Resident education in electroconvulsive therapy

Objective: In 2001, the American Psychiatric Association's Task Force on electroconvulsive therapy (ECT) recommended that psychiatry residents should receive at least 4 hours of didactic instruction on ECT, participate in at least 10 treatments, and assist in the care of at least 3 patients receiving ECT. Residency accreditation requirements as of 2007, however, require only that training programs ensure competency in "understanding the indications and uses" of ECT. Anecdotally, training in ECT is said to vary widely between residency programs. The purpose of the study was to obtain more systematic information about ECT training. Method: A survey was e-mailed to directors of all accredited psychiatry residency programs in the United States and Puerto Rico in early to mid 2008, requesting information regarding their didactic and clinical instruction in ECT and estimates of number of treatments provided by their institutions. Results: Responses were obtained from 91 training programs. Of these programs, 75% reported that some clinical exposure to ECT was required of their residents, but 37% estimated that the typical resident would participate in fewer than 10 treatments and 27% estimated that the typical resident would care for fewer than 5 patients receiving ECT. Most programs devoted less than 4 hours of lecture time to ECT. Most respondents believed that ECT was underused nationally; this perception did not differ based on the theoretical orientation of the training program. Conclusions: This study suggests that resident education in ECT varies considerably between programs but is often less than that suggested by the American Psychiatric Association's Task Force.