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Initial Certification in the Specialty of Psychiatry
The ABPN issues certificates in general psychiatry. Psychiatrists specialize in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Psychiatry Certification Process: New Format and Timetable Announced September 2008
For residents who began training as a PGY-1 on July 1, 2007 or as a PGY-2 on July 1, 2008:
The Psychiatry Part II (oral) examination will be eliminated. The Psychiatry certification process will
consist of a single computerized examination (Psychiatry Certification Examination); first administration
in 2011.
For residents who began training as a PGY-1 before July 1, 2007 or as a PGY-2 before July 1, 2008:
To become Board certified in Psychiatry, candidates must pass both the Part I (computer-administered)
and Part II (oral) examinations.
Candidates who do NOT pass the Psychiatry Part I examination in 2013* or before or who do NOT
complete the certification process by December 31, 2016, will be required to submit documentation of
satisfactory performance in the evaluation of clinical skills completed by the current Program Director of
an ACGME-accredited program as part of the ABPN credentialing process. In addition, such candidates
will be required to pass the new Psychiatry Certification Examination.
* Note: The 2013 Part I examination will not be available for first-time takers. The current format Part I
examination will be eliminated after 2013.
Specific Requirements
Specific requirements for certification in psychiatry are described in detail in the Information for Applicants (IFA) publication. This publication and corresponding application are revised each year and are available as pdf files.
Additionally, the ABPN annually revises content outlines of topics that will be covered in each examination that is offered. These publications may be downloaded from the Content Outlines page. The ABPN also maintains core competencies outlines for its specialties and subspecialties.
Psychiatry Part II examination format Psychiatry candidates participate in two sections, each approximately one hour long:
Patient section in clinical psychiatry
Vignette section in clinical psychiatry
Patient Section In the patient section, the candidate is given approximately 30 minutes to examine a patient under the observation of one or more examiners. Following the examination of the patient, the candidate discusses the case with the examiner(s) for approximately 30 minutes. Candidates are assessed in the following areas:
Physician-patient relationship
Conduct of psychiatric interview
Organization and presentation of data
Phenomenology, diagnosis, and prognosis
Etiologic, pathogenic, and therapeutic issues (biologic, psychologic, social)
Vignette Section (replaces the AV Section beginning May 2006) The clinical psychiatry vignette section will consist of four vignettes. The vignette cases may be in a written format or a short video clip. Candidates will be examined by one or more examiners with particular reference to the content of the vignettes. These discussions may also include other clinical topics.
Sample Written Vignette An 18-year-old unmarried woman comes to a local community mental health center with her three-week-old daughter. She reports experiencing depressed mood, low energy, anorexia, and frequent crying spells for the past two weeks. She states she’s not a good mother and wonders if her daughter would be better off without her. Further inquiry reveals the woman is suspicious of and cannot trust others. She hears a voice inside her head saying, “Do it,” related to hurting herself and/or her daughter.
She says she lives alone and isn’t certain who the baby’s father is. Because the woman had been in foster care as a child, she is very concerned about her baby being taken away from her by the authorities if she’s admitted to the hospital. She says that, if necessary, she is willing to take medication as an outpatient. She reports that neither she nor her infant have had any medical care since they left the hospital 24 hours following delivery.
Previous clinic records document that the young woman was seen for three evaluative sessions at age 16, after which she was prescribed medication. At that time, she was agitated, had pressured speech, and revealed a history of substance use and sexual promiscuity. She did not return for follow-up and was reported to be truant from a second foster home placement. There was no further contact in the past two years.
Written Vignette Sample Questions with Diagnostic Focus
Discuss a key aspect of the phenomenological presentation of the patient
List and prioritize the most likely Axis I diagnoses for this patient.
Discuss the predisposing, precipitating, perpetuating, and protective factors in this case.
Discuss the additional studies (e.g., diagnostic laboratory tests, neuroradiologic results, psychological testing) that should be obtained and the rationale for each one. Could also be asked to address a co-morbid illness.
Written Vignette Sample Questions with Treatment Focus
Discuss pharmacologic or somatic treatment.
Discuss psychotherapy or other environmental intervention.
Discuss aspects of the clinical management of the patient, e.g., risk-management issues, long-term management, management of co-morbid conditions.
Discuss aspects of the context of clinical practice, e.g., optimal setting of care, legal/ethical issues, quality-of-life issues.
Video Clip Vignette Sample - Click Play to Start Please note that you must have a recent version of the Flash player installed on your computer. If you are having difficulties with viewing or hearing the video clip, please click on the link below to download a free Flash player: http://www.adobe.com/shockwave/download/download.cgi?P1_Prod_Version=ShockwaveFlash
This 23-year-old woman came to the ER because she felt like killing herself.
Video Clip Vignette Sample Items for Axis I Diagnosis
Observations of patient: Describe the patient’s appearance, dress, grooming, ethnicity; estimated intellectual level; ability to tell his/her story; evidence of physical disability, and behavior in interaction with the examiner.
Present the mental status examination, focusing on one of the following (appearance, psychomotor level, affect, mood, thought content/process/perception, cognition, insight and judgment).
Present the differential diagnosis for this patient on Axis I.
Describe the patient’s level of impairment due to his/her symptoms and his/her subjective level of distress. Estimate the patient’s global assessment of functioning and substantiate the rating. Describe the patient’s strengths and weaknesses in his/her coping strategies.
Video Clip Vignette Sample Items for Axis II Diagnosis
Observations of patient: Describe the patient’s interaction with the interviewer and/or the pattern of relationships described in the video clip. Identify pertinent nonverbal communication and behavior demonstrated by the patient and the interviewer.
Present the differential of Axis II personality traits or disorders, including examples.
Treatment issues: Discuss treatment challenges and pitfalls related to one or more of the following issues:
Treatment issues: Discuss treatment challenges and pitfalls related to one or more of the following issues:
Please note that applications for examinations are only available for a brief period of time in the year preceding the examination. Please see the examination schedule for application dates and deadlines.
