This was mentioned in the nurse practitioner crisis thread, but how can we go about reforming psychiatry residency to make it 3 years total instead of 4 years. Both internal and family medicine residency are 3 years. Thus fellowship taking the 4th year eg child fellowship would take 4 years instead of 5 when fast-tracked. All requirements are met after the third year and 4th year is often regarded as elective time better served by fellowship. Keep in mind, NPs are working independently in all settings eg in CAAP and Geriatric psychiatry without any fellowship whereas resident psychiatric physicians are spending unnecessarily long lengths of poorly paid and unnecessary training time 4th year better served with fellowship.