For some time now, psychiatry has been in a nationwide funk.
The United States is short on psychiatrists, and Texas is really short on them. In fact, Texas needs 432 psychiatrists to end its shortage, more than any other state or territory, a recent report by the Henry J. Kaiser Family Foundation says. Compared to the U.S. average, Texas has only about 60 percent as many psychiatrists per capita.
But recent residency match data show some rays of sunshine are peeking through. Texas psychiatry residency programs offered 95 entry-level training positions in 2017 and 2018, the largest number recorded since the Texas Medical Association began collecting this information in 1996. In 2018, every one of these 95 positions were filled.
What’s more, the number of psychiatry training positions has increased 41 percent in Texas over the past 10 years.
Nationwide match data also show a growing interest in psychiatry as a career. In 1999, U.S. medical school seniors filled only 53 percent of the entry-level psychiatry positions offered in the U.S. By 2018, that percentage had risen to 63 percent.
Psychiatry has long been one of the lowest-paying specialties, but that also appears to be changing. The Medscape Psychiatrist Compensation Report for 2018 shows psychiatrists reported the largest percentage gains in compensation, followed by plastic surgeons and physiatrists. Just as important, about two-thirds of psychiatrists felt they were fairly compensated, similar to specialties that reported much higher pay.
The rainclouds are still out there. In Texas, 185 counties (out of 254) with a combined population of 3.3 million people have no psychiatrist, according to a 2015 Merritt Hawkins study done on behalf of the North Texas Regional Extension Center.
And the shortage of psychiatrists is expected to get worse in coming years. The Texas Department of State Health Services Health Professions Resource Center projects the demand for psychiatrists statewide will exceed available supply by about 50 percent in 2030, with a total deficit of 1,200 psychiatrists.
However, the influx of fresh blood into psychiatry reflected in the match data is badly needed. According to Merritt Hawkins, 60 percent of psychiatrists are 55 or older. That is compared with about 43 percent of physicians as a whole.