LAUSR

According to the U.S. Department of Labor [1], there has never been a better time to be a physician. Employment for physicians is expected to grow 13% between 2016 and 2026, faster than for any other occupation. In psychiatry, demand for expert clinicians continues to grow [2]. Despite this, applications to psychiatry fellowship programs continue to stagnate or decline even as applications to general psychiatry residency programs rise [3–6]. The Institute of Medicine published a report in 2012 projecting that by 2030, there will be 72 million adults above the age of 65 in the USA. About 14–20% of these individuals (10 to 14 million people) will have a mental health or substance use disorder. The Institute estimates that in 2030, the ratio of geriatric psychiatrists to individuals over the age of 65 will drop from 1:23,000 to 1:27,000. At the same time, shortages in psychiatrists trained in addiction, consult-liaison, and child and adolescent psychiatry continue to grow [2]. This paper will review the trends in psychiatry fellowship applications, analyze why residents are choosing not to pursue fellowship, and discuss potential solutions to the growing demand for specialty-trained practitioners.