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Objective: With the increase in diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in adults, it is expected that more resident physicians will require accommodations so that their academic performance and clinical competency can be measured adequately. The authors provide an overview of the requirements and issues regarding the provision of ADHD accommodations for psychiatry resident physicians as well as recommendations regarding policy development in this area.
Method: The authors review the symptoms of ADHD, proper documentation of ADHD, and the rationale and legal basis for providing accommodations to resident physicians with ADHD.
Results: Executive functioning, attention, and affect regulation are three domains that could negatively affect the functioning of a resident physician with ADHD. Possible accommodations specific to each general competency are described.
Conclusions: In order to comply with existing guidelines, training programs should be proactive and have a procedure in place that 1) requires adequate documentation; 2) ensures confidentiality; 3) grants accommodations which measure core knowledge and not the limits of the disability; and 4) does not alter the core curriculum of the program.
Academic Psychiatry 2007; 31:290-296
Psychiatry residents occupy a unique place in the medical education system. Though technically classified as employees of a hospital or other institution, in reality they are both employees and students. Alternately referred to as "house staff," they function as "in house" physicians for the hospital under the direct supervision of fully trained doctors. Implicit in this arrangement is that recent graduates of medical school work longer hours with significantly lower pay in order to gain knowledge, education, experience, and, ultimately, certification in their particular specialty.
In order to graduate and be eligible for specialty certification in psychiatry, resident doctors are required to demonstrate competency in designated core areas of clinical practice and to pass academic and functional testing required by their residency program and by the Accreditation Council for Graduate Medical Education (ACGME). Because of the emphasis on demonstrating "core competency," psychiatry residency programs now must be more diligent in documenting a resident's knowledge base and clinical competence in order to graduate the resident and be able to obtain accreditation.
While there has been an increase in the requirement for documentation of resident physician competency, there has been a parallel increase in...