, less than half of those children receive any intervention at all — a gap that widened further during the pandemic as schools, activities and peer networks that had been quietly supporting struggling kids disappeared.
Still, Dr. Walkup said the workforce challenge shouldn’t overshadow the field’s progress. “There is an evidence base in child and adolescent psychiatry. Our treatments get people better. We do have a workforce challenge. We do have an overt demand that is potentially overwhelming, but we have treatments that work, and families should feel comfortable seeing a child and adolescent psychiatrist.”
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