Assessing Training Gaps in the Diploma in Primary Care Psychiatry Program for Primary Care Doctors: A Post-Hoc Analysis

Abstract

Objective

India faces a critical shortage of mental health professionals, leaving primary care physicians (PCPs) as the primary point of contact for many individuals needing psychiatric care. The Diploma in Primary Care Psychiatry Program (DPCP), a one-year training initiative, aims to equip PCPs in India to manage psychiatric conditions in underserved areas. On-Consultation Training (OCT) is a module in the DPCP designed exclusively for practicing PCPs where a psychiatrist trains PCPs in live video streaming of their own real-time general consultations of primary health centres. This study identifies a training gap within the DPCP.

Methods

PCPs (n = 62) from Uttarakhand, Bihar, and Karnataka states in India received training in the DPCP from 2019 to 2024. Assessed were their exposure to six psychiatric disorders (tobacco addiction, alcohol addiction, psychosis, somatization disorder, anxiety disorder, and depressive disorder) during On-Consultation Training (OCT) sessions. Adequate training per doctor was defined as encountering at least two patients with each disorder.

Results

A total of 650 psychiatric cases seen during OCT sessions were reviewed. Only tobacco addiction and depressive disorder met the training adequacy benchmark (exposure to two cases with the disorder). Alcohol addiction, psychosis, somatization disorder, and anxiety disorders fell below the threshold, highlighting a specific training gap.

Conclusions

This study identified a training gap in the DPCP. The restructuring of the Collaborative Video Consultation (CVC) module with case-specific quotas, expert case demonstrations, and enhanced real-time feedback during OCT could help close this and other training gaps. Addressing these issues will better prepare PCPs in India to manage a broader range of psychiatric conditions, enhancing mental health care delivery in primary care settings.