The Evolution of Public Psychiatry Fellowships

The growth of Public Psychiatry Fellowships (PPFs) has reached a new developmental stage, providing a wide array of academic partnerships and educational opportunities in psychiatric leadership and administration. The authors examine the evolution of these programs and illustrate three distinct models. Data from yearly surveys and discussions with PPF directors were used to identify key similarities and areas of divergence as the programs have evolved. The first period of program expansion took place 8–10 years ago when new programs were modeled on the Columbia PPF, and key elements of that program and the American Association of Community Psychiatrists (AACP) guidelines were incorporated broadly. Examples of multiple source (Columbia), single source (Yale and UCSF), and grant-funded programs (Alabama and UCSD) are presented. A review of the current status of PPFs reveals a diversity of structures and strategies for success, which can be attributed to the range of their funding sources. The advantages and potential disadvantages of those models are outlined with respect to the educational experience and opportunities for growth and sustainability.