Columbia University's fellowship in public psychiatry.

In 1981 the fellowship in public psychiatry was established at New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons to provide subspecialty training for psychiatrists who plan careers in the public sector. Ten one-year postresidency fellowships are awarded annually. The fellowship consists of supervised work and didactic experiences focused on the clinical modalities most effective in public mental health services and the managerial skills that the psychiatrist must possess to make those services work well. Fellows work three days a week at collaborating public-sector agencies throughout the New York metropolitan area. The curriculum includes an academic seminar, which gives fellows an introductory overview of major topics in public psychiatry; an organizational practicum, which is an exercise in management principles and practices; an evaluation practicum, which addresses the theory and practice of program evaluation; and an applied seminar, organized as a cycle of clinical, administrative, fiscal, and evaluation presentations in which each fellow applies the concepts learned in the other seminars to his or her field placement work. Of the 75 fellows who have graduated from the program, only six have chosen to leave the public arena. Nearly all work full time in the public sector, where more than half hold management positions. More than three-fourths hold academic appointments at medical schools in the area in which they are working as public psychiatrists.